Browsing by Author "Rust, George"
Now showing 1 - 8 of 8
Results Per Page
Sort Options
Item A CRASH-COURSE IN CULTURAL COMPETENCE(2006) Rust, George; Kondwani, Kofi; Martinez, Ruben; Dansie, Roberto; Wong, Winston; Fry-Johnson, Yvonne; Woody, Rocio Del Milagro; Daniels, Elvan J.; Herbert-Carter, Janice; Aponte, Laura; Strothers, HarryItem ACHIEVING HEALTH EQUITY IN AMERICA(2006) Satcher, David; Rust, GeorgeItem Disparities in Antidepressant Treatment in Medicaid Elderly Diagnosed with Depression(2005) Strothers III, Harry S; Rust, George; Minor, Patrick; Fresh, Edith; Druss, Benjamin; Satcher, DavidOBJECTIVES: To determine whether there were racial or ethnic disparities in the use of antidepressants in low-income elderly patients insured by Medicaid. DESIGN: Examination of 1998 Medicaid claims data. SETTING: Centers for Medicare and Medicaid Services Medicaid claims data for five U.S. states. PARTICIPANTS: All Medicaid recipients aged 65 to 84 with a diagnosis of depression. MEASUREMENTS: Treatment versus no treatment; in those treated, treatment with drugs was classified as old- or new-generation antidepressants. RESULTS: In 1998, 7,339 unique individuals aged 65 to 84 had at least one outpatient encounter with depression as the primary diagnosis. Nearly one in four (24.2%) received no antidepressant drug therapy, and 22% received neither psychotherapy nor an antidepressant. African-American individuals were substantially more likely to be untreated (37.1%) than Hispanic (23.6%), white (22.4%), or Asian (13.8%) individuals. In logistic regression models adjusting for sex, state, long-term care status, and age group, African Americans with a primary diagnosis of depression were almost twice as likely as whites not to receive an antidepressant within the study period (odds ratio51.91, 95% confidence interval51.62–2.24). Patients in long-term care facilities and those aged 65 to 74 were less likely to receive treatment. CONCLUSION: Substantial numbers of elderly Medicaid enrollees with a primary diagnosis of depression did not receive antidepressants or behavioral therapy. This gap in care disproportionately affected African-American patients.Item Do Clinicians Screen Medicaid Patients for Syphilis or HIV When They Diagnose Other Sexually Transmitted Diseases?(2003) Rust, George; Minor, Patrick; Jordan, Neil; Mayberry, Robert; Satcher, DavidBackground: Patients diagnosed with gonorrhea or chlamydia are at high risk for HIV and syphilis, and should be offered screening for both. Goal: This study measures HIV and syphilis screening rates among Medicaid patients diagnosed with another sexually transmitted disease (STD). Study Design: Using 1998 Medicaid claims data from 4 states, we identified individuals diagnosed with gonorrhea, urogenital chlamydia, or pelvic inflammatory disease, and then measured the proportion receiving screening tests for HIV and syphilis. Results: Only 25% of STD-diagnosed Medicaid patients received screening tests for syphilis and only 15% for HIV. We found significant state-to-state variability in screening rates. Conclusion: Medicaid patients diagnosed with a nonbloodborne STD represent a high-risk group that is not adequately screened for syphilis and HIV despite repeated contact with medical professionals. Interventions should focus on eliminating missed opportunities for screening these high-risk individuals.Item Racial/Ethnic Disparities, Social Support, and Depression: Examining a Social Determinant of Mental Health(2012) Shim, Ruth S.; Ye, Jiali; Baltrus, Peter; Fry-Johnson, Yvonne; Daniels, Elvan; Rust, GeorgeAbstract available at publisher's website.Item The Health Impact of Resolving Racial Disparities: An Analysis of US Mortality Data(2004) Woolf, Steven H.; Johnson, Robert E.; Fryer, George E., Jr; Rust, George; Satcher, DavidThe US health system spends far more on the “technology” of care (e.g., drugs, devices) than on achieving equity in its delivery. For 1991 to 2000, we contrasted the number of lives saved by medical advances with the number of deaths attributable to excess mortality among African Americans. Medical advances averted 176 633 deaths, but equalizing the mortality rates of Whites and African Americans would have averted 886202 deaths. Achieving equity may do more for health than perfecting the technology of care.Item United States black:white infant mortality disparities are not inevitable: identification of community resilience independent of socioeconomic status.(2010) Fry-Johnson, Yvonne W; Levine, Robert; Rowley, Diane; Agboto, Vincent; Rust, GeorgeModels for reduction/elimination of racial disparities in US infant mortality, independent from county-level contextual measures of socioeconomic status, may already exist.Item What If We Were Equal? A Comparison Of The Black-White Mortality Gap In 1960 And 2000(2005) Satcher, David; Fryer, George E., Jr.; McCann, Jessica; Troutman, Adewale; Woolf, Steven H.; Rust, GeorgeThe United States has made progress in decreasing the black-white gap in civil rights, housing, education, and income since 1960, but health inequalities persist. We examined trends in black-white standardized mortality ratios (SMRs) for each age-sex group from 1960 to 2000. The black-white gap measured by SMR changed very little between 1960 and 2000 and actually worsened for infants and for African American men age thirty-five and older. In contrast, SMR improved in African American women. Using 2002 data, an estimated 83,570 excess deaths each year could be prevented in the United States if this black-white mortality gap could be eliminated.