Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item Medicaid: A Lifeline for Blacks and Latinos with Serious Health Care Needs(2011) UNSPECIFIEDReport, commissioned by the Families USA, the Joint Center Health Policy Institute and other allies, describes the likely impact on African Americans and Latinos of cuts to Medicaid, the program on which millions of low-income Americans rely. It contains state-specific data for blacks and Latinos who rely on Medicaid and suffer from chronic medical conditions such as cancer, diabetes, chronic lung disease and heart disease.Item Luchando por el Aire: The Burden of Asthma on Hispanics(2011) UNSPECIFIEDLuchando por el Aire: The Burden of Asthma on Hispanics is part of the American Lung Association’s Disparities in Lung Health Series of reports, which takes an in-depth look at a specific problem in a specific community. The Spanish title translates as “fighting for air,” an experience that is all too common among Hispanics with asthma. Compared to non-Hispanic whites, Hispanics with asthma are less likely to be in the care of a regular doctor or clinic; less likely to be prescribed appropriate medicines; less likely to have access to specialized care; and more likely to end up being treated in the emergency department or hospitalized in a crisis. This report presents an overview of research into the complex biological, environmental, political and cultural factors that increase the burden of asthma on Hispanics.Item Improving the Health of Low-Income and Minority Communities(2011) UNSPECIFIEDWHY ARE HEALTH DISPARITIES A THREAT TO OUR NATION’S HEALTH? Lower-Income and Minority Communities Systematically Have Less Access to Health Care, Higher Exposure to Health Threats, and Worse Health Outcomes:Item National Archives Releases John Cutler Papers Online(2011) UNSPECIFIEDAtlanta, GA…The National Archives at Atlanta announced that on March 29, 2011, it will release online the papers of Dr. John C. Cutler. Dr. Cutler, a former employee of the U.S. Public Health Service, 1942-1967, was involved in research on Guatemalan soldiers, prisoners, and mental health patients who were exposed to the syphilis bacteria. The collection is available online [http://www.archives.gov/research/health/cdc-cutler-records] and at the National Archives at Atlanta, located at 5780 Jonesboro Road, Morrow, Georgia, 30260. This collection which consists of approximately 12,000 pages of correspondence, reports, photographs, and patient records was donated in September of 1990 to the University of Pittsburgh by Dr. Cutler. In September 2010, the University contacted the Centers for Disease Control and Prevention to request the transfer of the material to the Federal government. After examining the material, it was determined that they were Federal records and they were transferred to the National Archives at Atlanta in October, 2010.Item Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic(2002) UNSPECIFIEDContext: Antihypertensive therapy is well established to reduce hypertensionrelated morbidity and mortality, but the optimal first-step therapy is unknown. Objective: To determine whether treatment with a calcium channel blocker or an angiotensin-converting enzyme inhibitor lowers the incidence of coronary heart disease (CHD) or other cardiovascular disease (CVD) events vs treatment with a diuretic. Design: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), a randomized, double-blind, active-controlled clinical trial conducted from February 1994 through March 2002. Setting and Participants: A total of 33357 participants aged 55 years or older with hypertension and at least 1 other CHD risk factor from 623 North American centers. Interventions: Participants were randomly assigned to receive chlorthalidone, 12.5 to 25 mg/d (n=15255); amlodipine, 2.5 to 10 mg/d (n=9048); or lisinopril, 10 to 40 mg/d (n=9054) for planned follow-up of approximately 4 to 8 years. Main Outcome Measures: The primary outcome was combined fatal CHD or nonfatal myocardial infarction, analyzed by intent-to-treat. Secondary outcomes were allcause mortality, stroke, combined CHD (primary outcome, coronary revascularization, or angina with hospitalization), and combined CVD (combined CHD, stroke, treated angina without hospitalization, heart failure [HF], and peripheral arterial disease). Results: Mean follow-up was 4.9 years. The primary outcome occurred in 2956 participants, with no difference between treatments. Compared with chlorthalidone (6- year rate, 11.5%), the relative risks (RRs) were 0.98 (95% CI, 0.90-1.07) for amlodipine (6-year rate, 11.3%) and 0.99 (95% CI, 0.91-1.08) for lisinopril (6-year rate, 11.4%). Likewise, all-cause mortality did not differ between groups. Five-year systolic blood pressures were significantly higher in the amlodipine (0.8 mm Hg, P=.03) and lisinopril (2 mm Hg, P.001) groups compared with chlorthalidone, and 5-year diastolic blood pressure was significantly lower with amlodipine (0.8mmHg, P.001). For amlodipine vs chlorthalidone, secondary outcomes were similar except for a higher 6-year rate of HF with amlodipine (10.2% vs 7.7%; RR, 1.38; 95% CI, 1.25-1.52). For lisinopril vs chlorthalidone, lisinopril had higher 6-year rates of combined CVD (33.3% vs 30.9%; RR, 1.10; 95% CI, 1.05-1.16); stroke (6.3% vs 5.6%; RR, 1.15; 95% CI, 1.02-1.30); and HF (8.7% vs 7.7%; RR, 1.19; 95% CI, 1.07-1.31). Conclusion: Thiazide-type diuretics are superior in preventing 1 or more major forms of CVD and are less expensive. They should be preferred for first-step antihypertensive therapy.Item PRESCRIPTION FOR PENNSYLVANIA Right State Right Plan Right Now: STRATEGIC PLAN(2008) UNSPECIFIEDThe present system of providing health care was designed to treat acute illness, not control chronic diseases. In the face of rising levels of chronic disease and spiraling health care costs, governments, businesses, insurance companies and Pennsylvania families have, out of necessity, chosen to limit health care services, benefits and visits as ways of fighting expenses. Evidence is mounting around the country that exactly the opposite approach to chronic disease is more successful. Early, consistent and persistent health care intervention for those with chronic disease will likely be more cost-effective and will dramatically improve the quality of life for anyone with chronic disease. In May 2007 the Pennsylvania Chronic Care Management, Reimbursement and Cost Reduction Commission was created and its first requirement was to develop a strategic plan for a Chronic Care Model to improve the quality of care while reducing avoidable illnesses and their attendant costs. This report is part of that requirement.Item A Perscription for Health: A Directory of CDC Services(2006) UNSPECIFIEDSince its founding in 1946 to combat malaria, the Centers for Disease Control and Prevention (CDC) has remained at the forefront of public health efforts to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. Today, CDC is globally recognized for its scientific research and investigations and for its action-oriented approach to public health, applying its findings to improve people’s daily lives and to respond to health emergencies. A significant part of CDC’s mission is to provide Americans with the information they need every day to live long, healthy, and happy lives. To that end, the agency has developed the following products and services to help people improve their own health by preventing disease and injury and promoting healthy lifestyles. You can also find this directory online at www.cdc.gov/about/stateofcdc. If you cannot find information on a particular topic in this directory, please contact 1.800.CDC.INFO or visit www.cdc.gov.Item Advancing the Nation’s Health: A Guide to Public Health Research Needs, 2006-2015(2006) UNSPECIFIEDThe U.S. Centers for Disease Control and Prevention (CDC), which includes the Agency for Toxic Substances and Disease Registry, is recognized as a lead federal agency for protecting the health and safety of people at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships. Research is the foundation of CDC’s success and enables CDC to develop, improve and disseminate evidence-based interventions, programs, and decision support to improve health (Figure I-1). The primary focus of CDC’s research is to fill gaps in knowledge necessary to accomplish the agency’s Health Protection Goals (Chapter II), but it must also be CDC’s core public health mission and be responsive to new opportunities, threats, and future health needs. A recent analysis indicates that the evidence base to support much of public health practice has not kept pace with the growing requirements, and much more research is needed to demonstrate the best methods that support effective public health practices.Item BREAST CANCER MORTALITY REPORT: CLOSING THE GAPS IN EIGHT COMMUNITIES(2007) UNSPECIFIEDResearchers retained by Susan G. Komen for the Cure analyzed eight locations in the United States with high rates of breast cancer mortality – six counties, one city neighborhood, and the nation’s capital, Washington, D.C. The goals of this analysis were to: ❖ Understand the circumstances unique to each location that might contribute to the disparity in mortality statistics, as seen through the eyes of front-line care providers and community health care workers; ❖ Identify common issues, including screening and treatment barriers, that might be factors associated with high breast cancer mortality rates in these locations; and ❖ Propose policy options and possible funding strategies for reducing breast cancer mortality rates in these locations and similarly affected areas throughout the United States.Item Policy Issues Associated with Undertaking a New Large U.S. Population Cohort Study of Genes, Environment, and Disease(2007) UNSPECIFIEDThis report describes the efforts of the Secretary’s Advisory Committee on Genetics, Health, and Society (SACGHS) to assess the need and readiness for a new large population study (LPS) in the United States and presents recommendations to the Secretary of the U.S. Department of Health and Human Services (HHS) so that this concept can be further explored. The HHS Secretary established SACGHS in 2002 as a public forum for deliberation on the broad range of human health and societal issues raised by advances in genetics and, as warranted, the development of advice on these issues. In a March 2004 priority-setting process, SACGHS identified 11 high-priority issues warranting its attention and analysis. One of those issues was the need for an analysis of the opportunities and challenges associated with conducting an LPS aimed at understanding the relationships between genes, environments,1 and their interactions and common complex diseases. Among the considerations that led the Committee to this decision was the fact that discussions were underway at the National Institutes of Health (NIH) about whether the United States should mount a new large population-based study. In June 2005, as SACGHS factfinding efforts were beginning, NIH Director Dr. Elias A. Zerhouni requested that the Committee develop a report on the preliminary questions, steps, and strategies that would need to be addressed before considering the larger question of whether the United States should undertake a new LPS. Specifically, the Committee was asked to (1) delineate the questions that need to be addressed for policymakers to determine whether the U.S. Government should undertake a new LPS to elucidate the influences of genetic variations and environmental factors on common complex diseases; (2) explore the ways in which, or processes by which, the questions identified in step 1 can be addressed, including any intermediate research studies, pilot projects, or policy analysis efforts needed; and (3) determine the possible ways in which these questions could be addressed, taking into account the feasibility of those approaches expect the Committee to recommend solutions to the questions raised. The next section summarizes exploratory work by the National Human Genome Research Institute (NHGRI) and factfinding and consultative efforts by SACGHS on this issue. Chapter II presents the scientific basis for an LPS. Chapter III outlines the key policy issues that SACGHS has identified as warranting further attention. Chapter IV discusses the critical role that public engagement must play in determining the willingness of U.S. citizens to support and participate in such an endeavor. In keeping with its agreed upon charge, throughout this report the Committee explores the ways in which the identified policy issues could be addressed and describes possible approaches for the HHS Secretary’s consideration.
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