PRI: #Diabetes undiagnosed in many Asians

From Public Radio International images

At the South Cove Community Health Center in Quincy, Massachusetts, Dr. Qiyue Hu conducts a checkup with his patient Jiping Chang. Chang is 76 and was diagnosed with Type 2 diabetes in 2009. He tells me that at the time, he was surprised. That’s because “I didn’t have any symptoms. I felt OK,” Chang says.

He wasn’t overweight either, traditionally a warning sign for Type 2 diabetes. But it turns out that isn’t uncommon among Asian Americans who develop the disease. In fact, they are two times more likely than whites to develop diabetes, despite having lower obesity rates. 

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Health Leaders: #Lacks family members now have a say in #Henrietta’s immortal scientific legacy

My report from Health Leaders on a recent talk by members of Henrietta Lacks’ famfile_000-4ily.

The ongoing story of the late Henrietta Lacks, the African-American
woman who unwittingly provided cells for years of medical research, has much to offer those battling disparities
in healthcare, according to family members who spoke in Boston last week.

That message, delivered at a panel discussion, came from Lacks’ grandson David Lacks, Jr. and her great granddaughter Victoria Baptiste, RN, as well as Joseph Betancourt, MD, director of the Disparities Solutions Center at Massachusetts General Hospital.

Will genetic advances address health disparities? Not much unless they are accessible.

The new issue of Health Affairs looks at health policy and health disparities. Many local researchers represented.

Of interest: Using Genetic Technologies To Reduce, Rather Than Widen, Health Disparities

The authors include two local researchers: Katherine L. Tucker is a professor in clinical laboratory and nutritional sciences at the University of MassachuseCapturetts, in Lowell…José M. Ordovás is director of the Nutrition and Genomics Laboratory at the Human Nutrition Research Center on Aging at Tufts University

Evidence shows that both biological and nonbiological factors contribute to health disparities. Genetics, in particular, plays a part in how common diseases manifest themselves. Today, unprecedented advances in genetically based diagnoses and treatments provide opportunities for personalized medicine. However, disadvantaged groups may lack access to these advances, and treatments based on research on non-Hispanic whites might not be generalizable to members of minority groups. Unless genetic technologies become universally accessible, existing disparities could be widened. Addressing this issue will require integrated strategies, including expanding genetic research, improving genetic literacy, and enhancing access to genetic technologies among minority populations in a way that avoids harms such as stigmatization.

And, a team from Harvard offers this :

Across US Hospitals, Black Patients Report Comparable Or Better Experiences Than White Patients

Patient-reported experience is a critical part of measuring health care quality. There are limited data on racial differences in patient experience. Using patient-level data for 2009–10 from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), we compared blacks’ and whites’ responses on measures of overall hospital rating, communication, clinical processes, and hospital environment. In unadjusted results, there were no substantive differences between blacks’ and whites’ ratings of hospitals. Blacks were less likely to recommend hospitals but reported more positive experiences, compared to whites. Higher educational attainment and self-reported worse health status were associated with more negative evaluations in both races. Additionally, blacks rated minority-serving hospitals worse than other hospitals on all HCAHPS measures. Taken together, there were surprisingly few meaningful differences in patient experience between blacks and whites across US hospitals. Although blacks tend to receive care at worse-performing hospitals, compared to whites, within any given hospital black patients tend to report better experience than whites do.




BHN Exclusive: Health inequalities are not black and white

           I happened to check out a campus event on inequality and health after teaching my NU class last week. What I learned is that color is an issue, but not the only issue.

            Latinos, people from Asia and the Pacific islands, gays and people with developmental disabilities also have concerns.

(This last definition was invented as a more dignified way of describing “individuals with mental retardation, cerebral palsy, autism, epilepsy and other seizure disorders, sensory impairments, congenital disabilities, traumatic injuries, or conditions caused by disease (polio, muscular dystrophy, etc.))”

            “Usually, when we talk about health disparities, we’re usually talking about a black and white paradigm, but that paradigm is shifting,” said Ramani Sripada of MAP (Mass Asian and Pacific Islanders) for Health.  (Toll Free: 1-800-479-7251 –Their website seems to be down. )

            Health inequality means some groups have poor access to doctors,  insurance, nutritious food and space to exercise. But it also refers to different health outcomes, or rates of disease. For example, African-American women are less likely to develop breast cancer than white women, but more likely to die from it. (For more on the topic in general, see NIH’s National Center on Minority Health and Health Disparities.)

            Not enough scientists look specifically at these groups in their research, according to the speakers. For example, no one understands the high rate of cervical cancer among Vietnamese women, Sripada said.

            Judith Bradford of the Fenway Institute, said colleting data on LGBTs (lesbian, gay, bisexual and transgender) is key to getting action on issues like higher rates of smoking, domestic violence and obesity.   

            “If your group isn’t measured by the folks fighting the battles, if they don’t have the numbers – it’s hard,” she said.  

            The program also included representatives of The Arc of Mass and The Latin American Health Institute .  (MAPP seems to be having some trouble with its web site so I’ll update it when I have more info.)  

  Also, check out the NYTimes story today on U.S. hospitals and immigrants.

 Many arrive with health problems seldom seen in this country – vitamin deficiencies, intestinal parasites and infectious diseases like tuberculosis, for instance – and unusually high levels of emotional trauma and stress. 

Over time, as they pick up Western habits, some develop Western ailments, too, like obesity, diabetes and heart disease, and yet they often question the unfamiliar lifelong treatments these chronic diseases need.