Archive for the ‘Guest Posts’ Category

When it comes to maintaining respiratory health, living in an environment with good air quality is clearly an important factor. In many urban areas inhabited by low-income populations, this clean air is nowhere to be found. Having green space within a city can play a significant role in reducing air pollution as well as mitigating the dangerous urban heat island effect. The need for green space is often recognized in more affluent parts of a city, while low-income areas are neglected. When these less affluent communities are overlooked, there can be serious health consequences such as the extreme disparity in negative asthma outcomes in the black and Hispanic children who inhabit these neglected areas.  In this article, Planet Forward and the National Society of Landscape Architects examine the benefits that parks can have for the health and prosperity of low-income urban communities. (more…)

Kenneth Eisner

Ivor B. Horn, MD, MPH

By Ivor Horn, MD, MPH and Kenneth Eisner. Asthma is the most common chronic pediatric medical condition in the United States.  Its prevalence has tripled in the last three decades with disadvantaged, urban, minority children incurring a disproportionate share: 12.8% of African American children are diagnosed with asthma compared to 7.9% of Whites, and African American children are nearly seven times more likely to die from asthma than Whites. Additionally, African Americans use emergency departments more frequently, incurring higher healthcare costs. (more…)

By Ronnie and Lamar Tyler. I remember when my son was first diagnosed with asthma. I was a single mom living over 600 miles away from my family and friends. He was in the 2nd or 3rd grade, and it seemed like he was always getting sick.

The nurse would call me at work and say, “Please come pick up your son. He has a low grade fever and he threw up on the playground.” Of course any child who throws up at school has to go home. So, I had to leave work to pick him up (it took about 30 to 45 minutes to get to his school). When I picked him up and took him home he was fine. (more…)

By Kathy Lim Ko. When it comes to understanding asthma in Asian American, Native Hawaiian and Pacific Islanders (AAs and NHPIs), we hit a road block because we don’t have the full breadth of data that we need — and the limited data we do have paints a concerning picture.  Doctors’ diagnoses alone tell us that the rate of asthma in NHPI children  is three times higher than that of white children and twice that of black or Native American children. But a reliable and accurate rate of asthma in NHPI children simply doesn’t exist. (more…)

Jovante Woods

By Chandra Baldwin-Woods. An asthma attack turned my world upside just less than two years ago, and it has never been the same since. After returning home from football practice on a typical hot, muggy August day, my 16-year-old son Jovante suffered an asthma attack that rendered him unconscious from anoxic brain injury. Jovante’s father and I spent the next four days by his side in the hospital praying for his recovery, which was not to be.

I do not have adequate words to describe the pain of losing a child. It’s something no parent should ever have to experience. Knowing that we will never watch Jovante graduate high school, attend college or experience the joy of starting a family is a pain we must live with every day. (more…)

By Dominique Browning. In the wake of the tragic shooting of Trayvon Martin in Florida, there’s been a lot of talk about the risks to black children of being shot and by whom. Last week Harry C. Alford, the President and CEO of the National Black Chamber of Commerce, testified against the new Mercury and Air Toxic Standards during a Senate committee hearing.

“Poverty brings far worse health than mercury coming out of a coal plant or utility plant. Violence, crime. These kids that I see are far more likely to get a bullet in the head than asthma. And that’s the reality of it.”

Two days later, during another Senate hearing on the EPA budget, Alabama Senator Sessions claimed that air pollution victims are “unidentified and imaginary.”

But neither of these gentlemen is talking about reality. (more…)

The following is a guest post. It is the author’s perspective on the Affordable Care Act rallies that took place at the Supreme Court earlier this week and their viewpoint on the law itself. We invite you to submit your opinions and thoughts on this week’s SCOTUS events and the ACA by commenting on this post.

By Paris Bienert. As a sophomore at the George Washington University I have lived in the nation’s capital for almost two years now, and in all that time I had not found an event that warranted waking up earlier than the sun. On Tuesday, though, for the first time there was an event I felt I could not ignore. A few days earlier, I had received an email asking me to partake in a rally at the Supreme Court to support the Affordable Care Act. As a college student, as a woman, and as an American, I could not pass up this opportunity to express my beliefs.

At the rally, fellow supporters of the law, most of whom hailed from pro-choice groups such as NARAL Pro-Choice America and Planned Parenthood, marched in a circle holding signs and chanting. Weaving in and out of the same area were Tea Partiers, pro-lifers, and other opponents of the law, all chanted in opposition of the supporters.

With posters in hand, my roommate and I joined in the circle of marchers; we were timid at first, but within seconds we were captivated by the crowd’s energy and began partaking in the passionate cheers led by supporters of the law. Of all the different chants, my favorite was a rhythmic mantra of “The health law works for you! The health law works for me! The health law works for every American family!”

Even though what we were chanting was fair, un-provocative, and – dare I say – true, many of the opponents responded with assertions that were unnecessarily extreme and hurtful, not to mention some that were downright untrue. For example, one pro-lifer proclaimed into the microphone that all of us pro-choicers are completely against all human rights, a claim which, in my opinion, is entirely nonsensical.

I would like to take a moment just to counter some of the accusations directed at me during the rally: No, I do not hate freedom. No, I do not support tyranny. But yes, yes I do support the Affordable Care Act. (more…)

The following is a guest post by Karen Kahn who is the director of Communications for PHI, a national, not-for profit organization that works to improve the lives of people who need home and residential care—and the lives of the workers who provide that care.

By Karen Kahn. When it comes to ensuring elders are safe, healthy and independent, it takes a village. We want our loved ones to be able to live at home in their communities, but often, we can’t be there to make sure Mom doesn’t fall getting out of the shower, or Dad doesn’t get confused by the bills.

When adult daughters—the primary caregivers for parents and other loved ones—can’t be there as often as needed, we often rely on paid home care aides. An often invisible workforce, home care aides make it possible for millions of elders and people with disabilities to remain in their homes—and for their children to have a little peace of mind.

Across the nation, our families employ about 2.5 million home care workers, and these jobs are expected to grow by about 1.3 million between 2010 and 2020. In fact, according to the latest occupational projections from the Department of Labor, home care jobs are the fastest-growing jobs in the nation.

Home care workers provide an array of critical services such as bathing, dressing, food shopping, meal preparation, medication management, and transportation to medical appointments. Yet, largely because they are women doing the work expected of women, these hardworking home care aides are undervalued. Half of them earn wages at or below 200 percent of the federal poverty level and rely on public assistance like food stamps and Medicaid to take care of their own families. (more…)

The following is a post by Annekathryn Goodman, MD who  is an Assistant Director, Vincent Gynecologic Oncology Division, Massachusetts General Hospital, Boston; Associate Professor, Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School and a resident of Boston.

By Annekathryn Goodman, MD. The loss of one loved soul punches a hole in the fabric of our universe. We experienced sadness and tragedy this past week when journalist Anthony Shadid died while reporting on the horrors of Syria’s war against its people.

Shadid was known to those of us who work at Massachusetts General Hospital in a small way – through his daughter, Laila. We know her through MGH’s own Marcela, ex-partner of Anthony’s first wife, Julie. Marcela is one of my work partners in the gynecological oncology department here. She and Julie broke up last year but Marcela has been an important part of Laila’s life since she was a baby, and remains so.

I am struck with how I can grieve for a man I have never met because I grieve for the people who love him. His death will now be a part of Laila’s identity. Growing up fatherless starting at the age of 10 will be part of the lens through which she views the world. We cannot protect her from that reality. But we can support her and the others who are impacted by this new hole in the universe. There is a circle of grief and meaning that radiates out from each death. In my imagination, I see this whole cloud of connection and meaning, sympathy and love that vibrates with each loss.

Of course as oncologists, we are all too familiar with that cloud. Now, one could imagine that these clouds of loss, familiar and sometimes daily, could bring us down. Maybe we should all be on anti-depressants. But, paradoxically, most of us are empowered by the work we do. The losses are unavoidable when dealing with cancer, but our reactions to it are completely in our control.

Reacting with love and support empowers us all. When Marcela called to tell us of Anthony’s death, John — the division chief of our department — immediately signed out her beeper so he could answer all of her calls. Whit, another doctor in our division, took on all her surgeries so she could be with Laila. Dr. Schiff, the chief of obstetrics and gynecology who no longer performs surgeries, donned scrubs and came down to the OR to ensure we were all okay. Texts and emails with words of support flew. We are a big village. Acknowledging this terrible pain honors the meaning of the life lost and how that life affected everyone else.

There was another, more personal, loss on Friday – my dog, SammyBear. I put him to sleep that evening after a two month illness with renal failure. Again, John helped me finish my last surgery so I could have time with SammyBear. I felt surrounded by love. (more…)

Carol Schechter

The following is a guest post by Carol Schechter, a leader in the field of health communication and social marketing. You can follow Carol on twitter @carol_schechter.

Last week was a bad week for the Susan G. Komen Foundation. On Monday, they were still an iconic charity; the group that successfully put women’s health issues in the public eye and the group that forever changed our associations with the color pink from babies to breast cancer survivors.

On Tuesday, their world changed. On January 31, AP broke the story that Komen decided  to stop funding Planned Parenthood, allegedly because Planned Parenthood was under Congressional investigation.   Social networks erupted with the news, and the world started to learn a lot about the workings of the Foundation: that the Komen VP behind the defunding decision was  tea party Republican who had long been opposed to Planned Parenthood; that Komen also opposed stem cell research; that a significant amount of Komen funds went to law suits against other charities that dared to use the phrase “for the cure” in their campaigns; that the decision to defund Planned Parenthood wasn’t shared with Komen grass roots chapters until after the announcement; and that many of these chapters opposed the decision when they learned of it. Komen started back pedaling quickly, first stating the real reason for the decision was not the Congressional investigation, but was because Planned Parenthood didn’t offer mammograms as a direct service. Excuses kept coming, but the damage was done. By the end of the week Komen reversed its decision and said Planned Parenthood was once again eligible to apply for grants. Then they engaged their PR firm. (more…)

The following is a guest post by by Dr. Olaoluwatomi Lamikanra, a Public Health Practitioner.

By Olaoluwatomi Lamikanra. Since the introduction of mobile phones in Nigeria, the number of users has increased exponentially and usage is pretty much found in both rural and urban areas.

With regards to the internet, Nigeria has about 43 million users (total population over 155 million) which far exceeds by more than double the next African country on the list-Egypt.¹

 
There are many projects associated with mobile health in Nigeria and with the exponential growth of mobile and internet users; there is an ever increasing market. Different sectors of the economy which have an impact on the health of the populace also stand to gain a lot from the introduction of mHealth initiatives. Water, Sanitation, Agriculture, Finance and Development are a few of the sectors. In Kenya, the introduction of the mPESA, a mobile phone application where moneys can be sent via mobile phones all around the country has solved the problems of money transfers. No longer do people in rural areas have to wait until someone is visiting from the city before money arrives. They receive the money as soon as it is sent from a PESA center. At a recent WaterHackathon event organised by CCHub in Lagos, one o f the tools suggested for Water development was a mobile system to facilitate the sharing of water resources in hard hit areas.²

Examples of some projects already in place include Mobile Community based Surveillance.mCBS is a mobile platform which is given to Traditional Birth Attendants to report vital maternal and child health indicators in real time using mobile phones. Using texts designed for this purpose the TBA can transmit alerts to nearby health officials who can respond immediately thus reducing delays in reaching appropriate care at a facility.³ Other mHealth projects currently being developed in Nigeria  is being collated by Ime Asangasi (@Imeasangasi- twitter handle) here.

REFERENCES:

1. http://www.internetworldstats.com/stats.htm (accessed 26th December 2011)
2. http://www.cchubnigeria.com/watermeetup (accessed 26th December 2011)
3. http://ehealthnigeria.org/where-we-work/list-of-implementations/mobile-community-based-surveillance-mcbs/

The following is  a guest post by Wendy D. Lynch, PhD the Founder, Lynch Consulting and Co-Director, Center for Consumer Choice in Health Care, Altarum Institute. For 25 years, Dr. Wendy Lynch has been making the connection between human and business performance.  Her career has included roles as faculty at the University of Colorado Health Sciences Center, Senior Scientist at Health Decisions International, and Principal at Mercer Human Resource Consulting.

By Wendy Lynch. In any other industry, minority and elderly discrimination would be front-page news. A recent study confirms elderly and minority customers get higher-cost hospital care than other more affluent white customers and are more often exposed to harmful, even deadly outcomes (1, 2). Fact: care for these patients will cost significantly more, yet their health outcomes and personal safety will be compromised. But in health care, it is not news.

This is the nature of health care disparity. But it reveals an even more troubling issue we rarely discuss: information, choice, and control. Not only do these patients receive substandard, over-priced care (1), they likely don’t even know it! The system limits information, limits choice, and offers patients little control over their options. In this and a subsequent blog, we will explore how lack of choice and control institutionalize the very disparities we aim to eliminate.

Disparities Are Real
It’s hard to dispute the facts; there are huge variations in health status and health resources among U.S. citizens. Comparing the most and least fortunate, differences are evident in every category: prevalence of risk factors and chronic illnesses (3); the availability of high-quality care (2); rates of preventive services (4); rates of premature mortality (5); and regular sources of care (6).

Nor are people surprised to learn that health disparities are closely linked to disparities in income and education (7). Health and health care delivery are worst among ethnic minorities, rural and poor communities, immigrants, and the elderly (7, 8). Despite decades of attention and investment by private and public agencies, the distance between the “haves” and “have-nots” remains as wide as ever (9). (more…)

Today’s post is by guest blogger, Shannah Koss

Dear Colleagues,

Health Information Technology and the substantial HITECH investment are a critical part of putting the U.S. health care industry and the U.S. consumer population on the 21^st century path to improved health and health care. The investment however is almost exclusively focused on enabling the provider infrastructure. We need a mirrored infrastructure that will help patients and caregivers navigate, access and understand the growing health information universe and what it means to them.

The newly announced “Putting the IT in TransITions” initiative is a critical opportunity to help consumers better access and use their own healthcare information, but only if it is put in context and made truly consumer friendly. This means not just plain language but with tools, translation and interpretation resources that make it actionable.

The two-page project summary “Patients and Caregivers the 1^st Step Not the Last Mile” describes an initiative that would explore how to enable a parallel consumer-facing infrastructure that complements and readily connects to the provider-facing infrastructure. Although ultimately there will be one shared infrastructure the timing and challenges of the emerging provider connectivity runs the risk of leaving consumers as the last mile.

We are stepping up to the IT in TransITions two-week challenge with a deadline of October 28, 2011 by seeking broad support for the project and its goals. We have many committed partners and we need your help in emphasizing to HHS and the industry leadership the critical importance of the consumer component to their efforts.

If you can lend your name and/or your organization’s name to this letter of support please email kossoncare@starpower.net by Thursday October 27th.

Your information, exactly as you provide it, will appear after the following statement: We the undersigned agree that successful care transitions need increased consumer IT support and focus consistent with the goals of the Patient and Caregiver Gateway project.

The following is a guest post by Dr. Jessie Gruman and ran on the Better Health on October 14th.

There is excitement in the air about how mobile phones are the breakthrough technology for changing health behavior.  Last Saturday, I was convinced this must be true. In two short hours, I:

• Skimmed the NYTimes op-ed, You Love your iPhone. Literally, that (questionably) claimed that functional MRIs show that our brains react to our iPhones the same way they do to the proximity of someone we love.
• Received an email on my iPhone from NYC Health Business Leaders inviting me to come to a meeting: Is Mobile Health the Next Killer App?
• Came across this podcast on how mobile technology is going to vastly change care for seniors with chronic conditions.
• Read a beautiful review of the behavior change literature that asks the question Is Mobile the Prescription for Sustained Behavior Change?
• Received a text about the highly anticipated release of the iPhone 5.
• And came across the entire kitchen crew of a fancy restaurant staring into/talking on their mobile phones.

Now I’m sure that the seductive power of our mobile phones hasn’t escaped your notice. Certainly, if you are concerned about people engaging more fully in their health and health care, you have seen the thousands of apps that intend to exploit the combination of widely available mobile phones with advances in Web-enabled technology as the new best way to spark and sustain health behavior change.

I love the optimism that has driven the development of these apps to date.  The theoretical reasoning of the behavioral scientists that finds mobile apps to be a potential game-changer – this is why this technology is different and what it offers above all other technologies and approaches — is subtle and compelling. And I love imagining the personalized guidance and support that will be possible to deliver to us once these theories are transformed into more sophisticated apps for our mobile devices. (more…)

The following is a guest post by Janice Lynch Schuster who  works at the Altarum Institute, a new voice in the field of aging and end of life issues.

By Janice Lynch Schuster. Sunday night, simultaneously tired and wired from my participation in a 39-mile fundraising walk for breast cancer, I attended my daughter’s one-year anniversary meeting to celebrate her achievement: She has one year of drug-free living. The ceremony was moving and painful, joyful and sad. She talked about her struggle, her journey and moments of arrival, insights into her addiction and awareness of ways to overcome it. She talked about people in the room who had helped her along the way, who had called her on it when she tried to bamboozle them, who had loved and supported her as she worked to find other ways to cope with a world in which she had trouble living by the rules. Others in the room testified about their experiences with her—her determination to stay sober had inspired theirs; the fact that she had made it for a year gave them hope to reach similar goals; her enthusiasm and dedication, they said, was electrifying. To other teens in the meeting, she was a role model. She was—and is—a beloved part of this community of addicts and alcoholics. The outpouring of love and affection these people have for my daughter made me understand more fully and deeply just what it means to be on a journey with a community of like-minded people, and how important it is to be surrounded by such people when the journey is long and difficult, when there are barriers to be overcome and milestones to reach.

This time last year, we were in a very different place.  Aware that my daughter was self-destructing, I admitted her to a rehab facility; she was furious with me and told me our relationship was over, that I was not her mother, and she would never be my daughter again. She was livid and, until I stopped answering the phone, would call me daily with her fury. I was heartbroken—my beautiful girl, so smart and talented and funny—had been waylaid by a disease that has plagued our family for generations. She was 17, at the end of her junior year in high school, and at a time when I had expected her to be visiting colleges, studying for the SATs, buying her class ring, we were sitting in a locked room, crying and angry and overwhelmed by what was happening. The weekend I checked her in to the rehab facility coincided with the annual 39-mile walk, and despite my sorrow, I felt obligated to walk. So many people had donated so much money to me, and although the funds were committed whether I showed up or not, I felt compelled to go along with my plan. (more…)