July 15th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
No Comments »
In the 12 years since our government acknowledged we had a problem with racial disparities in health care, we’ve made significant progress in reducing them. Steep declines in the prevalence of cigarette smoking among African Americans have narrowed the gap in lung cancer death rates between them and whites, for example. Inner city kids have better food choices at school. The 3-decade rise in obesity rates, steepest among minorities, has leveled off.
Still, racial disparities persist across the widest possible range of health services and disease states in our country. The racial gap in colorectal cancer mortality has widened since the 1980s. Overall cancer death rates are 24% higher among African Americans. Sixteen percent of African American adults and 17% of Hispanic adults report their health to be fair or poor, whereas only 10% of white American adults say that. The number of African Americans and Hispanics who report having access to a primary care physician is 30-50% lower than white folks who have one.
How can EMRs Help? Read more »
*This blog post was originally published at Pizaazz*
July 2nd, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy
No Comments »
In the 1993 film Groundhog Day, Bill Murray plays a TV weatherman who finds himself trapped in a do-loop, covering the numbingly boring display of Punxutawney Phil, over and over again.
Forgive those of us who follow news from the Department of Health and Human Services for feeling like Bill Murray in that movie.
Last month, HHS released an action plan to reduce racial disparities in health care. The plan called for new care models, more service delivery sites, a beefed-up health and human services workforce, and targeted efforts to reduce cardiovascular disease, childhood obesity and other scourges of minority populations.
Remarkably however, the plan came with no funding. Apparently, it was supposed to prompt agencies within HHS to assure that their own internal plans were aligned with the effort to reduce racial disparities. Worse yet, the plan involved only HHS itself. In effect, it assumed that a ‘medical model’ can solve racial disparities in health care. However as I argued here, these disparities aren’t about health, at all. They are about socioeconomic status, and HHS can’t fix that by itself.
Solving the problem of racial disparities in health care clearly requires input from many branches of government, including those involved with education, urban planning, transportation and more, in addition to HHS.
When it was all said and done, the HHS plan came off looking like a political stunt by the Obama administration. While the administration probably does want to fund a bona fide effort to reduce racial disparities, today’s incessant (and appropriate) focus on deficit reduction forced the administration to release a plan with no teeth. It isn’t going to make a dent in the problem. Read more »
*This blog post was originally published at Pizaazz*
June 23rd, 2011 by Glenn Laffel, M.D., Ph.D. in Opinion
No Comments »
We have all seen people exhibit flagrantly unhealthy behavior. Some of us–though we’d never admit it–derive a certain, smug satisfaction by observing them. At least I don’t do that!
Somewhere in the course of our daily lives though, most of us do exhibit behavior that suggests at least some disregard for our health. We don’t change our diet, though we know we should. We don’t floss, take medications as prescribed, or get the screening tests we’re supposed to.
Multiple intertwining causes underlie all unhealthy behavior, of course. I had always figured that one pervasive cause was the lack of a simple, observable connection between health-related behaviors and health outcomes. There is a long delay for example, between establishing unhealthy dietary preferences and the sequellae of that behavior (a heart attack, diabetes or whatever). The longer the delay between cause and effect, the more likely someone will be to exhibit unhealthy behavior.
On the other hand, if there’s a short interval between cause and effect—it only takes minutes for susceptible people to develop a severe allergic reaction after eating peanuts, for example—well, that’s where I’d expect high adherence to the required healthy behavior.
If I’m right, then we have a problem. For many chronic diseases (diabetes, heart disease, some cancers) Read more »
*This blog post was originally published at Pizaazz*
June 16th, 2011 by Glenn Laffel, M.D., Ph.D. in Research
1 Comment »
In recent posts on Web-based and mobile behavioral intervention programs, we reviewed evidence suggesting that social support, in one form or another, can improve participants’ adherence and engagement with the program. That didn’t always mean however, that participants achieved better outcomes as a result. In one study for example, an online community increased engagement with and utilization of a Web-based activity program, but it did not increase participants’ actual activity levels.
Another study, slightly older than the ones reviewed above, did show that a Web-based program improved outcomes. In this case, the intervention was an online videogame known as Re-Mission. Since I haven’t touched previously on outcome studies for automated lifestyle intervention tools or videogames as an example of such programs, I’ll do that here.
Re-Mission is intended improve medication compliance in teens and young adults with a history of cancer. In the game, players control a nanobot within a 3-dimensional body of a young person that has cancer. Play involves destroying cancer cells and managing chemotherapy-related adverse effects like vomiting and bacterial infections by using antiemetics and antibiotics. The game purports to help users understand Read more »
*This blog post was originally published at Pizaazz*
June 11th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
No Comments »
The appalling lack of women chief executives in today’s Health IT companies has been linked to a paucity of women in IT generally and the scarcity of female mentors and venture capitalists that could support them. Social norms regarding gender identity and child rearing also drive the disparity. In this post, I’ll briefly review these norms and some promising efforts to reduce the disparity.
Social Norms, Women and Tech
Many people believe social norms and expectations regarding women are the most important reason why there are so few female IT leaders out there today. As the father of 3 girls who are succeeding in tech, I don’t necessarily agree with this (I think the phenomenon is driven by these factors).
Still, there are some indisputable facts that have to be mentioned. Read more »
*This blog post was originally published at Pizaazz*
