A Human Capital Approach to Reduce Health Disparities

Objective: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research. Methods: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), a level 1 research institution to build expertise at a minority serving institution. The elements of Project EXPORT were created to advance the science base of disparities reduction, increase trained minority researchers, and engage the African American community at all stages of research. Conclusion: Building upon past collaborations between HBCU’s in South Carolina and USC, this project holds promise for a public health human capital approach to reduce health disparities

Prolonged Injustice in Urban America

Environmental inequality is the suggestion that the working class, the poor, persons of color, and ultimately the economically disadvantaged are subjected to living conditions that may prove to be hazardous both personally, professionally, and also to the infrastructure of the urban communities that these people inhabit. These injustices affect not only housing but education, quality healthcare access, and access to employment. This article investigates the distinct relationship of environmental inequalities imposed in urban communities that are promoted by a prominent institution: the government. It has been suggested that the government is primarily controlled by individuals who are incapable of identifying with individuals who are residents of these urban communities susceptible to the threat of environmental inequality. This introduces multiple questions: Are political leaders less concerned with such individuals and is this why the needed attention in these communities is positioned at the bottom of the agenda if it appears at all? This, in addition to the lack of funding distributed among these regions for improvements, demonstrates the neglect of the government and how this maintains environmental injustice in urban areas

Examination of Racial Disparities in Childhood Asthma Management Practices

Objective: To analyze asthma management plan practices for children with asthma in the United States considering race and other demographic and person-level characteristics. Methods: Univariate/Bivariate/Multivariate analysis was performed to examine asthma management plan physician recommendations among children in the United States utilizing secondary data analysis of the 2002 and 2003 National Health Interview Survey. Results: The majority of the study participants reported not having an asthma management plan at (59.00%). In multivariate analysis using SAS callable SUDAAN, Whites were significantly more likely to have an asthma management plan (OR=1.66, p=.0031). Conclusion: Findings from this study indicate that Black and Hispanic children with asthma are less likely to have an asthma management plan. Mandating all insurers to provide an asthma management plan to children with asthma may reduce the race-based inequities and requiring emergency room physicians to provide children with an asthma management plan may target those children that do not have a plan

Media Attention on African Americans with Human Immunodeficiency Virus

Human immunodeficiency virus (HIV) is a disease that has captured the attention of the media in various ways and to varying degrees. One of the ongoing debates and areas of research in HIV that provide many opportunities for discovery is the disproportionate number of African Americans infected with HIV compared to the amount of attention they receive in the media. This manuscript addresses the question that has preoccupied the minds of many people: Why have African Americans infected with HIV received so little media attention? Analysis of this question suggests that there are many reasons for this lack of media attention. One reason in particular is the media tends to be much less attentive to diseases, such as HIV, that disproportionately burden blacks relative to whites. We also find that the media is reluctant to write about HIV in African Americans because it portrays them negatively. The media suggests that people are bombarded with negative news about African Americans and writing about them with regard to HIV only reinforces the negative. Finally, analysis reveals that in recent years African Americans with HIV have received more media attention due to the increase in rates of HIV in African Americans. This increase in media attention helps educate African Americans about the disease, reduces the stigma associated with it, and inspires African Americans to get tested and linked to care. In this way, African Americans with HIV can help the community stay virus-free

Disparities in Mental Health Utilization among Persons with Chronic Diseases

This study used Aday and Andersen’s Behavioral Model of Health Services Use to examine the role of chronic disease and the joint impact of race and chronic disease type on mental health utilization. Using data from Community Tracking Survey Household Survey, we tested the assumption that chronic disease, chronic disease type, and race are related to lower rates of mental health visits when adjusted for predisposing, enabling, and need factors. After adjusting for population characteristics, we found that race significantly moderated the impact of chronic disease type on mental health utilization, showing that African Americans with cardiovascular disease were half as likely as whites with cardiovascular disease to have a mental health visit, and Hispanics relative to whites with other chronic diseases were two thirds a likely to have a mental health visit. Overall, chronic disease status was positively associated with mental health utilization. However, adjusted for chronic disease, mental health status, predisposing, enabling and need factors, African Americans and Hispanics were significantly less likely than whites to have a mental health visit. Clinicians and providers must be alert to the full spectrum of needs in underserved populations

Preventable Asthma Episodes Among Urban/Rural Children and Adolescents: A Comparative Study

Context: Asthma is a chronic respiratory illness that is increasing in prevalence among children in the United States. A limited number of studies have examined the relationship between rurality and the prevalence of asthma in minority children, and those studies found mixed results. The aim of this study is to examine urban/rural locality and its impact on asthma episodes and preventable emergency department visits, and to provide quantitative evidence concerning the relationship between patient characteristics and geographic location. Methods: This is a retrospective study and secondary data analysis of the 2000 National Health Interview Survey. Parametric testing using Univariate/Bivariate/Multivariate analysis was performed to examine emergency department utilization for asthma episodes among urban/rural children and adolescents in the United States. Findings: Regardless of the geographic location, Black children were more likely to visit the emergency room within the past twelve months (urban area (OR=1.59; 95% CI 0.87, 2.33) – rural area (OR=2.68; 95% CI 1.39, 4.05)). Additionally, children who experienced an asthma episode in the past twelve months were more likely to report not visiting the emergency department (OR=1.93; 95% CI 1.53, 2.44). Conclusions: Racial and urban/rural differences exist among children with asthma visits to the emergency department. Asthma prevalence and disparities continue to be a burden in the United States and its deficiencies across geographic locations reflect the health of the US population as a whole

Using photovoice as a tool for community engagement to assess the environment and explore environmental health disparities

Photovoice was used as a participatory research method to document perceived local environmental hazards, pollution sources, and potential impact on health among community members to address environmental health disparities. A convenience sample of 16 adults in Orangeburg, South Carolina participated in Photovoice. Photos depicted positive and negative implications of the environment across seven themes: recreation and leisure; food access; hazards and pollution; health, human, and social services; economic issues; beautification; and accommodation and accessibility. Positive and negative photos demonstrated a high level of interest among community members in considering how the environment influences health and health disparities

A Human Capital Approach to Reduce Health Disparities

Objective: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research. Methods: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), a level 1 research institution to build expertise at a minority serving institution. The elements of Project EXPORT were created to advance the science base of disparities reduction, increase trained minority researchers, and engage the African American community at all stages of research. Conclusion: Building upon past collaborations between HBCU\u27s in South Carolina and USC, this project holds promise for a public health human capital approach to reduce health disparities

Reasons Why Women Do Not Initiate Breastfeeding: A Southeastern State Study

Purpose - Despite the increase in breastfeeding initiation and duration in the United States, only five states have met the three Healthy People 2010 breastfeeding objectives. Our objectives are to study women\u27s self-reported reasons for not initiating breastfeeding and to determine whether these reasons vary by race/ethnicity, and other maternal and hospital support characteristics. Methods - Data are from the 2000-2003 Arkansas Pregnancy Risk Assessment Monitoring System, restricting the sample to women who did not initiate breastfeeding (unweighted n = 2,917). Reasons for not initiating breastfeeding are characterized as individual reasons, household responsibilities, and circumstances. Analyses include the χ2 test and multiple logistic regression. Results - About 38% of Arkansas mothers of live singletons did not initiate breastfeeding. There was a greater representation of non-Hispanic Blacks among those who did not initiate breastfeeding (32%) than among those who initiated breastfeeding (9.9%). Among those who never breastfed, individual reasons were most frequently cited for noninitiation (63.0%). After adjusting for covariates, Hispanics had three times the odds of citing circumstances than Whites (odds ration [OR], 3.07; 95% confidence interval [CI], 1.31-7.18). Women who indicated that the hospital staff did not teach them how to breastfeed had more than two times greater odds of citing individual reasons (OR, 2.25; 95% CI, 1.30-3.91) or reasons related to household responsibilities (OR, 2.27; 95% CI, 1.19-4.36) as compared with women who indicated they were taught. Conclusions - Findings suggest the need for targeting breastfeeding interventions to different subgroups of women. In addition, there are implications for policy particularly regarding breastfeeding support in hospitals