Reports Look at Health Disparities on the Gulf Coast

Newswise — "Health disparities" has become a buzzword in health care and public policy. However, a major task in addressing health disparities is delineating what they are and where they exist. The April issue of The American Journal of the Medical Sciences, official journal of the Southern Society for Clinical Investigation, presents a special section on collaborative efforts to recognize and address health disparities on the local level. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

Drawn from the Proceedings of the 2006 and 2007 University of South Alabama Center for Healthy Communities Regional Health Disparities Symposium, the special section features six papers representing innovative approaches to confronting racial and ethnic disparities in health care, focusing on the Gulf Coast region. "This project represents another mechanism where those interested in health disparities can 'listen to each other' and share ideas," write Drs. Errol D. Crook and Harvey L. White of University of South Alabama, Mobile, in an introductory editorial.

A study led by Dr. Edward Partridge, Director of the University of Alabama Birmingham Cancer Center, outlines efforts to address the disproportionately high rates of cancer and cancer deaths among African-Americans in Alabama and Mississippi. One program recruited and trained volunteer Community Health Advisors—"natural helpers" who could serve as community resources to promote screening and treatment of breast and cervical cancer.

Community Health Advisors have helped patients overcome barriers to high-quality care by providing information about breast cancer, advice in dealing with financial barriers, and help in navigating the health care system, and many other ways. Counties where the program was implemented saw increased use of mammography and Pap smear screening among African-American women—as well as an "unprecedented" rate of keeping up with recommended medical follow-up.

Dr Loran T. Clement and colleagues discuss the "epidemic" of asthma among low-income, urban, and African-American children. An approach that has shown promise in the Los Angeles area is a fully equipped and staffed mobile asthma clinic—the Breathmobile—sent to schools to identify and provide specialized care for children with asthma. Such school-based approaches can help control asthma, although considerable time and effort are required. "When achieving this goal becomes a priority, there is reason to be hopeful that the asthma epidemic can be controlled," the authors conclude.

Drs Errol D. Crook and Mosha Peters discuss the impact of health disparities in chronic diseases, such as high blood pressure, diabetes, HIV/AIDS, cancer, cardiovascular disease, and obesity. Disadvantaged populations may have low awareness of common chronic diseases and risk factors, and receive lower-quality care once they are diagnosed. The authors call for multidisciplinary approaches to improve access to care for chronic diseases, including prevention. Although the required cost and effort will be high, likely results include lower health care costs, increased years of productivity, and greater stability of at-risk communities.

A study led by Dr. Martha Arrieta evaluated the use of income and mortality statistics by ZIP code as an indicator of local health status in the Mobile area. ZIP codes where more than 20 percent of residents lived below the poverty level had more than a 40 percent increase in the risk of death from nearly all common causes. Disparities in actual death rates were highest for cardiovascular diseases and cancer, making them important targets for efforts to reduce health disparities.

Dr. Arrieta also narrates the development of a multidisciplinary academic group to study and design new projects to address health disparities in the Mobile area. The group includes researchers with expertise in business and economics, public policy, education, language and communication, and social work, teamed with more traditional health researchers. With ongoing effort, the group hopes to develop innovative research projects to address health disparities in Mobile and the Gulf Coast region, and eventually to other areas as well.

The special section also features a keynote address by Dr. Gail Christopher, formerly Vice President of the Joint Center of Political and Economics Studies, who stresses the importance of public policy for the nation's health. Before making headway toward eliminating health disparities, Dr. Christopher writes, "We must understand that national and regional public policy has implications on the health outcomes of the citizenry"¦we must become aware of research opportunities and past successes in other regions and apply those strategies in our local communities."

About The American Journal of the Medical SciencesFounded in 1820, The American Journal of the Medical Sciences is the official journal of the Southern Society for Clinical Investigation. Regular features include the Southwestern Internal Medicine Conference, Cardiology Grand Rounds of the University of North Carolina, the Consortium for Southeastern Hypertension Control, Case Records of the VA Maryland Healthcare System/University of Maryland Medicine, and Case Report/Focused Reviews. The Journal also publishes original articles dealing with topics such as infectious disease, rheumatology/immunology, hematology/oncology, allergy, and endocrinology. Visit the journal website at http://www.amjmedsci.com.

About the Southern Society for Clinical InvestigationFounded in 1946, the Southern Society for Clinical Investigation (SSCI) is a regional academic society dedicated to the advancement of medically-related research. Its major focus is on encouraging students and postgraduate trainees (residents and fellows) to enter academic medicine and to support junior faculty success in clinical investigation. SSCI members are committed to mentoring future generations of medical investigators and promoting careers in academic medicine. Visit the SSCI website at http://www.ssciweb.org.

About Lippincott Williams & Wilkins Lippincott Williams & Wilkins (http://www.LWW.com) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

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