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OP-ED: Unhealthy state of affairs regarding Black health

THE PHILADELPHIA TRIBUNE — There is no disagreement that African Americans have worse health outcomes across the board. Researchers, scientists, sociologists, and doctor all agree. Data and statistics reflect the dismal reality that if you are African American, you will be more likely to die at birth, die giving birth, grow up sicker, be diagnosed of a life-threatening illness later, and die sooner.

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By Glenn Ellis

There is no disagreement that African Americans have worse health outcomes across the board. Researchers, scientists, sociologists, and doctor all agree.

Data and statistics reflect the dismal reality that if you are African American, you will be more likely to die at birth, die giving birth, grow up sicker, be diagnosed of a life-threatening illness later, and die sooner.

What is less known, and agreed upon, is the fact that the determining factors for all of these outcomes, is not because one is African American, but because of what are known as social determinants of health.

It’s true, research had concluded that medical care and is only responsible for 10 to 20 percent of a person’s health: regardless of what color they are. The remaining 80 to 90 percent is attributed to these social determinants of health (SDOH).

Doctors see this every day in their patient population. A recent survey by The Physician Foundation revealed that 90%of the doctors in this country say that most of their patients have a social condition that poses a serious threat to their health. Only 1 percent of the doctors surveyed felt that none of their patients were affected by SDOH.

So, what exactly are social determinants of health?

According to the World Health Organization (WHO), these are the “conditions in which people are born, grow, live, work, and age”. In other words, the conditions of health are alarming in communities with poor SDOH such as unstable housing, low income, unsafe neighborhoods, and/or substandard education.

One only has to look at every city (urban and rural) to see how this plays out in most of our lives.

In the United States, it is SDOH, not race that accounts for the dismal health outcomes for African Americans. In fact, the inequities in outcome are clear all the way down to the level of neighborhoods in the same city.

Several years ago, The Robert Wood Johnson Foundation initiated a first of its kind initiative to look at life expectancy by neighborhood in respective cities around the country.

Known as United States Small-Area Life Expectancy Estimate Project (USALEEP), the found shocking differences in life expectancy of as much as 20 years for residents in the same city, living just a few miles apart; in some cases, just a few blocks.

Further examination of the data shows that, almost with exception, neighborhoods with the lowest life expectancy were those with substantial African American or Latino populations.

As the cities in this country become more gentrified, we are seeing the health outcomes for the black and brown people in this country worsen.

Are there other reasons that HVI/AIDs is a chronic condition for whites, while it continues to be an epidemic in the African American communities in this country? Or, black women are two to six times more likely to die from complications of pregnancy than white women? And their babies almost three times the infant mortality rate as whites?

Is it due to the genetic makeup of African Americans? I think not!

Every human being on the planet is 99.99 percent identical. A difference of 0.01 percent is all that separates us from each other. That means that the 3 billion pairs of genes (human pairs) that make up our individual genetic code are equal to a book with 262,000 pages. The individual differences between us represents only 500 of those pages!

Understanding this is what will allow us to stop using race, a totally social construct, in the concepts of medicine and healthcare. Instead, we must realize how much of our human and financial resources are “misused” applying race to issues of health.

We can see it in how, even today doctors have been found to believe that there is something about being African American that results in not providing adequate pain medications due to the belief that we have a higher tolerance for pain, because of our skin color. The same phenomena were observed even in children at Emergency room with appendicitis; African American children were denied pain medication for the same reason.

Most alarming to me are the implications as we move further into genomic medicine.

If we are not careful, we can see research from this endeavor to further engrain the notion that there are racial differences that justify our higher rates of high blood pressure; diabetes; and other diseases and conditions.

Currently, policy, legislation, and funding are directed towards supporting the theory that African Americans are more susceptible to poorer health outcomes, while SDOH are being largely ignored.

Dr. Richard Cooper of Loyola University has done research on high blood pressure that has made an indisputable case for the dismissal of the fallacy of African Americans being “predisposed” to poor health outcomes.

In his research, Dr. Cooper studied high blood pressure in Nigerians, Jamaicans, and in African Americans. His conclusions: only African Americans had the highest rates of high blood pressure. To further make the case, he found that Germans and Russians has rates that were significantly higher than African Americans!

Seems like its more about being African American in this country, than it is about just being African American.

It begs the question: Is it race or is it racism?

Glenn Ellis is a Research Bioethics Fellow at Harvard Medical School and author of “Which Doctor?” and “Information is the Best Medicine.” He has a weekend podcast at www.wurdradio.com. For more good health information, visit www.glennellis.com.

This article originally appeared in The Philadelphia Tribune.

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Community

For Cervical Cancer Month, Medical Community Focused on Education

January was Cervical Cancer Awareness Month. Physicians, advocates and others in the medical community commemorated the month by raising awareness about a form of cancer they say is highly preventable and treatable. Cervical cancer is caused by a virus called the human papillomavirus (HPV) and it develops slowly over time but can be prevented with proper care in girls as young as 13 years old.

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A Mayo Clinic article published last month stated that Black women are more likely to be diagnosed and die of cervical cancer, compared to White women in the U.S. 2,000 Black women are diagnosed every year with cervical cancer and 40% die as a result.
A Mayo Clinic article published last month stated that Black women are more likely to be diagnosed and die of cervical cancer, compared to White women in the U.S. 2,000 Black women are diagnosed every year with cervical cancer and 40% die as a result.

By Magaly Muñoz

January was Cervical Cancer Awareness Month.

Physicians, advocates and others in the medical community commemorated the month by raising awareness about a form of cancer they say is highly preventable and treatable.

Cervical cancer is caused by a virus called the human papillomavirus (HPV) and it develops slowly over time but can be prevented with proper care in girls as young as 13 years old.

Sonia Ordonez, an OBGYN and gynecology surgeon at Kaiser Permanente, stated that as soon as people with cervixes reach the maturity reproductive age, they should start taking preventative measures like getting the HPV vaccine. The vaccine involves a series of two-doses for people aged 9 through 14 or three-doses for people 15 through 45 years old.

“I see a lot of young women who can’t remember or may not have gotten [the vaccine] when they were younger, or maybe got one, but we can give them the series of vaccines and restart at any point in time,” Ordonez said.

She said that cervical cancer is not the only cancer caused by HPV. Strains of the virus can also lead to throat, anal and penile cancers.

Screening is also an effective way to check for cervical cancer and should be done every three years after someone turns 21, doctors recommend. It is best to start as early as possible to catch occurrences early.

Ordonez said that this cancer is also more likely found in people of color and has led to more deaths overall.

A Mayo Clinic article published last month stated that Black women are more likely to be diagnosed and die of cervical cancer, compared to White women in the U.S.

2,000 Black women are diagnosed every year with cervical cancer and 40% die as a result.

“This disparity is not due to genetic differences among White, Black or Hispanic women, but rather related to systemic racism, access to healthcare and socioeconomic factors,” Dr. Olivia Cardenas-Trowers, a Mayo Clinic urogynecologist, said in the article.

Ordonez stated that immigrant women are also highly susceptible to the cancer, as many Latin American countries may not have accessibility to screenings or lack of insurance makes it harder for them to get tested.

Hispanic women are 40% more likely to be diagnosed with cervical cancer, and 30% more likely to die from it, as compared to non-Hispanic White women, according to the Office of Minority Health.

Family medicine physician, Joy Anyanwu, stated that the pandemic contributed to hesitancy about getting cervical cancer screenings among some women. Other factors are people’s aversion to vaccines, parents not wanting to believe that their children are or will become sexually active, and doubt about the overall effectiveness of the vaccine.

“The vaccine is very safe — over 97% effective in preventing cervical cancer,” Anyanwu said. “Even if you aren’t having sex, the earlier you start would actually help.”

Anyanwu said she understands that parents might not want to ask questions about their children’s reproductive health, but it’s a mindset that can be a barrier to having important conversation about prevention or care.

To keep families their families and communties healthy, the doctor emphasized that people should prioritize keeping up with their vaccine series and going to screenings every year.

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Antonio‌ ‌Ray‌ ‌Harvey‌

Sacramento Lawmakers Step Up Push for “Smart Solutions” on Crime, Public Safety

Assemblymember Tina McKinnor (D-Inglewood) and Sen. Lola Smallwood-Cuevas (D-Ladera Heights), both members of the California Legislative Black Caucus (CLBC), have joined other lawmakers and criminal justice reform advocates to address public safety in the state.  On April 2, CLBC members gathered outside the State Capitol for the unveiling of the #SmartSolutions Public Safety Policy Platform, a package of 30 bills that addresses the top concerns of retailers, retail workers, the fentanyl crisis, and support for victims and survivors of crime.

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Assemblymember Tina McKinnor (D-Inglewood), second right, and Assemblymember Eloise Gómez Reyes (D-Colton), right, have introduced bills that would protect victims, reduce recidivism, and treat substance-use disorders. CBM photos by Antonio Ray Harvey.
Assemblymember Tina McKinnor (D-Inglewood), second right, and Assemblymember Eloise Gómez Reyes (D-Colton), right, have introduced bills that would protect victims, reduce recidivism, and treat substance-use disorders. CBM photos by Antonio Ray Harvey.

By Antonio Ray Harvey, California Black Media

Assemblymember Tina McKinnor (D-Inglewood) and Sen. Lola Smallwood-Cuevas (D-Ladera Heights), both members of the California Legislative Black Caucus (CLBC), have joined other lawmakers and criminal justice reform advocates to address public safety in the state.

On April 2, CLBC members gathered outside the State Capitol for the unveiling of the #SmartSolutions Public Safety Policy Platform, a package of 30 bills that addresses the top concerns of retailers, retail workers, the fentanyl crisis, and support for victims and survivors of crime.

“Instead of being tough on crime, we need to be smart on crime,” Smallwood said at the press briefing. “I am not saying that we’re not going to be holding folks accountable for the actions that they take. But we will not rely on incarceration as a solution.”

McKinnor, Smallwood-Cuevas, a coalition of advocates, addiction treatment experts, and Yurok Tribal leaders joined Sen. Nancy Skinner (D-Berkeley), and Assemblymember Eloise Gómez Reyes (D-Colton) at the press conference organized to promote legislative solutions that ensure safety and justice.

Organizers say #SmartSolutions is an intersectional campaign that combats criminalization and mass incarceration by pushing for the redirection of state resources to fund housing, health care, schools, services for victims, and programs that reduce recidivism and promote accountability, beyond incarceration.

Opponents of the bills proposed in the #SmartSolutions campaign say their colleagues who support reform-focused strategies are looking the other way on crime and encouraging lawlessness.

For example, Assemblymembers Wendy Carillo (D-Boyle Heights), Carlos Villapudua (D-Stockton) and Mike Gipson (D-Carson) are supporting Assembly Bill (AB) 1990, legislation that would allow a peace officer to arrest shoplifters without a warrant or without witnessing the theft.

Assemblymember James Ramos (D-Highland) authored AB 1772 and introduced it in January. The legislation proposes sterner penalties for retail theft, particularly for repeat offenders.

The #SmartSolutions campaign is co-sponsored by Ella Baker Center for Human Rights, Smart Justice California, American Civil Liberties Union (ACLU) California Action, Californians for Safety and Justice, and Californians United for a Responsible Budget (CURB).

Smallwood recently introduced two bills she hopes will provide solutions to the escalating retail theft problem in the state. Senate Bill (SB) 1446 addresses theft, technology and job security in retail establishments and aims to minimize workplace violence, according to supporters. SB 1282 requires counties to expand the use of a diversion program for theft cases.

“Restorative Justice is the essential pillar of making our criminal justice system more fair, just, and equitable,” McKinnor said. “Restorative justice recognizes the trauma of victims and preparatory of crimes and provides a constructive space for victims to find healing.”

Dr. Amiee Moulin, founder of the California Bridge program and chief of the Division of Addiction Medicine at the University of California (UC) Medical Center, said drug “addiction and overdose” are taking a toll on patients, families and the community.

“I believe that California’s proposed legislation focused on expanding access to treatment is a crucial step towards saving lives,” Moulin said. “By removing barriers to care and embracing evidenced-based strategies we can provide patients the support they need to heal and recover.”

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California Black Media

Stakeholders Warn Lawmakers of Expanding Aging Population; Older Black Californians Included

The California Commission on Aging (CCoA) hosted its second annual forum focused on challenges facing Californians over 65 years old. Titled “Aging and Disability Issues: What Legislative Staff Need to Know for 2024,” the virtual event was organized to bring awareness to lawmakers that California’s aging adults are living longer and to emphasize the importance of developing policy to support this growing population, according to organizers.

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The discussion encompassed a range of topics including planning for long-term care, assisted living, enhancing healthcare quality, technology use, services for senior adults with disabilities, state budget considerations, and the best policies and practices to help aging adults stay healthy, active, independent, and confident.
The discussion encompassed a range of topics including planning for long-term care, assisted living, enhancing healthcare quality, technology use, services for senior adults with disabilities, state budget considerations, and the best policies and practices to help aging adults stay healthy, active, independent, and confident.

By Antonio Ray Harvey, California Black Media 

The California Commission on Aging (CCoA) hosted its second annual forum focused on challenges facing Californians over 65 years old.

Titled “Aging and Disability Issues: What Legislative Staff Need to Know for 2024,” the virtual event was organized to bring awareness to lawmakers that California’s aging adults are living longer and to emphasize the importance of developing policy to support this growing population, according to organizers.

This year’s meeting included the perspectives of gerontologists and other subject-matter experts who provided data and insights critical to informing policy.

Former Assemblymember Cheryl Brown (D-San Bernardino), who chairs the CCoA’s Executive Committee, began the discussion.

“The landscape of California is changing. Aging is changing and it’s changing California,” Brown said. “Older adults are living longer, and the cohort is becoming more ethnically diverse, underscoring the need to develop culturally, appropriate services.”

The discussion encompassed a range of topics including planning for long-term care, assisted living, enhancing healthcare quality, technology use, services for senior adults with disabilities, state budget considerations, and the best policies and practices to help aging adults stay healthy, active, independent, and confident.

The CCoA acts as the principal advocate for older Californians and as a catalyst for change that supports and celebrates Californians as they advance in age. The CCoA advises the Governor and Legislature, along with state, federal, and local agencies on programs and services that affect senior adults.

Statewide organizations that participated in the event included LeadingAge California, Disability Rights California, California Foundation for Independent Living Centers, and California Collaborative for Long-Term Services and Supports.

In addition, representatives and staff members of Choice In Aging, Age Watch Newsletter, California Elder Justice Coalition, California Association of Area Agencies on Aging, and the California Long-Term Care Ombudsman Association were presenters during the 90-minute discussion.

“In California, we know that older adults are underserved and unserved relative to their needs,” CCoA Executive Director Karol Swartzlander said. “In stark terms, we know that 4% of older adults who need service actually receive services.”

According to the California Department of Aging (CDA), California’s aging population is expected to reach an estimated 4.5 million individuals ages 60 to 69 and 4.2 million senior adults ages 70- to 79 by the year 2040, based on information from CDA’s Master Plan for Aging. 

Recognizing that the state’s 65-plus population is projected to grow to 8.6 million by 2030, Gov. Gavin Newsom issued an executive order calling for the development of the MPA.

Debbie Toth, from ChoiceInAging, said the MPA is a model of “how we can do better” to service the needs of older adults. ChoiceInAging, Toth said, “is going to be shopping accessible transportation and rate increases for adult day healthcare.

“But we need to have legislation to do it,” Toth told legislative staff members.

A 2016 California Health Report (CHR) revealed that by 2030, 18% of the state will be 65 or older. Projections in that study also indicated that 52% of these older adults would be from diverse minority groups but “no population is expected to be harder hit than African Americans,” the report stated.

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