We made a few new additions to our resources today that we think you should take a look at:

The Kirwan Institute for the Study of Race and Ethnicity

• Site Summary: The Kirwan Institute for the Study of Race and Ethnicity’s “ultimate goal is to stimulate and facilitate transformative change to bring about a society that is fair and just for all people.” It approaches this goal “with the understanding that all communities of people are interconnected and that by fostering positive relationships through research, scholarship and collaboration, we will deepen the possibility for change.” The Kirwan Institute is a true pioneer in the fight to achieve equitable results for communities of color and its research and advocacy, particularly around opportunity mapping, represents some of the most innovative and effective advocacy currently being undertaken by advocates for race equity. The Institute also posts all of their PowerPoint presentations on their site. Available presentations cover topics ranging from GIS to framing to structural racism.

HealthyCity

• Site Summary: HealthyCity offers perhaps the most comprehensive access to community resources, demographic/health data, and cutting edge online GIS mapping technology that the REP has ever seen. For the time being, the site only offers geographic coverage for Los Angeles county. We hope that HealthyCity will be going statewide soon but until that time we will have to stew in our jealousy of the wonderful online mapping and data analysis tools that residents of the city of angels have access to.

• Suggested Uses: If you have any mapping or data analysis needs related to Los Angeles county and you are not adverse to free, powerful, user-friendly online mapping and data analysis tools than HealthyCity is for you.

REP staff recently had the pleasure of meeting Catholic Healthcare West (CHW) staff members involved in the production of their Community Need Index (CNI).

The CNI is a very nifty and well-crafted index that measures the health of a community. It takes into account several indicators related to community health including, but to name a few, income, language isolation, educational attainment, insurance coverage, and housing. CHW has conducted multiple statistical tests that show that a high CNI score is a valid indicator of poor community health and they have published a detailed report on the methodology behind the CNI. The CNI is calculated at the zip code level for California (2006 CNI) and the country (2007 CNI). The REP was not surprised to find that areas in Sacramento County with a high CNI score tended to be in low-income communities of color. We think that the use of the CNI, particularly with GIS, could be a wonderful tool to activate support for community health initiatives. It would also be a great tool to evaluate whether the health related services you organization provides are being directed at the communities with the highest need.

If you are interested in obtaining the CNI data or more information about the CNI, we encourage you to contact CHW.

Estimated at nearly 15 million, the AA&NHPI community is the second fastest growing population in the U.S. However, the community’s health needs remain underserved, with little existing research and data to accurately measure its social/economic and health status. The research that does exist shows many alarming disparities:

• Higher rates of uninsurance: Compared to whites, Asian Americans are 1.5 times and Native Hawaiian Pacific Islanders twice as likely to lack health insurance (Current Population Survey data from 2005 to 2007).
• AA&NHPIs have one of the nation’s lowest cancer screening rates, but have disproportionately higher rates of lung, liver, stomach, breast and cervical cancers.
• Nationally, 10% of AA&NHPIs are infected with Hepatitis B compared to 0.1% for whites. Hepatitis B infection is a primary cause for liver cancer.
• Cultural and language barriers routinely prevent AA&NHPIs from accessing prevention, education and treatment services.

The Asian & Pacific Islander American Health Forum announced today that eight community organizations from around the country have been selected to receive community grants totaling $4.8 million. The grants are part of an $16.5 million national community investment partnership called “Health Through Action for Asian Americans, Native Hawaiians, and Pacific Islanders.”

Launched in 2006, Health Through Action is a partnership between Asian & Pacific Islander American Health Forum and the W.K. Kellogg Foundation. The initiative marks the first time a private sector foundation has joined forces with a national Asian American, Native Hawaiian and Pacific Islander (AA&NHPI) organization to tackle health disparities in the AA&NHPI communities. Through the initiative, eight community organizations will each receive four-year grants of $600,000 to address urgent health and health care issues in their respective communities.
The eight organizations chosen to receive funding to lead their community collaboratives are:

• Asian Pacific Community in Action: With this grant, APCA intends to develop a system to track API health status, needs and utilization of health services. APCA will also develop and implement a cancer screening and prevention plan.
• Center for Pan Asian Community Services: Through this grant, the Center for Pan Asian Community Services will provide health assessments, and develop targeted health education and promotion programs with a primary focus on cancer.
• Asian American Health Coalition of Greater Houston, Inc.: The Coalition will use the funding to raise public awareness, push for policy changes, and mobilize the community. It will also work to implement culturally and linguistically appropriate cancer awareness, screening and intervention programs.
• Kokua Kalihi Valley Comprehensive Family Services: Through culturally and linguistically appropriate health services, the organization will increase access to preventative health care for AA&NHPI children and their families.
• Asian Services in Action:This statewide program will use its grant to continue to advocate for increased public awareness of Hepatitis B, with a focus on community education, screening, vaccination, treatment and research.
• Asian Health Services: AHS will use the grant to increase participation of the three least visible and most vulnerable sub-ethnic groups (Laotian, Cambodian, Mien) in collaboration with others in advocating for health policy and program services needs.
• Coalition for Asian American Children & Families: The collaborative will provide policy and advocacy training that will enable residents to educate decision makers about the need for improving health care access.

The REP would like to thank the Health Rights Hotline for directing our attention to this news release.
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Two Duke University studies just published in the Journal of the American Medical Association reveal that men are three times more likely to obtain an implantable cardioverter defribrillator than women, though heart disease is the leading cause of death for women. Black men fare poorly in this regard as well, receiving the device 25 percent less often than white men. The device can be implanted with minor surgery and is considered one of the most effective treatments available for those at risk of sudden cardiac arrest. “[Physicians] have stereotypes about minorities and about women. . .We all do. It doesn’t mean that physician are bad people. But physicians are the ones who have to write it down and have their judgments studied[,]” said Jay Kaufman about the studies, as quoted in the Raleigh News & Observer. Kaufman is an UNC-Chapel Hill epidemiologist unaffiliated with the studies. In one Duke study, researchers studied the records of 236,000 Medicare patients who appeared eligible for the defibrillator. The second study looked at 13,000 patients in 217 hospitals across the country. Both studies found significant underuse of the device overall.

Hot off the press - the Census Bureau just released the new Income, Poverty, and Health Insurance Coverage in the United States report.

The report documents disturbingly high rates of lack of health insurance amongst people of color: 10.8% of non-Hispanic Whites are uninsured; 20.5% if African Americans are uninsured; 15.5% of Asian Ameicans are uninsured; 34.1% if Hispanics and Latinos are uninsured.

Interestingly, in a press conference yesterday, the Bureau responded to comments made by other government departments, including the Executive Branch, that Bureau numbers on the incidence of uninsured persons were misleading and “bogus”. The Bureau stated that these statistics represent the “best estimate[s]” possible.

The Washington Post recently published an article, The Color of Health Care: Diagnosing Bias in Doctors, that discusses the prominent role racial bias plays in determining core quality of care issues.

The article highlights a recent study that proves that that implicit physician bias, measured by the IAT, is the root cause for certain disparities. This study is a first insofar as it settles the oft disputed issue of whether certain disparities in care are caused by implicit bias or how patients of color present to physicians.
The studies cite is: Green, A.R., Carney, D.R., Pallin, D.J., Ngo, L.H., Raymond, K.L., Iezzoni, L.I., Banaji, M.R. (2007). Implicit Bias among Physicians and its Prediction of Thrombolysis Decisions for Black and White Patients. Journal of Internal Medicine.

The REP would like to thank Jen Flory of the Western Center On Law And Poverty for bringing the article to our attention.

As if it’s not bad enough that race and gender correlate significantly with subpar health care. A new study recently published in the Journal of Epidemiology and Community Health found that those who felt they were regularly treated unfairly were 55 percent more likely to have a coronary event such as a heart attack or angina than their counterparts who did not experience injustice. The study, which tracked over 6,000 British civil servants (none of whom has any sign of coronary disease at the beginning of the study) over approximately 11 years, found that the subjects who reported even moderate levels of unfairness had a 36 percent higher risk of heart problems. The Los Angeles Times reports that “the study adds to a growing field of research linking cardiovascular and mental health to racial and gender discrimination” according to Harvard public health professor Nancy Krieger.

The Poverty & Race Research Action Council is up to some great things! Interested in their current housing projects? How about their work on minority health care disparities? And last but definitely not least, you can’t go wrong with PRRAC’s Education Research Guide.

A big “thank you” to Phil for being the first brave soul to share his work with us!