Symptoms of Posttraumatic Stress Disorder in a New Orleans Workforce Following Hurricane Katrina
On August 29, 2005, Hurricane Katrina made landfall resulting in catastrophic damage and flooding to New Orleans, LA, and the Gulf Coast, which may have had significant mental health effects on the population. To determine rates and predictors of symptoms consistent with a diagnosis of posttraumatic stress disorder (PTSD) in New Orleans residents following Hurricane Katrina, we conducted a web-based survey 6 months after Hurricane Katrina made landfall. Participants included 1,542 employees from
Our Lives Were Healthier Before: Focus Groups With African American, American Indian, Hispanic/Latin
Focus groups were conducted to explore health-related beliefs and experiences of African American, Hispanic/ Latino, American Indian, and Hmong people with diabetes and engage community members in improving diabetes care and education for these populations. Eighty participants attended 12 focus groups, 3 per population. Major themes were loss of health attributed to modern American lifestyles, lack of confidence in the medical system, and the importance of spirituality. Participants recommended
Developing a Community Health Promotion Agenda for a Managed Care Organization
Coordination and collaboration between organizations interested in promoting the health of the populations they serve can potentially help to ensure that key services are provided as well as augment the efforts beyond that which could be accomplished by each organization alone. Understanding the perspectives of each organization can facilitate development of health promotion initiatives that will be of mutual benefit. In Maryland, when a Medicaid managed care program was initiated, Memoranda of
Prostate Cancer Screening Decision Making Under Controversy: Implications for Health Promotion Pract
Prostate cancer is a major health problem for U.S. men and is characterized by paradoxes and controversies. Despite the wide availability of the prostate-specific antigen (PSA) test, prostate cancer screening remains a controversial practice mainly because the direct impact of screening on mortality is not yet proven. As the relative value of screening, early detection, and treatment strategies continue to be debated, glaring racial-ethnic disparities persist with African American men experienci
A National Study of Chronic Disease Prevalence and Access to Care in Uninsured U.S. Adults
Background: No recent national studies have assessed chronic illness prevalence or access to care among persons without insurance in the United States.
Objective: To compare reports of chronic conditions and access to care among U.S. adults, by self-reported insurance status.
Design: Population-based survey. Setting: National Health and Nutritional Examination Survey (1999–2004).
Participants: 12 486 patients age 18 to 64 years.
Measurements: Estimates of national rates of cardiovascular d
Ensuring Community-Level Research Protections
Community-Campus Partnerships for Health (CCPH) and the Tuskegee University National Center for Bioethics in Research and Health Care (the Bioethics Center) sponsored an Educational Conference Call Series on Institutional Review Boards (IRBs) and Ethical Issues in Research that took place between February 2007 and June 2007, which advanced their shared goal of meaningfully involving communities in decisions made about every aspect of research. The call series was intended to increase understandi
The Role of Community Advisory Boards: Involving Communities in the Informed Consent Process
Ethical research involving human subjects mandates that individual informed consent be obtained from research participants or from surrogates when participants are not able to consent for themselves.The existing requirements for informed consent assume that all study participants have personal autonomy; fully comprehend the purpose, risks, and benefits of the research; and volunteer for projects that disclose all relevant information. Yet contemporary examples of lapses in the individual informe
What Is Community? An Evidence-Based Definition for Participatory Public Health
Increased emphasis on community collaboration indicates the need for consensus regarding the definition of community within public health.This study examined whether members of diverse US communities described community in similar ways.
To identify strategies to support community collaboration in HIV vaccine trials, qualitative interviews were conducted with 25 African Americans in Durham, NC; 26 gay men in San Francisco, Calif; 25 injection drug users in Philadelphia, Pa; and 42 HIV vaccine res
Can Public Health Researchers and Agencies Reconcile the Push From Funding Bodies and the Pull From
Responding to growing impatience with the limited application of research findings to health practices and policies, both funding bodies and communities are demanding that research show greater sensitivity to communities’ perceptions, needs, and unique circumstances. One way to assure this is to employ participatory research—to engage communities at least in formulating research questions and interpreting and applying research findings and possibly also in selecting methods and analyzing dat
Study: Many wary of health system Care often seen as lacking by poor or nonwhite Arkansans
Many Arkansans who are black, Hispanic, Asian or poor whites distrust doctors and hospitals, according to a study presented Tuesday at the state Capitol.
After researchers talked to 148 people around Arkansas, study co-investigator Dr. Eduardo Ochoa said they found "a deep-seated suspicion of the health care
system."
Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-
Objectives. We examined the effects of self-reported experiences of racial discrimination on Black–White differences in preterm (less than 37 weeks gestation) and low-birthweight (less than 2500 g) deliveries.
Methods. Using logistic regression models, we analyzed data on 352 births among women enrolled in the Coronary Artery Risk Development in Young Adults Study.
Results. Among Black women, 50% of those with preterm deliveries and 61% of those with low-birthweight infants reported having
Experiences of Racism Among African American Parents and the Mental Health of Their Preschool-Aged C
Objectives. We examined the relationship between parents’ experiences of racism and children’s well-being and the influence of the residential neighborhood characteristics on this relationship.
Methods. African American families were recruited from Baltimore neighborhoods. Parental measures included racism experiences and coping. Neighborhood measures included demographic characteristics, social cohesion, and social climate. Children’s mental health was assessed with the Child Behavior Ch
Racial Differences in Cardiac Catheterization as a Function of Patients’ Beliefs
Objectives. We examined racial differences in cardiac catheterization rates and reviewed whether patients’ beliefs or other variables were associated with observed disparities.
Methods. We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible cardiac ischemia.
Results. There were few demographic differences between White and African American patients in our sample.
AMA Apologizes To Blacks For Past Racial Inequality
Transplant surgeon Clive Callender has hurtful memories of being the only black doctor at medical meetings in the 1970s, met with stark silence when he pleaded for better access to transplant organs for blacks.
So when the American Medical Association formally apologized Thursday for more than a century of policies that excluded blacks from a group long considered the voice of American doctors, it was belated, but still welcome.
Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits.
Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–Northern Virginia metropolitan area. Outcome
The Health Impact of Resolving Racial Disparities: An Analysis of US Mortality Data
The US health system spends far more on the “technology” of care (e.g., drugs, devices) than on achieving equity in its delivery. For 1991 to 2000, we contrasted the number of lives saved by medical advances with the number of deaths attributable to excess mortality among African Americans. Medical advances averted 176 633 deaths, but equalizing the mortality rates of Whites and African Americans would have averted 886202 deaths. Achieving equity may do more for health than perfecting the te
Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance
Little is known about the self-care practices of chronically ill African Americans or how lack of access to health care affects self-care. Results from a qualitative interview study of 167 African Americans who had one or more chronic illnesses found that self-care practices were culturally based, and the insured reported more extensive programs of self-care. Those who had some form of health insurance much more frequently reported the influence of physicians and health education programs in sel
Asleep at the Switch: Local Public Health and Chronic Disease
Local health departments generally do a good job of monitoring and controlling conditions that killed people in the United States 100 years ago. Yet noncommunicable diseases, which accounted for less than 20% of US deaths in 1900,1 now account for about 80% of deaths.2 Our local public health infrastructure has not kept pace with this transition. Health departments must continue to handle traditional public
health priorities as well as emerging infectious diseases. They must also increasingly ad
The Meaning of Translational Research and Why It Matters
Translational research means different things to different people, but it seems important to almost everyone. The National Institutes of Health (NIH) has made translational research a priority, forming centers of translational research at its institutes and launching the Clinical and Translational Science Award (CTSA) program in 2006. With 24 CTSA-funded academic centers already established, other universities are transforming themselves to compete for upcoming CTSA grants. By 2012, the NIH expe
Poverty and Elimination of Urban Health Disparities Challenge and Opportunity
The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.
