Studies Examine Health-Racism Link, Quality Reporting, Nutrition and Blacks, Managed Care’s Effect on Quality

• "Associations of Abdominal Fat With Perceived Racism and Passive Emotional Responses to Racism in African-American Women," American Journal of Public Health: Researchers conducted phone interviews with 447 black women to determine whether perceived racism increased their abdominal fat, which can raise the risk for chronic health conditions such as diabetes. Researchers found an association between daily stress and waist-to-hip ratio but their findings did "not support [their] hypothesis that passive emotional responses to perceived racism increase abdominal fat." More research on the stress physiology of perceived racism in black women is needed, according to the study (Vines, et al, AJPH First Look, 1/31).
  
  
• "Enhancing Public Hospitals' Reporting of Data on Racial and Ethnic Disparities in Care," Commonwealth Fund: Researchers analyzed quality-related data from five large public hospitals with large black and Hispanic populations to determine how the hospitals used the data to reduce racial and ethnic disparities. Hospitals reported quality data by race or ethnicity on acute myocardial infarction, heart failure and pneumonia using measures from the Hospital Quality Alliance. Researchers also interviewed senior hospital officials about their use of quality data and views on racial and ethnic health disparities and public data reporting. The hospitals generally exceeded national norms on most quality measures, and high performance was primarily consistent among all races and ethnicities, according to the report. However, the report also noted some disparities in patient communication. Researchers said that the "findings should be interpreted cautiously," and they recommended that hospitals adopt guidelines to collect quality data based on race and ethnicity and establish ways to address any disparities (Siegel et al., "Enhancing Public Hospitals' Reporting of Data on Racial and Ethnic Disparities in Care," January 2007).
  
  
• "Question Authority," National Medical Association HealthyLiving magazine: A study by lead researcher Howard Gordon of the Michael E. DeBakey VA Medical Center and colleagues concluded that blacks are less likely than whites to question their doctors or raise concern about the care they receive. NMA HealthyLiving magazine reports that patients might feel intimidated by complicated medical terminology, confused about medications or vulnerable. Jane Fort, an assistant professor at Meharry Medical College, said, "When we see the doctor, we are at one of our most sensitive times and are usually anxious. ... We know there are other patients waiting and often feel we will take up too much valuable time. We may not feel sure enough to speak up and ask for explanation." NMA HealthyLiving includes a list of questions that patients should ask their physicians, such as how and when to take medications (NMA release, 1/29).
  
  
• "Dairy Consumption and Related Nutrition Intake in African-Americans," Journal of the American Dietetic Association: Blacks of all age groups have lower average intakes of calcium, magnesium and phosphorus and consume fewer servings of dairy foods than do other races, according to a new report released by the National Dairy Council. Lead author Greg Miller, executive vice president of science and research at the council, and colleagues also found that blacks do not meet the 2005 Dietary Guidelines recommendation for three daily servings of low-fat or fat-free milk or other milk products. National Medical Association President Albert Morris said the report "further underscores the importance of African-Americans increasing intake of key nutrients found in dairy foods," adding, "Because of the benefits of dairy foods, it is important to educate patients who are sensitive to lactose to use simple strategies to make dairy easier to digest." A NMA report found that 24% of blacks believe they are unable to tolerate lactose (NDC release, 1/31).
  
  
• "Does Managed Health Care Reduce Health Care Disparities Between Minorities and Whites?," Journal of Health Economics: For the study, Ana Balsa of the Health Economics Research Group at University of Miami and colleagues used the Medicare Current Beneficiary Survey and the National Health Interview Survey to examine access, cost and use of Medicare managed care plans by minorities and whites to determine whether managed care affects beneficiaries' access to care. They found that minorities were at least equal to whites in terms of cost and benefits in Medicare managed care plans and that minorities benefit at least as much as whites by having the option of managed care. The effect of managed care on use of services is as positive for Hispanics as for whites. For blacks, managed care led to smaller gains and some losses in access compared with whites and Hispanics, though researchers noted that the differences were very small. In addition, the study found that minorities benefit more than whites from smaller out-of-pocket costs under managed care plans (Balsa et al., Journal of Health Economics, January 2007).
  
  
• "Key Facts: Race, Ethnicity and Medical Care, 2007 Update," Kaiser Family Foundation: The updated report contains demographic data on racial and ethnic minority populations for each state, as well as data from the National Healthcare Disparities Report examining changes in health care disparities over time. The report includes data on uninsured minority populations, access to care for racial and ethnic minorities, and information on conditions and diseases that disproportionately affect minorities (Kaiser Family Foundation, "Key Facts: Race, Ethnicity and Medical Care, 2007 Update," 2/1).