In November, the Utah Department of Health (UDOH) Office of Health Disparities Reduction (OHD) in partnership with the U.S. Department of Health & Human Services (HHS) collaborated to bring Affordable Care Act Patient Navigation Training to Utah. In this training participants learned about the Affordable Care Act (ACA) and what provisions are in place now that patients can take advantage of today. Participants navigated the new website where consumers can go to read the entire law, find out when key provisions become effective, the latest in funding opportunities and many other provisions encompassed by the ACA. The website also publishes local and state agencies, public and private companies that have been awarded federal grant dollars through ACA for early retirement provisions, funding to promote healthy communities, among other grant awards. Visit www.healthcare.gov to find out more.
For information contact Christine Espinel at cespinel@utah.gov.
Dieters may want to reconsider that mid-morning snack.
In a 12-month study of 123 overweight or obese women, those who snacked between breakfast and lunch lost less weight than those who skipped a mid-morning nosh. The mid-morning snackers lost about 7 percent of their total body weight, but those who didn't snack mid-morning lost 11.5 percent, according to the report.
The finding may not relate to time of day as much as the short interval between breakfast and lunch for these snackers, explained study author Dr. Anne McTiernan, director of the Prevention Center at the Fred Hutchinson Cancer Research Center's Public Health Sciences Division.
The women may have been eating out of boredom, or for reasons other than hunger, she said. The net result is too many calories in a day.
"Snacking, per se, isn't bad, it's more what you eat and when you are snacking," she said. "If you start snacking in the morning, you might be eating more throughout the day and taking more food in."
Smart snacking can be part of a sound weight-loss plan, McTiernan noted. The timing of snacks, frequency of eating them and quality of snacks all have to be considered, she added.
The study is published in the December issue of the Journal of the American Dietetic Association. The U.S. National Cancer Institute and U.S. National Institutes of Health funded the research.
Medicare announced Tuesday it will pay for screenings and preventive services to help recipients curb obesity and the medical ailments associated with it, primarily heart disease, strokes and diabetes.
"Obesity is a challenge faced by Americans of all ages, and prevention is crucial for the management and elimination of obesity in our country," Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, said in a news release. "It's important for Medicare patients to enjoy access to appropriate screening and preventive services."
According to the STOP Obesity Alliance, the overall costs of being overweight over a five-year period are $24,395 for an obese woman and $13,230 for an obese man. Thirty-four percent of U.S. adults are obese, according to the alliance, which expects that percentage to rise to 50% by 2030.
"As small of a weight loss as 5% to 7% can lead to a huge health improvement," said Christy Ferguson, director of the STOP Obesity Alliance, which sent recommendations to Health and Human Services Secretary Kathleen Sebelius in September.
The new Medicare benefits will include face-to-face counseling every week for one month, then one counseling appointment every other week for the following five months for people who screen positive for obesity.
Here is an excerpt from a recent report by the Insitute for Social Policy and Understanding: Meeting the Healthcare Needs of American Muslims. The full report can be accessed from our website at http://health.utah.gov/disparities/culture.html#cultures
...our participants noted that these accommodations could be provided rather easily and required some flexibility and strategic planning, “Why don’t we go the extra mile with...Muslims? ...Their needs are very tiny...What’s the big deal...” In addition, the results of doing so will lead to improved healthcare experiences for both parties. These patient perspectives suggest the need for health systems to utilize cultural competency initiatives and train staff in order to improve interpersonal interactions, thereby enhancing cultural sensitivity and contributing to positive changes in the overall health system culture.
Gender-Concordant Care
Participants requested gender-concordant care based upon Islamic conceptions of modesty and privacy.38 Some of them further described how the lack of female personnel may play a role in delaying or avoiding healthcare services, “Yeah. I would not even walk into a clinic that I didn’t have a choice of the gender.” Gender-concordant care was also discussed in relation to helping patients maintain a secure and private space, such as a hospital room, as well as protecting the body’s personal space. In the event that such care was unavailable, participants made some further recommendations, such as more modest hospitals gowns and signs on the doors that requested providers to knock and wait for permission to enter.
Halal Food
The provision of halal (Islamically slaughtered) food was also identified as an important healthcare accommodation. Some patients requested it for health reasons, and many identified food in general as a priority area in which healthcare providers could take the initiative. One participant stated, “I would also think that (the) hospital needs to take the initiative to ask every patient, do you have any dietary restrictions or even preferences. Because some people again, not being a very good advocate for themselves aren’t going to ask and they’re just going to assume…that they get what they get.” This quote speaks to a common theme in our focus groups: patients feel that they are outsiders and thus experience a further degree of stigmatization when asking for or explaining their need for certain accommodations.
Prayer Space
Participants identified prayer space as an important healthcare accommodation due to prayer’s role in healing and as a ritual five-time daily obligation. Participants described the challenges they had faced and suggested that a religiously neutral space would be welcomed. Some hospitalized participants mentioned being interrupted while praying and experiencing discomfort. One participant told of her effort to find a suitable place, “I had knee surgery so couldn’t go anywhere, and I was very worried about that...my husband was with me and put me in a wheelchair and wheeled me to the bathroom, I (supplicated) and I came back and prayed.” Another participant described an uncomfortable experience, “So we were praying but…nurses and…security had come and asked if everything was ok…Doctors were you know, hesitant to come back in the room and…everybody came by after that and kind of looked in the door….we just praying how we pray.”
The National Committee for Quality Assurance (NCQA) has developed the Multicultural Health Care (MHC) Distinction Program. MHC Distinction is a voluntary program that aligns with NCQA’s Accreditation standards for insurers and other health care organizations. Organizations can earn MHC Distinction by meeting rigorous and practical requirements for assessing and improving efforts to meet individuals’ cultural and linguistic needs.
Roadmap for Meeting Standards & Addressing Disparities: NCQA’s MHC standards and guidelines show how to meet, and even exceed, federal Office of Minority Health (OMH) culturally and linguistically appropriate services (CLAS) standards. Not only can NCQA help organizations comply with state OMH CLAS requirements, federal, state and other payers could deem organizations with NCQA MHC Distinction as satisfying OMH CLAS standards. MHC Distinction also helps establish benchmarks for tracking improvement and measuring what works in meeting CLAS standards and reducing disparities in health care. Each of the program expectations is in a set of standards. NCQA awards points towards the MHC Distinction based on how closely an organization’s activities meet the standards.
Through initiatives that help earn MHC Distinction “we can drill down by race, ethnicity, language—even zip code on disparities we want to improve,“ says Mary K Stom, MD, chief medical officer and senior vice president of healthcare management, Health Partners of Philadelphia, the first to receive NCQA’s MHC Distinction. “By looking at data in ways we didn’t before, we see what we were doing well and can apply that to new activities.” This helped identify, for example, cultural barriers inhibiting good perinatal care in inner city African American neighborhoods. “We learned that women in these communities trust relatives and neighbors more than our nurses and education. So now we’re educating entire neighborhoods, not just pregnant women on that block.”
MHC Distinction builds on NCQA’s work with Lilly to develop the Multicultural Health Care: A Quality Improvement Guide, now interactive online at http://www.clashealth.org/.
A brief report by the Utah Department of Health (UDOH), Office of Health Disparities Reduction, included in the November Utah Health Status Update, finds that many obese, Utah Pacific Islanders are not aware that they are obese.
The UDOH, Office of Health Disparities Reduction recently surveyed 605 Utah adult Pacific Islanders and found that 63.6% (58.9-68.0) were obese, which is defined as a body mass index (BMI) over 30. The statewide obesity rate was 23.1% (21.9-24.3; 2010 BRFSS).
However, some studies have suggested that Pacific Islanders can be healthy at a larger BMI than can be tolerated by people of European descent (1). Researchers in New Zealand have developed a BMI scale specifically for people of Pacific Island descent (2). Using this scale, about half of Utah Pacific Islander adults (50.9%, 46.2-55.6) are still identified as obese.
Many overweight Pacific Islanders were not aware that they were overweight. Although only 15.1% of PIs were at healthy weight or low weight BMIs according to the PI-specific scale, 33.1% perceived their weight as healthy or underweight.
1. See http://apjcn.nhri.org.tw/server/apjcn/volume18/vol18.3/finished/13_1503_404-411.pdf and https://researchspace.auckland.ac.nz/bitstream/handle/2292/4675/15608799.pdf?sequence=1
2. According to the New Zealand Pacific Islander scale, overweight is a BMI higher than 26, instead of 25, and obese is a BMI higher than 32, instead of 30. See http://www.everybody.co.nz/tool-06fb03f0-0ebf-4c02-8551-c1db35f6fb7b.aspx
The Utah Department of Health (UDOH), Office of Health Disparities Reduction (OHD) has created new health education videos featuring diverse Utah communities titled For Me, For Us. The videos are available in English, Spanish, Samoan, and Tongan and address access to health care, infant mortality, and obesity. Different versions are designed for Utah’s African American, Hispanic/Latino and Pacific Islander communities and feature local Utahns from these racial/ethnic groups.
Utah minority groups face unique health challenges. African American and Pacific Islander babies are significantly more likely to die before their first birthday than infants statewide. Hispanics are less likely to have access to needed medical care than any other Utah racial/ethnic group. All three of these groups have higher obesity rates than the statewide population. The new DVDs address these issues in a culturally and linguistically appropriate manner.
“This is part of the Department’s commitment to helping Utahns become the healthiest people in the nation, by eliminating health disparities and achieving health equity for all our citizens,” said Marc E. Babitz, MD, Director, UDOH Division of Family Health and Preparedness.
Utah community members who screened the videos had rave reviews. Jacob Fitisemanu, an OHD Advisory Board member, shared the video with his family.
“Some of them were really touched, wiping a tear once or twice during the video, because they thought it really spoke to their heart in a way that a doctor or school presenter had never been able to reach them before,” he reported. “I didn't expect that emotional response, but it resonated so well to see people like them speaking in their language and they were very impressed.”
“My family loved it,” said Joyce Ah You of the Queen Center. “My daughters were so impressed with the way the messages were conveyed. The filmmaker did an outstanding job speaking to the Pacific Islander community. What a wonderful project,” she added.
The videos include tips like preparing lower-far, higher-fiber meals, taking care of your body during pregnancy, and pregnancy spacing. They also remind viewers that everyone should get an annual checkup, even if they're feeling healthy, because many common diseases often have no symptoms. They will be distributed to health care and community- based organizations to show in their waiting rooms or at community events. Copies will also be sent to churches and posted on YouTube.
The videos were recorded in Salt Lake, Summit, and Weber counties in partnership with local community-based organizations: the People's Health Clinic, Project Success and the Queen Center. The videos were produced by Williams Visual Digital Films and Imaging.
Linguistica International the largest interpreting and translation agency in the state is currently looking for interpreters and translators to help our non-English speaking community communicate with their medical providers and social service case managers.
Being an interpreter for Linguistica International is perfect for students that need a flexible schedule, return missionaries that are interested in continuing to use their language skills, and refugees interested in gaining professional experience.
We are currently looking for interpreters to work nights, weekends, and holidays
All of our interpreters are independent contractors and are called on an as needed basis.
We are looking for interpreters to cover the following locations: Salt Lake Valley, Ogden, Park City and Heber.
All of our interpreters receive extensive training in standards and protocols of healthcare and social service interpreting as well as interpreting code of ethics.
We are looking for interpreters in the following languages:
Burmese
COMPANY SCOPE: The Robert Wood Johnson Foundation, a nationally recognized philanthropic organization specializing in the health care needs of all Americans, is currently seeking a program officer to work in Research and Evaluation (R&E) with the Childhood Obesity Team. The Foundation, with $9 billion in current assets, has existed as a national foundation since 1972 and is dedicated to improving the health and health care of all Americans through grant making, communications efforts, the design and implementation of initiatives, and the dissemination of knowledge. The R&E strategy is to provide better information for better decisions by highlighting lessons learned from our investments and by providing a useful knowledge base designed to assist the efforts of colleagues in the health and health care fields.
JOB SCOPE: The Foundation currently seeks a program officer to work with the Childhood Obesity team whose goal is to reverse the childhood obesity epidemic by 2015 by improving access to affordable healthy foods and increasing opportunities for physical activity in schools and communities across the nation.
Program officers in the Research and Evaluation (R&E) Unit are professional staff responsible for creating, developing, implementing and managing the research and evaluation aspects of the Foundation’s initiatives to improve health and health care. Their primary responsibility is to work with team directors, team members and executive staff to design and implement research and evaluation strategies that generate impact congruent with the specific objectives of the teams and the Foundation. They are also responsible for the development and management of performance measurement systems, and the maintenance of the publications and research portion of the RWJF website to disseminate findings from research, evaluation and policy investments.
This position is a three-year renewable term appointment.
MINIMUM REQUIREMENTS: Qualifications include completion of Ph.D. or experience equivalent to a Ph.D. degree in public health, public policy, economics, psychology or related fields or experience equivalent to an advanced degree and three (3) or more years of relevant experience. A combination of education and experience may be substituted for the education requirements. Successful candidates must have experience and leadership potential in childhood obesity and in developing innovative, break through programs in health and health care. Interest in policy analysis with experience in state and local policy is desirable.
HOW TO APPLY: Click here for more information about this position. Click here to submit your resume and letter of interest.
Overall, disparities remained unchanged for about 80% of the objectives, according to the report.
For example, minority and low-income groups continue to be less likely to have a regular source of medical care. Cigarette smoking also remains more common among the poor and those with less education compared with college graduates who have higher incomes.
Health disparities worsened in 13% of the objectives. Deaths due to coronary heart disease is one area where disparities increased for minorities and people with no more than a high school degree.
Also concerning to public health experts is that little progress was made meeting nutrition and weight targets.
The amount of obese adults 20 and older climbed from 23% between 1988 and 1994 to 34% between 2005 and 2008. During that period, obesity among children 6 to 11 increased from 11% to 17%.
A high community uninsurance rate may affect access to and quality of care by restricting provision of unprofitable services, shortening hours, and providing lower quality of care to all patients, whether insured or uninsured.
This article explores the indirect, or spillover, health care effects on people who are currently insured, specifically privately insured working-age adults (18 to 64) and Medicare enrollees (65 and older), when the community uninsurance rate is high.
Using data from the 1996 through 2006 Medical Expenditure Panel Survey (MEPS) Household Component, the study considers whether a person has a usual source of care, the use of office visits, and the satisfaction with usual provider and overall health care. Data from 200 metropolitan areas in the United States over the preceding 12 months were used to analyze two samples totaling 86,928 insured adults.
Key Findings:
Working-age adults with private insurance residing in areas with a high rate of uninsurance were less likely than their peer in areas with a low rate of uninsurance to have a usual source of care, an office-based visit, and any medical care expenditures.
Seniors with Medicare coverage were more likely than their counterparts to report difficulty getting the care and prescription drugs needed.
The authors note that across a wide range of measures, an adverse effect of high community uninsurance is access to and satisfaction with health care for those who are insured.
The Utah Department of Health (UDOH) invites public input as the State embarks on another effort to transform Medicaid.If approved by the federal government, the new pilot program will require a select group of fewer than 100 Medicaid enrollees to give service to the community in exchange for their health program benefit.
Medicaid is committed to a public process in the development and implementation of the proposed initiative.Members of the public are invited to come to the following meetings to provide their input:
Informal Public Work Group
Thursday, Nov. 10, 3:30 - 5:00 p.m.
Cannon Health Building (288 North 1460 West, Salt Lake City), Room 128
Formal Public Hearing
Thursday, Nov. 17, 3:30 - 5:00 p.m.
Cannon Health Building (288 North 1460 West, Salt Lake City), Room 125
House Bill 211 (2011), sponsored by Rep. Ronda Menlove, directed UDOH to develop this pilot program and submit a waiver amendment to the Centers for Medicare and Medicaid Services (CMS).If approved, the amendment will allow the State to modify enrollment rules for the Primary Care Network (PCN), which will create a new eligibility group for the pilot participants.Applications will be accepted only during open enrollment periods and approved applicants will receive the same medical benefits afforded to other PCN clients.
Medicaid officials believe the service donation will help build a sense of contribution to the program and enhance the client’s experience. The waiver application will be available for review and comment on November 15, 2011 at http://health.utah.gov/medicaid/HB211proposal.htm.
In addition to providing comment during the public hearings, written comments will also be accepted through December 2, 2011.Comments may be submitted to the Utah Department of Health, Division of Medicaid and Health Financing, PO Box 143102, Salt Lake City, UT 84114-3102 or to cdevashrayee@utah.gov
On November 13, the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) will launch a national campaign, Toma las rienda (Take the Reins), in an effort to encourage Hispanics to take control of their health, explore treatment options, and work with their health care team to make the best possible treatment decisions. Central to this effort is providing consumers and clinicians information about treatment options for numerous medical conditions including diabetes, heart disease, cancer, depression and more.
This campaign will promote AHRQ’s Effective Health Care (EHC) Program Spanish-language guides and other resources that inform patients about the various treatment options available for their condition. EHC Program resources also guide patients on how to work with their clinician to select the best treatment option for their situation. All of the resources are evidence-based, unbiased, free and relevant to all generations.
The campaign will kick-off at Telemundo’s Feria de la Familia at the Armory in Washington, D.C. During a pledge ceremony, leadership from AHRQ will be joined by representatives from several partnering advocacy and clinician organizations committed to supporting this effort to improve health outcomes of the Hispanic community. To date committed partners include: the Latino Student Medial Association, National Association of Hispanic elderly, the District of Columbia Office of Latino Affairs, and the National Center for Farmworkers Health.
The campaign will also be made accessible through the AHRQ Spanish-language Facebook page www.facebook.com/AHRQehc.espanol, where individuals and organizations can “Like” the page, electronically sign the pledge, watch related health care videos, listen to audio podcasts, exchange ideas with others, and participate in an online chat with health experts.
Please let me know if you have questions or if you'd like to sign the pledge.
If you would like to submit a proposal for the Prevention of Violence and Trauma of Women and Girls funding opportunity, please complete the Request for Proposals (RFP) and e-mail to John Snow, Inc. (JSI) at owhapplication@jsi.com by December 7, 2011 at 5:00 p.m. Mountain Time.
Please note, proposals will be not be accepted by the Office on Women’s Health.
For a copy and help with this RFP, please e-mail: owhapplication@jsi.com or call toll-free: 1-866-224-3815.
