Utah Department of Health Office of Health Disparities
The Connection: News about overcoming health disparities in Utah

Wednesday, December 28, 2011

SelectHealth Now Accepting Applications for the 2012 Select 25 Award!

Select25 Award Honors Those Making a Difference!

This award recognizes twenty-five organizations or causes that promote healthy living or serve special populations in Utah.  Each winner will receive $2,500.  Only the first 500 applications will be considered so don't wait!

To learn more, visit www.select25.org

The deadline for applications is February 10, midnight.

New Research Briefs Examine Obesity Epidemic Among Latino Youths

Salud America!, an RWJF national program, has released a comprehensive collection of research briefs examining the obesity epidemic among Latino children and teens.


Three of the new briefs review current evidence with respect to Latino youth in three major areas: the availability of healthy, affordable foods; opportunities for physical activity; and the impact of food marketing on diets and obesity rates. These briefs also provide several policy recommendations.

Tuesday, December 20, 2011

Winter Holidays are Peak Time for Heart Attacks

It's the grimmest of holiday statistics: Heart-attack deaths peak on three days of the year, and one of them is Christmas. The other two are the day after Christmas and New Year's Day.EnlargeClose
Talk about your lump of coal.
And it gets worse. The holiday peak is just part of a larger, well-established pattern: More people die of heart attacks in winter than at any other time of year. In other words: It's truly the season to know your risks — and reduce them, if you can. But first, it may help to ponder why these days are so deadly.
The seasonal link
In the USA, cardiac deaths peak in December and January, says Robert Kloner, a cardiologist at Good Samaritan Hospital in Los Angeles. In Australia, he says, they peak in July — winter there.
So there's something about winter. But what?
"Nobody knows," says David Phillips, a sociologist at the University of California-San Diego who studies death patterns. Flu and pneumonia, which are tough on people with heart disease, clearly play roles in the high rate of all natural deaths in the winter, he says.
Shorter, darker days might matter, too, says Kloner, who has studied the winter link. Cold alone, he says, can make blood vessels constrict, blood pressure rise and the heart work harder. It also might trigger changes in the blood that produce clotting and inflammation.
And what about snow shoveling? In many areas, it might be a factor. One recent study found that 7% of winter heart-attack victims in one Canadian hospital had been shoveling snow.
Then there's Christmas. David John, an emergency-room physician for 20 years, can't say that he's noticed the holiday death surge, which was first documented in a 30-year study led by Phillips and published in 2004. But one explanation rings true to him: People feeling sick around Christmas or New Year's may put off getting help — and end up dead.
A final suspect: Holiday stress
"People are in denial," says John, who works at Johnson Memorial Medical Center in Stafford Springs, Conn. "They don't want to spoil Christmas dinner by going to the hospital." They also might forget to take medications and may be away from their usual doctors and pharmacies, he notes.
Kloner says: "The stress. Facing relatives, buying gifts, trying to find a parking space in a busy mall."
And now add one more stressor: Worrying about having a holiday heart attack.
But worrying won't help. Taking these steps throughout the winter just might:
Keep taking your medicines and showing up for medical appointments if you have heart disease or risk factors such as high blood pressure or high cholesterol.
Get a flu shot, if you haven't already.
Keep warm. If it's freezing where you are, wear layers of clothes and a hat and cover your mouth with a scarf when you step outside.
Know your strength. If you are not fit or have heart disease, leave the heavy snow-shoveling to others.
Keep up other good habits, such as exercising, eating well and not smoking.
Never ignore the warning signs of a heart attack — even if it's Christmas Day.
Heart attack warning signs
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes or goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath, with or without chest discomfort.
Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
Source: American Heart Association

Thursday, December 15, 2011

Lots of Improvements at the OHD Website

The About Us, Data & Reports, and Health Care pages at the OHD website have all been updated and organized during the past several weeks.  Check out some of our new features:
  • About Us, Data & Reports and Health Care all have relevant news feeds.
  • The About Us page has updated information about our office, a glossary of health disparities-related terms and the newsletter of the federal Office of Minority Health.
  • The Data & Reports page has new sections, including health rankings, interactive maps, demographic factsheets and databases.
  • The Health Care page has added links to valuable resources and directories to help people find providers in their area that speak their language and make informed health care decisions.

Wednesday, December 14, 2011

First-ever Utah Study Uncovers Pacific Islander Health Disparities

Report details worrisome diabetes, obesity rates

The Utah Department of Health (UDOH) recently completed its first statewide health survey conducted in three languages, interviewing 605 adult Utah Pacific Islanders in English, Tongan, and Samoan. This is likely the first study of its kind addressing mainland Pacific Islanders in the United States.

The UDOH Office of Health Disparities Reduction (OHD) initiated the study because Utah death certificates indicate Pacific Islanders had unusually high rates of infant mortality and diabetes-related death.  

"We wanted to know more about their risk factors, but our usual statewide surveys didn't reach enough Pacific Islanders to give us the information we needed," explained April Young Bennett, OHD, UDOH.

The survey found higher rates of diabetes (13.7%, or 1 in 7), obesity (50.9%), and high blood pressure (25.2%) among Utah Pacific Islanders than previously estimated. The Utah Pacific Islander rates for these conditions exceeded the statewide prevalence rates: 6.5% for diabetes, 24.8% for obesity and 23.1% for high blood pressure.

"We may have underestimated in the past because we never interviewed Samoan and Tongan speakers before," Bennett suggested.  Pacific Islanders interviewed in Tongan or Samoan had higher rates of these conditions than Pacific Islanders interviewed in English.

Health officials are particularly concerned about the obesity rate among Utah Pacific Islanders.  Obesity increases the risk for diabetes and obese women are less likely to have healthy pregnancies.

"Some research does suggest that Pacific Islanders can be healthy at a slightly larger size than Caucasians," said Bennett.  "We took that into consideration and used a special Body Mass Index scale designed for the unique Pacific Islander body type.  We still found that about half of Utah Pacific Islander adults were obese."

Utah Pacific Islanders were involved in all stages of survey implementation: building the questionnaire, pilot-testing, translation, survey promotion, and interviewing respondents.

"I commend the investigators on welcoming the involvement and feedback of Pacific Islander community leaders, consultants, and data collectors throughout the development of this study," said Jacob Fitisemanu, a member of the Healthcare Access for Minorities Advisory Board who participated in the study design.

"It is important to tailor qualitative and quantitative public health assessments to address the needs of culturally diverse groups," added Dulce Díez, Manager, OHD, UDOH.

Community members also helped OHD create new health videos designed for Utah Pacific Islanders in English, Tongan, and Samoan. OHD is distributing the videos to community-based organizations, churches, health care organizations, and individuals to promote obesity prevention, healthy pregnancies, and preventive health care.  (Versions are available for African Americans and Hispanics as well.)

The videos are available at http://www.health.utah.gov/disparities/community/ForMeForUs.html. 

The report can be found at http://health.utah.gov/disparities/data/PacificIslanderReport2011.pdf.  

April Young Bennett, MPA | Utah Department of Health Office of Health Disparities Reduction
Phone: 801-703-0127 Email: aybennett@utah.gov

Utah Pacific Islanders and Diabetes

The Utah Department of Health, Office of Health Disparities Reduction coordinated a survey of adult Utah Pacific Islanders (PIs) in 2011. Of adult PIs surveyed, 13.7% (11.2%–16.6%) reported that they had diabetes. When adjusted for age, the Utah PI adult diabetes rate approximately tripled the statewide rate. The high obesity rate among Utah Pacific Islanders likely contributes to the high diabetes rate.

The Utah adult PI diabetes rate estimated through the Utah Pacific Islander Survey is higher than the Utah adult PI diabetes rate obtained through the Behavioral Risk Factor Surveillance System, 2005–2010 (BRFSS). The Utah BRFSS may underestimate PI disease rates because it is not conducted in Samoan and Tongan. Utah Pacific Islanders interviewed in Tongan were particularly likely to have diabetes.
 
See the original report at: http://health.utah.gov/opha/publications/hsu/1112_HlthSummit.pdf

Survey of Physicians Highlights Overlooked Connection Between Social Needs and Health

Physicians Believe Addressing Patients' Social Needs Is As Important As Addressing Their Medical Conditions.

Medical care alone cannot help people achieve and maintain good health if they do not have enough to eat, live in substandard housing or lack access to reliable transportation. A new survey of 1,000 primary care providers and pediatricians conducted by Harris Interactive on behalf of the Robert Wood Johnson Foundation (RWJF) indicates physicians believe these unmet social needs are leading directly to worse health for Americans.

Unfortunately, the poll also reveals physicians do not feel confident in their capacity to address their patients’ social needs and wish the health care system would pay for the costs associated with connecting their patients to the services in their communities that can help them take steps to improve their health.

“Housing, employment, income and education are key factors that shape our health, especially for the most vulnerable among us,” said Jane Lowe, team director for RWJF’s Vulnerable Populations portfolio. “Physicians are sending a clear message: The health care system cannot continue to overlook social needs if we want to improve health in this country.”

While promising models exist that address social needs, more can be done. Leadership and commitment from health care providers, insurers and government leaders will be required to create system-wide and lasting change.

Read more results from this national survey of physicians and share your responses to the results.

CDC: Health reform extends coverage to young Americans

About 2.5 million young people have received health insurance coverage as a result of health care reform measures that President Barack Obama signed into law last year, the Centers for Disease Control and Prevention reported Wednesday.

About 2.5 million more people, aged 19 to 25, have health insurance than had it before the law took effect because of a provision that lets young adults remain on their parents' insurance plans through age 26, the agency's National Center for Health Statistics said.

"Moms and dads around the country can breathe a little easier knowing their children are covered," Health and Human Services Secretary Kathleen Sebelius said in a statement.

Young adults have traditionally been the age group least likely to have health insurance, the Department of Health and Human Services said.

The policy extending dependent coverage up to age 26 took effect for plan renewals beginning in September 2010.

The new estimates show that by the following June, the percentage of insured young people in that age group rose from 64% to 73%, Health and Human Services said. Based on census figures, that percentage change equates to about 2.5 million young people, the agency said.

Tuesday, December 13, 2011

State Unveils New Numbers on Hospital Care in Utah

Online report now at consumers' fingertips
(Salt Lake City, UT) – The expanded online Utah Hospital Comparison Report, released today by the Utah Department of Health (UDOH), brings together information from different sources about hospital care in Utah.

In addition to measures of in-hospital deaths, average charges, and patient safety, the report shows maps of county rates for avoidable hospitalizations, readmission rates, hospitals' adherence to guidelines for recommended care, and patient satisfaction.

The report shows Utah hospitals are doing better overall than the rest of the nation in measures including injuries to newborns, women giving birth, and in-hospital deaths among patients with heart failure, pneumonia, and stroke. However, there are differences among hospitals.

Patients and their family members can use the information to discuss their best health care options with providers. Health care professionals, policy makers, and legislators can use the findings to inform discussions about ways to increase the quality and safety of health care while lowering costs.

To view this resource, visit http://health.utah.gov/myhealthcare

Affordable Care Act in Your State: Utah

The Affordable Care Act is being implemented with partners across the country and, since the enactment of the Affordable Care Act, the Department of Health and Human Services has awarded $12.8 million in new grant funding in Utah.

Specifically, the Affordable Care Act is already helping the people of Utah by:

Providing New Benefits and Lowering Costs for Medicare Beneficiaries 
Nearly all of the 290,000 Medicare beneficiaries in Utah can now receive certain preventive services – like mammograms and colonoscopies – as well as an annual wellness visit with their doctor without paying coinsurance or deductibles. In fact, 4,476 residents of Utah have already received an annual wellness visit this year.  In addition, more than 22,353 Utah residents who hit the Medicare prescription drug coverage gap known as the “donut hole” received $250 tax-free rebates in 2010.  This year, seniors are receiving a 50% discount on covered brand name prescription drugs in the donut hole, and by 2020 the donut hole will be closed.

Bringing Insurance Reforms to Utah Residents
People across Utah are benefiting from key insurance reforms that went into effect in 2010:
  • 1.9 million residents with private insurance are free from worrying about lifetime limits on coverage.
  • The 216,000 residents of Utah who buy coverage on the individual market can now trust that their coverage will not be rescinded due to a mistake on an application.
  • Because of the Affordable Care Act, most young adults can stay on their parents’ plan until their 26th birthday.  An estimated 10,500 young adults in Utah will gain coverage this year because of this provision.
  • Insurance companies are prohibited from denying coverage to the 206,000 children in Utah with pre-existing conditions.
$1 Million to Scrutinize Unreasonable Rate Increases 
New rules require insurers to publicly justify unreasonable premium rate increases, and strengthen States’ abilities to crack down on rate hikes. Utah is receiving $1 million to crack down on unreasonable insurance rate increases.
Supporting Utah’s Work on Affordable Insurance Exchanges with $1 Million in Planning Grants
These grants will give States the resources they need to conduct the research and planning necessary to build a better health insurance marketplace and determine how their Exchanges will be operated and governed. Learn how the funds are being used in Utah here.
Lowering Early Retiree Coverage Costs 
48 employers in Utah have enrolled in the Early Retiree Reinsurance Program, and Utah employers have already received $6.9 million in reimbursement. The Early Retiree Reinsurance Program provides much-needed financial relief to businesses, schools and other educational institutions, unions, State and local governments, and non-profits, in order to help retirees and their families continue to have quality, affordable health coverage.  Find a list of organizations accepted into this program here.
Preventing Illness and Promoting Health
In 2010, Utah received $3.4 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. This new fund was created to prevent illness and promote health, so that all Americans can lead longer, more productive lives.
  •  $670,000 for community and clinical prevention activities, which will help Utah and its partners prevent and manage costly conditions.
  • $550,000 to support public health infrastructure.  These grants strengthen State and local capacity to meet 21st century public health challenges.
  • $2.1 million invested in primary care training, which will expand and support Utah’s health workforce.
In 2011, the Prevention and Public Health Fund has already provided $1.6 million to Utah to support the critical work of State and local health departments.
$3.6 Million Investment in Community Health Centers
The Affordable Care Act has invested $3.6 million in new and existing community health centers in Utah. Currently there are more than 1,100 health centers operating over 8,100 service delivery sites across the country. 
$12.7 Million in Therapeutic Discovery Project Program Tax Credits and Grants
This program was created by the Affordable Care Act to support groundbreaking biomedical research to produce new therapies, address unmet medical needs, reduce the long-term growth of health care costs and advance the goal of curing cancer within the next 30 years.  In Utah, this program will support projects that show significant potential to produce new and cost-saving therapies, support good jobs, and increase U.S. competitiveness.  This program is operated by the Department of the Treasury, and a full list of small businesses participating in this program is available here.
Other Grants Awarded in Utah:
  • $1.6 million for Maternal, Infant, and Early Childhood Home Visiting Programs.  These programs bring health professionals to meet with at-risk families in their homes and connect families to the kinds of help that can make a real difference in a child’s health, development, and ability to learn - such as health care, developmental services for children, early education, parenting skills, child abuse prevention, and nutrition.
  • $60,000 to support outreach to eligible Medicare beneficiaries about their benefits.
  • $530,000 for the Personal Responsibility Education Program, which will educate young adults on the prevention of pregnancy and sexually transmitted infections.
  • $95,700 for Family-to-Family Health Information Centers, organizations run by and for families with children with special health care needs.
For more information, go to healthcare.gov

Monday, December 12, 2011

Uninsured Parents Urged to Apply for PCN

Primary Care Network opening enrollment Dec 10th

What: Utah’s Primary Care Network (PCN) will open enrollment for parents Saturday, December 10 through Friday, December 23. PCN is a primary preventive health coverage plan for uninsured adults. Benefits include physician services, prescriptions, dental services, eye exams, emergency room visits, birth control, and general preventive services.

Why:  Since November 2010, PCN has been closed for enrollment and has not accepted new applications. Beginning Saturday, December 10 through Friday, December 23, Utah parents may apply online, by mail, or in person to receive primary health care.

Who:  Parents who meet the following requirements may apply:
- Age 19 through 64
- Have dependent child(ren) under age 19 living at home
- U.S. citizens or legal residents
- Not covered by other health insurance
- Meet income guidelines (e.g., a family of 4 with a maximum  income of $33,525 per year)
- Not qualified for Medicaid
- Have no access to student health insurance, Medicare, or Veterans benefits

When: Friday, December 10 through Friday, December 23 at 5:00 p.m.

Where:  Apply online at www.health.utah.gov/pcn  or call the PCN hotline at 1-888-222-2542.

Job Opening: Developmental Screening Coordinator

The Bureau of Child Development in the Utah Department of Health has an opening for our full-time Developmental Screening Coordinator.  If you are interested or know anyone who may be interested, the job posting can be found at:
This opening closes on December 18th.

Thursday, December 8, 2011

CDC Data to Action

The Centers for Disease Control and Prevention have added new features to their website that allow you to compare data across states.  These tools have been added to the OHD website at http://health.utah.gov/disparities/data.html#otherutah

Sortable Stats

See how Utah compares to other states in several health indicators. Click on a health indicator at the top of the screen to view states in order of rank at that measure.
http://wwwn.cdc.gov/sortablestats/
Policy Implementation Analyses
Compare state laws affecting health.
http://www.cdc.gov/program/data/policyanalyses/index.htm

Tuesday, December 6, 2011

Americans urged to put flu shots on holiday to-do lists

This year's flu season is off to a mild start, but confirmed cases have been seen in 30 states so far — and January and Feburary are often the peak.

Which is why health officials on Monday urged Americans to get their flu shots or flu nasal sprays now, so "you're protected before the holiday season begins, when you get on that plane, train or bus to go see loved ones," says Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases.

A total of 36.3% of Americans older than 6 months of age had been vaccinated for influenza by early November, say officials at the Centers for Disease Control and Prevention (CDC). This year's rate is a little better than last year's, which in early November stood at 32.8.8%. And for children it's even better, 36.7% compared with last year's 30.6%.

"But the season's not over, and we can still do better," says Schuchat, who reminded Americans that this is National Influenza Vaccination Week.

The flu is a serious disease. Each year between 5% and 20% of the U.S. population gets influenza, says Howard Koh, assistant secretary for health with the Department of Health and Human Services. On average, 200,000 people a year are hospitalized during flu season, he says. Death totals vary tremendously depending on the strains circulating, ranging from 3,000 to 49,000 a year, he says.

For the past two years, the CDC has recommended that everyone six months or older be vaccinated against influenza. It's especially important for young children, pregnant women, older people and those with chronic conditions such as asthma, diabetes and heart or lung disease, Schuchat says. All of these groups are at particular risk for complications.

One positive note, Schuchat says, is that the elderly are also getting vaccinated at higher rates; this year, 62.3% of people 65 and older have received flu vaccine.

The message also seems to be getting to pregnant women. Before 2009, the rate was less than 15%; this year, 43.2% of pregnant women had been vaccinated by early November, she says.

That's good news because there's still time to get vaccinated before the worst of the flu season hits.

Another shift that has increased vaccination rates is that flu shots are available many more places than previously. Rather than have to go see the doctor, flu shots and nasal sprays are available at supermarkets, pharmacies and in the workplace.

This year, 55% of adults got vaccinated at a clinic or the doctor's office; 21% at a supermarket or pharmacy; and 16% at work. Most children still get vaccinated at the doctor's office, though 5% were vaccinated at school this year.

Although there were no racial or ethnic disparities for children getting the flu vaccine, that's not the case with adults. Currently, coverage is 40% for whites, 28% for blacks and 26% for Hispanics, Schuchat says.

Read entire article at USA Today http://yourlife.usatoday.com/health/story/2011-12-05/Americans-urged-to-put-flu-shots-on-holiday-to-do-lists/51657678/1

Medicare Gives Employers, Consumers Information to Make Better Health Care Choices


Health care law will allow patients to compare options, find best value
Consumers and employers will have the health care information they need to make more informed choices about their care, thanks to the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) announced in a final rule today.

The rule gives qualified organizations, like employers and consumer groups, access to data that can help them identify high quality health care providers or create online tools to help consumers make educated health care choices.  Information that could identify specific patients, however, will not be publicly released and strong penalties will be in place for any misuse of data.

"This is a giant step forward in making our health care system more transparent and promoting increased competition, accountability, quality and lower costs," said Marilyn Tavenner, Acting CMS Administrator. "This provision of the health care law will ensure consumers have the access they deserve to information that will help them receive the highest quality care at the best value for their dollar."

For years, employers, consumers, and health care quality advocates have expressed frustration about the limited and piecemeal availability of Medicare data that could be used to help evaluate health care provider or supplier performance.  Although many health plans have created provider and supplier performance reports, these reports are based solely on the health plans' own claims, and do not reflect information from other health plans, including Medicare.

Providers, too, have expressed frustration at receiving performance reports that are piecemeal and produced without an opportunity for review and correction.  This final rule creates a framework for providers to receive a single, actionable performance report covering all or most of their practice.

The final rule makes a number of important changes from the original proposed rule. The final rule makes this data less costly for qualified entities, gives qualified organizations more flexibility in their use of Medicare data to create performance reports for consumers, and extends the time period for health care providers to confidentially review and appeal performance reports before they become public.  The rule also includes strict privacy and security requirements to protect patients, health care providers, and suppliers as well as stringent penalties for any misuse of Medicare data.

The final rule on Availability of Medicare Data for Performance Measurement is on display until Dec. 7, 2011 at the Office of the Federal Register at: http://www.ofr.gov/OFRUpload/OFRData/2011-31232_PI.pdf 

Friday, December 2, 2011

Make an educated healthcare treatment decision

Your quality of life depends on knowing your options, according to the U.S. Agency for Healthcare Research and Quality (AHRQ).  A website by AHRQ, Explore Your Treatment Options, explains what your options are.  From the website:


Just one food item on the menu? Only one dress in the store? You expect to have options everywhere else in life. Why not your health care?
You might not think to ask why your doctor recommends a certain treatment or if other options are available. But every patient is different. When it comes to medical tests and treatments, you deserve to know your options.

Whether you just got sick or you’ve been receiving care for a long time, ask your doctor about treatment options. The answers you get may help improve your health care and your quality of life.

This site has tips to help you talk with your doctor. Because knowing your options is the best option.
At the website, you can get information about treatment options for a variety of health conditions.  The Office of Health Disparities Reduction has linked to this website here: http://www.health.utah.gov/disparities/healthcareinutah.htm#informed