US Dept of Health & Human Services held Affordable Care Act training in Utah

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.

Midmorning Snacks May Thwart Diets

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. 

To read full article visit USA Today at:  http://yourlife.usatoday.com/fitness-food/story/2011-11-30/Mid-morning-snacks-may-thwart-diets/51493870/1

Medicare to Pay for Obesity Prevention

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.

To read entire article visit: http://www.usatoday.com/news/health/healthcare/story/2011-11-29/Medicare-to-pay-for-obesity-prevention/51478232/1?csp=34news

Find a local healthcare provider that speaks your language.

The new, Utah Healthscape website has been added to the OHD website.  Search for a provider near you.  See http://www.health.utah.gov/disparities/healthcareinutah.htm#resources

Meeting the Healthcare Needs of American Muslims

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.”

"Multicultural Health Care Distinction" Offered to Health Care Organizations

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/.
 
Read the complete article at:
http://www.ncqa.org/LinkClick.aspx?fileticket=-sEvPOkSGfo%3D&tabid=61

Obesity among Utah Pacific Islanders

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

You can see the original report here: http://health.utah.gov/opha/publications/hsu/1111_Inductions.pdf