The State of the Black Union on Health Care February 28, 2008

 

This weekend I watched Tavis Smiley’s State of the Black Union (SOBU), a forum that is a discussion of the most important issues facing the African American community in the 21^st century.  The forum consist of 2 discussion panels and the panelist are some of the country’s most prominent visionaries, educators, public policy makers, religious leaders, opinion makers, and community organizers.  Two years ago SOBU developed a national plan of action to address the primary concerns of African Americans today — from health to housing, from crime to criminal justice, from education to economic parity which was published in a book, The Covenant with Black America.  The Covenant was a New York Times best seller without the media hype.  

The 2008 SOBU was very much anticipated by many in the African American community given the presence of an African American candidate in the presidential primary and The Covenant’s outlined goals for discussion.  Leading up to the forum much was made of Tavis Smiley’s invitation to all of the presidential candidates to appear on SOBU to discuss their positions on the issues laid out in The Covenant.  Senator Obama’s decision not to attend the event and Senator Clinton’s decision to attend drew significant media attention.  Tavis was widely criticized by many in the African American community for remarking on Senator Obama decision not to attend.  Tavis stated that SOBU would focus on the issues laid out in The Covenant and not engage in discussions solely around a particular personality or candidate.  The vast majority of the panel discussion was focused on the current political race and the democratic primary.  Health care, one of the Covenant’s priority issues was not discussed until the very end when Senator Clinton was asked about the differences between Senator Obama’s health plan and her own.   

I looked forward to the African American community engaging in a healthy dialog about health care in America but was disappointed by the lack of presence by key health care advocates, health care providers or policy makers.  The country for the first time, that I can remember, is not only paying attention to health care reform but is engaging in a real discussion about change in our health care system.  I can’t stress how important it is for the African American community to add their voices to this pivotal discussion that has such significant impact on the African American community.  African Americans have suffered greatly from social disparities, and has been documented to receive less than equal health care quality and access which has lead to major disparities in healthcare and health outcomes.

I encourage Tavis Smiley to make health care the number ONE priority in the 2009 State of the Black Union forum and invite the leading policy makers, activists and health care providers to address the health care crisis in our community. 

Yours in Good Health

President Bush and Global Health February 20, 2008

While Americans are focused (rightfully so) on the Presidential Primaries, President Bush is touring Africa doing what he does well, touching hands. While on his 5 country tour of Africa President Bush will make available $350 million to provide treatment for tropical diseases, such as river blindness, hookworm and schistosomiasis, that have often been ignored by major funding sources.  He has noted that the American government has spent nearly $20 billion over the past five years fighting diseases such as AIDS and Malaria.

Health Care Providers in the Line of Fire February 18, 2008

Dr. Faughey

As I prepared to post a story on the over-use of antibiotics for Otitis Media, I learned about the vicious killing of Dr. Kathryn Faughey, a Manhattan therapist.  Thru building surveillance tapes the New York Police Department has pieced together some of the events prior to Dr. Faughey’s death.  A man entered the building in which Dr. Faughey’s practice was housed stating he had an appointment with Dr. Stinbach, a psychiatrist who practices in the same office.  He proceeded to the office and sat in the waiting area for 30 minutes then for unknown reasons went to Dr. Faughey’s office where he used a knife and meat cleaver to mutilate her.  Dr. Shinbach who was in an adjacent office with a patient heard screams and went to assist her only to be stabbed in the face.  He is currently in critical condition. 

The story in itself is disturbing but as a female physician who functions out of a private office it gave me chills.  Health care providers are not often thought of as civil servants in the line of fire.  However as Dr. Faughey’s death graphically demonstrates that couldn’t be further from the truth.  Many health care providers are in the line of fire as they perform their daily work.  I, like most physicians, have often thought that the most vulnerable physicians are those taking care of prisoners, the mentally disturbed, developmentally challenged, and international relief workers.   

When you search for articles on ‘Health Care Providers and violence in the work place’ the majority of articles are focused on physician’s description of violence and how to care for violent victims but fewer articles about violence perpetrated against health care workers.  One British study showed that a third of doctors have been a victim of physical or verbal violence; 50% of doctors identified violence in the workplace as a problem; female doctors were more likely to experience violence, followed by general physicians; two thirds of psychiatrist thought that violence in the workplace was a problem compared with one fifth of surgeons.  Most physicians have little or no training in dealing with violent patients and most outpatient medical facilities are not built to secure the health care provider, but to the comfort of the patient.  

What does this say to me:  Health Care Providers may not be in the direct line of fire as are soldiers, police officers, firemen, however they are public servants that fall victim to violence.  Dr. Faughey’s tragic death should serve as a wake up call to the Health Care Community.  Psychiatrist, General Physicians, Receptionist and other health care providers who practice out of private offices are particularly vulnerable to being victims of physical and verbal violence therefore medical facilities (private practices or large hospital practices) need to be designed with Health Care Providers safety in mind.  Most importantly providers should be trained in how to deal with violent patients.      

My prayers go out to Dr. Faughey and Dr. Shinbach’s family and friends. 

Yours in Good Health

National Black HIV Awareness Day February 7, 2008

Today is National Black AIDS Awareness Day and it seems like it is being commemorated in no more than a whisper.  In a time where more African American men and women are becoming infected with HIV than ever, everyone in America should have awaken to HIV prevention messages in African Americans.   

This week I attended the Conference of Retroviruses and Opportunistic Infections (CROI) in Boston.  CROI is a gathering of the worlds leading HIV scientist and clinicians to present, discuss, and critique studies in the field of HIV (a retrovirus) with the ultimate goal of translating laboratory and clinical research into progress against the AIDS epidemic. The main focus of CROI 2008 was on basic science, prevention, and epidemiology.    

There are greater than 1 million Americans living with HIV and 49% of people living with HIV are African Americans.  The HIV epidemic has disproportional affected African American women, specifically in the South and Northeastern US.   Heterosexual contact is the main transmission risk among Black women.  Young Black and Hispanic men (ages 18-24) having sex with men are increasingly being infected with HIV and Syphilis.  The HIV prevalence rates for Blacks in the United States compare with several developing countries such as Burkina Faso, Ghana, Rwanda, Cambodia, and Haiti.  Several studies have revealed that driving forces in the transmission of HIV in the African American community are sexual transmitted diseases (Herpes Simplex-2), sexual networks, and social context such as poverty, incarceration, etc.  Black men born today are 29% chance of spending time in jail or prison in his lifetime; 1 in 8 black men ages 25 – 29 are currently in jail. 

What does this say to me: The US efforts to stem the tide of HIV transmission in the African American community has clearly failed.  The US public health efforts have focused on individual interventions.  In this Presidential Primary season where the buzz word is change, I strongly advocate that we change the direction of our public health approach to HIV prevention as well.  I believe that an integrated approach is needed to affect real change which means working with social and community networks.  More importantly it means looking at the underlying issues that lead to HIV transmission which really means looking at ourselves as a country.  If you have been tested practice safe sex; if you haven’t been tested GET TESTED; if you are HIV positive get into the care of an experienced HIV provider. 

For additional information click on link below: http://www.hhs.gov/aidsawarenessdays/factsheets/docs/05-1221afams.pdf

“The ultimate measure of a man is not where he stands in moments of comfort, but where he stands at times of challenge and controversy”            - Dr. Martin Luther King Jr.

What a High!! February 4, 2008

Presidential Candidates on Health Care February 1, 2008

I urge you to take the time to look at the candidates positions on health care.  It is one of the most critical issues in the 2008 presidential campaign and an issue that the American people have to force their elective officials to address.  The American College of Physicians and The Kaiser Family Foundation have summarized the candidates health plans and provide comparisons between them in the following links:

http://www.acponline.org/advocacy/where_we_stand/election/

http://health08.org/sidebyside.cfm 

 Yours in Good Health