Publications and Reports

Fighting Diabetes' Deadly Impact on Minorities

You inherit more than your eye and hair color from your family. You can also inherit a predisposition for diabetes, a disease that disproportionally affects racial and ethnic minorities.

The Office of Minority Health (OMH) at the Food and Drug Administration (FDA) is building relationships with the American Diabetes Association (ADA) and other groups to help Americans prevent and treat diabetes, and to address the disparity in how severely it affects minority groups in particular. (more)

The Southeastern Health Equity Council's Release of the Health Equity Report Card

The Southeastern Health Equity Council (SHEC) has developed a health equity report card that presents findings on gaps in health care access, healthy food access, and cultural competency within the Southeastern region of the United States. To download the Health Equity Report Card, visit http://tinyurl.com/o8n844l.

 

Diabetes Report Card 2012: National and State Profile of Diabetes and Its Complications
Purpose of This Report -This report is required under the Catalyst to Better Diabetes Care Act of 2009, which is part of the Patient Protection and Affordable Care Act (Section 10407 of Public Law 111-148, hereafter called the Affordable Care Act). The act states that the report card should be published by the Centers for Disease Control and Prevention (CDC) every 2 years and include data about diabetes and prediabetes, preventive care practices, risk factors, quality of care, diabetes outcomes, and, to the extent possible, trend and state data.

The Diabetes Report Card 2012 uses 2010 data (the most recent data available) to present a profile of diabetes and its complications at the national and state level. It includes information about prediabetes awareness, diabetes outcomes, and risk factors. The estimates in this report were calculated by CDC staff and are available in more detail at CDC's National Diabetes Surveillance System Web site at http://apps.nccd.cdc.gov/DDTSTRS/default.aspx.

Read report here.

 

How Will the Uninsured in North Carolina Fare Under the Affordable Care Act? 

The 2010 Affordable Care Act (ACA) has the potential to extend coverage to many of the 47 million nonelderly uninsured people nationwide, including the 1.6 million uninsured North Carolinians. The ACA establishes coverage provisions across the income spectrum, with the expansion of Medicaid eligibility for adults serving as the vehicle for covering low-income individuals and premium tax credits to help people purchase insurance directly through new Health Insurance Marketplaces serving as the vehicle for covering people with moderate incomes. With the June 2012 Supreme Court ruling, the Medicaid expansion became optional for states, and as of December 2013, North Carolina was not planning to implement the expansion. As a result, many uninsured adults in North Carolina who would have been newly-eligible for Medicaid will remain without a coverage option. As the ACA coverage expansions are implemented and coverage changes are assessed, it is important to understand the potential scope of the law in the state. (more

 

Health Care Quality Improving, While Some Americans Still Lack Access  

The quality of U.S. health care is slowly improving, while access to health care remains a great challenge for some Americans, especially racial and ethnic minorities and low-income people, according to the Agency for Healthcare Research and Quality's newly-published 2012 National Healthcare Quality Report and National Healthcare Disparities Report.

 

The reports note that “urgent attention” is needed to ensure continued improvements in the quality of diabetes care, maternal and child health care, and treatment for conditions such as pressure ulcers and blood clots. Included in this year's reports are new measures on early and adequate prenatal care, colorectal cancer screening, national rate of hospital-acquired conditions, standardized infection ratios at the state level for central line-associated bloodstream infections, and patient safety culture hospital survey findings.(more)  

 

Diurnal Salivary Cortisol Is Associated with Body Mass Index and Waist Circumference:  The Multiethnic Study of Atheroscllerosis

Neuroendocrine abnormalities, such as activation of the hypothalamic-pituitary-adrenal (HPA) axis, are associated with obesity; however, few large-scale population-based studies have examined HPA axis and markers of obesity. We examined the cross-sectional association of the cortisol awakening response (CAR) and diurnal salivary cortisol curve with obesity.

Read publication here.

 

The Diversity of North Carolina’s Health Care Workforce

Racial and ethnic diversity among health care professionals is vital to maintaining high quality health care that is accessible, equitable, and culturally competent.1,2,3 The provision of culturally competent health care requires not only a health care workforce that is prepared to interact with the variety of cultures represented in North Carolina's population, but also requires a workforce that represents the population and communities they serve. (continued)

 

"Addressing Race and Genetics: Health Disparities in the Age of Personalized Medicine." The paper asserts that "certain issues regarding racial and ethnic health disparities need to be addressed in order for personalized medicine to offer the greatest benefit to all."
http://www.americanprogress.org/issues/2011/06/pdf/race_genetics.pdf

American Progress posted a new report on Monday titled, "Addressing Race and Genetics: Health Disparities in the Age of Personalized Medicine." The paper asserts that "certain issues regarding racial and ethnic health disparities need to be addressed in order for personalized medicine to offer the greatest benefit to all."

http://www.americanprogress.org/issues/2011/06/pdf/race_genetics.pdf

The Diabetes 2025 Forecasting Data - New data forecast the prevalence, morbidity, and economic burden of diabetes through 2025, with regional and demographic analyses.

Practice-Based Report - Voices of African American Health: Stories of Health and Healing Jaimie Hunter, Sarah Langdon, Dianne Caesar, Scott Dd. Rhodes, and Clarissa Pinkola Estés. 
This project used artistic means to enable community members to portray their experiences with chronic disease as a means to increase awareness of minority health. A traveling art exhibit showcases participants' photographs and journal vignettes, allowing them to share their stories with viewers from a diverse audience. (Read full publication

AHRQ Research and Other Activities Relevant to American Indians and Alaska Natives - Program Brief
American Indian and Alaska Native (AI/AN) people continue to have disproportionately higher rates of illness and higher mortality rates when compared with other Americans.  AI/ANs die at higher rates than other Americans from tuberculois (500 percent higher), alcoholism (550 percent higher), diabetes (200 percent higher),  unintentional injuries (150 percent higher), homicide (100 percent higher), and suicide (70 percent higher).  This group is also burdened with high infant mortality rates and high rates of obesity and diabetes among children.  To read the full brief click here.

Wake Forest Program Helps Cherokee Youth  Explore Medical Careers
The Eastern Band of Cherokee Indians wants to increase the number of Cherokee medical experts to address urgent community health issues in culturally respectful ways.

Wake Forest is responding to this need for more health workers with a summer program to help Cherokee youth explore health careers.

National Diabetes Fact Sheet 2011 Communications Material - This report provides analysis and reporting of the recent trends and ongoing variations in health disparities and inequalities in selected social and health indicators, both of which are important steps in encouraging actions and facilitating accountability to reduce modifiable disparities by using interventions that are effective and scalable.

 Diabetes and Cardiovascular Disease by Dr. Alain G. Bertoni and Dr. David C. Goff. - Diabetes affects over 200 million people worldwide; its chronic nature and long-term economic burden make it one of the prototypical public health problems of our time. Numerous research programs have developed over the last decade to improve the understanding of the causes, prevention and treatment of diabetes and its complications, but effective delivery of preventive strategies remains challenging at best. Efficient synthesis of the data and information from these diverse sources is crucial to prioritize interventions and assemble resources for the implementation of public health programs. This book meets this need and builds on previous works to reflect the evolution of science related to diabetes public health. 

Disparities in Peaks, Plateaus, and Declines in Prevalence of High BMI Among Adolescents - The objective of this study was to investigate trends in prevalence of high BMI from 2001-2008 and examine racial/ethnic disparaities.

Racial and Ethnic Health Disparities in North Carolina - Report Card 2010 - from the Office of Minority Health and Health Disparities and State Center for Health Statistics.

North Carolina Minority Health Facts: Hispanics/Latinos - from the Office of Minority Health and Health Disparities and State Center for Health Statistics.

North Carolina Minority Health Facts: American Indians - from the Office of Minority Health and Health Disparities and State Center for Health Statistics.

North Carolina Minority Health Facts: African Americans - from the Office of Minority Health and Health Disparities and State Center for Health Statistics.

Interactions Between Race/Ethnicity and Anthropomentry in Risk of Incident Diabetes  - AJE has now published our MESA manuscript looking at interactions between race/ethnicity and anthropometry in risk of incident diabetes. 

Mirror, Mirro on the Wall -How the Performance of the U.S. Health Care System Compares Internationally - 2010 Update. 

National Quality Forum - Cultural Competency 
A comprehensive framework and preferred practices for measuring and reporting cultural competency.

"Navatigating a Complex Landscape to Foster Greater Faculty and Student Diversity in Higher Education"
A first-of-its kind handbook from the American Association for the Advancement of Science (AAAS) and the Association of American Universities (AAU) offers in-dept, cross-referenced legal resources to help promote effective diversity programs for science faculty and students.  

National Health Care Quality and Disparities Reports for 2009 available.  
The results of the NHQR are based on 200 measures that examined the effectiveness, safety, timeliness, and patient centeredness of health care in the United States.  New sections in the report include data on reducing unnecessary costs, pain management, and care coordination.  The NHDR examines the quality and access of health care among racial, ethnic, and income groups.  Data on new immigrant and limited-English-proficient populations and resources for training culturally competent health care professionals are included.

Effect of Intensive Compared With Standard Glycemia Treatment Strategies on Mortality by Baseline Subgroup Characteristics - Jorge Calles-Escandón, MD 

Inflammation and the Incidence of Type 2 Diabetes - Alain G. Bertoni, MD, MPH

Study Looks at Fat, Sleep - Research Study by Dr. Kristen Hairston
Not getting enough sleep may lead to more severe problems than just a lack of energy and alertness.  It also could lead to an increase in fat accumulating around vital organs, according to a study released today by researchers at Wake Forest School of Medicine.  That could result in higher rates of metabolic disease among minorities, including obesity, insulin resistance and type 2 diabetes, the study found. 

Researchers focused the study on 1,107 minority participants, 775 Hispanics and 332 blacks over five years because the races have been underreported regarding the issue.  The participants ranged in age from 18-81.  They were examined through CT scans. For entire article click here.

Poverty's Impact on the Health of North Carolina: The Socioeconomic Determinants of Health
Ronny Bell, PhD, MS

Inflamation and the Incidence of Type 2 Diabetes: the Multi-Ethinic Study of Atherosclerosis (MESA
Bertoni AG, Burke GL, Owusu JA, Carnethon MR, Vaidya D, Barr RG, Jenny NS, Ouyang P, Rotter JI.

Equal Health Care for All
Opportunities to Address Health Care Disparities in Health Care Reform
Dr. Lesley Russell, Visiting Fellow December 2009

Closing the Health Care Workforce Gap
Reforming Federal Health Care Workforce Policies to Meet the Needs of the 21st Century

The Role of Academic Health Centers in Addressing the Social Determinants of Health - The Blue Ridge Academic Health Group 

A Systematic Review of Qualitative Research on the Meaning and Characteristics of Mentoring in Academic Medicine  - Article from Journal of Internal Medicine

La Clínica del Pueblo: A Model of Collaboration Between a Private Media Broadcasting Corporation and an Academic Medical Center for Health Education for North Carolina Latinos
La Clínica del Pueblo, a health education collaboration between the Maya Angelou Center for Health Equity at Wake Forest School of Medicine and Que´ Pasa Media, Inc., disseminates culturally appropriate health information to the North Carolina (NC) Latino community. (Jorge Calles-Escando´n Jaimie C. Hunter, Sarah E. Langdon/Eva M. Go´mez  Vanessa T. Duren-Winfield  Kristy F. Woods)

The Role of Culture in the Context of School-Based BMI Screening
The high prevalence of overweight and obesity is a significantpublic health concern in the United States. Minority populations are disproportionately affected, and the impact of obesity on minority children is especially alarming. (Marian L. Fitzgibbon and Bettina M. Beech)

Neighborhood Resources and Incident Diabetes
This paper from the Multi-Ethnic Study of Atherosclerosis showed that better neighborhood resources were associated with lower incidence of type 2 diabetes, which suggests that improving environmental features may be a viable population-level strategy for addressing this disease. This study included data from Forsyth County. (Auchincloss AH, Diez Roux AV, Mujahid MS, Shen M, Bertoni AG, Carnethon MR.)

Self-reported influences of hopelessness, health literacy, lifestyle action, and patient inertia on blood pressure control in a hypertensive emergency department population.
In response to almost universally recorded poor blood pressure (BP) control rates, we developed a novel health paradigm model to examine the mindset behind BP control barriers.  This approach, termed patient inertia (PtInert), is defined as an individual's failure to take responsibility for health conditions and proactive change. (Joyner-Grantham J, Mount DL, McCorkle OD, Simmons DR, Ferrario CM, Cline DM.).

AHRQ Activities Using Community-Based Participatory Research to Address Health Care Disparities 
Community-based participatory research (CBPR) is an approach to health and environmental research meant to increase the value of studies for both researchers and the communities participating in a study. The CBPR approach is particularly attractive for academics and public health professionals struggling to address the persistent problems of health care disparities in populations that the U.S. Department of Health and Human Services has designated as priority populations (including racial and ethnic minorities; low-income, rural, and inner-city populations; women; and children).

The Blue Ridge Academic Report
The Role of Academic Health Centers in Addressing the Social Determinants of Health

2009 FC Infant Death Report - Forsyth County
This report contains the latest Infant Mortality data for Forsyth County, with U.S. and international rates for comparison.  

Excell Protein in Urine is Indicator of Hearth Disease in Whites, But Not Blacks
The cariovascular risk that is associated with proteinuria, or high levels of protein in the urine, a common test used by doctors as an indicator of increased risk for progressive kidney disease, heart attack and stroke, has race-dependent effects, according to a new study by researchers at Wake Forest School of Medicine.

Last Updated: 12-03-2014
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