Health disparities


HIV Rates Among Black Women In Cities Higher Than Previously Thought

Amanda Richards / Flickr

An HIV test.

Black women in some cities, including D.C., are five times more likely to contract HIV than the average black woman in the United States. That’s according to a recently released study conducted in six cities and funded by the National Institutes for Health.

Researchers focused on six HIV “hotspots:” D.C., Baltimore, New York City, Newark, N.J., Atlanta and Raleigh-Durham, N.C. In these communities, 24 black women in every 10,000 is infected with HIV annually. Nationally, the annual HIV-infection rate is 5 in every 10,000 black women.

The new data, which shows higher infection rates than previously thought, came as a surprise to scientists working in the field, including AIDS experts at Johns Hopkins University who assisted with the study.

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New Dental Clinic Bolsters Access for D.C.’s Low-Income Patients

Elahe Izadi / DCentric

Dentist Steven Myles shows how he is able to access a patient's medical records during appointments in Bread for the City's new dental clinic.

It’s been more than a decade since Florence Sandridge has been to a dentist. Now, the 80-year-old needs a plate put in her mouth.

“Usually the dentist is so expensive,” she said. That’s why last week she went to the ribbon-cutting of a free dental clinic for low-income D.C. residents.

The Bread for the City single-room clinic — with its green walls, new equipment and a couple of dentist chairs — fills a big gap. There are few options for low-income D.C. residents. Those on Medicare, Medicaid or signed up with D.C. Health Alliance receive some dental coverage. There are also a few other free dental clinics in the city — such as one run by nonprofit So Others Might Eat — and a mobile dental clinic that makes stops throughout the city. “But there just aren’t enough services,” said Kristin Valentine, Bread for the City’s development director. Dental care is consistently the most requested service among the Bread for the City’s clients.

Even those with dental coverage don’t regularly see a dentist; about half of low-income adults with coverage haven’t been to the dentist in at least a year, according to a Kaiser Family Foundation report. The reasons vary. Some have problems finding dentists who accept Medicaid. Out-of-pocket costs for those under private and public plans may be too expensive for families. Other issues keep low-income adults from getting dental care, such as lack of transportation, child care and work arrangements and cultural barriers, according to the Kaiser report.

Joan Carson, 56, is a Bread for the City client who serves on the nonprofit’s advisory board. She said it’s difficult to find dentists who accept Medicare and Medicaid. Another advisory board member and client, 54-year-old Deborah Branch, said she was thankful for the clinic, which has been a long time coming.

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On Blaming Food Deserts

David McNew / Getty Images

We pondered yesterday whether lack of access to supermarkets is the major reason behind health inequality, in response to a survey showing most urban families were actually satisfied with their grocery options.

We asked readers: are food deserts really to blame, or do other factors loom larger? From the responses, it looks like prices and having time to prepare meals were also big concerns for families.

DCentric commenter molly_w wrote:

One thing I completely failed to appreciate until I became a mom was how hard it is for parents to find time to cook. I get home at 6, and my 4-year-old daughter needs to head upstairs and start her bedtime routine at 7:30. So I have 90 minutes a day to hang out with my child (never mind my husband), and I want to spend as little of it as possible fixing supper. (She doesn’t want me to spend it in the kitchen, either; she interrupts me every couple minutes with all sorts of invented needs — which only makes dinner prep take longer.) These days I’m all about frozen microwavable rice covered in something that came out of a crock pot, because I can get food on the table in about five minutes and have that time to hang out with my family. And I’m lucky in a lot of ways — I only work one job, I have a partner to help, we only have one kid.

In response to our post on the survey, Sylvia C. Brown, an ANC 7C04 commissioner, tweeted that saving money can come at the cost of saving time:

@ it still corroborates food deserts bcs it puts pressure on one--go to corner store save time but food price high +
Sylvia C. Brown

Corner stores also don’t have the same variety of fresh fruits and vegetables as supermarkets do. There’s a local effort underway to address that problem, with nonprofit D.C. Central Kitchen delivering fresh produce to corner stores as part of its “Healthy Corners” initiative.

Also, simply having a supermarket in a community doesn’t translate into healthier eating habits, according to a study published in the Archives of Internal Medicine. Researchers said healthy food isn’t always visibly displayed in supermarkets and it can be expensive. So you could build it, and they may come, but what will they buy?

Can Moving to a Middle Class Neighborhood Make You Healthier?

Adrian Clark / Flickr

It’s well documented that poverty and bad health have a strong connection. A team of researchers wondered if simply moving from a low income to middle class neighborhood could make a person healthier.

Turns out that it does, according to a new study published in the New England Journal of Medicine does. The U.S. Department of Housing and Urban Development researchers studied three groups. One group stayed in poor neighborhoods. Another group received rent subsidies to move into middle class neighborhoods. The third group received the same subsidies to help with rent, but remained in poor neighborhoods. The results: the group who moved to the middle class neighborhood were 5 percent less likely to be obese and show signs of diabetes. The people who stayed in the poor neighborhoods, even with the help of extra money, experienced no improvement in health.

From ScienceNOW:

The experiment clearly shows that the neighborhood effect is real, says Nicholas Christakis, a sociologist at Harvard Medical School in Boston who studies the effect of social ties on health, but the mechanisms remain murky. Is it the shops and restaurants, the parks and pools, he wonders, “or the people in a neighborhood that affect you most?” For example, Christakis says, the people who moved might have lost weight because safer streets and open spaces “allowed them to walk outside more, or because they saw thinner people around them, or both.”

Even if a neighborhood has plenty of recreational facilities and opportunities, it doesn’t mean people will take advantage of them. Research shows the fear of violence discourages people from being active outside. People are less likely to walk, bike or let their kids play outside. That rings true in D.C., where Ward 8, the ward with the most violent crime thus far this year, also has the lowest physical activity rate. We may have plenty of food deserts, but we also have our fair share of exercise deserts.

There are Only 90 Doctors East of the River

Flickr: NCinDC

Howard University Hospital

If you reside in Columbia Heights, Dupont Circle or Friendship Heights, chances are, you live near a practicing physician. For D.C. residents who make their home east of the river, it’s a very different situation, according to a recent article in the Washington Post, which focused on a potential shortage of doctors in this city. One part of the article stood out to us; when it comes to a lack of practicing physicians, certain areas in D.C.- have it much worse than others.

In Ward 3, for example, there is an abundance of physicians, with “literally hundreds of doctors to choose from,” said Michael Williams, chief of health-care operations for the nonprofit D.C. Primary Care Association. But he said only 90 doctors list a business address east of the Anacostia River.

The District has a “severe mal-distribution of physicians” rather than a shortage, given that roughly 23 percent of the population lives east of the river but only a tiny fraction of physicians have a business location there, he said.

The Post reported that there are 4,000 full- or part-time physicians in D.C. but it’s important to keep in mind those doctors are sometimes seeing patients who work in the city, but live in Maryland or Virginia. So doctors who maintain a practice in the city are treating patients from across the region, which for locals makes finding a doctor even more challenging.

Five Factors Behind the ‘Alarming’ HIV Infection Rate for Young Black Gay and Bisexual Men

Stephen Chernin / Getty Images

A young man inserts the Rapid HIV test swab into its tube.

The HIV infection rate for young black men who have sex with men is growing at an “alarming” rate.

That’s according to a report released this month by the Centers For Disease Control and Prevention. The CDC studied HIV infection rates from 2006 to 2009, and found that the rate increased by 48 percent for 13 to 29 year-old black men who have sex with men. Meanwhile, infection rates have remained relatively stable for all other groups.

Healthcare providers and organizers in D.C., where 3 percent of the population has HIV/AIDS, are seeing the trend. Justin Goforth is the director of community health at Whitman-Walker Health, a center offering medical, counseling and legal services to D.C.’s LGBT community.

“This is who we see come in every day that’s testing positive: young black gay men,” Goforth says.

Below are five factors contributing to higher infection rate among this group:

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Racial Disparity in Care for D.C. Stroke Patients Not Due to Bias

Christopher Furlong / Getty Images

A new study shows that the disparity in care for D.C.’s black and white stroke patients isn’t due to institutional bias, but addressing the problem may involve “culturally tailored” outreach programs.

Georgetown University researchers found that African-American patients in the District were one-third less likely than white patients to receive tPA, the medicine needed to treat the most common type of stroke. Dr. Chelsea Kidwell, medical director of the Georgetown University Stroke Center, authored the study. WAMU reports:

Among the reasons African-Americans are not receiving tPA as often, Kidwell says, “is that the African-American population does not get to the hospital in time. They don’t call 911.”

Also, Kidwell says, African-American patients are more likely to have existing medical conditions, like high blood pressure, that would make tPA unsafe for them.

“[In] patients who do arrive in time and are eligible for treatment, there in fact is no racial disparity,” she says. “So our finding is important in showing that there’s no institutional or medical care bias in treating patients.”

About 75 percent of black stroke patients interviewed in the study called a friend or relative before calling 911. And nearly half of those who received delayed care reported it was because they didn’t think the symptoms were serious.


Raheem Jackson’s Death and Scary Walks Home

Flickr: Barjack

The tragic circumstances surrounding the April 7th shooting death of a popular H.D. Woodson High School student point to a challenge that many of D.C.’s kids face as they seek to have active, healthy lives.

Raheem Jackson, 16, was reportedly trying to buy a gun from someone who robbed and killed him instead. Washington Post columnist Courtland Milloy wrote that

… If true, he would not have been the first otherwise law-abiding youngster who felt the need to carry a firearm for protection.

A star basketball player at Woodson, he’d leave practice long after sundown and have anxious walks home in the dark. Many students have refused to participate in extracurricular school activities because it just isn’t safe to be out at night.

As noted by Homicide Watch D.C., Jackson had even written a poem about his scary walks home, which was published by his school newspaper The Insider:
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