The Office of Disease Prevention and Health Promotion (ODPHP) and the Office of Minority Health (OMH) are pleased to announce the release of a new HealthyPeople.gov data search function. The Health Disparities widget is a new way for you to access this health disparities information.
The new widget provides an easy way to find health disparities data related to the Healthy People 2020 objectives for the Leading Health Indicators (LHIs). LHIs are critical health issues that when addressed will help reduce the leading causes of death and preventable illnesses.
It’s easy to embed the widget on your site and give your stakeholders easy access to the latest available disparities data. Once you’ve added the widget, there’s no technical maintenance required. The content will update automatically with the latest available data.
The widget provides charts and graphs of disparities data at your fingertips. Use the widget to browse data by:
Disparity type—including disability, education, income, location, race and ethnicity, and sex)
Leading Health Indicator
Explore, use and share the widget to help inform issues related to health equity.
States and managed care organizations need assurance that their partners can coordinate care effectively across medical, behavioral and social services and help keep people in their preferred setting—often, their home and community. NCQA has released Roadmap to Success in LTSS, a compilation of resources to guide organizations through standards for Long Term Services and Supports (LTSS). NCQA’s LTSS programs provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state and MCO requirements.
Roadmap to Success in LTSS:
Helps you understand the accreditation process and standards
Guides you through the steps of preparing for the accreditation review process
Provides examples, tools and resources you can use to prepare your organization for the accreditation journey
In NH, women with disabilities are significantly less likely than the general population to comply with breast and cervical cancer screening recommendations of the U.S. Preventive Services Task Force. Preventive screenings are especially challenging for women with disabilities due to barriers, such as:
Lack of accessible health care facilities and medical equipment; and
Health care providers who lack cultural competence with disability and awareness of needed accommodation.
In New Hampshire, adults with mobility and cognitive limitations are significantly more likely to experience diabetes (26%) than adults with no disability (9%).1 The disparity in diabetes prevalence results in higher costs to Medicaid programs and poorer health outcomes and quality of life for people with disabilities.2 Several factors contribute to a higher risk of diabetes, including:
Unhealthy eating habits that result, in part, from uninformed and limited food choices;
Lack of physical activity due to social, environmental, and behavioral barriers; and
Lack of knowledge and support to address risk factors for diabetes.2
The CMS Office of Minority Health Issue Briefs offer insight and examination into a variety of health and health disparity topics. The briefs are a concise summary of a particular issue and examine policies that impact the quality of and access to health care for minority and disadvantaged populations. Issue Briefs evaluate CMS programs, including Medicare and Medicaid, to include recommendations and suggestions relating to the issue at hand.
Adults with disabilities are almost twice as likely as other adults to report unmet health care needs due to problems with the accessibility of a doctor’s office or clinic.9 Structural, financial, and cultural barriers persist for people with disabilities when trying to access care.10 Many individuals with mobility disabilities face difficulties locating or otherwise traveling a burdensome distance to physically accessible services.11 Providing equal access to health care for people with physical disabilities involves many factors including, but not limited to:
Facility access. This includes accessible routes from parking or bus stops into the building, accessible parking, accessible entry doors with the required clearance width, clear floor space, and maneuvering clearance, accessible restrooms, and accessible signage for people who are blind or have low vision.12
Health care services access. This includes accessible scales and exam tables to facilitate a medical exam, accessible treatment and diagnostic equipment (including infusion chairs, mammography machines, and radiology equipment), appropriate resources for individuals with visual and auditory disabilities, and staff trained to assess patient needs and safely help patients move in between and transfer on and off medical equipment.
Protect Our Care – Illinois is a statewide coalition of health care advocates, providers, consumers, and workers, joining together to prevent the repeal of the Affordable Care Act (ACA), prevent disastrous changes to Medicaid, and protect and expand access to quality affordable health care. We know the crusade to undermine the ACA is not over whether there is a repeal vote this week, next week, or next year, so Protect Our Care – Illinois invites you to join Illinoisans across the state to defend access to quality affordable health care for all.
Sunscreen use is on the rise, but so are cases of skin cancer. That’s because a poor-quality sunscreen might keep you from getting a sunburn, but it won’t shield skin from UVA rays that cause melanoma. Recently, scientists with the Environmental Working Group tested almost 1,500 sunscreens, moisturizers, and lip balms that advertise sun protection. They found that 73 percent of those products don’t provide the protection consumers think they’re getting. David Andrews, a senior scientist at the Environmental Working Group, joins Ira to discuss.
During her first year at Washington University School of Medicine in St. Louis, Hilary Gallin studied racial and gender disparities in health care. She learned about various physicians’ approaches to community and global medicine. During overviews of medical specialties — from pediatrics to gerontology — Gallin learned about age-specific patient care.However, she felt one important element was missing in her medical education.
“I kept thinking about people with chronic disabilities, whether physical or cognitive,” said Gallin, who will earn her medical degree in May. “And I kept asking myself if I, as a physician, would have the knowledge and skills to best treat a patient with disabilities.”
Her answer was no.
“I also asked myself if, as a physician, I would have access to specialized exam equipment and other resources,” Gallin said.
She didn’t know the answer to that question. The topic wasn’t formally included in medical school training.
Feeling she’d be unprepared as a physician, Gallin decided to create a multiyear curriculum for the School of Medicine that focused on treating patients with disabilities. According to research published in 2016 in the journal Academic Medicine, most medical schools do not offer formal training in caring for people with disabilities; rather, disability often is viewed as an obstacle to overcome, and health-care providers sometimes discount disability’s social, emotional and cultural contexts.
However, physicians nationwide, including at Washington University, say medical schools have started recognizing the need for training students to effectively and compassionately treat patients with disabilities. Some medical schools have implemented various degrees of disability education or have begun the process of considering or developing a disability curriculum.
Gallin witnessed firsthand the struggles facing people with disabilities. The 29-year-old grew up with a friend who navigated life in a wheelchair due to cerebral palsy, an incurable disorder caused by abnormal brain development, often before birth, that impairs motor function. Also, while a young girl, Gallin spent a lot of time in hospitals in her native New York while shadowing her mother, a pediatric ophthalmologist.
“These experiences inspired me to learn more about what I can do, what we can do, to help people with disabilities,” said Gallin, who also is earning a master of business administration this May from Harvard University and formerly worked as an investment banker at Goldman, Sachs & Co. on Wall Street. She believes business skills will make her a better doctor by guiding her through all aspects of the changing health-care system.
“I want to approach medicine from different angles instead of limiting myself to the clinical and research perspective,” said Gallin, whose undergraduate degree in biomedical engineering from Yale University provides an even deeper understanding of the industry as a whole. “A lot of major policy affecting health care is made without a physician in the room.”
Developing a disability curriculum
Academics aside, Gallin values considering patients’ personal backgrounds in evaluation and treatment. For instance, she imagined herself giving a medical exam to her friend with cerebral palsy. She wondered: “How would I weigh her? Would I need a special exam table? What’s it like to go to the doctor when you have a disability?”
So she asked her friend and other people with disabilities. Their insights reflected national findings that people with disabilities often feel that their overall abilities, self-knowledge about their conditions and quality of life are underestimated by health-care providers. Many felt embarrassed to discuss disability-related health concerns such as treating pressure sores or practicing safe sex.
“Physicians may assume the person is not sexually active, and that may not be the case,” said Gallin, who was elected by classmates and faculty to the Gold Humanism Honor Society, which honors those who exhibit compassion in medicine.
“Another example occurred when I was working on cervical cancer screenings, or pap smears, with the National Health Service in the United Kingdom,” Gallin said. “One primary-care physician cited that people with disabilities have lower screening rates, and he admitted that he didn’t feel competent in screening some patients due to lack of training. Physician lack of knowledge increases the risk for negative health outcomes.”
Indeed. “In the medical literature, physician education is cited as a source of health discrepancies in patients with disabilities,” Gallin said. “Formal training in medical school would help to remedy disability as a health disparity.”
A few weeks after Gallin started medical school, she sought guidance on developing a disability curriculum from one of her mentors, Alan I. Glass, MD, assistant vice chancellor for students and director of the Habif Health & Wellness Center, which offers student health services at Washington University.
“Because of her focus, passion and persistence, the project evolved into a mission within the medical school to better care for this large and important population,” Glass said. “Hilary’s work has become an important part of the diversity curriculum for medical students. It serves as a model for other schools.”
For the White House, too. In 2014 and 2015, Gallin presented her curriculum to the director of the National Council on Disability, the agency responsible for devising national policy for people with disabilities.
“In developing the curriculum, I reached out to leaders to learn what they thought was needed in physician education,” Gallin said. “It was around the 25th anniversary of the Americans with Disabilities Act, and the White House director was curious to learn about what medical schools were doing to improve the care of people with disabilities.”
Washington University’s curriculum continues to evolve and improve, Gallin said.
“What is unique about the School of Medicine’s curriculum is that it builds on itself over time,” she said. “Students at other medical schools may receive informal training during their third year or attend isolated curriculum events over the year.
“But with our curriculum, students begin during the first year and continue throughout their studies,” she said. “They must demonstrate mastery of material through exams or standardized patient encounters, which is when an actor plays the role of patient and the student is scored based on performance.”
Gallin said she will continue to advocate for patients with disabilities — as well as all patients — when she begins her post-graduation residency in anesthesiology at the Harvard-affiliated Massachusetts General Hospital.
“One of a physician’s greatest assets is curiosity,” Gallin said. “With each person I treat, I will ask myself, ‘What are the preconceived assumptions that could hinder patient care?’”
Female sterilization accounts for 50% of all contraceptive use in the U.S. The extent to which U.S. women with physical and/or sensory disabilities have undergone female sterilization is unknown.
Our primary objective was to determine the prevalence of sterilization for women with physical/sensory disabilities, and compare this to the prevalence for women without disabilities. We also compared use of long-acting reversible contraceptive (LARC) methods between women with and without disabilities.
We conducted a secondary analysis of data from the National Survey of Family Growth 2011–2013, a population-based survey of U.S. women aged 15–44. Bivariate comparisons between women with and without disabilities by female sterilization and LARC use were conducted using chi-square tests. Using logistic regression, we estimated the odds of female sterilization based upon disability status.
Women with physical/sensory disabilities accounted for 9.3% of the total sample (N = 4966). Among women with disabilities only, 28.2% had undergone female sterilization, representing 1.2 million women nationally. LARC use was lower among women with disabilities than those without disabilities (5.4%, 9.3%, respectively, p < 0.01). After adjusting for age, race/ethnicity, education, insurance, marital status, parity, and self-reported health, women with disabilities had higher odds of sterilization (OR 1.36, 95% CI 1.03, 1.79).
The odds of female sterilization is higher among women with physical/sensory disabilities than those without disabilities. Future research is necessary to understand factors contributing to this finding, including possible underutilization of LARC methods.