disparities

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‘Old Ways’ Of Healthy Eating By Ethnic Group

(Flickr/ebruli)

Home-cooked holiday feasts aside, our eating patterns are trending in the wrong direction.

Over time, we’ve tended to go from cooking our own food to relying on more processed, packaged and non-perishable fare. Researchers say this slow transition, along with other factors, has resulted in an increasingly obese population, rife with heart disease, diabetes and other illnesses.

Oldways, a Cambridge non-profit that promotes healthy eating, wanted to help solve this problem. The group spearheaded a 20-year research project that put together a panel of experts — community health experts, culinary historians, nutrition scientists and even a representative from Whole Foods who has worked with the WIC program for needy women, infants and children — to collectively come up with a healthy eating model.

African Heritage Diet Pyramid (Courtesy of Oldways)

They came up with more than one. Indeed, the culmination of their work is several diets based on the traditional eating habits and foods of people from the Mediterranean, Asia, Latin America and the Caribbean and Africa. There’s even a vegetarian food pyramid. The African Heritage Diet pyramid is the newest of them all — you can read more about it on NPR’s Shots Blog, and see the pyramid full size by clicking on the image to the right.

Each food pyramid comes with detailed lists that name specific kinds of foods for each level of the pyramid that are both healthy and traditional to that culture. Also at the base of every food pyramid: physical activity.

Some examples of the cultural-specific foods featured in the pyramids:

While anyone can follow any of the pyramids as a guideline for healthy eating, the pyramids were specifically designed to appeal to those ethnic groups. Instead of one standardized graphic with general rules, it’s an attempt to broach the subject of healthy eating with foods familiar to each ethnic group. Continue reading

Must-Read: Why Do Black Yale Men Die So Young? Is It ‘John Henryism’?

flickrCC/wallyg

As we age, it’s normal to start losing a sprinkling of classmates to accidents and disease. But what’s happening to the pioneering black men of the Yale class of 1970 is not normal. At a deeply disturbing rate, they are dying off by around age 60. Among the 32 African-American men of the Yale class of ’70, the death rate appears to be roughly triple that of their white classmates.

Reporter and Brooklyn College journalism professor Ron Howell documents this frightening phenomenon in a superb article just out here in the Yale alumni magazine titled “Before their time.” He mixes his fond memories of the extraordinary friends he has lost with analysis from experts about possible explanations. He writes:

Demographers tell me not to extrapolate too far with these numbers, which are by no means a valid sampling. But for those of us who have been thinking about this for years, the numbers have profound meaning. Denis E. Kellman ’70, an attorney, lost his two best friends, Carl Palmer ’70 and Ron Norwood, in 2005 and this past February, respectively. “I feel like the last man standing,” Kellman says.

That black males overall die before others in America is well established. According to the latest National Vital Statistics report, life expectancy is 80.6 years for women in America overall and 75.7 for men. For white women, it’s 80.9; for black women, 77.4. For white men, 76.2. For black men, 70.9.

Much of that difference can be ascribed to poverty, violent crime, and inequitable access to health care, and might be expected to narrow for black men of higher socioeconomic status. So the question is this: are the black men who went to Yale and similar institutions in the throes of the blooming civil rights era of the ’60s—and who represented the first significant presence of African Americans on Ivy League campuses—now experiencing inequality in death, as their forebears did in life?

Many scientists, it pains me to report, believe the answer is yes.

Sociologist David R. Williams has done research showing that racial disparities in death rates pertain at “every level of income.” In a 2002 paper, Williams went on to say something as surprising as it is ominous: “This pattern has been observed across multiple health outcomes, and for some indicators of health … the racial gap becomes larger as [the socioeconomic status] increases.”

What in the world is going on here? Ron offers the “John Henryism” hypothesis:

One reason for this, researchers believe, is a phenomenon known as “John Henryism,” a determination among these men to succeed even at the cost of their health. Duke psychiatrist Christopher L. Edwards explained the idea in reporting on a 2006 study: Continue reading

Latest State Death Report Is Out; Is Health Reform Helping Only Whites Live Longer?


The latest state “death report” is out here, on 2008 data, and as I read through its highlights, these were the two that stopped me:

-In 2008, 10% of all deaths were amenable mortality (5,255), that is, deaths from certain causes that should not occur in the presence of timely and effective health care. For persons under 75 years of age, 28% of deaths were amenable mortality. Another way of saying this is that 28% of premature deaths were amenable to health care.

-The amenable mortality rate declined 6% since health care reform was implemented. When the amenable mortality rate for 2008 is compared with that of 2006 (before health care reform), the state rate went down from 82.5 (deaths per 100,000 population) to 77.4. This decline was only for Whites. There has been no change in the amenable mortality rate for Blacks, Hispanics, and Asians since 2006. (emphasis mine.)

Did we know this? I had understood that while racial disparities had not shrunk, the rising tide of access had lifted all boats.

Having Chest Pain While Black: MGH Finds Triage Bias

Among patients diagnosed as having a probable heart attack, emergency room staffs tend to treat everyone alike. But among patients merely suffering chest pain, those who are African-American or Hispanic are less likely to be classified as emergency cases and to get EKGs and other cardiac testing, according to a national study just released by Massachusetts General Hospital and published in the journal Academic Emergency Medicine.

The hospital reports:

Among patients who received an ED diagnosis of probable myocardial infarction (heart attack), there were no significant differences in initial symptoms between racial or ethnic groups…But among all those presenting with chest pain, African American and Hispanic patients were significantly less likely than white patients to be triaged as emergent. In addition, African American and Hispanic patients, as well as those who were uninsured or covered by Medicaid, were less likely to receive such basic cardiac testing procedures as ECG, cardiac monitoring or measurement of cardiac enzymes. Factors such as whether patients arrived by ambulance or the day of the week on which they were seen did not make any difference.

“These differences in ED triage may be important drivers of disparities in testing, procedures and eventual outcomes,” says [lead author Lenny] Lopez. “If you are misclassified at this first step, you’re less likely to get the ECG because your condition is not considered urgent. In the long term, you may have an even more severe heart attack that could have been prevented if intervention had occurred earlier. This is not an area of medicine where there is a lack of clarity about what we are supposed to do, so quality improvement strategies need to focus on 100 percent guideline-driven triage management for every single patient.”