Medical Monday

Medical 7-18-16Medical Monday – July 18, 2016

Medical Monday is a service of Project RACE for the multiracial community. We seek, gather, and list health articles of interest to interracial families and people of all races. We welcome health information from outside sources as long as the original source is cited.

  1. Pigmentation in African American Skin Decreases With Skin Aging

Journal of the American Academy of Dermatology

  1. Genetic Variant Increases Risk for Atrial Fibrillation in Whites

JAMA Cardiology

3.    Adolescent birth rate drops across all racial groups, annual report shows



If you have current medical news to contribute, please email it with the source and your contact information with MEDICAL NEWS SUBMISSION in the subject line to:

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Medical Monday

Likelihood of Finding an Optimal Donor for a Stem-Cell Graft Varies by Ethnicity

Both registries of hematopoietic stem-cell donors and banked units of umbilical cord blood are currently sufficient to provide almost all U.S. patients with the stem-cell or cord-blood grafts they need, although many will not receive optimal grafts, according to a report published online July 23 in the New England Journal of Medicine.

Researchers sought to estimate the likelihood that patients will find suitable stem-cell donors or cord-blood doses using the National Marrow Donor Program (NMDP). To do so, they performed population-based computer modeling that matched current “supplies” with hypothetical patients, taking into account 21 possible racial and ethnic categories “to adequately reflect the large diversity of the U.S. population in the NMDP registry and to have a sample that would be large enough to characterize the HLA genetic profiles of each group,” said Loren Gragert of NMDP/Be the Match, Minneapolis, and his associates (N. Engl. J. Med. 2014;371:339-48).

They showed that most patients seeking stem-cell grafts will find a 7/8 or 8/8 HLA-matched unrelated adult donor in the registry. However, the chance of finding an optimal donor varies widely by race and ethnicity: Whites of European ancestry have a 75% likelihood of finding an 8/8 HLA-matched donor; whites of Middle Eastern or North African descent have a 46% likelihood; Hispanics, Asians, and Pacific Islanders have likelihoods ranging from 27% to 52%; and black Americans of all ethnic backgrounds have likelihoods ranging from 16% to 19%.

Similarly, most patients will find a 4/6 or higher HLA-matched cord-blood unit with an adequate cell dose for their needs, but the likelihood varies widely according to the patient’s race, ethnicity, and age. Age comes into play with cord-blood grafts because the number of cord-blood cells required is higher with increasing patient weight. Almost all patients in all racial/ethnic groups who are under age 20 will find cord-blood grafts with 4/6 or higher HLA-matching; the rate is lowest, at 81%, among African American youths.

Whites of European ancestry have a 38% chance of finding a 6/6 HLA-matched cord-blood unit and an 87% chance of finding a 5/6 HLA-matched unit if they are under age 20, and a 17% chance of finding a 6/6 HLA-matched cord-blood unit and a 66% chance of finding a 5/6 HLA-matched cord-blood unit if they are over age 20. The likelihoods of finding suitable cord-blood units were slightly lower for whites of other ethnic backgrounds; intermediate for Hispanics, Asians, and Pacific Islanders; and lowest for black Americans of all ethnic backgrounds.

The NMDP is continually adding stem-cell donors and cord-blood units, but overall these additions raise the likelihood of finding a suitable match for each individual patient by only about 1% per year. “We anticipate that an additional 5.5 million donors will be added by 2017, and project that this will increase the probability of identifying an 8/8 HLA-matched donor by 4-7 percentage points,” Mr. Gragert and his associates said.

This shows that “if a fully matched donor is not identified early, delaying transplantation in the hope that such a donor will appear is unlikely to be beneficial and may indeed be detrimental, because match likelihoods increase by only 1 percentage point per year, [whereas] survival decreases as diseases progress. … For patients without a suitably matched graft, treatments other than [stem-cell or cord-blood] transplantation therapy should be considered and should not be unduly delayed,” they added.

This study was supported by a grant from the Office of Naval Research in the U.S. Department of the Navy and the C.W. Bill Young Cell Transplantation Program in the U.S. Department of Health & Human Services. No relevant financial conflicts of interest were reported.

Source: Practice Update

Medical Monday


DNA: The Basics

We each have 23 pairs of chromosomes. Each chromosome holds packages of DNA, which contains genes passed down from your parents and holds potential keys to everything from your hair color to your risks of certain illnesses. Within the DNA are many types of genetic variants, including one called single nucleotide polymorphisms, There are about 10 million SNPs in the human genome, and some have been found to predict risk of diseases or have a regulatory effect on a gene’s function.

Source: Prevention

Race and Medicine

Associations of Candidate Genes to Age-Related Macular Degeneration Among Racial/Ethnic Groups in the Multi-Ethnic Study of Atherosclerosis

Am J Ophthalmol 2013 Aug 12;[EPub Ahead of Print], R Klein, X Li, JZ Kuo, BE Klein, MF Cotch, TY Wong, KD Taylor, JI Rotter


Results of a cross-sectional study of data extracted from the Multi-Ethnic Study of Atherosclerosis suggested that the association between several candidate genes for cardiovascular disease selected for analysis and early age-related macular degeneration (AMD) differs among blacks, whites, Chinese Americans, and Hispanics, which contributes to the variation of AMD prevalence among the groups.


Purpose: To describe the relationships of selected candidate genes to the prevalence of early age-related macular degeneration (AMD) in a cohort of whites, blacks, Hispanics, and Chinese Americans.

Design: Cross-sectional study.

Methods: setting: Multicenter study. study population: A total of 2456 persons aged 45-84 years with genotype information and fundus photographs. procedures: Twelve of 2862 single nucleotide polymorphisms (SNPs) from 11 of 233 candidate genes for cardiovascular disease were selected for analysis based on screening with marginal unadjusted P value <.001 within 1 or more racial/ethnic groups. Logistic regression models tested for association in case-control samples. main outcome measure: Prevalence of early AMD.

Results: Early AMD was present in 4.0% of the cohort and varied from 2.4% in blacks to 6.0% in whites. The odds ratio increased from 2.3 for 1 to 10.0 for 4 risk alleles in a joint effect analysis of Age-Related Maculopathy Susceptibility 2 rs10490924 and Complement Factor H Y402H (P for trend = 4.2×10−7). Frequencies of each SNP varied among the racial/ethnic groups. Adjusting for age and other factors, few statistically significant associations of the 12 SNPs with AMD were consistent across all groups. In a multivariate model, most candidate genes did not attenuate the comparatively higher odds of AMD in whites. The higher frequency of risk alleles for several SNPs in Chinese Americans may partially explain their AMD frequency’s approaching that of whites.

Conclusions: The relationships of 11 candidate genes to early AMD varied among 4 racial/ethnic groups, and partially explained the observed variations in early AMD prevalence among them.

American Journal of Ophthalmology

Associations of Candidate Genes to Age-Related Macular Degeneration Among Racial/Ethnic Groups in the Multi-Ethnic Study of Atherosclerosis

Am J Ophthalmol 2013 Aug 12;[EPub Ahead of Print], R Klein, X Li, JZ Kuo, BE Klein, MF Cotch, TY Wong, KD Taylor, JI Rotter

This abstract is available on the publisher’s site.


Source: Elsevier Inc./Practice Update


Protecting Your DNA

Would you post your DNA on Facebook?

Thousands of Americans could be giving away family secrets

We are all Henrietta Lacks. Or, according to privacy experts, we soon could be. Americans are giving their DNA to companies that research their family origins, scientists say, without thinking through the potential long-term consequences.

This week, the National Institutes of Health said it reached a landmark agreement to protect the privacy of the family of Henrietta Lacks, who died in 1951. Since her death, Lacks’s cancer cells and DNA have been used as the basis for as many as 74,000 scientific papers. For decades, the Lacks family had no idea her cells were being used in experiments around the world. Since finding out, they’ve expressed concern about what Lacks’s genes could reveal about her extended family. The new agreement acknowledges Lacks as the source of the “HeLa” cells, and restricts public access to her — and, by extension, her family’s — genetic information.

Shutterstock.comEnlarge Image

Her case provides a cautionary tale for those who willingly give up their DNA for genealogy tests, lawyers say. (Lacks’s tumor cells were taken without her permission, before federal regulations required patient consent.) With TV shows like “Who Do you Think You Are?” becoming more popular, thousands of Americans are sending swabs of their DNA to genealogy companies to find out where their ancestors came from. What they may not realize: They are potentially handing over medical secrets of their grandparents and future grandchildren, says Erin Murphy, professor of law at New York University School of Law. “These companies operate in a legal gray area,” she says. “They’re not quite doctors, and they’re not quite medical-testing facilities.”

While many genealogy companies do have privacy policies stating that they will not sell DNA or use it for research and development without the customer’s permission, Murphy says they’re still subject to court orders and subpoenas. “Let’s say somebody is in a dispute with their insurer about whether they have some health condition, or they got fired because of some medical condition, this data could become part of the court process,” she says.

In a worst-case scenario, the data could be misplaced or hacked, says Harvard Medical School genetics professor George Church, founder of the Personal Genome Project, which aims to sequence and publicize the complete genomes of 100,000 volunteers. But many companies that promise they won’t sell information to third parties can invite third parties to work on internal research — without breaking that privacy policy. “Even if they only let 50 people look at your DNA,” he says, “you still don’t know who they are.”

700,000-year-old horse DNA found

Dr. Ross MacPhee, curator of mammals at the American Museum of Natural History, joins Lunch Break to discuss the discovery of horse DNA that is 700,000 years old.

Several other studies have even shown that DNA itself can be used to “reverse identify” individuals. In 2008, the Translational Genomics Research Institute, a nonprofit research firm in Scottsdale, Ariz., published a study that identified owners of DNA, even if it accounted for 0.1% of a complex mixture of other people’s DNA.

Another study using software and plain old Internet searches, published in the journal Science in January, demonstrated that surnames can be recovered by matching the Y chromosome of an anonymous subject to genetic data from, say, a third cousin with a known surname. “In most western societies, you get your surname from father and you get your Y chromosome from your biological father as well,” says Yaniv Erlich, a fellow at the Whitehead Institute at the Massachusetts Institute of Technology and co-author of the study. Then, using the state of residence and age of the owner of the DNA, he was able to identify the individuals.

Companies say your DNA is safe with them. Personalized genetics company 23andMe in Silicon Valley, which has over 350,000 customers, says it won’t sell or rent personal information without customer consent. The company’s privacy policy states it won’t use customer data for scientific research in peer-reviewed scientific journals. However, they may still use data for internal R&D purposes to improve their services, “which may include disclosure of aggregated genetic and self-reported information to third-party nonprofit and/or commercial research.” If you choose to close your account, spokeswoman Catherine Afarian says, “you can take your data with you.”

Similarly, FamilyTreeDNA, a Houston-based genealogy company, does not sell or rent personal information without customer consent, but its privacy policy also states that using its services constitutes customer consent, allowing use of “your personal information for purposes of quality control and internal research and development activities.” Bennett Greenspan, founder of FamilyTreeDNA, says the company only carries out scientific research for publication with the consent of customers. “It’s your DNA,” he says, “not mine.”

Even some scientists remain cautious. “We don’t know what exactly you can learn about me from my genome and, in the future, what you will be able to know about me,” says Erlich. “That’s the scary question.” When people upload a Facebook photo, he says, they usually have a sense of how it might infringe on their privacy. Not so with that complex and mysterious hereditary information encoded in our DNA. “Our study showed the downside is that people can still identify these genomes,” he says.

Source: MarketWatch/Quentin Fottrell

Category: Blog · Tags: , , , ,

Minority Kids and Healthcare

Minority Kids Less Likely to Be Diagnosed, Treated for ADHD: Study

Finding points to possible disparities in care

Minority children are significantly less likely than their white peers to be diagnosed or treated for attention-deficit/hyperactivity disorder (ADHD), new research shows.

The study, which is published online June 24 and in the July print issue of the journal Pediatrics, followed more than 17,000 children across the nation from kindergarten to eighth grade. Researchers regularly asked parents if their children had been diagnosed with ADHD.

Even after taking into account a host of factors that may influence behavior, attention and access to health care, researchers found that Hispanic and Asian children and those of other races were about half as likely to receive a diagnosis as whites. Blacks were about two-thirds less likely to be recognized as having problems with attention or hyperactivity as whites.

In addition, when minority children were diagnosed, they were less likely to receive medication than white kids with ADHD, the investigators found.

The study can’t say, however, whether the differences mean that ADHD is being underdiagnosed in minorities or overdiagnosed in whites. Previous research has raised both possibilities.

A study published in the journal Clinical Psychology Review in 2009, for example, found that despite having more symptoms of distractibility and hyperactivity, black children were diagnosed with ADHD less often than whites.

On the other hand, a study published in April 2012 in the Canadian Medical Association Journal found that the youngest children in their school class were more likely to be diagnosed compared to the oldest children in those grades, suggesting that some doctors and teachers may mistake immaturity for ADHD, leading to overdiagnosis.

One expert suggested that socioeconomic and cultural differences may be at work.

Doctors still don’t know if one or both problems may be driving the rates of lower diagnoses in minorities seen in the current study, said Dr. Tanya Froehlich, a pediatrician at Cincinnati Children’s Hospital in Ohio.

“It does seem to be clear that there are some cultural differences at work, and also probably some differences in access to health care and access to health care information,” said Froehlich, who was not involved in the research.

For example, the study noted that children without health insurance were less likely to be diagnosed with ADHD than children who had coverage. Kids from lower-income families were also less likely to be diagnosed.

Yet, children with older mothers, who tend to be more highly educated, and those with parents who spoke to doctors in English were more likely to be diagnosed with the condition. Both those factors are signs that access to health care and awareness of the problem may also be playing a role.

Several risk factors for ADHD occur more often in minority children than in whites. Those include a lower household income, less educated parents and low birth weight.

“What that suggests in our study is that there are children who are likely deserving of a diagnosis, but who aren’t receiving a diagnosis, which raises the question of a lack of treatment,” said study author Paul Morgan, director of the educational risk initiative at Pennsylvania State University in University Park, Pa.

The consequences of ADHD can be serious if the condition is left untreated.

“We know that people with ADHD have higher rates of failing a grade in school, lower academic achievement, lower achievement in their jobs, higher rates of incarceration, higher rates of substance abuse, more problems with relationships, and higher rates of depression and anxiety,” Froehlich said. “It is extensive.”

There’s some evidence that treatment, either with behavioral therapies or medication, can improve the outlook for affected children.

“Definitely, we want all kids to be treated and to have the best chance possible for success in life,” Froehlich said. “So if people truly have ADHD and they’re not identified, that’s going to hold them back.”

Source: Health Day/Brenda Goodman

Race-based Lawsuit

Lawsuit: Race-based request sidelined Michigan nurse
By Ben Brumfield , CNN
updated 1:35 PM EST, Sat February 16, 2013
(CNN) — A nurse is suing a hospital, claiming it agreed to man’s request that no African-Americans care for his baby.
The lawsuit accuses managers at Hurley Medical Center in Flint of reassigning Tonya Battle, who has worked at the facility for 25 years, based on the color of her skin.
The man approached Battle, while she was caring for his child in the hospital’s neonatal intensive care unit, asking to speak to her supervisor, according to the complaint filed in January by Battle’s attorney.
She pointed the charge nurse in his direction.
The man, who is not named in the filing, allegedly showed her a tattoo that may have been “a swastika of some kind” and told her that he didn’t want African-Americans involved in his baby’s care.
The request, according to the lawsuit, made its way through management ranks, and was granted. Battle’s manager called her at home to tell her she would be reassigned — and why, the suit says.
She was shocked and in disbelief, her attorney Julie Gafkay told CNN affiliate WNEM. “She was very upset. She was very offended.”
The hospital did not immediately respond late Friday to a CNN request for comment.
A note made its way onto prominent spot on the baby’s medical chart, according to the suit: “Please, no African-American nurses to care for … baby per dad’s request.”
The hospital’s lawyer then objected to the decision, and the note was removed. The staff then told the father that they could no long honor his request, according to the complaint.
Even so, the lawsuits alleges, for more than a month no African American nurses were assigned to care of the child.
CNN’s Marlena Baldacci contributed to this report.
© 2013 Cable News Network. Turner Broadcasting System, Inc. 

Where’s the Diversity?

Diversifying the allied health care workforce is vital in providing quality health care for all Americans
What do Martha Stewart house paint and the allied health workforce have in common? Give up? Both come in any shade of white you can imagine. Of course, the controversial diva of decorating also offers 4,000 or so other choices, whereas the color palette for allied health professionals is currently much more limited. In fact, statistics indicate that minorities comprise only about 10% of allied health care professionals in this increasingly diverse country.

At the turn of the 20th century, the U.S. population was 13% minority (African American, Hispanic, Native American and Asian/Pacific Islander). Today, these individuals comprise one-quarter of our nation’s population. According to the U.S. Census Bureau, by 2050 it is likely that more than one-third of our residents will identify themselves as minority. With this kind of increase, one would expect to see a similar rise echoed in the health care workforce across the U.S. This, disappointingly, is not the case.

The lack of diversity certainly is not due to a lack of available positions. The Allied and Auxiliary Health Care Workforce Project from the Center for the Health Professions at University of California, San Francisco, reports that allied health workers make up an estimated 60% of the U.S. health care workforce, totaling more than 11 million workers. The Bureau of Labor Statistics lists pharmacy technicians, laboratory technologists, physician assistants, physical therapists and occupational therapists as some of this decade’s fastest-growing occupations. In fact, out of the list of the top 30 fastest growing jobs in the U.S. from 2000-2010, more than half are expected to be allied health jobs. Unfortunately, the supply of allied health care workers isn’t expected to keep up with this rise in demand. The American Hospital Association (AHA) estimates vacancy rates of 21% for pharmacists, 18% for radiological technologists and 12% for laboratory technologists.

The Importance of Diversity


Having a poor representation of minorities in the allied health care profession poses many problems. It has become painfully obvious that in this culturally rich country, minorities do not receive the same level of health care as their white counterparts. Research from the Institute of Medicine, the Kaiser Family Foundation and the Commonwealth Fund suggests that there are differences in treatment and health care outcomes based on race and ethnicity. These disparities are caused by many factors, such as differences in socioeconomic status (education level and income), differences in the health behaviors of those seeking care and adhering to treatments, the lack of multicultural tools and sensitivity in part of the health care provider, language barriers, payment and coverage, outright discrimination and stereotyping by health care practitioners, and the lack of diversity in the health care workforce.

The recognition that we have a problem in this area has prompted the federal government to issue the bold goal of eliminating racial and ethnic health disparities in this country. As addressed in the U.S. Department of Health and Human Services’ Healthy People 2010 initiative, the mission is to achieve health care parity by the end of the decade. Specific emphasis will be placed on ensuring cultural competency among health care providers.

With a more diverse population of health care providers, many issues of health care disparity might be resolved. By increasing the representation of minorities in the health care workforce, more underserved populations could receive health care. A culturally diverse health care workforce can more effectively care for a diverse population, as many people prefer to discuss their health care concerns with someone from a similar background.

“Most of the major public health issues today disproportionately affect minorities,” says Terry Brown, RD/LD, vice president of the North Texas Chapter of the National Organization for Blacks in Dietetics and Nutrition. “Who could better understand their plight than someone from their racial/ethnic group? We want to speak to people who understand us culturally and face some of the same challenges we do.”

By creating a more culturally diverse health care team, better patient communication and treatment will occur along with the bonus that non-minority health care workers will become more aware and sensitive to ethnically diverse patients. In “up close and personal” professions, like physical therapy and occupational therapy, cultural sensitivity becomes even more important in patient care. “When mastering activities of daily living like meal preparation, bathing, etc., you need to have an appreciation of the values and beliefs of a population,” says Janie Scott, the director of the Practice Department and Ethics for the American Occupational Therapy Association.


How Do We Get There From Here?

Most everyone agrees that we need a more culturally diverse population walking the halls of America’s hospitals and clinics, but how do we get them there? This is the question that has puzzled allied health organizations for years. Many professional organizations faced up to the issue of workplace diversity about 20 years ago, formally waging war against the underrepresentation of minorities in their professions.
Johnette Meadows, PT, MS, who served as director of the Department of Minority and International Affairs in the American Physical Therapy Association (APTA) for 14 years, reports that the APTA recognized the need to address this issue about 15 years ago. Since then, the APTA has worked to embed cultural diversity into its goals, objectives and vision. “We are involved with promoting cultural diversity in workshops at schools, in our Web page, and during recruitment and speaker’s bureaus,” says Meadows.

“We market people of color. We want to show that our membership is diverse. We want advocates and speakers of all races to represent our organization,” Meadows continues. “The APTA is proud of their accomplishments, which not only promote cultural competency to its professionals, but also attempts to recruit a diverse enrollment at the local level.”

Despite the APTA’s ongoing efforts to increase diversity, they currently report that 90.8% of their members are white, 4.2% Asian, 1.9% Hispanic, 1.5% African American, 0.5% American Indian/Alaskan Native and 1.1% other. Physical therapy has traditionally been considered a female field, with 65% of its members female.

The American Dietetic Association (ADA) has also long recognized that their membership is far too homogenous, with only 13.6% male, 2.5% African American, 1.7% Hispanic, 4.8% Asian/Pacific Islander, and .2% American Indian/Alaskan Native/Hawaiian Native. According to Terry Brown, RD/LD, “The lack of visibility of dietetics to young minority people and the academic disadvantaged is one of the principle reasons for underrepresentation of minorities.” She also credits poor rates of cultural diversity among dietitians to contributing factors such as few minority role models, low pay in the profession, lack of access to a dietetics program, discrimination, poor recruitment, lack of knowledge to the field of dietetics, and lack of financial resources for a program.

In an attempt to improve diversity, the ADA has promoted a diversity committee, mentoring contract, action award, promotion grant, resource list, and ADA networking groups, such as the National Blacks in Dietetics and Nutrition, the Chinese American Dietetic Association and the Hispanic Dietetic Association.

Jeannette Jordan, a Charleston, S.C.-based registered dietitian and spokesperson for the ADA, serves as a nutrition consultant for the Reach 2010 Project, which is funded by the Centers for Disease Control and Prevention to decrease disparities in African Americans with diabetes. Jordan believes that lack of knowledge regarding the opportunities that exist in the field, apprehension about acceptance into the profession, the difficulty of being accepted into an internship affect minority participation in the profession of dietetics.

In the mid-1980s, the American Occupational Therapy Association (AOTA) began establishing multicultural initiatives that focused on student recruitment from a cross section of the population. “When our profession started in World War I, it was primarily white middle class women who wanted to help soldiers. This captured the hearts of women at the time. Services were provided in private hospitals, in a confined community,” says Janie Scott, of the AOTA. With noncompetitive salaries, the profession became a convenient one for suburbanite mothers who wanted to move in and out of their profession.

The AOTA looked at ethnicity in their membership in 2002. Out of 33,003 members, 20% did not list ethnic origin. Of those who did list their ethnicity, 1.9% were African American, .2% American Indian, 3.3% Asian, .3% Asian American, 1.5% Hispanic/Latino/ Latina, .2% Multiracial, .8% other and 71.9% white. With a growing diverse patient base, the AOTA wants to enlist a more diverse membership and boost support groups such as the Black Occupational Therapy Caucus and the Native American Occupational Therapy Group.


Educating the Future

The problem of poor diversity in health care professions has its roots in the higher education system. For many reasons, minorities are not enrolling in allied health programs, as is evidenced in the 10th Report by the Center for Health Workforce Studies, which shows a decline in the number of minorities applying to all health professions education programs.

Despite ardent measures to attract a diverse population, at the Texas Tech University Health Sciences Center in Lubbock the enrollment is estimated at 8% minority. Yet at Texas Southern University College of Pharmacy and Health Sciences in Houston, enrollment is typically only about 10% white. Since 1949, Texas Southern University College of Pharmacy and Health Sciences has educated approximately 35% of the nation’s black pharmacists. Schools that have been designated as special purpose institutions serving minorities, such as Texas Southern University of Pharmacy and Health Sciences, don’t appear to have troubles attracting diverse students in search of allied health careers to campus.

The University of Kansas Medical Center and the University of Missouri-Kansas City recognized that they needed to increase the participation of minority students in health professions and put together a groundbreaking package to do something about it. The Health Professions Pipeway Initiative, a multi-institutional, multidisciplinary strategy, hopes to lead the way to greater diversity in health professions.

Funded by a grant from the U.S. Department of Health and Human Services, Division of Disadvantaged Assistance and the University of Kansas Medical Center, this program targets high school seniors and college undergraduates. Offered throughout the year at satellite centers on university campuses, the program hosts many opportunities, such as counseling, field trips, academic enrichment, tutorials, health career clubs and seminars. At no cost to the student, an eight-week Health Science Enrichment Institute Summer Program is provided for disadvantaged or minority students and offers them preparation for admission to a health professions school. The enrichment program focuses on reading, communication, mathematics, biology, chemistry and test-taking skills, which may not be developed in disadvantaged students.

Many other organizations are addressing the health care diversity crisis. The Institute of Medicine has identified strategies to increase the racial and ethnic diversity of the nations’ health care workforce, which includes modifying admissions practice and criteria, placing greater emphasis on cross-cultural skills and competencies in heath professions training and accreditation procedures, and increasing the number of minority faculty. In South Carolina, the South Carolina Hospital Association and South Carolina Technical College System announced a $476,000 grant through the federal Workforce Investment Act to assist students seeking a career in health care.


Setting Examples

One of the programs shining the brightest light on the path of cultural diversity in health care is the Health Careers Opportunity Program (HCOP), which has established goals of increasing the number and quality of individuals from disadvantaged backgrounds into health profession schools. By achieving these goals, we might better meet the expanding health care needs of an underserved population while developing a more competitive applicant pool to build diversity into health professions. In 1999, the Bureau of Health Professions awarded 112 HCOP grants for a total of $28.2 million to 59 undergraduate institutions and community colleges, 50 health professional schools and health science centers, and three public and nonprofit organizations. Of these 112 grants, 29 grants were awarded to Historically Black Colleges and Universities.

The HCOP has made a significant impact on careers. Over the past 20 years, the HCOP has nurtured the entrance and graduation of thousands of minority and disadvantaged students into health professions school. Between 1980-1999, an average of 8,500 students participated in HCOP each year. In addition, thousands of students received counseling or other services.

Now the HCOP focuses on increasing education and social and cultural competence early on in the educational pipeline. Major emphasis is placed on developing partnerships with community-based organizations that promote education and cultural diversity. They reach out to students in lower grade levels to attract more into heath professions.

Often health professional programs admit students in their junior year of college, which may be too late to attract the interest of minority students who are simply underrepresented in college to begin with. Organizations like the AHA have developed a Commission on Workforce for Hospitals and Health Systems, which encourages hospital leaders to build a thriving workforce by reaching out to students in grades K-12 with the help of local colleges and universities.

The Robert Wood Johnson Foundation and the W.K. Kellogg Foundation, in conjunction with the Health Professions Partnership Initiative, awarded six grants to increase minority participation in health professions. A requirement of this grant is that efforts focus on middle and high school curricula.


A Question of Class

Chances are, however, that plenty of minority kids will still go to disadvantaged schools that aren’t targeted for recruitment or aid, causing them to miss the opportunity to discover careers in health professions. Even the kids that consider an education in a health field may lack the math and science skills, not to mention the financial resources, needed to enter an allied health program.

Michael Castillo, now president of the Latino Midwest Medical Student Association, attended the University of California, Berkeley, where he graduated with an undergraduate degree in biochemistry and molecular biology. Castillo reported that at Berkeley the initial enrollment of 180 minority students in his class wound up with only three graduating with a degree.

When talking about the issues of cultural diversity in the health care education setting, Michael Castillo says, “This isn’t an issue of color. It has to do with socioeconomic class. The minority students who attend college are from affluent backgrounds; the black child from Beverly Hills doesn’t share the same experience as the white person in Harlem.”

 Even for college-bound minorities, the allied health professions may not appear glamorous or financially rewarding enough to be worth the cost in sweat and dollars. “There is a hefty cost associated with entering an allied health field. It’s much cheaper to become a computer programmer,” says Janie Scott of the AOTA.

But the wave of the future may be in the hands of those working the health care beat. Health professionals on the home front can make a difference in diversifying the health care force. As they create opportunities to educate children about their profession, mentor minority children in the community and attend career days at local schools, they can make a difference by boosting the number of minorities entering their profession.

Providing high-quality, sensitive care to all cultures probably speaks the best recommendation to the impressionable patient and their families. It sends the message that these careers offer opportunities for all ethnicities. And the more culturally diverse the health care team becomes, the more role models are sent out into the community. By creating a diverse profession that provides health care services to an equally diverse population across our country, the caregiver opens his or her eyes to the unique values and backgrounds of every patient.

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Genetics Blamed for School Transfer

California Boy, Ordered To Transfer Schools For Carrying Cystic Fibrosis Gene

Colman Chadam, an 11-year-old California boy, has been ordered to transfer from his current school to another one miles away because of his genetic makeup. Now, his parents are taking the issue to court.

Colman carries the genetic mutations for cystic fibrosis, a noncontagious but incurable and life-threatening disease. Despite the gene’s presence, the Jordan Middle School student in Palo Alto doesn’t actually have the disease and doesn’t exhibit the typical symptoms of thick mucus that can clog and infect the lungs.

Cystic fibrosis is inherited from both parents and while not contagious, can pose a threat if two people with the disease are in close contact. In an effort to protect other students at the school who do have the disease, officials declared that Colman would have to transfer out to prevent cross contamination.

“I was sad but at the same time I was mad because I understood that I hadn’t done anything wrong,” Colman told TODAY. “It feels like I’m being bullied in a way that is not right.
Colman’s parents argue that their son’s doctor has confirmed that the boy doesn’t have the disease, and therefore isn’t a risk to other students. They disclosed his condition on a medical form for the school at the beginning of the year as a precautionary measure, but never expected their son to be barred from the school, as his genetic makeup had not been an issue in the past at other schools with students who have cystic fibrosis.

“They made this decision without seeing one medical record on my son,” mother Jennifer Chadam told the San Francisco Chronicle. “Honestly if I felt Colman was a risk to others, I would move him. I don’t want anyone to get sick.”

Palo Alto Associate Superintendent Charles Young told NBC News that officials made the request to move Colman based on consultations with medical experts who said a transfer would be the “zero risk option.”

While the district’s attorney Lenore Silverman told the Chronicle that school officials are “not willing to risk a potentially life-threatening illness among kids,” Dr. Dennis Nielson says a child is “at absolutely no risk to the children that have classic cystic fibrosis” if he or she has a normal sweat test — which is the case for Colman. Nielson is the University of California, San Francisco’s chief of pediatric pulmonary medicine and head of its Cystic Fibrosis Clinic.

Colman’s condition echoes situations experienced by students across the country with allergies. A U.K. study last year found that adolescents who have a nut allergy tend to feel isolated, stigmatized or left out of activities.

Those findings are anecdotally supported by stories like one out of Edgewater, Fla., where parents in the Volusia County School District rallied behind a movement to remove a 6-year-old girl from the classroom last year. Homeschooling the child, they said, would reduce frustrations other families experience for having to comply with special rules to ensure the girl’s wellbeing.

Colman is currently being homeschooled pending a court hearing next week.

Source: Huff Post