Each county is ranked within the state on how healthy people are and how long they live. They also are ranked on key factors that affect health such as: smoking, obesity, binge drinking, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates and number of children living in poverty.

Other studies have ranked states on health factors, but this is the first time researchers have examined the multiple factors that affect health in each county in all 50 states.

Poorly ranked counties often had multiple challenges to overcome, including:

• Two- and three-fold higher rates of premature death, often from preventable conditions.
• High smoking rates that lead to cancer, heart disease, bronchitis and emphysema.
• High rates of obesity which can put people at risk for diabetes, disability and heart disease.
• High unemployment and poverty rates.
• High numbers of liquor stores and fast-food outlets but few places to buy fresh fruits and vegetables.

“For the first time, people have a tool to help identify what is making people in every county unhealthy,” says Patrick Remington, M.D., M.P.H., associate dean for public health at the University of Wisconsin School of Medicine and Public Health. “We hope this kind of check-up will mobilize community leaders to take action and invest in programs and policy changes that make their counties healthier places to live.”

The online Rankings, available at www.countyhealthrankings.org, include snapshots of U.S. counties with a color-coded map that compares each county’s overall health with other counties in each of the 50 states. Researchers used the latest data available for each county, ranging from 2000 to 2008, to develop the Rankings.

For more information, visit www.countyhealthrankings.org.

Click below for an important brochure from the Centers for Disease Control about the H1N1 flu

Below is the introduction. You can download the entire report here: http://www.jointcenter.org/hpi/sites/all/files/raceethnicityandhealthcarereform.pdf

Health care reform proposals before Congress offer potential for great progress in improving health care affordability, access and quality for all Americans—an opportunity not seen for decades. Little discussed, however, is that major provisions are likely to have a significant impact on minorities as they present opportunities to redress longstanding inequities. Moreover, the bills which have emerged from House and Senate committees explicitly recognize the need to reduce disparities; each includes provisions intended to support initiatives targeting racial and ethnic minorities and language access services. While both leading bills offer solutions to reduce racial and ethnic disparities in health, each one differs in the level of its commitment and approach.

This issue brief identifies, analyzes and compares provisions which explicitly address the health and health care needs of racial and ethnic minorities within the two leading Congressional health care reform proposals: The Affordable Health Choices Act of 2009 (H.R. 3962)passed in the House of Representatives on November 7, 2009; and The Patient Protection and Affordable Care Act of 2009 (H.R. 3590) introduced in the Senate on November 18, 2009, as a merged version of the Senate Finance Committee’s America’s Health Future Act (S.1796) and Senate Committee on Health, Education, Labor, and Pensions’ (HELP) Affordable Health Choices Act (S. 1697). Additionally, this issue brief explores the potential implications of broad health care reforms for racial and ethnic minorities. Also discussed is how each bill could decrease disparities and improve minority health, where each falls short in advancing these goals, as well as the transitional challenges and questions for the future should health care reform legislation be enacted.

INCREASING PARTICIPATION OF ASIAN AMERICANS
AND PACIFIC ISLANDERS IN FEDERAL PROGRAMS

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1. Policy. The more than 16 million Asian Americans and Pacific Islanders (AAPIs) across our country havehelped build a strong and vibrant America. The AAPI communities represent many ethnicities and languages that span generations,and their shared achievements are an important part of the American experience. They have started businesses and generated jobs, including founding some of our Nation’s most successful and innovative enterprises. The AAPI communities have made important contributions to science and technology, culture and the arts, and the professions, including business, law,medicine, education, and politics.

While we acknowledge the many contributions of the AAPI communities to our Nation, we also recognize the challenges still faced by many AAPIs. Of the more than a million AAPI-owned businesses, many firms are small sole-proprietorships that continue to need assistance to access available resources such as business development counseling and small business loans. The AAPI community also continues to face barriers to employment and workplace advancement. Specific challenges experienced by AAPI subgroups include lower college-enrollment rates by Pacific Islanders than other ethnic groups and high poverty rates among Hmong Americans, Cambodian Americans,Malaysian Americans, and other individual AAPI communities. Additionally, one in five non-elderly AAPIs lacks health insurance.

The purpose of this order is to establish a President’s Advisory Commission on Asian Americans and Pacific Islanders and a White House Initiative on Asian Americans and Pacific Islanders. Each will work to improve the quality of life andopportunities for Asian Americans and Pacific Islanders throughincreased access to, and participation in, Federal programs inwhich they may be underserved. In addition, each will work to advance relevant evidence-based research, data collection, and analysis for AAPI populations and subpopulations.

To read the rest of the Executive Order, see below.

Note: There is a file embedded within this post, please visit this post to download the file.

HIV prevalence among African Americans is ten times greater than the prevalence among whites. This racial disparity in HIV prevalence has persisted in the face of both governmental and private actions, involving many billions of dollars, to combat HIV. In the November 2009 issue of the American Journal of Preventive Medicine, researchers from the University of North Carolina at Chapel Hill examine factors responsible for the stark racial disparities in HIV infection in the U.S. and the now concentrated epidemic among African Americans.

The article is “Ending the Epidemic of Heterosexual HIV Transmission Among African Americans” by Adaora A. Adimora, MD, MPH, Victor J. Schoenbach, PhD, and Michelle A. Floris-Moore, MD. It appears in the American Journal of Preventive Medicine, Volume 37, Issue 5 (November 2009) published by Elsevier.

Earlier this month, the U.S. Census Bureau released the latest data on income, poverty, and health coverage.

Our new fact sheet, Health Coverage in Communities of Color: Talking about the New Census Numbers takes a closer look at the latest data and finds that communities of color continue to bear the brunt of the uninsured crisis. This fact sheet looks at who is uninsured, who is living in poverty, and why public programs are vital to communities of color.

As Congress continues to debate about how to best improve our nation’s health care system, we’re presented with the opportunity to eliminate disparities in health coverage and address other inequities in the system.

We hope you find this a valuable resource in your work to achieve health equity.

To download the new fact sheet, click here.

A DRA Project “State of the Health Equity Movement” Memo 09-01

Prepared by Jerusha Haasenritter and Stella Han, Institute for Alternative Futures
September 17, 2009

“The growth of the Health Equity Movement is reflected by a rising number of government entities (local, state, federal) and organizations explicitly recommending and pursuing health equity. This memo compiles the recommendations for 28 of these efforts and provides a table to illustrate the recommendations from nine of these.”

The introduction of this memo can be found below. To read the report in its entirety, you can download it here:

Introduction

In 2005 Michael Marmot stated, “If you catch the metro train in downtown Washington, D.C., to suburbs in Maryland, life expectancy is 57 years at beginning of the journey. At the end of the journey, it is 77 years. This means that there is 20‐year life expectancy in the nation’s capital, between the poor and predominantly African American people who live downtown, and the richer and predominantly non‐African American people who live in the suburbs … The social determinants of these two individual’s lives are different, and we must acknowledge this and think of poverty in a different way. It is about opportunities in life and control over one’s life, in addition to social conditions that shape the physical environment one lives in1.” The differences in these two individual’s lives reflect health inequities as they exist in the United States. However, a growing movement towards acknowledging and taking steps to reduce these inequities exists and is referred to as the health equity movement. This movement focuses on prevention and addressing the social determinants of health which include “income and social status (income inequality and social class), social support networks (social exclusion and social isolation), education, employment and working conditions (unemployment), physical environments (food and transportation), social environments, community norms, healthy child development, health services, and gender and culture2.” This movement advocates for health reform, not just health care reform.

Currently, health equity advocates are moving beyond solely identifying the inequities, to focus on what actions will create health equity. The following document compiles 28 reports (including memos and briefs) that serve as indicators of the health equity movement and its growth. All of these reports offer recommendations, strategies, and/or priorities for health equity, specific to the subject area of the report. The reports presents an examination of a variety of recommendations, representing different subject areas, and delivering a diverse focus.

The purpose of this document is to disseminate information by presenting varying strategies and recommendations for those who are interested to get a better idea of possible means to bring about an end result. This document has two components:

1. An illustrative chart of ten reports, giving an overview of certain themed recommendations; and
2. A list of 28 significant reports regarding health disparities, health equity, prevention, and the social determinants of health. The list details recommendations, priorities, and/or strategies, with links to each report included.

The reports included illustrate the growing activity in the health equity field. We acknowledge there are others and will gather these for subsequent inclusion in DRA Project reviews of activity. In considering the range of policies recommended, the advice from the Multnomah County Health Initiative (2009) is relevant to share. The effort recognized three emergent themes:

1. There is no single “magic bullet” policy or short list of policies that will eliminate the inequities that result in health disparities, solutions need to come from the coordinated effort of policy makers, bureaucrats and community members,
2. local efforts at eliminating inequities should be driven by local data on existing health disparities, and
3. local governments should look at their own policies that perpetuate inequities.

If you would like to request that any information be edited or added, or have other examples please email Jerusha Haasenritter at jhaasenritter@altfutures.com. This document is part of a larger DRA Project effort to identify “The State of the Health Equity Movement”. For more information, please email jhaasenritter@altfutures.com. To find out more about the DRA Project, please visit http://www.altfutures.com/draproject/ .

By Paul Kleyman
Editor’s Note: Seasoned aging and elder issues commentator Paul Kleyman remixes the news–and misinformation–on health care reform as he pronounces “The Boomers are coming!” Many conservative news sources have distorted the stats on Obama’s victory, Kleyman argues, especially when it comes to the assumption of conservatism among America’s elders.

Read this article here

2. Aging in the Inland Empire: African-American Elders in Peril

This is the first in a two-part series examining the plight of African-American elders and people with disabilities in Southern California’s Inland Empire. New America Media political journalism fellow Linnie Frank Bailey examines the effects of recent budget cuts that have reduced services in the state’s adult day health care centers from five to three days a week.

Part One -– The Unraveling of the Safety Net: click here

See below for an excerpt and click here to read the full article.

With the rapid aging of the U.S. population, American Indian and Alaska Native (AI/AN) communities face many of the same concerns as the rest of the nation, such as the diminishing size of families, which traditionally have provided informal assistance to older adults.

As of mid-2002, U.S. Census data show more than 4.3 million AI/AN people in the United States, comprising 1.5% of the total population. Overall, Al/ANs have higher rates of mortality and morbidity from heart disease, injuries, cancer and diabetes. Also, rates in AI/AN populations of these and other conditions, such as communicable diseases, infant mortality and kidney disease, exceed those of the general population.

DISTINCT COMMUNITIES

In addition, AI/AN people have long maintained separate and distinct lands. Within these mostly small and independent geographic areas, the aging of populations can have devastating results. For example, our research shows that some AI/AN communities already have no potential caregivers available.

Older adults in AI/AN communities have always depended heavily on their families for care. This system seems to have functioned well in the past, contributing to the belief that AI/ANS are stoic figures who do not need assistance and can take care of their own elders. However, some researchers have concluded that the reason caregivers in these populations performed so well with fewer health problems was because AI/AN caregivers tended to be younger than those in the broader population. This advantage will be lost if there are fewer younger AI/ANS-and, therefore, fewer caregivers-available to look after an increasing number of chronically frail older adults in the local population.

Although families remain the primary providers of long-term care services to older adults for all races and ethnicities, AI/AN communities exhibit changing dynamics, which will further affect their families’ capacity to provide care in the future. Identifying these dynamics is important because if caregivers-especially those in small communities-are less available, it behooves local planners to search for alternative ways to meet the needs of their frail and disabled older adult constituents.

The Opportunity Agenda, in collaboration with the Health Policy Institute at the Joint Center for Political and Economic Studies, has released a body of research that explores best practices for integrating maps into health advocacy. The volume, Using Maps to Promote Health Equity, provides research and case studies, while presenting key strategies for effective use and overcoming technical hurdles.

Pulling from some of the brightest and most innovative scholars and practitioners in the field of mapping and health advocacy, the volume presents eight chapters and an executive summary that helps focus advocates on how this mapping can be a vehicle for change. Recent advancements in web-based mapping have grown extensively, thanks to the integration of web tools like Google Earth and Geographic Information Systems (GIS), which allow access to, and plotting of, complex sets of data.

The volume goes beyond the technical foundation, providing additional insight into social engagement of communities and the media, bridging the art and science of mapping at the intersection of health advocacy. Readers not only learn how maps can bring life to complex data, but also how data, when mapped effectively, can show us the path for a better life for the millions of Americans who are exposed to unequal health factors every day.

For over 150 years, since British physician John Snow published his London maps that isolated the cholera pandemic of 1853, maps have helped us gain a greater understanding of the world around us, as it relates to social and health inequities. Projects like HealthyCity.org and Not Just a Number have stayed on the forefront of interactive mapping, bringing a sense of community and activism around what would otherwise be a static image on a page. Their model, in addition to the many other case studies shared throughout this compendium, demonstrates how new media and maps can act as a powerful tool for health advocacy.

Drawing from its findings, this series of papers offers guidance for all those advocating for social justice and the public interest. Taking direction from leading voices across a broad range of issues, the authors used health equity as a frame to hallmark just how powerful maps can be toward breaking down barriers on the road to opportunity.

The executive summary and full report is available at opportunityagenda.org/mapping. For a print copy of the summary and a CD-ROM which includes the entire volume of research, contact Tony Stephens at tstephens@opportunityagenda.org.