Health Policy Fellows
Health Affairs published a study by lead author Danny McCormick, MD, MPH, a 2004 Health Policy Fellow and assistant professor at the Harvard Medical School. The study found that computerized patient records are unlikely to cut health care costs and may encourage doctors to order expensive tests more often. Health Affairs also featured a blog post about the study, which received media coverage in the New York Times. McCormick is also a member of the department of medicine at the Cambridge Health Alliance.
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- Clinical Scholars
- Community Health Leaders
- Health & Society Scholars
- Health Policy Fellows
- Investigator Awards in Health Policy Research
- New Connections
- Nurse Faculty Scholars
- Physician Faculty Scholars
Clinical Scholars
Nazleen Bharmal, MD, a Clinical Scholars alumna (’09) and clinical instructor in the division of general internal medicine and health services research at UCLA, was lead author on a study that traced disparities in life expectancy between Blacks and Whites in the United States. The study, published in the February issue of Health Services Research, found that White males live about seven years longer on average than African American men and that White women live more than five years longer than their Black counterparts. When comparing life expectancy on a state-by-state basis, Bharmal and colleagues found that in those states where the disparities were smallest, the differences often were not the result of African Americans living longer but of Whites dying younger than the national average.
Clinical Scholar James Burke, MD, (’10) is the lead author of a study that finds that stroke patients often get redundant and costly brain scans. The study was published in the February issue of the Annals of Neurology. Burke and colleagues explain that an MRI scan is a more accurate test for a stroke, but patients often get CT scans as well, raising the cost of inpatient stroke care. The study received media coverage in Health Day, CBS Detroit, MDNews.com, and others.
Deepa Camenga, MD, (’09) a third-year Clinical Scholar at Yale University, and Kelly Kyanko, MD, (’08) a program alumna and instructor of medicine at New York University, conducted a pilot project to increase adult caregiver Tdap (also known as whooping cough) vaccination rates by offering the vaccine during infant well-child visits. They vaccinated 69 percent of mothers and non-mother caregivers during their child’s two-week well-child visit and discovered that a large proportion of caregivers did not receive routine medical care or have insurance. These findings, published in the January issue of Academic Pediatrics, suggest that vaccination in the pediatric office represents a substantial opportunity to increase vaccination rates. Read an RWJF story about their work.
In a study published in the March issue of Health Affairs, Robin Clarke, MD, (’10) and colleagues found that the assessment tool used by federal government programs to measure whether a community health center is functioning as a “medical home,” does not adequately evaluate the services that determine the quality of diabetes care in community health centers. In fact, they found that there is no relation between how well a health center scored on the assessment and the quality of diabetes care it provided. Read a Health Affairs Blog post about the study.
A study of Latina women with young children led by Lisa DeCamp, MD, (’08) a pediatrician at Johns Hopkins Children’s Center, revealed that moms value a pediatrician’s empathy and warmth more than their ability to speak Spanish. In an article for Medical News Today, DeCamp said, “Many medical schools emphasize the importance of sensitivity to ethnic and cultural differences, but this study suggests there may be more similarities than differences across ethnic groups. Such commonalities are what we should really focus on.” The findings were published online on February 15, 2012 in Maternal and Child Health Journal.
The Archives of Internal Medicine published a research letter by Justin Fox, MD, (’10) and colleagues, including Clinical Scholars alumnus and Yale Program Director Cary Gross, MD, (’97) where they discuss “Older Patient Experiences in the Mammography Decision-making Process.” They argue that the benefit of mammography for breast cancer screening among women older than 75 years is unclear. Therefore, a more individualized approach to cancer screening that considers a patient’s age, health status, and preferences would optimize screening practices and avoid screening women unlikely to benefit, a phenomenon that may apply to two of every five mammograms in this age group.
In a study published in the New England Journal of Medicine, Clinical Scholars alumna Margaret Gourlay, MD, MPH, (’02) assistant professor at the University of North Carolina, and colleagues found that frequent bone-density scans may not be necessary for half of women over the age of 65. Of the 5,000 women in the study, half were in this low-risk group at the age of 67. According to a story on National Public Radio about the study, Gourlay found that women who show no bone loss, or very little, on their first bone density scan do not need another scan for 15 years. For women whose initial bone scan shows a moderate level of bone loss, the study indicates another scan in five years. Medicare currently pays for bone scans every two years, but Gourlay cautions that many women may not be getting the baseline test that would provide information about their risk category, and thus how often they should get a repeat scan.
Community Health Leaders
Rajiv Kumar, MD, (’09) a founder of ShapeUp Inc., is co-author of a study, “Teammates and Social Influence Affect Weight Loss Outcomes in a Team-Based Weight Loss Competition,” published in the March 2012 issue of Obesity. The study found that people who lost at least 5 percent of their initial body weight during a weight loss competition were likely to be on the same teams. The findings are based on the results of the 2009 Shape Up Rhode Island campaign, a 12-week, statewide, online weight loss competition.
Health & Society Scholars
Dawn Alley, PhD, (’06) is the lead author of a February 13 Archives of Internal Medicine study that finds that obesity, and the chronic conditions that often come with it, are a major contributor to the growth in Medicare expenses. Each obese beneficiary adds an additional $149 a year to Medicare, according to the study, “Changes in the Association Between Body Mass Index and Medicare Costs, 1997–2006.” Alley and colleagues collected survey data on nearly 30,000 Medicare beneficiaries. They divided the people into three groups—normal, overweight, and obese—depending on their body mass indexes, or BMIs, a measure of weight in relation to height. Between 1997 and 2006, the percentage of obese people rose from 21 percent to 29 percent of Medicare beneficiaries.
Investigator Awards in Health Policy Research
Lisa Iezzoni, MD, MSc, a 1996 Investigator Awardee and a member of the Clinical Scholars program national advisory committee, is lead author of a study published in Health Affairs that finds that a large number of physicians are not always honest and transparent with patients. A fellow physician discusses Iezzoni’s findings for the New York Times Well blog.
New Connections
Do purchases of sugar-sweetened beverages among low-income Black adolescents reduce after people are exposed to caloric information? Sara Bleich, PhD, Healthy Eating Research–New Connections alumna, answers this question in her recently published study in the American Journal of Public Health. Watch a video of Bleich discussing her findings.
New Connections alumnae Emma Sanchez-Vaznaugh, ScD, MPH, (’08) and Cristiane Duarte, PhD, MPH, (’06) will discuss their research at the 2012 Latina Researchers Conference: Increasing the Pipeline for Future Scholars. Sanchez’s work focuses on racial/ethnic disparities and population patterns in obesity, while Duarte’s research examines the relationship between Hispanic children’s mental health and factors of high social impact.
Using structural equation modeling, New Connections alumnus, Raphael Travis, DrPH, (’08) examined the influences of rap music on ethnic identity, self-esteem, perceptions, and health behaviors among youth. The study is published in the Journal of Youth Studies.
Nurse Faculty Scholors
The University of California at Los Angeles (UCLA) School of Nursing received a five-year, $1.2 million grant from the National Institutes of Health for a program to increase physical activity among youth in the predominantly minority Los Angeles public schools. Kynna Wright-Volel, PhD, MPH, RN, FAAN, (’08) assistant professor at UCLA School of Nursing, will direct the grant. Project SHAPE LA will target 24 middle schools in low-income neighborhoods of Los Angeles and will involve about 12,000 students.
Physician Faculty Scholars
Ingrid Binswanger, MD, MPH, (’08) published “Return to Drug Use and Overdose After Release from Prison: A Qualitative Study of Risk and Protective Factors” in Addiction Science & Clinical Practice on March 15. Former inmates are at high risk for death from drug overdose, especially in the immediate post-release period. Binswanger and colleagues sought to understand former prisoners’ drug use experiences, perceptions of overdose risk, and experiences with overdose. The study included 29 former inmates who were recruited within two months after their release. Findings included the following: 1) relapse to drugs and alcohol occurred in a context of poor social support, medical comorbidity and inadequate economic resources; 2) former inmates experienced ubiquitous exposure to drugs in their living environments; 3) intentional overdose was considered as “a way out” given situational stressors, and accidental overdose was perceived as related to decreased tolerance; and 4) protective factors included structured drug treatment programs, spirituality/religion, family, and community-based resources including self-help groups. The authors conclude that interventions to prevent overdose after release from prison may benefit from including structured treatment with gradual transition to the community, enhanced protective factors, and reductions of environmental triggers to use drugs.