Category Archives: Health disparities
Majority of Youth C. Difficile Infections Linked to Doctor Visits
Antibiotics prescribed in a doctor’s office for other conditions are associated with the majority of Clostridium difficile infections, according to a new study in the journal Pediatrics. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) determined that 71 percent of the cases for youth ages 1-17 were linked to the visits, rather than to overnight stays in health care facilities; two-thirds of adult cases are linked to hospital stays. The findings raise the profile of ongoing efforts to reduce unnecessary prescriptions. “Improved antibiotic prescribing is critical to protect the health of our nation’s children,” said CDC Director Tom Frieden, MD, MPH. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.” Read more on prescription drugs.
Study: Even Slightly Elevated Blood Pressure Can Do Cardiovascular Damage Over Time
Even slightly elevated blood pressure that does not rise to the clinical definition of hypertension can do cardiovascular damage over time, according to a new study in the Journal of the American Medical Association. Researchers at the University of Oklahoma Health Sciences Center analyzed blood pressure data on more than 4,600 participants, all of whom had their readings tracked over 25 years from young adulthood to middle age. They placed the participants in five blood pressure trajectory categories:
- Low-stable: blood pressure that starts low and stays low
- Moderate-stable: blood pressure that begins only slightly elevated and stays that way
- Moderate-increasing: blood pressure begins only slightly elevated and increases over time
- Elevated-stable: blood pressure that starts at elevated levels, but does not increase
- Elevated-increasing: blood pressure that begins elevated and increases over time
The study determined that participants in the moderate-stable group were 44 percent more likely to have coronary artery calcification than those in the low-stable group. Read more on heart health.
Study: Men Die Earlier in More Patriarchal Societies
Gender differences when it comes to mortality rates are higher in more patriarchal societies, meaning women’s rights are good for men’s health, according to a new study in the American Psychological Association’s Evolutionary Behavioral Sciences. Utilized sociodemographic and mortality data from the World Health Organization, researchers from the University of Michigan (UM) School of Public Health found that men living in the top 25 percent most-patriarchal societies were 31 percent more likely to die than men in the least patriarchal quartile, compared to mortality rates for women. Researchers noted that the study only included societies with infrastructures capable of providing reliable data, so the difference could be even more pronounced. Possible explanations include:
- Males in societies where they are more socially dominant tend to engage in riskier behaviors that can lead to death.
- These societies tend to have more resources and social status concentrated in a smaller group of elite men, and men with greater control of resources and social status historically have had more reproductive success.
- In their quest for social dominance, men will go up against other men to gain power and engage in forms of competitive, and sometimes dangerous, behavior.
"Gender inequality is inherently related to inequality in general, and this is bad for both men and women's health, though especially harmful to men in increasing the risk of death," said UM researcher Daniel Kruger. Read more on health disparities.
Georgia State University College of Law Names Ten Faculty Fellowships to Promote Public Health Law Education
The Georgia State University College of Law and its Center for Law Health & Society have announced ten faculty fellows to participate in the Future of Public Health Law Education: Faculty Fellowship Program. “This fellowship program is an extraordinary opportunity to promote innovative teaching, create a supportive community of practice and share best practices in teaching public health law,” said Charity Scott, JD, MSCM, Catherine C. Henson Professor of Law and director of the Center for Law, Health & Society. “The fellows’ projects will serve as models for innovation in public health law education and the resources developed will be shared with other law and public health faculty nationally.” The program is funded by the Robert Wood Johnson Foundation. Among the five faculty members serving as mentors will be Mary Crossley, JD, professor of law at the University of Pittsburgh School of Law, who NewPublicHealth previously spoke with about her role in the Scholars in Residence program. Read more on public health law.
Study: Better Boundaries, Enforcing Rules Can Improve Kids’ Sleep Health
Parents can improve their children’s sleep habits and overall health by setting boundaries around electronics use, enforcing rules and setting a good example, according to new findings from the National Sleep Foundation’s (NSF) Sleep in America poll. The annual study began in 1991, with the 2014 poll focusing on sleep practices and beliefs of the modern family with school-aged children. “For children, a good night’s sleep is essential to health, development and performance in school,” said Kristen L. Knutson, PhD, University of Chicago. “We found that when parents take action to protect their children’s sleep, their children sleep better.” The NSF recommends that children ages 6-10 get 11 hours of sleep per night, although the poll found that parents estimate their kids in that age group only get about 8.9 hours. The poll also found averages of 8.2 hours for kids ages 11-12, 7.7 hours for ages 13-14 and 7.1 hours ages 15-17; NSF recommends between 8.5 and 9.5 hours for each of those groups. Read more on pediatrics.
Stress of Racism Tied to Obesity in Black Women
Frequent experiences of racism are associated with a higher risk of obesity among African-American women, according to a new study in the American Journal of Epidemiology. Researchers analyzed data from the Black Women's Health Study, a longitudinal study of approximately 59,000 African-American women who were tracked beginning in 1995, finding that the psychosocial stress associated with long-term experience with racism can result in dysregulation of neuroendocrine functions that influence the accumulation of excess body fat. Yvette C. Cozier, DSc, MPH, assistant professor of epidemiology at Boston University who led the analyses, said in a release that work-place- and community-based programs to combat racism and interventions to reduce racism-induced stress could help prevent and combat obesity in high-risk communities. Approximately half of African-American women are obese, which raises their risk factors for cardiovascular diseases, type 2 diabetes, orthopedic problems, and death. Read more on health disparities.
WIC Expands to Offer More Options to 9 Million Poor Women and Children
Newly announced changes to the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants and Children—also known as WIC—will expand access to fruits, vegetables and whole grains for approximately 9 million poor women and young children. The changes include an increase over 30 percent, or $2 per month, in the allowance for each child's fruit and vegetable purchases. They also allow fresh produce instead of jarred infant food for babies. The changes, which were recommended by the Institute of Medicine, mark the first comprehensive revisions to the voucher program allowances since 1980. Read more on nutrition.
Survey Finds Majority of Hispanic Adults Are Not Confident in Their Understanding of Key Insurance Terms
While the majority of white, non-Hispanic adults feel confident in their understanding of key insurance terms, the same cannot be said for Hispanics. According to the Urban Institute’s Health Reform Monitoring Survey (HRMS), only one in four Hispanic adults express confidence in their understanding of terms such as “premium,” “copayment” and “deductible.” This disparity is an impediment to Affordable Care Act marketplace and Medicaid enrollment. The findings demonstrate the need for culturally appropriate education campaigns and bilingual navigators to provide assistance in target communities. The quarterly HRMS is funded by the Robert Wood Johnson Foundation and the Ford Foundation. Read more on health disparities.
New Program to Train Police Officers in Bleeding Control for Mass Casualty Victims
As part of ongoing efforts to increase the number of survivors of active shooter or mass casualty incidents, more than 36,000 police officers across the country will receive bleeding control kits and training this year. The goal is to train officers to slow or stop bleeding at the scene before other first responders arrive. The five-step “THREAT” approach:
- T - Threat suppression
- H – Hemorrhage control
- RE – Rapid Extrication to safety
- A – Assessment by medical providers
- T – Transport to definitive care.
The initiative is led by the Hartford Consensus, a collaborative group of trauma surgeons, federal law enforcement and emergency responders, and driven by the American College of Surgeons, the Federal Bureau of Investigation, the Major Cities Chiefs Association and the Prehospital Trauma Life Support program. “Controlling hemorrhage has to be a core law enforcement tactic,” said Alexander Eastman, MD, MPH, FACS, chief of trauma at UT Southwestern/Parkland Memorial Hospital and Dallas Police Department lieutenant, in a release. “We saw the dramatic impact of this tactic in the Tucson, Ariz. shooting in 2011. With training and tourniquets, law enforcement officers will save lives – many lives.” Read more on violence.
New Study Shows Latinos of Different Origins Can Have Different Diseases, Risk Factors
A review of a recent study, the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) that enrolled about 16,415 Hispanic/Latino adults, finds diversity among Latinos not only in ancestry, culture and economic status, but also in prevalence of certain diseases, risk factors and lifestyle habits. The study was done among Latinos living in San Diego, Chicago, Miami, and the Bronx, N.Y., who self-identified with Central American, Cuban, Dominican, Mexican, Puerto Rican, or South American origins.
- The percentage of people who reported having asthma ranged from 7.4 (among those of Mexican ancestry) to 35.8 (among those of Puerto Rican ancestry).
- The percentage of individuals with hypertension ranged from 20.3 (South American) to 32.2 (Cuban).
- The percentage of people eating five or more servings of fruits/vegetables daily ranged from 19.2 (Puerto Rican origin) to 55.0 (Cuban origin). Also, men reported consuming more fruit and vegetables than women.
- Women reported a much lower consumption of sodium than men among all Hispanic groups represented in the study.
- About 1 in 3 individuals had pre-diabetes, also fairly evenly distributed among Hispanic groups.
- Only about half of individuals with diabetes among all Hispanic groups had it under control.
A second study among the same population will start in October 2014 to reassess certain health measurements and understand the relationship between the identified risk factors during the first visit and future disease in Hispanic populations. Read more on health disparities.
Study: Acetaminophen During Pregnancy Tied to Increased Risk for ADHD, HKDs in Kids
Children whose mothers used acetaminophen during pregnancy are at higher risk for developing attention-deficit/hyperactivity disorder (ADHD)–like behavioral problems or hyperkinetic disorders (HKDs), according to a new study in JAMA Pediatrics. Researchers analyzed data on 64,322 children and mothers enrolled in the Danish National Birth Cohort from 1996 to 2002, finding that approximately 56 percent of the mothers reported acetaminophen use during pregnancy. Their children were 37 percent more likely to be diagnosed with an HKD, 29 percent more likely to be prescribed ADHD medications and 13 percent more likely to exhibit ADHD-like behaviors at age 7. Approximately five to six percent of babies born today will develop ADHD symptoms at some point in their lives. Jorn Olsen, MD, one of the study's authors and a professor of epidemiology at UCLA and at Aarhus University in Denmark, noted that the risk was relatively modest, but that “for women who are pregnant and who have not taken these drugs, I think that the take-home message would be a lot of the use of these particular drugs during pregnancy is not really necessary," according to Reuters. Read more on maternal and infant health.
Stigma Remains Powerful Barrier Impeding Mental Health Care for Many
The stigma surrounding mental health continues to remain a very real and very serious barrier keeping many people from seeking the health care they need, according to a new study in the journal Psychological Medicine. The analysis, from researchers at King’s College London and funded in part by the U.S. National Institutes of Health, combined the results of 144 studies including more than 90,000 people from around the world. Approximately 25 percent of people are estimated to have mental health problems, but only 75 percent of those in the United States and Europe seek treatment; delays in treatment are linked to worse outcomes for many mental health disorders, such as psychosis, bipolar disorder, major depression and anxiety disorders. The study pointed specifically to “treatment stigma” (the stigma associated with using mental health services or receiving mental health treatment) and “internalized stigma” (shame, embarrassment) as the most significant barriers, as well as concerns about confidentiality, wanting to handle the problem by themselves and not believing they needed help. "We now have clear evidence that stigma has a toxic effect by preventing people seeking help for mental health problems,” said Professor Graham Thornicroft, from the college’s Institute of Psychiatry and the study’s lead author. “The profound reluctance to be ‘a mental health patient’ means people will put off seeing a doctor for months, years, or even at all, which in turn delays their recovery." Read more on mental health.
Last year, the U.S. Department of Health and Human Services released updated national Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care to help health organizations improve care in diverse communities.
When the updated standards were released, Howard K. Koh, MD, MPH, the Assistant Secretary for Health in the U.S. Department of Health and Human Services (HHS), said “the enhanced CLAS Standards provide a platform for all persons to reach their full health potential.” Koh added that the updated CLAS Standards provide a framework for the delivery of culturally respectful and linguistically responsive care and services. By adopting the framework, health professionals will be better able to meet the needs of all individuals at all points of contact.
“As our nation becomes increasingly diverse, improving cultural and linguistic competency across public health and our health care system can be one of our most powerful levers for advancing health equity,” said Nadine Gracia, MD, MSCE, and Deputy Assistant Secretary for Minority Health and Director of the HHS Office of Minority Health.
NewPublicHealth recently spoke with Gracia about the updated standards and opportunities that efforts to increase health equity can bring to the health of individuals and communities.
NewPublicHealth: How does cultural respect help improve health in diverse communities?
Nadine Gracia: As we see the growing diversity of our country and the persistence of health disparities, really having everyone engaged in the discussion of health equity and the attainment of the highest level of health for all people is vital. Culture and cultural respect are really important when we talk about health equity as well as quality of care, and that’s because culture really influences health beliefs and practices. It influences one’s health-seeking behaviors and attitudes and the experience that someone may have in a health care setting.
So, it is essential that providers and health care delivery institutions understand the critical role that they play in providing culturally and linguistically appropriate services. We define those services as ones that are respectful of and responsive to an individual’s cultural health beliefs, their preferred languages, their health literacy levels and their communication needs. They are really applied by and employed by all members of an organization at every point of contact.
Culturally and linguistically appropriate services are essential when we talk about the health care encounter because they are increasingly recognized as being effective in improving the quality of services and increasing patient safety by preventing miscommunication; facilitating accurate assessment and diagnosis of a patient’s condition; and enabling everyone engaged in health services to truly develop an accurate and effective treatment plan.
SAMHSA Disaster Distress Helpline Open 24/7 to Help People Impacted by the Severe Weather
The Substance Abuse and Mental Health Administration (SAMHSA) issued a bulletin yesterday to remind public health officials and the community that its Disaster Distress Helpline (1-800-985-5990) can provide immediate counseling to anyone who needs help in dealing with the damage caused by the winter storms in the Mid-Atlantic and Southern states. The helpline is a 24 hours-a-day, seven-days-a-week resource that responds to people who need crisis counseling after experiencing a natural or man-made disaster or tragedy. The helpline immediately connects callers to trained professionals from the closest crisis counseling center; helpline staff provide confidential counseling, referrals and other needed support services. Assistance is available in several languages. The helpline can also be accessed by texting TalkWithUs to 66746, by going here and by TTY for deaf and hearing impaired at 1-800-846-8517. Read more on disasters.
Well-Child Visits Linked to More than 700,000 Cases of Flu-Like Illness
A recent study in Infection Control and Hospital Epidemiology links well-child doctor appointments for annual exams and vaccinations with an increased risk of flu-like illnesses in children and family members within two weeks of the visit. This risk translates to more than 700,000 potentially avoidable illnesses each year, costing more than $490 million annually, according to the researchers.
"Well child visits are critically important. However, our results demonstrate that healthcare professionals should devote more attention to reducing the risk of spreading infections in waiting rooms and clinics [and] more attention should be paid to these guidelines by healthcare professionals, patients, and their families," said Phil Polgreen, MD, MPH, lead author of the study.
The researchers used data from the Agency for Healthcare Research and Quality's (AHRQ) Medical Expenditure Panel Survey to examine the health care trends of 84,595 families collected from 1996-2008. After controlling for factors including the presence of other children, insurance and demographics, the authors found that well-child visits for children younger than six years old increased the probability of a flu-like illness in these children or their families during the subsequent two weeks by 3.2 percentage points. A commentary in the journal on the study also pointed out the likelihood of some unnecessary antibiotics being prescribed for some of the illnesses.
"Even with interventions, such as the restricted use of communal toys or separate sick and well-child waiting areas, if hand-hygiene compliance is poor and potentially infectious patients are not wearing masks, preventable infections will continue to occur," said Polgreen. Read more on infectious disease.
NIH Study Seeks to Improve Asthma Therapy for African-Americans
A new study by researchers at the National Heart Lung and Blood Institute, a division of the U.S. National Institutes of Health, is enrolling about 500 African-American children and adults with asthma in a multi-center clinical trial to assess how they react to therapies and to explore the role of genetics in determining the response to asthma treatment. The study will be conducted at 30 sites in 14 states, and its goal is to determine the best approach for asthma management in African-Americans, who suffer much higher rates of serious asthma attacks, hospitalizations and asthma-related deaths than whites. “While national asthma guidelines provide recommendations for all patients with asthma, it is possible that, compared with other groups, African-Americans respond differently to asthma medications,” said Michael Wechsler, MD, principal investigator for the study and professor of medicine at National Jewish Health in Denver. “Our study is designed to specifically address how asthma should be managed in African-American asthma patients, both adults and children.” Read more on health disparities.
AHA Releases Stroke Prevention Guidelines for Women
For the first time, the American Heart Association (AHA) has released stroke prevention guidelines for women. The guidelines outline stroke risks unique to women and provide evidence-based recommendations on how best to treat them, including:
- Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower preeclampsia risks.
- Women who have preeclampsia have twice the risk of stroke and a four-fold risk of high blood pressure later in life. Therefore, preeclampsia should be recognized as a risk factor well after pregnancy, and other risk factors such as smoking, high cholesterol, and obesity in these women should be treated early.
- Pregnant women with moderately high blood pressure (150-159 mmHg/100-109 mmHg) should be considered for blood pressure medication; expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated.
- Women should be screened for high blood pressure before taking birth control pills because the combination raises stroke risks.
- Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.
- Women over age 75 should be screened for atrial fibrillation risks; a risk factor for stroke.
Read more on prevention.
New Study Predicts Flu Severity
Researchers at St. Jude Children’s Research Hospital in Memphis say flu patients, regardless of age, who have elevated levels of three particular immune system regulators, called cytokines, early in the infection were more likely to develop severe flu symptoms and to be hospitalized than patients with lower levels of the same regulators. Study participants ranged in age from 3 weeks to 71 years.
The study, published in the American Journal of Respiratory and Critical Care Medicine, found that cytokine levels early in the infection were predictive of flu-related complications regardless of patient age, flu strain, the ability of the virus to replicate and other factors. The cytokines studied help to regulate inflammation caused by the body’s immune response to the flu until antibodies and T cells take over. Patients with the elevated cytokines seem to develop airway distress as a reaction to the immune response, a development separate from the effects of the flu virus. “We need to explore targeted therapies to address this problem separately from efforts to clear the virus, says study author Paul Thomas, PhD, an assistant member of the St. Jude Department of Immunology. Read more on flu.
Community Health Worker Model Can Reduce Hospital Readmissions
A new study in JAMA Internal Medicine reports on a community health worker (CHW) program developed at the University of Pennsylvania School of Medicine that hired people from the local community to help discharged patients navigate the health care system and address key health barriers, such as housing instability or food insecurity. The study found that the intervention improved patient experiences and health outcomes and reduced hospital readmissions.
The Penn team tested the model in a randomized trial with 446 hospitalized patients who were either uninsured or on Medicaid, and lived in low-income communities in which more than 30 percent of the population lived below the Federal Poverty Level. More than one-third of all readmissions to the hospitals participating in the study come from a five-zip code region. Patients in the trial received support from CHWs hired for traits such as empathy and active listening. The CHWs connected during a patient's hospital stay and continued after they were discharged to help with issues including scheduling doctor appointments, accessing medications, or finding child care or shelter. The control group received routine hospital care, medication reconciliation, written discharge instructions, and prescriptions from the hospital. The CHW group had a 52 percent greater chance of seeing a primary care physician within two weeks after being discharged from the hospital and scores measuring a patient's confidence in managing their own care in the future more than doubled in the CHW group. While the two groups had similar rates of at least one hospital readmission (15 percent vs 13.6 percent), the CHW group was less likely to have multiple readmissions (2 percent vs 6 percent in the control group). Read more on health disparities.
In January 2008, the Texas Health Institute received support from the Joint Center for Political and Economic Studies, a policy think tank with a particular focus on people of color, to track progress on efforts to advance racial and health equity through provisions of the Affordable Care Act (ACA). Shortly after the ACA became law, new support from the W.K. Kellogg Foundation and the California Endowment has led to a series of four reports that have assessed how well the law has been implemented in a way that addresses racial and ethnic health equity across five topic areas:
- Health insurance and exchanges;
- Health care safety net;
- Workforce support and diversity;
- Data, research and quality; and
- Public health and prevention.
To learn more about the reports’ findings, NewPublicHealth recently talked with Dennis Andrulis, PhD, MPH, the Senior Research Scientist at the Texas Health Institute and an Associate Professor at the University of Texas School of Public Health.
NewPublicHealth: How have the reports produced by the Texas Health Institute helped advance what we know about the ability of the Affordable Care Act to advance health equity?
Dennis Andrulis: The reports have provided an update of the progress, or lack thereof, in implementing race, ethnicity, language and equity provisions in the law. Did Congress appropriate dollars to support these provisions? If so, did the appropriations match the original requests and will they continue in future years?
The result is we have mapped out what we believe is a comprehensive overview of about 60 provisions related to health equity. Additionally, we have reported on the content and shape of related new initiatives, innovations, program support and other health care efforts.
NPH: What are some short-term and long-term efforts that your work indicated will help improve some health disparities?
Dennis Andrulis: First we need to have accurate and well-disseminated information about what’s in the law and the opportunities to change disparities that it provides.
Survey: Latinos See Diabetes as Greatest Family Health Concern
A new NPR/Robert Wood Johnson Foundation/Harvard School of Public Health poll found that Latinos see diabetes as the biggest health concern for their families. Almost 19 percent of Latinos surveyed cited diabetes as the top worry, including across both immigrant (19 percent) and non-immigrant (22 percent) populations. Cancer, at 5 percent, was the second-biggest concern. In addition to health and health care, the poll also asked about communities, financial situation and discrimination. According to the U.S. Centers for Disease Control and Prevention, Hispanic adults are 1.7 percent more likely than non-Hispanic whites to be diagnosed with diabetes, and 1.5 percent more likely to die from it. Read more on health disparities.
Heart Attack Patients in ER Off-Hours Seeing Higher Mortality Rates
Heart attack patients who present during off-hours—at night and on weekends—are more likely to die, according to a new study from the journal BMJ. Their emergency care is also more likely to take longer than it would during normal hospital hours, including inflation of the coronary artery, which can take an additional 15 minutes. After analyzed records on 1,896,859 patients, researchers at the Mayo Clinic determined that heart attack patients who present during off-hours had a 5 percent relative increase in mortality—or an additional 6,000 U.S. deaths. The study’s authors concluded that emergency departments "should focus on improving their off-hour care, with the goal of providing consistently high quality care 24 hours a day and seven days a week." Read more on heart health.
Study: HPV Vaccination Rate Remains Low, More Physician Recommendations Needed
Only 14.5 percent of girls ages 11 and 12 have received at least one does of the human papillomavirus (HPV) vaccination, with only 3 percent having completed a three-dose series, according to a new study in the American Journal of Preventive Medicine. The study from the Moffitt Cancer Center indicates that increasing the rate of physician recommendations, which so far remains low, could do much to up the vaccination rate and cut the risk of cancer. The vaccination protects against the two types of HPV that cause 70 percent of cervical cancer cases. “This study demonstrates that the change in consistent HPV vaccine recommendations to early adolescent females was modest, and for older adolescent females was virtually nonexistent, from three to five years after the vaccine became available,” explained Susan T. Vadaparampil, PhD, MPH, associate member of the Health Outcomes and Behavior Program at Moffitt. “Physician recommendation is central to increasing HPV vaccination rates because it is one of the most important predictors of whether a patient gets the HPV vaccine.” Read more on cancer.
Study: School Assaults Lead to Nearly 90,000 ER Visits Annually
Assaults at school account for almost 90,000 emergency-room visits annually, according to a new study in the journal Pediatrics. In a review of data on students ages 5-19, researchers determined that an average of 92,000 annual emergency visits were a result of deliberate injury, with student-on-student assault accounting for about 88,000. About 40 percent of the injuries were bruises or scratches, with few leading to later hospitalization. "[The number of injuries] appears to be concerningly high, especially when you realize that such a substantial number of injuries are occurring in the school setting, where safety measures are already in place," said lead author Siraj Amanullah, MD, an assistant professor of emergency medicine and pediatrics at Brown University's Alpert Medical School. "There is a need to continue addressing this issue at various levels—at home, at school and in the medical care setting—and there is a need to ramp up our existing prevention and safety strategies.” Read more on violence.
WHO: India Can Now Be Declared Polio-Free
With now three years passed since its last reported cased of polio—January 13, 2011—the country of India can now be declared polio-free, according to the World Health Organization (WHO). The certification process should be completed by the end of March. The country’s last victim was a two-year-old girl in West Bengal. This now leaves Afghanistan, Pakistan and Nigeria as the only countries where polio remains endemic. As part of our recent Outbreak Week, NewPublicHealth recently spoke with Sona Bari, WHO’s senior communications officer, about the efforts underway to eradicate polio globally. Read more on infectious disease.
Translation Errors Plague ACA’s Spanish-language Site, Impede Enrollment
Problems with the Spanish-language version of the Affordable Care Act’s website are making it difficult for many of the site’s users to navigate the site and enroll for coverage. In addition to launching late and sending users to English-language forms when they are clearly looking for Spanish-language content, CuidadoDeSalud.gov is also full of grammatical and other language mistakes. "When you get into the details of the plans, it's not all written in Spanish. It's written in Spanglish, so we end up having to translate it for them," said Adrian Madriz, a health care navigator who helps with enrollment in Miami. Several states with large Hispanic populations have fallen short in their goals to enroll Spanish-speakers, with critics pointing to the website as a major impediment. For example, while it’s not know how many of California’s 4.3 million residents who only speak Spanish intend to seek coverage under the Affordable Care Act, through the end of November only 5,500 had successfully enrolled. Read more on the Affordable Care Act.