Blacks at Highest Risk of Pregnancy-Related Death
African-American women in the U.S. are dying from complications due to pregnancy at a rate four times greater than non-Hispanic white women and more than twice that of other minorities, according to a study released recently by federal health experts.
Income disparities, access to quality health care and language and cultural barriers could be factors contributing to higher pregnancy-related death rates for blacks and other minorities, according to the Centers for Disease Control and Prevention (CDC)
The rate of pregnancy-related deaths among black expectant mothers and women in the first year after the end of pregnancy was 29.6 for every 100,000 live births between 1991 and 1997.
The corresponding mortality rate for non-Hispanic whites was 7.3 and fell within a range of 10.3 to 12.2 for Hispanics, Asians, Pacific Islanders and Native Americans, according to data based on death certificates from all 50 states and the District of Columbia.
``There is no biological reason why race and ethnicity should put women at risk,'' said Dr. Sara Whitehead, according to Reuters Health. Dr. Whitehead is an epidemiologist with the CDC's division for reproductive health and the author of the study.
According to Whitehead, the gap between blacks and whites in pregnancy-related deaths had not changed much in 20 years.
There were a total of 3,193 deaths attributed to pregnancy during the 1991-1997 period, for a national average of 11.5 deaths for every 100,000 live births. The rate tended to increase with age for all women regardless of race.
The CDC study included deaths attributed to pregnancy-induced bleeding, infection and high blood pressure, or pre-eclampsia. Accidental and other non-pregnancy-related deaths were excluded from the study.
Although pregnancy-related deaths in the United States have declined in step with medical progress, about 2,000 women each day still suffer potentially fatal ectopic pregnancies, severe bleeding, infection and other complications. An ectopic pregnancy occurs when an embryo grows in the Fallopian tube outside the womb.
``Despite advances in public health and obstetrics over the past century, not all women have a safe and healthy pregnancy,'' said CDC Director Dr. Jeffrey Koplan.
A National Summit on Safe Motherhood is planned by CDC in September (2001) to address reproductive health issues.
Source: CDC
U.S. Black Men More Likely to Die of Heart Disease
By James Knox
Black men who are poor and live in rural areas are at greater risk of dying of heart disease than other men in the United States, Centers for Disease Control and Prevention researchers said on Wednesday, June 20, 2001.
In a study of geographical and racial disparities in heart disease deaths from 1991-1995, researchers found African-American men were 26 percent more likely than white men, and nearly twice as likely as Hispanic men, to die of heart disease, the leading cause of death for men of all racial and ethnic groups.
According to the CDC, the overall heart-disease death rate for U.S. men in the study aged 35 and older was 675 per 100,000 people. Among African-American men, the rate was 841 deaths per 100,000, compared with 666 deaths per 100,000 for white men, and 432 deaths per 100,000 people for Hispanic men.
Higher rates of death occurred among men of any race residing in regions with poorer economies and few health-care resources, such as the Mississippi River Valley and Appalachian regions of the rural South.
Hawaii, Utah and Colorado had the lowest heart disease death rates, while Mississippi, West Virginia and Kentucky had the highest rates.
Hispanic men had overall lower rates of heart disease than blacks or whites, but with wide geographic disparity. Hispanic men in the rural Southwest tended to have high rates of heart disease while those concentrated in major urban centers had much lower rates.
Lead author of the study, Elizabeth Barnett, said the disparity reflected underlying differences that made some communities healthier than others. Social, economic, educational, and housing inequalities are contributing to this health disparity.
Obesity, lack of exercise and job stress are other causes that put blacks at higher risk of dying from heart disease.
Furthermore, less commonly known factors such as mental depression and lack of social support are involved.
The study found that about 40 percent of heart disease-related deaths in black men occur prematurely, before the age of 65, compared with 21 percent of heart disease-related deaths among whites. In general, black men experience disease earlier and more severely than their white counterparts.
Social isolation and bias, as well as racism and discrimination, also produce a negative effect on the physical health of blacks. Thus, the development of high blood pressure and other physiological problems that contribute to heart disease.
Limited access to health care is another significant contributing factor of premature cardiac death in blacks. Better health facilities are usually found in urban communities than in rural areas. Even the quality of food available in rural areas is different. It may be 25 miles to the nearest grocery store in order for people in rural areas to get fresh produce and other necessities.
Researchers conclude that intervention at different levels needs to take place in order to change this health disparity affecting African-American males.
Sources: Rueters, and CDC
Reviewed by: Carl Gilbert, M.D.
The Film "John Q" Exposes
the Ugly Side of the U.S. Health Care System
By Jean F. Gibbs
Feb. 15, 2002.-Through the great performance of a top notch cast led by Academy Award Winner Denzel Washington, Nick Cassevetes's new movie John Q puts in the forefront some of the health care issues that have raised for some time a lot of concern among the different segments of the U.S. society.
John Q. Archibald is an ordinary man who works at a factory and takes care of his family. His wife Denise and young son Michael are his world. But when Michael falls seriously ill and needs an emergency heart transplant operation that John Q. can't afford and his health insurance won't cover, John Q -- played by Denzel --, vows to do whatever it will take to keep his son alive. In the movie, the issues of profits, HMO's, big businesses, human tragedy, family ties, important persons versus small people, come into play and make their multifaceted and sometimes ugly appearance, as the father does what he thinks he should do in order to save his son.
Some movie critics also believe the film shows something rarely portrayed by Hollywood: an African-American family intact and with a loving father.
Nov. 30, 2001.- Robert
L. Tools, first man with an experimental artificial heart, died of
multi-organ failure in Louisville, KY. Tools was 59.