Advertisement
By Carl Gilbert, M.D.
The health disparity seen in African-American women may be caused in part by a lack of pharmaceutical advertising in Black-oriented magazines, suggests a report published by a Morehouse School of Medicine researcher in the July issue of the Journal of the National Medical Association.
The principal author of the study, Shakoora C. Omonuwa, M.D., reviewed for three months five black-oriented magazines, Black Woman, Ebony, Upscale, Essence, and Black Elegance, and compared their pharmaceutical ad content with the content of five white-oriented magazines. The results show a large disparity, with "black-oriented magazines having far less pharmaceutical ads than white-oriented magazines."
It's a well-known fact there is health disparity present for black women as compared to white women. African-American women show a delay in accessing prenatal care compared to white women and, as a result, show a higher incidence of hospital stay for pregnancy loss and complications. They also stay longer in the hospitals for other health problems. Black women have a higher mortality and higher incidence rate for cardiovascular disease when compared with white women. Subsequently, being less often seen by cardiologists, they are more likely to end up with disease stages requiring coronary surgery than white women.
This racial health disparity is believed to be due to socioeconomic factors. Even when these factors are eliminated, the authors of the study suggest that health care advertising, or to be more exact, the lack of health care adverting oriented to black women may play a role in this disparity.
According to one study, 43% people surveyed appear to trust or believe ads published in magazines compared to television or the Internet. Similarly, 44% said they are more likely to buy a product advertised in a magazine compared to TV or the Internet, meaning that magazines ads have more consumer attention than other media choices.
Studies have shown that the number of ads about alcohol, cigarette, or food significantly differ when directed to blacks and whites, which led people to believe that the health of blacks is not being promoted in those areas. On the other hand, the dollar amount spent by advertisers targeting blacks consumers is considerably less than it supposed to be. The fact is that direct advertising to consumer has some benefits (patients are informed of new treatments, new drugs and vaccines, made aware of certain symptoms associated with a specific medical problem).
After reviewing the five black-oriented magazines, which were selected on the basis of their circulation number and accessibility, the investigator of the study writes that "within these months, a black woman reading the five black-oriented magazines would not have the option of viewing information on medications used for the treatment of, for example, osteoporosis, menopause, Alzheimer's dementia, weight reduction, dyspepsia, and joint pain/inflammation, constipation, high cholesterol, tobacco abuse, and depression." While a white woman reading one or more of the five white-oriented magazines and none of the black-oriented magazines would not have the option of viewing only the ads regarding HIV or contraception.
The author has, however, acknowledged the limitation of the study that was done over a short period of three months. The counting of the ads were done manually, raising the possibility of human errors. He believes however this finding should be a concern, for " the more knowledgeable a patient is regarding health care, the more likely she will utilize the health care system in a more productive, timely, and cost-effective manner."
Survey: Hispanic
Women Twice As Likely To Avoid Gynecologic Care
by Jean F. Gibbs
According to a national survey from the American Social Health
Association, Hispanic women are twice as likely as Black and White women to
avoid seeing a gynecologist.
White, Black and Hispanic women were the survey's targeted respondents.
Fifty-five percent of all women surveyed claim at least one of the following
barriers as an obstacle to obtaining care: lack of health insurance and cost
of care; fear of diagnosis and embarrassment; discomfort with a physician, and
language and cultural differences between physicians and patients.
Findings about African American women and their obstacles to seeking
gynecologic care include:
Language differences (21 percent).
Discomfort with their physicians(17 percent).
Cost as a factor (16 percent).
Latinos Overcharged for Health Care, Report Says
Latino patients, many of whom lack health insurance, are often overcharged when they seek medical help and harassed by debt collection agencies when they cannot pay, according to a study released on
June 9, 2001.
The report by the Consejo de Latinos Unidos, a group based in Los Angeles, analyzed the medical bills of 123 Latinos in southern California who received hospital emergency room treatment or were hospitalized in recent years.
"Hospitals in southern California, both public and private, are billing self-paying, uninsured Latinos almost five times the amount that hospitals would receive and accept as payment in full from a health maintenance organization," the report said.
"Hospitals, colluding with merciless billing departments and renegade collection agencies, are charging outrageous fees ... while making a profit on the most vulnerable," it said.
Over 44 million Americans lack health insurance, one quarter of them Hispanic. In California, 40 percent of Latinos are uninsured. Previous studies have found that uninsured patients are often charged higher fees for medical services and drugs than those who have insurance and HMOs.
The report said debt collection agencies often played on the fears of Latinos regarding their legal status in the country to squeeze money out of them.
The report said Latinos who sought emergency help were often made to sign statements in English, which they did not understand, committing themselves to repay in full the costs of the services.
Josefina Basulto was charged over $13,000 for a caesarean delivery of her son, which entailed a three-day hospital stay. The debt collection agency eventually set up a payment plan that calls on her to pay off the debt in 268 payments of $40, which means she will still be paying for the birth of her son when he turns 22.
Others described how collection agents forced them to place their bills on credit cards, subject to interest rates of up to 30 percent a year.
In other cases, collection agents told patients they would destroy their credit ratings, taking away their ability in the future to buy a car or a home, unless they paid in full.
One Latino couple, Mario Sanchez and Norma Gonzalez, were involved in a traffic accident and landed with a $14,000 bill that would have been only around $1,200 for an HMO.
"I have never seen so much money as that in my life. They are taking away our dream of buying something big like a home. What are we going to do?" said Sanchez.
In some cases, Latinos were able to negotiate discounts with hospitals if they complained. One man had his bill cut in half from $6,000 to $3,000. But, the report said, an HMO would have been charged less than $1,000 for the same services.
In other cases, hospitals were reluctant to offer detailed, itemized statements of charges and refer the bill directly to collection agencies.
Source: Reuters
Hispanic Women Appear to be less likely to Seek Follow-Up Mammogram
This is the finding of a study that is published in the May 1st issue of the journal Cancer.
Investigators looked at screening rates among more than 21,000 New Mexico women in managed care plans. They found that among women whose initial mammogram showed nothing suspicious, Hispanic women had a longer lag time until their next screening test than other women did. Previous research has suggested Hispanic women undergo mammography less often than white and African-American women do.
But there was no such difference in return rate among women who had suspicious tissue removed after their initial mammograms. In fact, Hispanic women who had biopsy of suspicious breast tissue were prone to return for follow-up mammogram sooner, compared with other racial groups.
It is recommended that women have a mammogram every one to two years starting at age 40. About 3% of these mammograms will push surgeons to do biopsy of suspicious masses with less than one fifth of which turn out to be cancer. The concern was that these often-negative biopsy will needless scare women and deter them from seeking further mammograms. This study showed no evidence of that.
It was among women who did not have a biopsy that racial disparities were apparent, with Hispanic women being late to return for subsequent mammograms. Cultural differences may account for this disparity.
Source: Journal of Cancer 2001;91:1716-1723
HIV in 30% of Young Black Gays
Feb. 6, 2001 — Nearly one-third of gay, Black men in six U.S. cities are infected with the virus that causes AIDS, researchers reported. This finding was described as "chilling".
The findings come from an ongoing study of 2,400 gay and bisexual men between the ages of 23 and 29 in Baltimore, Dallas, Los Angeles, Miami, New York and Seattle. In those cities, the infection rate for black gay men was about 30 percent. That is compared with 12,3% infection rate for young gay men of all races, according to the new report. Dallas ranked worst, with an overall infection rate of 18% among young gays. Seattle ranked best, with an infection rate of 4.7% in this group.
Most of these men can be expected to die prematurely since AIDS is still a fatal disease despite advances in its treatment.
Several researchers blamed these high infection rates on inadequate and underfunded prevention programs in the United States, which cannot compare with programs in some other countries like Senegal, Uganda, Thailand where infection rates are steadily dropping.
Overall, 46% of participants said they had unprotected anal sex during the previous six months. Of the 293 HIV-positive men in the study, less than 30% realized that they were infected.
One of the main reasons for the increase seems to be that Black men are more likely to hide their homosexuality and live in denial, missing at the same time the calls for safe sex practices that has been constantly made in the white gay communities.
The study was presented in Chicago at the Eighth Annual Retrovirus Conference. The study was conducted by researchers from the Centers for Disease Control.
*******************
In a study released recently to mark the 20th anniversary of the emergence of the disease, the Centers for Disease Control and Prevention said an alarming number of gay and bisexual males between the ages of 23 and 29 were contracting HIV, the virus that causes AIDS.
The rate for blacks in the group was a staggering 14.7 percent, almost six times the 2.5 percent rate for whites.
The CDC said insufficiently targeted health education programs, growing complacency in the wake of successful drug therapies and the stigma attached to AIDS patients could be fueling riskier behavior among young gay and bisexual males.
CDC researchers noted that the new HIV infection rates it found among blacks within this group were comparable to rates recorded in parts of sub-Saharan Africa, considered the region hardest hit by AIDS.
''Whether you look at this country or throughout the world, this disease is becoming concentrated in marginalized populations,''
said U.S. Surgeon General David Satcher, commenting on the report at a press conference in
Washington.