Tag Archives: disparities

Radio series looks beyond medical care for New York’s least healthy county

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Photo by Axel Drainville via Flickr.

Photo by Axel Drainville via Flickr.

The Bronx has ranked as the least-healthy county in New York State for several years running. The news team at WNYC wanted to find out if the Affordable Care Act or other recent policies were having any impact.

Heart disease, diabetes and asthma are unusually prevalent in the borough, where people also struggle with high unemployment and poor housing.

“People in the Bronx have excellent access to health care. So why are so many of them so sick?” one of the resulting news reports asked. Others explored the links between education, employment and health; whether housing should be considered health care; and how neighborhood conditions shape food choices.

WNYC reporter Amanda Aronczyk was new to health reporting when she got the assignment. We asked her to share how she juggled all the moving parts to sustain the deeply reported series that aired in June.

“The assignment was to report a series on health and health care in the Bronx between January and May, with an airdate at the beginning of June,” Aronczyk says. “I had about month to propose a package of stories.” Read more…

Connections between housing, health: Finding stories and getting the reporting right

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Photo by Till Westermayer via Flickr

Photo by Till Westermayer via Flickr

Megan Sandel, M.D., M.P.H., an expert on the impact of housing on child health, says journalists would do well to broaden the conversation about health care to include questions about social support – especially support for safe, affordable and stable housing.

Sandel has contributed a tip sheet that includes key stories to pursue and critical insights on the housing-as-health-care trend.

Find out why housing has an enormous impact on educational attainment and economic stability, how unequal enforcement of health and safety codes creates disparities and what the three essential elements of healthy housing are. See the tip sheet now.

 

New key concept: The inequality of violent injury and death

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

The statistics are hard to believe.

  • The most dangerous counties in the United States have rates of violent death that are more than 10 times higher than the safest counties.
  • In Los Angeles County, homicide subtracts nearly five years from the expected life span of African American men in some neighborhoods.
  • Across the U.S., death by homicide is more than eight times more common among blacks, and three times more common among Native Americans, compared with white Americans.

What could account for such staggering inequalities? A new key concept in AHCJ’s core topic area on the social determinants of health sizes up the problem, what’s known about root causes, and how people are trying to reduce the unequal burden of violent injury and death.

Note how the risk of violent injury rose with each step of decreasing neighborhood socioeconomic status in this 10-year study of hospitalizations in Memphis, Tenn, and surrounding Shelby County.

Missing context in reports on diabetic amputations

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Photo by Victor via Flickr

Photo by Victor via Flickr

People with diabetes in the lowest income neighborhoods of California were 10 times more likely to lose lower extremities to amputation than people with diabetes in the highest income neighborhoods, according to a new paper published in Health Affairs.

Many news outlets covered the story, but none that I read provided much context beyond repeating what the Health Affairs paper had to say, which is a shame because there’s a lot to report. Most ignored the disturbing racial disparity in amputation rates. (HealthDay News did note the study’s finding that less than 6 percent of diabetics in California are black, but they account for about 13 percent of amputations.)

The study authors mapped hot spots of diabetic amputation in Los Angeles and across California, where rates varied from less than one to more than 10 amputations per 1,000 people age 45 and older with diabetes in 2009. Continue reading

Exploring the geography of violent death

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Measured by rates of violent death, the most dangerous counties in the United States have rates that are more than 10 times higher than the safest counties.

As you can see in the map below, rates vary from less than 10 to more than 100 violent deaths per 100,000 population, based on homicides, police shootings, and suicides in the years 2004 through 2010. (Counties with rates based on 20 or fewer deaths are unreliable and are marked as suppressed.)

1

I generated this map and the others below using WISQARS (Web-based Injury Statistics Query and Reporting System), an interactive database system that provides customized reports of injury-related data collected by the Centers for Disease Control and Prevention. The mapping module draws on seven years of data, the amount needed to produce reliable county-level injury-related death rates, according to the CDC, and it is a powerful tool to explore health disparities. Continue reading

Going deep on hospital closures and their human impact

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Pittsburgh’s dominant health system closed a hospital in the economically depressed town of Braddock four years ago and soon after opened a new hospital in the more affluent suburb of Monroeville, Pa.

Lillian Thomas

Lillian Thomas

Lillian Thomas of the Pittsburgh Post-Gazette wanted to know how common it was for hospital corporations to abandon disadvantaged towns and inner cities. That was the beginning of a reporting journey that has produced a hard-hitting, ongoing series by Thomas and colleagues at the Post-Gazette and Milwaukee Journal Sentinel.

The first installments revealed how most of the defunct hospitals were small to mid-size community hospitals and public hospitals that had served poor urban neighborhoods. The closures left many low-income neighborhoods without an effective safety net, undermined efforts to recruit doctors and did away with high-wage jobs for local residents. An incredibly detailed interactive map allows readers to track where old hospitals have closed and new ones have opened in cities across the U.S. since 1991.

I asked Thomas to share how she approached the project and mustered the resources to pull it off. Read more …

What do you really know about the social determinants of health?

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

It’s hard to think clearly about health reform if you ignore the social determinants of health, that is, how each person’s place in the hierarchy of self-determination and power, educational opportunity, neighborhood quality, working conditions, job security, income and wealth shape their vulnerability to illness and premature death. Check your knowledge by taking this true-or-false quiz: Continue reading

Stories missed the inequality of violent death in young people

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

News outlets duly noted the recent study showing that injuries and violence kill more young people in the U.S. than any other cause of death. But the coverage scarcely mentioned the researchers’ most troubling and revealing finding: How the burden of these deaths varies enormously by race, ethnicity and social class.

Take a look at figure 2 from the study showing age-adjusted suicide and homicide rates in the U.S. by race and ethnic origin in the year 2010. The unit of measure is the number of deaths by suicide or homicide per 100,000 members of each population:

Age-adjusted suicide and homicide rates in the USA by race and ethnic origin, 2010.

Generated with use of the CDC’s Web-Based Injury Statistics Query and Reporting System on Feb 19, 2013.Age-adjusted suicide and homicide rates in the USA by race and ethnic origin, 2010.

You can see that rates of suicide are three to four times higher among American Indian and Alaskan Natives and non-Hispanic whites than other populations.

Rates of homicide are more than eight times higher among blacks than among whites, and homicide deaths are three times more common among American Indians and Alaskan Natives than among whites. Continue reading

What happens when hospitals abandon inner cities

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Image by ken fager via flickr.

Image by ken fager via flickr.

Hospitals in the U.S. have been abandoning inner cities for years. By 2010, the number of urban hospitals still operating in 52 big cities had fallen to 426, down from 781 in 1970. Meanwhile, hundreds of medical centers built with cathedral-like grandeur have opened for business in affluent suburbs. A hard-hitting series produced by the Pittsburgh Post-Gazette and Milwaukee Journal Sentinel explains the consequences of this trend for people in neighborhoods where hospitals closed.

The series shows how most of the defunct hospitals were small to mid-size community hospitals and public hospitals that had served poor urban neighborhoods. The closures left many low-income neighborhoods without an effective safety net, undermined efforts to recruit doctors, and did away with high-wage jobs for local residents. An incredibly detailed interactive map allows readers to track where old hospitals have closed and new ones have opened in cities across the U.S. since 1991. Continue reading

Listeners hear from patients, dentists at charity dental clinic

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Katie Hiler

Katie Hiler

KBIA Mid-Missouri Public Radio listeners were recently offered an insightful report on the problems poor adults in the state have been facing in getting dental care.

Nearly a decade ago, Missouri eliminated funding for all Medicaid beneficiaries except children, pregnant women and the disabled.

The move “left a lot of people with only bad options,” reporter Katie Hiler explained, borrowing a quote from the film “Argo.”

To illustrate the point, Hiler invited her audience along on a visit to a rare charity clinic called Smiles of Hope, run out of a converted church attic. At the clinic, dentist William Kane spoke of his efforts to meet the overwhelming need for services such as emergency extractions.

Hiler ended her report with some news. A decision by the Missouri legislature to restore funding for adult dental care under Medicaid is expected to help to give some poor Missourians more options, she observed.

Yet at the same time, 300,000 low-income adults who would qualify for Medicaid under the Affordable Care Act are at this point shut out because of the state’s refusal to expand the program.

“Which means,” Hiler noted in closing, “Smiles of Hope isn’t going anywhere.”

In a Q&A for AHCJ, Hiler offers some thoughts on what got her started on this story and how her work unfolded. She also shares some wisdom on what it takes to make a radio story come alive.