Tag Archives: disparities

In sad, compelling stories, journalists are documenting a mental health care system in crisis

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo: Jan Bommes via Flickr

Photo: Jan Bommes via Flickr

Imagine the outcry if patients with cancer or any other chronic condition lacked standard, appropriate care. Such ill treatment would not be tolerated.

Yet the U.S. health care system routinely fails to provide basic care to Americans with mental illness, says Patrick J. Kennedy, a former congressman from Rhode Island and co-founder of One Mind, an organization seeking new treatments for neurologic and psychiatric diseases of the brain.

For a series of articles in USA Today, Liz Szabo quoted Kennedy on mental health care in America: “The failure to provide treatment and supportive services to people with mental illness – both in the community and in hospitals – has overburdened emergency rooms, crowded state and local jails and left untreated patients to fend for themselves on city streets.”

The burden of inadequate mental health care falls on individuals and families, but also on emergency rooms, hospitals, jails and other institutions, making this topic well worth the rich and deep coverage Szabo and other journalists have committed to it. Such coverage is important, as reporters have found in Colorado, Idaho, Oklahoma, and Wisconsin, and it can be rewarding because it forces journalists to confront and explain some most challenging health care issues in our society. Continue reading

How, and why, some schools provide dental care for needy children

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.

In a series of stories, “The Burden of Poverty: A Backpack of Heartache,” reporters at the School News Network, based in Grand Rapids, Mich., are exploring the deep challenges poverty creates for local students and their families as well as strategies schools are employing to helping disadvantaged students succeed.

Articles in the series so far have examined the correlation between low test scores and low income and have provided a candid look at the struggles of a nearly homeless honor student. The series has highlighted the ways schools are trying to address the health disparities that can make it harder for poor children to succeed in school.

One recent story looked at the role school nurses play in helping poor children cope with chronic diseases. A Nov. 14 piece explains how a school-based dental program attends to the oral health needs of children who might otherwise be distracted from their studies by the debilitating pain of untreated dental disease. Continue reading

Interactive atlases can help coverage of Diabetes Awareness Month

Kris Hickman

About Kris Hickman

Kris Hickman (@the_index_case) is a graduate research assistant for AHCJ, pursuing a master’s degree in public health. She has a bachelor's degree in anthropology, with a minor in journalism, from the University of Missouri. She spent two years in Zambia as an HIV/AIDS community education volunteer in the Peace Corps. She aspires to be an epidemiologist and science writer.

Sometimes it’s difficult to get a handle on major health determinants in your community, and it’s even harder to make them come alive in a story. Straightforward statistics can be dry or intimidating, while percentages and frequencies might fail to resonate.

So how can you give your readers, viewers or listeners a little extra background information without boring them to sleep? Interactive atlases are an effective way to do this – they can provide stories with both images and some enriched perspective. November is National Diabetes Awareness Month, and mapping tools like the CDC Diabetes Atlas provide a visual representation of diabetes in the U.S. The Diabetes Atlas helps to illustrate both diabetes and its many determinants using four indicators:

  • Diagnosed diabetes
  • Diagnosed diabetes incidence
  • Obesity
  • Leisure-time physical inactivity

Continue reading

Cultural perceptions of aging affect health status, caregiving

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology, Home Care Technology report and on HealthStyles Radio (WBAI-FM, NYC). She is a senior fellow at the Center for Health, Media & Policy at Hunter College, NYC, and a co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Images by Judy Baxter, NCVO and Steven Gray via Flickr.

Images by Judy Baxter, NCVO and Steven Gray via Flickr.

A new study out of the United Kingdom reinforces the influence that culture and societal attitudes can have on the health status of older adults. Psychologists from the University of Kent used data from the European Social Survey to ask respondents, all age 70 or older, to self-rate their health.

In countries where old age is thought of as signifying low status, participants who identified themselves as ‘old’ felt worse about their own health. The opposite was true in places where older people have a perception of higher social status. The researchers concluded that elevating perceived social status of older people would reduce negative connotations associated with old age and the negative impact on how healthy people felt.

The value different societies place on the elderly has a lot to with how they are cared for later in life, evolutionary biologist Jared Diamond explained in a recent TED talk. These effects in turn, influence public policy for global long-term services and supports. The International Federation of Social Workers recently noted, “Although older adults serve as essential resources to their communities, they face a great risk of marginalization.” Continue reading

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, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @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, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @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, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @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, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @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, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @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.)

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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, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @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 …