Racial/ethnic disparities, social support, and depression: examining a social determinant of mental health.

Objective: We examined the risk of depression as it relates to social support among individuals from African American, Caribbean black, and non-Hispanic White backgrounds.

Methods: 6,082 individuals participated in the national survey of American life (NSAL), a nationally representative, psychiatric epidemiological, cross-sectional survey of household populations. The survey is designed to explore racial and ethnic differences in mental disorders.

Paths to success: optimal and equitable health outcomes for all.

Abstract:U.S. health disparities are real, pervasive, and persistent, despite dramatic improvements in civil rights and economic opportunity for racial and ethnic minority and lower socioeconomic groups in the United States.

Overweight in school-aged children associated with emotional and behavioral difficulties: results from a national sample.

Objective: To determine whether there is an association between perceived pediatric overweight and emotional/behavioral difficulties among children ages 4 to 17 years in the United States.

Design: A cross-sectional study

Setting: Interview of an adult knowledgeable about a child's emotional and physical health. All statistical analyses were completed using SPSS 17.

Health care access and utilization among US-born and foreign-born Asian Americans.

Despite efforts to eliminate inequality in health and health care, disparities in health care access and utilization persist in the United States. The purpose of this study was to compare the access to care and use of health care services of US-born and foreign-born Asian Americans. We used aggregated data from the National Health Interview Survey (NHIS) from 2003 to 2005, including 2,500 participants who identified themselves as Asian.

United States black:white infant mortality disparities are not inevitable: identification of community resilience independent of socioeconomic status.

Introduction: U.S. disparities in Black:White infant mortality are persistent.

E-mail in patient-provider communication: a systematic review.

Objective: To review systematically the role of e-mails in patient-provider communication in terms of e-mail content, and perspectives of providers and patients on e-mail communication in health care.

Methods: A systematic review of studies on e-mail communication between patients and health providers in regular health care published from 2000 to 2008.

Results: A total of 24 studies were included in the review.

Context of clinical care: the case of hepatitis C in underserved communities--a report from the Primary Care Multiethnic Network (PRIME Net) Consortium.

Background: The importance of Hepatitis C (HCV) as a public and individual health concern is well established. However, national groups differ in their recommendations to primary care clinicians about screening people at high risk for HCV. The purpose of this study was to explore the context of care within which primary care clinicians decide to detect and initially manage HCV.

Role of the primary care safety net in pandemic influenza.

An influenza pandemic would have a disproportionately adverse impact on minority populations, the poor, the uninsured, and those living in underserved communities. Primary care practices serving the underserved would face special challenges in an influenza pandemic. Although not a formalized system, components of the primary care safety net include federally qualified health centers, public hospital clinics, volunteer or free clinics, and some local public health units.

The clinical content of preconception care: care of psychosocial stressors.

In the period before conceiving, many women are under considerable psychosocial stress, which may affect their ability to conceive and to carry a pregnancy successfully to term. Thus, health care providers who interact with women in the preconception and interconception period should ask their patients about possible psychosocial risks. It is no longer sufficient to wait until the woman mentions a problem or seeks advice; the provider must be proactive, because many women do not realize the potential impact of stressors on their pregnancy outcomes nor are they always aware that their provider is interested in their psychosocial as well as their physical health.

Diversity in academic medicine no. 5 successful programs in minority faculty development: overview.

Despite recent drastic cutbacks in federal funding for programs to diversify academic medicine, many such programs survive and continue to set examples for others of how to successfully increase the participation of minorities underrepresented in the healthcare professions and, in particular, how to increase physician and nonphysician minority medical faculty. This article provides an overview of such programs, including those in historically black colleges and universities, minority-serving institutions, research-intensive private and public medical schools, and more primary care-oriented public medical schools. Although the models for faculty development developed by these successful schools overlap, each has unique features worthy of consideration by other schools seeking to develop programs of their own.

Diversity in academic medicine no. 3 struggle for survival among leading diversity programs.

Since efforts to increase the diversity of academic medicine began shortly after the Civil War, the efforts have been characterized by a ceaseless struggle of old and new programs to survive. In the 40 years after the Civil War, the number of minority-serving institutions grew from 2 to 9, and then the number fell again to 2 in response to an adverse evaluation by the Carnegie Foundation for the Advancement of Teaching. For 50 years, the programs grew slowly, picking up speed only after the passage of landmark civil rights legislation in the 1960s.

Diversity in academic medicine no. 1 case for minority faculty development today.

For the past 20 years, the percentage of the American population consisting of nonwhite minorities has been steadily increasing. By 2050, these nonwhite minorities, taken together, are expected to become the majority. Meanwhile, despite almost 50 years of efforts to increase the representation of minorities in the healthcare professions, such representation remains grossly deficient.

Diversity in academic medicine no. 6 successful programs in minority faculty development: ingredients of success.

This article describes the ingredients of successful programs for the development of minority faculty in academic medicine. Although stung by recent cuts in federal funding, minority faculty development programs now stand as models for medical schools that are eager to join the 140-year-old quest for diversity in academic medicine. In this article, the ingredients of these successful faculty development programs are discussed by experts in minority faculty development and illustrated by institutional examples.

Trends in mental health and substance abuse services at the nation's community health centers: 1998-2003.

Objective: We examined trends in delivery of mental health and substance abuse services at the nation's community health centers.

Methods: Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care's (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data.

Results: Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210,000 to 800,000.

Black-White mortality from HIV in the United States before and after introduction of highly active antiretroviral therapy in 1996.

Objectives: We sought to describe Black-White differences in HIV disease mortality before and after the introduction of highly active antiretroviral treatment (HAART).

Methods: Black-White mortality from HIV is described for the nation as a whole. We performed regression analyses to predict county-level mortality for Black men aged 25-84 years and the corresponding Black:White male mortality ratios (disparities) in 140 counties with reliable Black mortality for 1999-2002.

Sexual history-taking among primary care physicians.

Background: Because many people seek sexual healthcare in settings where they seek primary healthcare, the extent to which primary care physicians take sexual histories is important. We surveyed Atlanta-area primary care physicians to estimate the extent to which they take sexual histories as well as the components of those histories and the circumstances under which they are taken.

Methods: Four-hundred-sixteen physicians in four specialties (obstetrics/gynecology, internal medicine, general/family practice, pediatrics) responded to a mail survey conducted during 2003-2004.

Trends in Mental Health and Substance Abuse Services at the Nation's Community Health Centers: 1998-2003.

Objective: We examined trends in delivery of mental health and substance abuse services at the nation's community health centers.

Methods: Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care's (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data.

Results: Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210,000 to 800,000.

Pediatricians' knowledge, training, and experience in the care of children with fetal alcohol syndrome.

Objectives: Prenatal exposure to alcohol interferes with fetal development and is the leading preventable cause of birth defects and developmental disabilities. The purpose of this study was to identify current knowledge, diagnosis, prevention, and intervention practices related to fetal alcohol syndrome and related conditions by members of the American Academy of Pediatrics.

Methods: This study was developed collaboratively by the American Academy of Pediatrics and the Centers for Disease Control and Prevention.

A crash-course in cultural competence.

America is a multi-cultural society. Yet, there are cultural dimensions to the clinician-patient relationship that have not been systematically addressed in medical education or in clinical practice. Lack of diversity and lack of cross-cultural skills in the medical profession may contribute to health disparities in America.

Being uninsured: impact on children's healthcare and health.

Purpose Of Review: There are 8.4 million uninsured children in the United States. Many are eligible for coverage.