New U.S. Plan to Improve Health Care for Minorities

Government Strategy Calls for Better Access to Health Care

April 12, 2011 -- The U.S. government has introduced a new approach to fight barriers to good health care faced by many minorities.

Racial and ethnic minorities are more likely to suffer from serious illness, like diabetes and heart disease, and less likely to have access to quality health care than white Americans.

To reduce those health disparities, the Department of Health and Human Services (HHS) has released what it's calling the most comprehensive action plan and strategy yet to expand health care access and improve minority health.

"While some have benefited from tremendous medical advances, the health and wellness of the entire nation will not improve until disparities and inequities have been eliminated," said Howard Koh, MD, assistant secretary at HHS, in a conference call.

"Our goal as a nation is for each person to reach the highest attainable standard of health, which is currently out of reach for many," says Koh.

The HHS action plan has five broad goals:

Transform health care by expanding health care coverage and increasing access to care.Strengthen the health care workforce by recruiting more minorities for public health and medical careers, improving health care interpreting services, and supporting more training of community health workers such as promotoras (Spanish-speaking community health workers) to help people navigate the health care system.Improve the health of minority communities through community transformation grants to target heart disease, childhood obesity, tobacco-related illnesses, maternal and child health, flu, and asthma.Improve data collection and research involving racial and ethnic minorities.Increase transparency and accountability of HHS programs with respect to reducing minority health disparities.

“For the first time, the United States has a coordinated road map designed to give everyone the chance to live a healthy life,” says HHS Secretary Kathleen Sebelius in a news release. “We all need to work together to combat this persistent problem so that we can build healthier communities and a stronger nation.”

In combination with the HHS action plan, the agency also unveiled a new National Stakeholder Strategy for Achieving Health Equity.

The strategy provides a common set of goals and objectives for public and private sector involvement in reducing racial and ethnic health disparities.

These goals include increasing awareness of the significance of health disparities and improving the cultural and linguistic competency and diversity of the health care work force. The HHS will also offer community organizers a toolkit to help them make use of provisions of the new plans.

Officials say funding for these plans is already provided in the HHS budget, largely through the Affordable Care Act.

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Embarrassed by Your Singing? It’s a Clue to Brain Health

Scientists Observe Karaoke Singers to Get Better Understanding of Neurodegenerative ConditionsBy Cari Nierenberg
WebMD Health News

April 15, 2011 -- Belting out a karaoke tune and then listening to the cringe-worthy performance afterward gave researchers new insights into how the brain processes embarrassment.

In the study, scientists from the University of California, San Francisco and University of California, Berkeley observed 79 people, 58 of whom had neurodegenerative conditions while the rest had healthy brains. In neurodegenerative conditions, brain cells are progressively damaged or destroyed.

Although not asked to sing karaoke in a club or bar, each volunteer crooned "My Girl" by the Temptations along with the voice-recording device and were videotaped while doing it. They were then asked to watch and listen to their vocal chops minus any accompanying music.

The goal was to embarrass the singers while researchers measured their facial expressions and reactions, including sweating, breathing, and heart rate.

"In healthy people, watching themselves sing elicits a considerable embarrassment reaction," says Virginia Sturm, PhD, a postdoctoral neuropsychology fellow at the University of California, San Francisco Memory and Aging Center, in a news release.

But people who had neurological damage in a region of the brain known as the medial frontal cortex seemed less concerned. "The smaller the region, the less embarrassed the people were," says Sturm.

The study was presented at the 2011 Meeting of the American Academy of Neurology in Hawaii.

The experiment also used magnetic resonance imaging to gauge the size of different regions of the brain to figure out if these would predict embarrassment.

Doing karaoke as part of a science experiment is unusual, but it allowed researchers to pinpoint a thumb-size area in the front part of the brain's right hemisphere that's necessary for feeling embarrassed.

The more damage participants had in the area of the front part of the brain called the pregenual anterior cingulate cortex, the less mortified they were about their singing. Although not self-conscious about their vocal skills, people in this same group did startle and show fear in response to hearing the sound of a gunshot in a second test done as part of the study.

"So, it's not like they don't have any emotional reactions at all," Sturm says. But feeling no shame is a telling warning sign. "Emotions like embarrassment are particularly vulnerable in neurodegenerative diseases that target the frontal lobes.”

Researchers hope that a better understanding of the subtle shifts seen in emotions such as embarrassment in people with thinking and memory problems may give doctors an earlier clue for diagnosis and may help family members and caregivers grasp the behavior changes seen in certain forms of dementia.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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How a 'Diabetes Diet' Protects Your Health

Healthy food can help prevent diabetes complications.

If you have diabetes, a healthy diet does more than keep your blood sugar under better control. A good diabetes diet can also help prevent or delay the onset of complications such as nerve pain or heart disease.

Although some people talk about a "diabetes diet," there's really no such thing, experts say. The same healthy diet recommended for those without diabetes will help you if you have diabetes, too. You may need to then tailor the meal plan to your specific needs, such as lowering your cholesterol. But the general concepts of healthy eating are the same for you as for someone without diabetes.

Type 2 Diabetes and the Insulin Pump

If you have type 2 diabetes and take insulin, you may want to ask your doctor about the insulin pump. Insulin pumps are small, computerized devices (about the size of a small cell phone) that you wear on your belt or put in your pocket that allow for a continuous flow of a rapid-acting insulin to be released into your body. The pumps have a small flexible tube (called a catheter) with a fine needle on the end, which is inserted under the skin of your abdomen and taped in place. The insulin pump...

Read the Type 2 Diabetes and the Insulin Pump article > >

Here, what you need to know about eating to feel better now -- and for years to come.

"The diet that used to be termed a diabetes diet is now considered just a healthy diet for all Americans based on the healthy guidelines from the Department of Agriculture," says Ruth S. Pupo, RD, a registered dietitian and certified diabetes educator at the East Los Angeles Center for Diabetes at White Memorial Medical Center.

One slight difference when she counsels those with diabetes: "We might encourage them to be more cautious with concentrated sugars like juices, candy, cake," she says.

Diet plans for people with type 2 diabetes are also more individualized than in the past. Such diet plans follow good nutrition, but also take into account the individual's specific dietary needs, says Angela Ginn-Meadow, RD, a registered dietitian and certified diabetes educator at the Joslin Diabetes Center, in Baltimore.

One person with diabetes may need to lower cholesterol. Another may need to lower high blood pressure.

"One diet [plan] is not going to work for everyone," she says.

Yet, all are based on the same general concepts proven effective for improving blood sugars and controlling diabetes. Eat a diet that is:

Lower in caloriesHigher in complex carbohydrates found in vegetables, fruits, beans, and whole grain cerealsLower in saturated fats like butter, cheese, and fatty meatHigher in mono and polyunsaturated fat like olive oil or canola oil   

Although experts disagree somewhat on the "ideal" meal plan details, they agree that spreading your carbohydrates over the day, or counting them carefully, are good ways to maintain blood glucose control.  

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