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8 Health Disparity Knowledge Gaps that Nurses Can Help Fill
by Pam Chwedyk Minority Nurse Writer
• Last fall, the National Lipid Association’s “Moving Beyond Cholesterol” survey of over 2,000 patients found that African Americans are less likely than other ethnic groups to be aware of the cardiovascular risks associated with unhealthy levels of triglycerides, a lipid (fat) found in the blood. The survey also found that African Americans are highly concerned about the risks of unsafe lipid levels, but are least likely to know what the safe levels are, to be aware of the causes of unsafe lipid levels and to have discussed lipids with their physicians.
• A recent survey by the American Psychiatric Association reveals a significant lack of knowledge and understanding among Hispanics about the warning signs, causes and effective treatments for mental illnesses, such as depression. Two in five Hispanics surveyed (42%) reported knowing only a little or almost nothing about mental illnesses. Asked whether they would benefit from knowing more about the warning signs of mental illness, 84% said yes.
• More than one third of parents of children with type 1 diabetes are unaware of a crucial blood ketone test that may help prevent the onset or progression of diabetic ketoacidosis (diabetic coma), the leading cause of death among children with diabetes. Survey findings from Abbott and Children with Diabetes (CWD) indicate that more than 30% of parents test their child’s ketone levels only once or twice a month, 30% are unaware that testing blood ketones can easily be done at home using a hand-held meter and 75% are still using the traditional urine ketone test method, which takes longer to deliver results.
• A recent analysis of 2005 data from the National Cancer Institute’s Health Information National Trends Survey (HINTS) reveals that the majority of Americans do not know the recommended age at which they should begin receiving cancer screening exams such as mammograms, Pap tests and colonoscopies--and that Americans of color know less about it than their Caucasian counterparts. For example, when asked when screening for colorectal cancer should begin, 38% of white respondents did not know the recommended age, compared with 79% of Hispanics, 75% of African Americans and 70% of American Indians/Alaska Natives.
• According to the Vision Council of America, more than 2.4 million African Americans have an undiagnosed, uncorrected vision problem that could lead to permanent vision loss if left untreated. In fact, blacks are almost 70% more likely than whites to have visual impairment from serious eye diseases like glaucoma, diabetic retinopathy and age-related macular degeneration. However, says optometrist Edwin C. Marshall, OD, “too many African Americans skip eye exams because they don’t recognize the need for preventive vision care. I often encounter patients who could have avoided vision loss or other serious health complications by seeing an eye doctor regularly.”
• As reported in the October 2, 2006 edition of HealthDay News, as many as 6.5 million American children and adolescents--especially those who are Hispanic or Asian American--could have a common but often-overlooked condition called non-alcoholic fatty liver disease (NAFLD). NAFLD, an accumulation of fat in the liver cells, can lead to cirrhosis, end-stage liver disease and liver cancer, but there has been little data available about its prevalence in children. But when researchers from the University of California, San Diego did a major study of autopsy reports and tissue samples from local children and teens aged two to 19 who died from accidents, murder or suicide between 1993 and 2003, they found that 13% of these youths had NAFLD. Hispanic and Asian kids had higher rates of fatty liver--11.8% and 10.2%, respectively--than whites (8.6%) or blacks (1.5%).
• Many people still don’t fully understand the label instructions on their prescription medications, according to a 2006 study of low-income patients by Northwestern University’s Feinberg School of Medicine. And it’s not just patients with low literacy levels--even study participants with a high school education and higher had problems understanding or interpreting the prescription labels they were shown. The most common mistakes were misinterpreting dosage instructions (e.g., a tablespoon versus a teaspoon) and misunderstanding the dose frequency.
• According to research findings presented last November at the annual meeting of the American Heart Association, African Americans who suffer cardiac arrest in a public place or at home are less likely than Caucasians to receive CPR from a bystander or family member. A study of 770 patients in Delaware who had cardiac arrest away from a hospital in 2005 revealed that 45% of white victims were given CPR, compared with only 34% of black victims. Why the disparity? The study’s author, Robert O’Connor, director of education and research at Christiana Care Health System, believes the most likely reason is lack of training in CPR among African Americans. For an example of an innovative nurse-led project that is teaching residents of an African American urban neighborhood to perform CPR and use a defibrillator.