Monthly Archives: January 2013

Colorado Suffers From Huge Health Gap

In Colorado, a Latino baby is 63% more likely to die in the first year of life than a white baby.

The mortality rate for black babies is more than 3 times the rate of white babies. The mortality rate for white babies in Colorado is lower than the national average, and yet the mortality rates for Latino and black babies is higher than the national average.

Not only that, but while the mortality rates for white babies improves, the rates for minority babies worsens.

Black adults are more likely to suffer from asthma, diabetes, high blood pressure, prostate cancer and obesity in Colorado. Latino adults are more likely to die from the flu or pneumonia.

Infant mortality – the tragic occurrence when a baby dies within its first year of life – is often use an indicator of a nation’s overall health. It’s also used to distinguish between developed and developing countries.

Not only does access to healthcare affect these differences, but many social determinants are in play. Poverty, education, the food one eats, whether one wears a seatbelt, exercise. The list covers many and most aspects of life. The biggest in play seems to be poverty, especially when combined with race or ethnicity. A study conducted by Boston Children’s Hospital found that black and Latino children reported significantly lower levels of physical activity, and were much less likely than white children to wear seat belts or bike helmets.

One way to improve life expectancy is to educate those who have a harder time gaining access to information, traditionally the poor. The Center for African American Health in Denver offers courses in diabetes management and screenings for various types of cancer. However, health is also determined by individual choices and there are those who refuse information when offered. Debates exist on the level of compulsion governments can induce with regards to personal health decisions. In general, the ideal is to strike a balance between being overly coercive and letting people die. So instead of outlawing cigarettes, for example, smoking in restaurants is outlawed.

The people of Colorado are currently trying to address these issues, many through non-profit and non-governmental organizations. Organizations like the Center for African American Health have been cropping up, to mild success.

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Connecticut To Improve Mental Health Support in Public Schools

Since the Newtown shooting, the national discourse on mental health and treatment has been at the forefront of political interest. Connecticut is currently reviewing a chance to improve mental health policies in public schools.

While President Obama is developing a plan to provide $15 million for training school teachers and officials to recognize and deal with students with mental health issues, Connecticut is looking towards supplementing that plan with more social workers in schools.

Senator Beth Bye points out, “We need people in the schools to be more aware of kids who are dealing with social and emotional issues. Early intervention does make a difference.”

Connecticut does not currently allow involuntary outpatient treatment, but change is in the air. It is only one of six states that prohibits this type of treatment.

Some advocates are concerned that improvement to the mental health industry is coming on the heels of a violent tragedy. Those with mental illness are more likely to be victims of violent crimes, they warn, more than they are likely to be the perpetrators. Conflating mental health with violence does more harm than good, to the detriment of all.

As Victoria Veltri, the state’s healthcare advocate, says, “The system needs a lot of work but it’s not because of what happened on Dec. 14… People may be unintentionally equating gun violence with having a mental health diagnosis. Gun violence is its own public health crisis.”

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Anti-Trans Insurance Policies Banned in Oregon

It was announced on December 19, 2012 by the Oregon Insurance Division of the Department of Consumer and Business Services that private health insurance companies could no longer discriminate against trans policy holders.

Transgender advocates have been lauding the regulations, which prohibit denying coverage of hormone therapy, hysterectomies, mastectomies, and other medically-necessary treatments for gender dysphoria and sex-reassignment surgery. Even though many of these surgeries are already protected for non-trans policy holders, the law now specifically prohibits denying coverage for a surgery because the recipient is trans. The regulations also expand mental health services to include trans policy holders.

Being transgender is considered a mental health disorder known as Gender Identity Disorder in Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) – a highly controversial decision. On December 2, 2012, the APA announced that it would be removing Gender Identity Disorder from DSM-V and replacing it with Gender Dysphoria. The difference is that GID focuses on whether a person feels their birth sex and gender are in alignment, and GD focuses on the anguish caused by being unable to make the alignment between sex and gender. For example, a person who might be diagnosed with GID doesn’t necessarily suffer from dysphoria if they have access to gender reassignment surgery, but a person who might be diagnosed with GID could suffer dysphoria if they’re prevented from getting medical treatments and surgeries to change their sex to suit their gender.

In the US, payment for health care treatment by insurance companies, Medicare, and Medicaid relies on the diagnosis of a specific disorder categorized in the DSM-IV. Some say the “disorder” should be struck because it inappropriately stigmatizes trans identities, much like homosexuality was until 1973, and some say it’s necessary in order for trans people to receive the health care they need, such as gender reassignment surgery. The American Psychological Association seems to agree that it is not being trans that causes the requisite distress or disability that qualifies a psychological state as a disorder, but rather the social stigma, discrimination, violence, and difficulty obtaining access to health care that trans people face.

For more information on what being trans means, you can visit the APA’s website on sexuality and gender identification.

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