Minorities less likely to plan for end-of-life care
September 30, 2008
Black and Hispanic adults who are terminally ill are less likely than their white counterparts to have a plan in place for end-of-life care, a new study suggests.
Researchers found that among patients with advanced cancer, African-American and Hispanic patients were about one-third less likely to have an advance care plan — documented preferences for end-of-life care, such as a living will or do-not-resuscitate order.
In general, minority patients were less likely than whites to consider themselves terminally ill and were more likely to want intensive treatment to prolong their lives. However, that did not explain their lower rates of advanced care planning, the researchers report in the Journal of Clinical Oncology.
For now, the reasons for the racial differences are unclear, according to the investigators, led by Dr. Alexander K. Smith of Beth Israel Deaconess Medical Center in Boston.
Still, past studies may offer some clues, they add.
Some research, for example, has shown that minority patients tend to have less trust in the health system — which, in theory, could affect their willingness to plan for end-of-life care. It’s also possible, according to Smith’s team, that the way doctors communicate about terminal illness and advanced care planning plays a role.
There is some evidence, the researchers note, that unconscious racial bias influences some doctors’ treatment of patients — but whether bias affects doctors’ communication about end-of-life care is unknown.
Smith and his colleagues based their findings on interviews with 449 cancer patients who were believed to have fewer than six months left to live. They found that 80 percent of white patients had at least discussed end-of-life care with their doctors or had a documented plan in place — through a living will, for example, or by designating a person to make their medical care decisions if they became too ill to do so.
In contrast, this was true of only 47 percent of both black and Hispanic patients.
Minority patients were more likely than whites to say religion was “very important” to them, and to say they would want life-prolonging treatment, even if they were told they had only a few days to live.
However, those differences did not explain the lower rate of advanced care planning, according to Smith’s team. Future studies, they say, should investigate the reasons for the racial disparity.
Reuters
African-American pastors rally in support of marriage amendment
September 29, 2008
JONI B. HANNIGAN & JAMES A. SMITH SR., Florida Baptist Witness
- Filling the pulpit before a backdrop of about 40 Tampa Bay area pastors, a coalition of African-American pastors Sept. 24 announced their support of a state constitutional amendment to protect traditional marriage.
Urging support of Amendment 2, the Florida Marriage Protection Amendment, pastor of the host church, Beulah Baptist Institutional, W. James Favorite told reporters he believes the comparison of gay marriage to the fight for equality by black men and women in America is wrong.
A “life-long” member of the National Association of Colored Persons (NAACP), Favorite reacted with surprise when he learned after the news conference the Florida NAACP is opposed to the amendment which puts him and potentially many of its members at odds with the organization.
Norfolk officials announce events to commemorate school integration
September 29, 2008
Denise Watson Batts, The Virginian-Pilot
- Norfolk officials announced today a series of events to commemorate the 50th anniversary of the deathblow to Massive Resistance, a strategy used to prevent the integration of Virginia schools.
The events, which are scheduled for January and February, will recognize the opening of six Norfolk schools, which were closed 50 years ago today, by state laws that banned white and black students from attending school together.
The city will kickoff the series with a “Unity March’’ on Jan. 19, the anniversary of Martin Luther King Jr.’s 80th birthday. The march will begin at 10 a.m. at the Scope Plaza and will be led by members of the “Norfolk 17,” the group of African-American students who desegregated the six schools in February 1959. Members of the “Lost Class of ‘59,’’ those white seniors who were shut out when the schools closed, will lead the march as well. They will be joined by the families of Walter E. Hoffman, the federal judge who ordered the Norfolk School Board to desegregate, and Lenoir Chambers, the Virginian-Pilot editor who won a Pulitzer Prize for his editorials denouncing Massive Resistance.
National Black Caucus of State Legislators to Host 15th Annual Mental Health Conference
September 29, 2008
The National Black Caucus of State Legislators today announced it will host its 15th Annual Mental Health Conference to address the more pertinent mental health issues on both state and federal levels facing us today. The goal of the conference is to educate state legislators, healthcare professionals, community leaders and the public about mental illness and what can be done to reduce the cultural stigmas and barriers that prevent access in the African American community.
This year’s conference will be a first for NBCSL, as the event will broadcast live from Indianapolis via satellite to Miami, FL and Detroit, MI. The conference theme, “Black America’s Dialogue on Mental Health,” will allow open dialogue between the conference participants and attendees in the three cities. In addition, the conference will be available live through the Internet, allowing the public to listen in on the conference at www.nbcsl.org.
“We are experiencing a mental health crisis across all communities today,” said Rep. Calvin Smyre (GA), NBCSL President. “The cultural barriers and stigmas associated with mental illness in the African American community make it an even more difficult illness to overcome. We will continue to fail our community unless we rise to the challenge and start providing solutions. We must provide the leadership to gain an understanding of these issues and then become a voice for those affected.”
Rep. Smyre added, “One of our conference topics will cover African American mental health in the military. As our troops come home from Iraq and Afghanistan over the next several years, we need to dedicate significant attention to helping them readjust to civilian life. Our conference panel discussion will equip us to better handle this issue and help our veterans.”
Speakers and panel discussions will be held throughout the day on Friday. U.S. Congressman Kendrick Meek (FL), U.S. Congresswoman Carolyn Kilpatrick (MI) and U.S. Congressman Andre Carson (IN) will be speaking at the luncheon presentation to offer a federal perspective. Topics for this year’s event include “Mental Health and African Americans in the Military,” “Barriers and Cultural Stigmas,” and “The Black Family.”
For the past fifteen years, the mental health conference has been supported through a generous grant by Eli Lilly and Company.
The stigma of mental illness is so powerful in the black community that many refuse to admit a problem or even seek the opinion of a medical professional. Many are forced to hide behind the problems of mental illness without seeking help for fear of labels or lack of support by family.
Insufficient access to appropriate mental healthcare, mistrust of medical health professionals, and the misdiagnoses of illnesses top the list of additional factors that complicate overcoming mental illness.
According to the U.S. Department of Health and Human Services, nearly 25 African Americans are uninsured, compared to 16 percent of the overall U.S. population. Rates of employer-based health coverage are just over 50 percent for employed African Americans, compared to over 70 percent for employed non-Hispanic whites. Medicaid covers nearly 21 percent of African Americans.
Culture biases against mental health and healthcare professionals prevent many African Americans from accessing care due to prior experiences with historical misdiagnoses, inadequate treatment, and a lack of cultural understanding. According to NAMI only 2 percent of psychiatrists, 2 percent of psychologists, and 4 percent of social workers in the United States are African Americans.
In addition, when seeking help, instead of turning to mental health specialists, African Americans are more likely to visit emergency services or a primary care provider. This leads to under-diagnoses or misdiagnoses.
To register for the conference or to learn more, please e-mail mentalhealth@nbcsl.org.
Report: Kentucky schools need to help minorities
September 28, 2008
The state has made strides in increasing access to higher education for minorities, but major work still needs to be done, according to a report commissioned by the Kentucky Council on Postsecondary Education.
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The 156-page report by the Civil Rights Project at UCLA says the preparation of black and white students for college remains highly unequal.
The report recommends considering race for admission to competitive campuses like the University of Kentucky and Louisville. It also says the state should expand its definition of diversity to include Hispanics and American Indians.
The report also suggests the state focus on helping students from poor counties in eastern Kentucky regardless of race.
“It is no longer sufficient to focus only on black students,” the report states.
There are still “massive leaks” in the education system, though the schools themselves are hardly to blame, the report states.
“I t is obvious that Kentucky’s problems are not just problems of the campuses and that a broader commitment from state and local institutions would greatly help reach the goals,” it says.
The report is part of data being collected by the council’s Committee on Equal Opportunity and university presidents in creating a new diversity plan for the state. The plan will replace a 1999 agreement between the state and the U.S. Department of Education’s Office for Civil Rights. That agreement asked the state to increase the number of black students, faculty members and administrators at public colleges and universities.
The report also takes the state to task for funding at historically black Kentucky State University, saying it should work with the school to create “consistent funding, a strong board of regents and a clear structure to assure progress.”
Kentucky State University President Mary Evans Sias said she would like to have more money in the budget, but balke d at the report’s assertion that the school lacks a clear mission.
“I think we are well on the march to getting to where we need to be,” she told The Courier-Journal of Louisville. “We are clearly three things. We are a public liberal arts university. We are historically black, and we are a land grant institution.”
The state did receive high marks for increasing access to higher education for minorities. Enrollment of in-state African-Americans increased from 7 percent to more than 8 percent in 2006.
Western Kentucky University president Gary Ransdell said that some of the report had merit, but that he wasn’t so sure about other parts of it - including expanding the focus of diversity.
“We shouldn’t dilute or shift the focus from the African-American responsibility we all share,” he told the Louisville newspaper.
That focus extends beyond the classroom and into the boardroom. The report said there should be higher representation among minorities on university governing boards. Only 18 of the 120 seats on those boards are filled by minorities.
The problem extends beyond four-year schools to community colleges. The report says the two entities are not working together to make it easier for students to transfer.
“(The process) is functioning very poorly and is a basic threat to the state’s educational goals,” the report says.
AP
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