Orleans Parish PLACE MATTERS Team Leader Andre Perry speaks to 89.9 WWNO about PLACE MATTERS and community advocacy in New Orleans.

A sense of place is powerful in New Orleans, where people tend to identify strongly with their neighborhoods. But while the culture and tradition of these neighborhoods may enrich the local lifestyle, a new initiative is analyzing how other particulars of place can have precisely the opposite effect. The program is called Orleans Place Matters and it takes a hard look at neighborhood-level factors ranging from housing and transportation to discrimination and the legacy of segregation.

“So we see and are not surprised by the Lower Ninth Ward, Central City, parts of Treme, parts of the Seventh Ward with extremely low life outcomes, because of the history, because of the inability to bring equity to those places,” says Andre Perry, an education policy expert at Loyola University. “Just to be clear, in some communities, the life expectancy rate is 55.5 years compared to 80 for others, so there’s a stark difference.”

Perry is the team leader for Orleans Place Matters. This local program is part of a national initiative from the Joint Center for Political and Economic Studies, a research group based in Washington, D.C. In cities across the country, its Place Matters program gives community organizations the data and analysis they need, both to understand what factors impact health in their neighborhoods and to advocate for effective change.

“We’re going to continue to produce reports and produce data that community members can leverage to get better policy for their communities,” Perry says. “Families need data to go to city council and go to the mayor and say, look this is what’s happening. And so we want to provide that data for them.”

Read more and listen to the radio story at 89.9 WWNO.

The Joint Center for Political and Economic Studies applauds a new report released yesterday by Community Catalyst on the practice patterns of dental therapists, who are mid-level providers of oral health care.  The report, entitled The Economic Viability of Dental Therapists, is the first assessment of how mid-level dental providers, specifically dental therapists, are practicing in the United States.  

Oral health care disparities are some of the deepest and most persistent health disparities in the United States.  People who have low incomes, children, racial and ethnic minorities, older adults and residents of rural communities face an array of barriers to accessing routine and preventive dental care. Yet dental disease is the number one chronic illness affecting children, and is more common than asthma. Seventy-two percent of American Indian and Alaska Native children aged six to eight have untreated cavities—more than twice the rate of the general population.  Thirty-seven percent of non-Hispanic black children and 41 percent of Hispanic children have untreated tooth decay, compared with 25 percent of white children.

The Economic Viability report assesses dental therapists practicing in Alaska and Minnesota, and finds that they have effectively expanded access to routine and preventive oral health care for low-income adults, children, and people living in tribal communities. The report finds that 85 percent of the care dental therapists provide is routine and preventive, and that dental therapists cost their employers less than 30 cents for every dollar of revenue they generate.

“The report comes at a time when more than a dozen states are exploring using mid-level dental providers as a way to greatly expand access to dental care,” said Brian D. Smedley, Ph.D., Vice President and Director of the Joint Center’s Health Policy Institute. “Eight states have put forward legislation seeking to authorize dental therapists. Several other states have called for studying the model further. Outside of the U.S., dental therapists have practiced successfully in more than 50 other countries for the better part of a century. We believe they are an important part of a comprehensive strategy to reduce and ultimately eliminate oral health care disparities.”
 

Download the entire press release by clicking the icon below.

This morning, the Joint Center for Political and Economic Studies’ Health Policy Institute hosted members of Congress and a panel of local leaders for a congressional briefing on health inequities.  Panelists discussed their experience with the center’s PLACE MATTERS program, an initiative dedicated to helping local leaders to identify and improve social, economic and environmental conditions that shape health in their communities.

The PLACE MATTERS Program aims to advance health equity by acknowledging racial inequities as the “root cause” of health inequities in communities across the U.S. Research commissioned by the Joint Center estimated the cost of health inequalities experienced by African Americans, Asian Americans and Latinos to be $1.24 trillion from 2003-2006, prompting a desire to further the analysis and advance creative policy solutions through the development of the PLACE MATTERS program, operated since 2006. Place Matters teams work in 24 jurisdictions in 10 states and the District of Columbia, using research to build a case around the root causes of health disparities and developing innovative policy solutions to improve health.

Representatives Barbara Lee (CA-9), Jim McDermott (WA-7) and Robin Kelly (IL-2) attended the briefing, acknowledging the connection between local conditions and community health. Rep. Barbara Lee told the group, “Our health really is determined by our environment – place matters.”

Read more at the W.K. Kellogg Foundation.

Dr. Brian Smedley delivers a plenary speech on health disparities at the National Conference on Family Relations' annual conference on November 2, 2012.

For many years and in countless articles, physicians have been the scapegoat for rising healthcare costs in the U.S. In fact, they have been blamed by many critics for the U.S. leading the world in healthcare expenditures.

A close examination of the data indicates that this blame is misplaced. Something else is revealed by digging deeper into the key components in healthcare spending: Technology, administrative expenses, hospital costs, lifestyle choice and chronic disease conditions have all had greater impacts on rising overall healthcare costs than physicians.

Some critics have suggested that physicians’ incomes and the fact that physicians direct most healthcare spending (80 percent is a frequently used number) are the real culprits in soaring healthcare costs. Yet despite this, physicians are not necessarily the principal beneficiaries of healthcare spending. The bulk of medical procedure payments go to hospitals and device manufactures.  For example, in California, Medicare pays on average $18,000 for a total hip replacement – $16,336 to the hospital and $1,446 to the surgeon. This reimbursement disparity is certainly not limited to California, and is representative of a broader trend on a national level.

Moreover, doctors’ net take-home pay amounts to only about 10 percent of overall healthcare spending. Which if cut by 10 percent would save about $24 billion – a considerably modest savings when compared to the $360 billion spent annually for administrative costs as estimated by the Centers for Medicare & Medicaid Services (CMS), and the fact that 85 percent of excess administrative overhead can be attributed to the insurance system. Administrative costs for physicians are in the range of 25-30 percent of practice revenues and insurance-related costs are 15 percent of revenues, according to a National Academy of Social Insurance report for The Robert Wood Johnson Foundation.

Once the physician impact on healthcare costs is placed in proper perspective, the true role of other key factors can be examined more clearly.

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Moreover, there is a real issue of health disparities that exists in this country leading to higher healthcare costs. Between 2003 and 2006, the Joint Center for Political and Economic Studies estimated the total direct and indirect costs of health inequities affecting racial and ethnic minority populations, including lost wages and productivity – exceeded $1.2 trillion.

Read more at Forbes.

Cultural Competence Training for Health Professionals (HB 2611), led by communities of color who face significant and persistent health disparities and backed as a top priority by the Oregon Health Equity Alliance (OHEA), passed the Oregon House of Representatives on a 46-12 bipartisan vote.

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Cultural competence is about interacting effectively with people of different backgrounds. Ineffective patient communication leads to misdiagnosis and improper treatments that drive health inequities.

A report released by the Joint Center for Political and Economic Studies conducted by researchers at Johns Hopkins University and the University of Maryland shows that between 2003 and 2006, the expenses linked to health inequities for communities of color cost more than $229 billion. Add the indirect costs for lost work days and reduced productivity, and the total cost for health inequities came to $1.24 trillion nationally.

Read the entire article at The Albany Tribune.

Maybe it’s just the power of suggestion, but my throat felt raw and my lungs felt irritated after sitting in Esther Abeyta’s living room in Albuquerque’s San Jose neighborhood for an hour talking about the area’s Superfund sites, the tank farms full of gasoline and other petrochemicals, the asphalt plant, the concrete aggregate company.

Abeyta’s home belonged to her grandmother. Her mother lives two blocks away. Her property south of Downtown backs up to the railroad tracks that run north and south through the city. Tanker cars were parked by her backyard. Diesel-fueled train engines idle on the tracks by her house five or six days a week, sometimes for hours at a time.

Abeyta served as her neighborhood association’s president, and now she and her husband, Steve, are working to understand the environmental condition of the area that may or may not be shortening their neighbors’ lives.

The raw data are truly frightening. A study called Place Matters, put together by the Joint Center for Political and Economic Studies in Washington, D.C., says that in Bernalillo County the difference in life expectancy between census tracts can be measured in decades. Life expectancy in some census tracts in the South Broadway area, where San Jose is located, is from 66 to 70 years. In parts of the Northeast Heights and on the Southwest Mesa life expectancy is from 85 to 94 years.

Low birth weights as a share of all births can range from 12.3 percent to 17.5 percent in some neighborhoods to from 1.4 percent to 4.7 percent in other neighborhoods.

Place Matters measures “community-level health risks,” which include factors such as “educational attainment, violent crime rates, foreclosure rates, unemployment rates, and the percentage of overcrowded households” found in a census tract.

The index Place Matters created to measure those factors is worst in the San Jose area and other neighborhoods in the county. It is best in the far Northeast Heights, in the foothills, and in parts of the West Mesa.

Read more at the Albuquerque Journal.

On Capitol Hill, there are two ways that people tend to talk about the sequester -- a slate of automatic federal spending cuts that are difficult but necessary, or a blunt tool that will inflict tremendous suffering.

But a growing chorus of researchers, political analysts and economists say that the cuts are poised to inflict particularly intense pain on people of color and impede the country’s ability to prosper as these populations grow.

“What you will keep hearing is that it is a little to early to know exactly what is going to happen. And I agree. But I think there are certainly a number of areas where you can expect a disproportionate impact on black and Latino families," said Margaret C. Simms, a fellow at the Urban Institute think tank in Washington, D.C., and director of its Low-Income Working Families Project. "What we are talking about is taking the existing inequalities this country has and really making them worse, much worse.”

If the Obama administration and Congress fail to reach an agreement to modify the slate of automatic spending cuts, as much as $900 million could be cut from Head Start, a federal early education program aimed at helping low-income children keep pace with their peers in school, according to a February analysis by the Center for American Progress, a left-leaning think tank. Losing those funds means that as many as 700,000 children in need of Head Start services may not be able to enroll. A full 60 percent of children enrolled in Head Start are black, Latino or Asian.  

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The sequester is also slated to cut funding for medical research, community health centers that provide care to low-income and uninsured individuals and programs that cover the costs of child vaccinations. These cuts will disproportionately affect people of color, said Brian D. Smedley, vice president and director of the Joint Center for Political and Economic Studies’ Health Policy Institute.

"Sequestration results in significant cuts to very important programs that again, in my view, are likely to widen the health gaps rather than close our fiscal hole," Smedley said.

Read more at The Huffington Post.

Dr. Brian Smedley spoke on the effect a federal government sequestration can and will have on health and other programs that assist a large number of people of color during a Joint Center panel discussion on February 28, 2013.