* A recent study has found that black men are more likely than white men and women to be unaware that they are suffering from high blood pressure, according to an article in Wednesday's Reuters Health.  The researchers claim that this disparity stems from the fact that men are less likely than women to believe that they need to see a doctor.   Moreover, men, particularly African American men, are less likely to have access to a primary care physician:

What is not good, the researchers say, is that men were less likely than women to have a regular doctor, and they were four to five times more likely to say they had no doctor because they did not need one.

Study participants who did have a regular doctor were nearly four times more likely to know they had high blood pressure, and more than eight times more likely to be taking medication for it.

* The Kaiser Health Disparities Report has linked to a study on the prevalence of asthma that appeared in the Journal of Health and Social Behavior.  By looking at 10 different racial and ethnic groups in New York City, researchers examined how housing and neighborhood conditions might contribute to disparities among asthma patients:

Researchers found that Puerto Rican-Americans, other Hispanics and blacks had the highest levels of asthma, while Mexican-Americans, Chinese-Americans and Asian/Indians had the lowest levels. They also found that reducing minorities' exposure to deteriorated housing conditions and increasing levels of community unity, as well making improvements in other household factors, reduce asthma rates among blacks and Puerto Rican-Americans.

* An article in Saturday's New York Times discusses how rising gas prices have led to cuts in various services for the elderly.   Agencies have been forced to cut back on many programs, such as Meals on Wheels, because of the rising costs of transportation.  Elderly people, particularly those who are homebound, are among those most affected by these cuts, since they rely not only on the programs but on at-home volunteers as well:

Val J. Halamandaris, president of the National Association for Home Care and Hospice, said that rising fuel prices had become a significant burden for the 7,000 agencies represented by his group, with some forced to close and others compelled to shrink their service areas or reduce face-to-face visits with patients. A recent survey by the group concluded that home health and hospice workers drove 4.8 billion miles in 2006 to serve 12 million clients. "If we lose these agencies in rural areas, we'll never get them back," Mr. Halamandaris said.

* The Washington Post is reporting that New Jersey is one of the states facing the harshest effects of the health care crisis - hospital closures.   New Jersey's state hospitals are required to treat any person that walks through their doors, and in turn the state is supposed to reimburse the hospitals.   However, the state's budget crisis has led to cuts in reimbursements, and ultimately to hospital closures:

Six [hospitals] have closed in the past 18 months, and half of those remaining are operating in the red...

The situation has come to a head in this city [Plainfield, NJ] of 48,000 people -- majority black, largely poor and with many new immigrants moving in. The city's hospital of 130 years, Muhlenberg Regional Medical Center, is slated to become the latest casualty of this faltering system, closing its acute-care facility later this year. The obstetrics and pediatrics wards have already shut, and equipment is being packed up and wheeled out.

New Jersey is not the only state that has a problem of hospital closures.  To learn about the extent of the problem of hospital closures in New York, visit The Opportunity Agenda's GoogleMaps mashup site, Health Care That Works.

Last Thursday, June 26th a California Superior court upheld the LAPD's 29-year-old policy of neither arresting people based on immigration status nor asking about immigration status during interviews. This policy, described by Police Chief William Bratton as "an essential crime-fighting tool for us," is meant to avoid discouraging the undocumented population in many LA communities from communicating with police officers and reporting crimes. Proponents of the policy's abandonment, who filed suit in April 2007, argue that it conflicts with federal and state law. While under the policy officers do alert immigration officials in the case of a suspect who has either previously been deported or is arrested for a felony/multiple misdemeanors, plaintiffs argue that illegal immigrants are repeatedly arrested rather than appropriately deported.

The judge's decision affirms that immigration law is to be applied on the federal, and not the local level. Local law enforcement officials cannot and will not be asked to act as federal immigration agents. The defendants argued, and the court agreed, that this conflation of positions is not warranted on legal grounds and is detrimental to the goals of local law enforcement.

The overturning of this lawsuit averts several troubling implications that elimination the disputed policy would have had. The role of a local police officer and that of an federal immigration agent have vastly different objectives; while the former exists "to protect and serve" residents, the latter aims to "effectively enforce our immigration and customs laws... by targeting illegal immigrants." In an area with a significant undocumented population, these roles are often at odds with each other. To ask that police officers assume the duties of immigration agents is to cast them into a confused role that ineffectively pursues conflicting goals. Furthermore, incorporating these duties into local law enforcement greatly increases the risk of racial profiling in pursuit of undocumented residents.

The court's decision to uphold the LAPD's longstanding policy marks a victory for security in these communities. As one of its six core values, the Opportunity Agenda holds security to be vital to our human dignity. Without safe and healthy living conditions, it becomes overwhelmingly difficult for residents to access any of the other opportunity that society has to offer. To put local police officers in a position that undermines their ability to serve their communities as a whole would be to betray a fundamental commitment to equality, security, and community. With its policy on immigrants intact, the LAPD can go forth in its goal to "build safer communities throughout the City of Los Angeles."

Earlier this month the Atlas Project at the Dartmouth Institute for Health Policy and Clinical Practice released a report documenting the state of health inequalities in the United States.  The report (which was previously mentioned in a post on The State of Opportunity blog) titled "Disparities in Health and Health Care among Medicare Beneficiaries" can be accessed here.

The report calls attention to the fact that health care reform is not only about expanding insurance coverage and improving efficiency standards for health spending - it is also about addressing the unequal access to and the quality of health care in the U.S.  As the Dartmouth report articulates, health disparities are widespread and extensive.  There are higher rates of obesity and smoking among African Americans than there are among whites; this leads to blacks experiencing higher rates of diabetes and cardiovascular disease than whites do.  Blacks have poorer access to primary and specialty care, and this limits their ability to manage any chronic illnesses they might have.  Blacks also have poorer access to advanced surgical solutions, and are more likely to face unfavorable, last resort treatments like leg amputation for diabetes.

Dr. Nancy Bennett, director of the Center for Community Health at the University of Rochester, and Dr. Wade Norwood, director of community engagement at Finger Lakes Health Systems Agency, recently wrote an op-ed addressing what local communities are doing to address health disparities in their areas.  They describe the problem as follows:

Although these [disparities] may be related to the adequacy of insurance, studies have shown that differences remain even when coverage is equal. We need to understand, through public health and health services research, the complexities of this pathway so that we can eliminate inequalities.

If the federal government is unable to address problems of unequal access and quality of health care in the U.S., local community organizations must take it upon themselves to deal with these issues. The Finger Lakes Health Systems Agency has established a number of African American and Latino health coalitions to prioritize improving health equity in New York.  They have already made significant progress:

More people had access to primary care in 2006 compared with 2000, more received annual mammograms and fewer were admitted to the hospital for complications of chronic disease. We know from our own local health data that we have almost eliminated racial and ethnic disparities in immunization rates for both children and adults, and in mammography and cervical cancer screening. Much of this success can be attributed to specific, targeted programs that improve our overall measures while reducing racial disparities.

The Opportunity Agenda has written numerous reports on the prevalence of health disparities in the U.S., as well as how these inequalities inhibit people's ability to achieve their full potential. In New York, The Opportunity Agenda has been part of various efforts to improve health equality through empowering communities.  The Coalition for Community Health Planning, a group that The Opportunity Agenda is an active member of, has been pushing the state and city governments to commit to investing in community health planning programs and to facilitating community involvement in health care.

To learn more about health inequalities in New York, read our report: Dangerous and Unlawful: Why Our Health Care System is Failing New York Communities and How To Fix It. Also, visit our Google Maps mashup Health Care That Works to see how recent hospital closures have had a disproportionate impact on communities of color.

*    This past week there have been a number of news articles on HIV and the racial disparities among those who are infected.  The Washington Post reported that the number of young homosexual men diagnosed with HIV has risen 12%.  The largest increase of 15% was among young African American men (compared to a 9% increase among young white men):

Previous studies have found that gay black men on average have fewer sex partners, are less likely to use drugs and are no more likely to have unprotected intercourse than gay white men. Consequently, their higher rate of infection does not appear to arise from riskier behavior.

Instead, it reflects the higher prevalence of HIV -- as well as syphilis and gonorrhea, which increase a person's susceptibility to HIV -- in the black population.

Despite this negative news of increasing health disparities between whites and African Americans, there was also a positive step in the battle against HIV.  According to the New York Times, the New York City Health Department has announced a three year plan to give an HIV test to everyone living in the Bronx:

While Manhattan has long been the epicenter of the AIDS epidemic in New York, with the highest incidence of both AIDS and H.I.V., the virus that causes it, the Bronx, with its poorer population, has far more deaths from the disease. Public health officials attribute this to people not getting tested until it is too late to treat the virus effectively, thus turning a disease that can now be managed with medication into a death sentence.

Though the story does not mention the demographic population of the Bronx, 35.6% of Bronx residents are African American, a much larger percentage than the percentage of African American Manhattanites (who make up only 17.4% of the borough's population).  Expanding HIV testing in the Bronx is an important part of combating the racial disparities among those with HIV and helping end the upward trend of HIV rates among young African Americans.

*    The Kaiser Health Disparities Report has a story on a House bill to reduce allowable lead levels in paint.  The bill, which just unanimously passed the House Financial Services Committee, aims to lower the number of children exposed to lead-based paint (many of whom are poor, minority children who live in older homes):

According to bill sponsor Rep. Keith Ellison (D-Minn.) and other lawmakers, despite a 1992 law that restricted the use of lead-based paint in houses, hundreds of thousands of children are exposed to excessive levels of lead, which can cause brain damage and other serious health problems.

*    The HealthBeat blog has a posting on how progressives should incorporate cost control into their discussion of health care reform.  Without cost control on the agenda of health care reform, it will be difficult to bring Americans who are most concerned with rising costs of health care on board:

That is why I believe that progressives must begin talking about the high cost of care, and how we need to wring the waste out of the system to make truly effective, high quality care affordable for everyone. Don't let the conservatives dominate the debate about spending. If they do, they'll take the conversation in the wrong direction.

The Opportunity Agenda believes that addressing the issue of cost is crucial to a fruitful, productive discussion on health care reform. For example, 52% of American workers do not enroll in employer insurance plans because they are too costly.  Premiums for family coverage have increased by 59% since 2000.  Decreasing these costs, in addition to addressing the problems of unequal access and unequal quality, is absolutely necessary in order to reform the health care system in the U.S.  To learn more, take a look at The Opportunity Agenda fact sheet, Health Care and Opportunity.

*    For a touch of humor, check out a recent posting on Disease Management Care Blog.  Along with a YouTube video of Canned Heat's "Let's Work Together" there are new lyrics encouraging all to work together to reform health care in the U.S.:

Together we'll stand
Divided we'll fall
we need more data
the... cash flows will stall
let's work together
Come on, come on
let's work together
Now now people....
Because together we will stand
Every doc, all the vendors and Plans!...

*    Last week, The Opportunity Agenda's Immigration Blog Roundup linked to an Of América posting about the Guantanamo-like treatment of individuals held at ICE detention facilities.  The latest Breakthrough video titled "Death by Detention" documents individuals' stories of their horrific experiences at these facilities.  The video has been posted on numerous pro-migrant blogs, including Standing FIRM.

*    Immigration News Daily has posted an editorial titled "No Getting Around the Wall."  The editorial, which originally appeared in La Opinión, condemns the Supreme Court for refusing to hear a challenge to the Department of Homeland Security decision to build a wall along the U.S.-Mexico border.  Numerous Arizona environmental organizations have claimed that the DHS ignored 36 environmental protection laws in deciding to construct the wall:

Once again, as in the case of the "mismatch letters" and other similar actions, the Bush Administration is trying to improvise an immigration policy without taking into account the consequences triggered, the rights violated, or the injustices committed.

Building a wall along the border is bad policy. As long as it continues, the courts have the responsibility to stop the abuse of authority that stems from its implementation.

*    Wednesday's Immigration Equality Blog posting calls attention to a USA Today story describing how U.S. citizens are suing the DHS after they were detained and interrogated by ICE workers.  The plaintiffs in the suit claim that they were subject to racial profiling and that ICE officials violated workers rights in the process of detaining people.  One immigrant worker, Jesus Garcia, was thrown in jail because of the ICE agents' "mistake":

ICE agents went to Jesus Garcia's home on April 16 in conjunction with a raid on a nearby Pilgrim's Pride poultry processing plant, where he worked marinating chicken meat. Garcia, from Mexico, has been a legal permanent resident for a year and a half. When about 10 ICE agents and local sheriff's deputies knocked on his door, they told him he was using the wrong Social Security number, says his wife, Olivia Garcia, a U.S. citizen.

Though Garcia showed the agents his green card, they handcuffed him and jailed him. He was released a day and a half later after agents told him he wasn't the person they wanted, he says. He had spent the night in jail. "He said it was pretty bad," Olivia says. "People were crying and screaming."

*    A story that appeared in Medical News Today and was initially reported by the Ventura County Star examines California Governor Arnold Schwarzenegger's decision to save $87 million in the state's Medicaid program ("Medi-Cal") by cutting funding for health care services to approximately 91,000 immigrants each month:

Immigration advocates say the cuts would prevent patients from obtaining preventive care, thus increasing emergency department visits and costs. State Assembly and Senate budget committees have voted against the proposals and other Medi-Cal changes, but state officials say they will continue to push for the cuts.

So if you call Obama black, you're a racist because you're using the "one drop" rule.

Like Tiger Woods, Obama has only one black parent. Woods will not refer to himself as merely black because, as he told Barbara Walters "that would be like saying my mom doesn't exist."

So we can't call Obama black.

So let's call him biracial. Oh no, say some of you. That's racist:

When you try and tell us Obama is only 6.25% black, and use terms like bi-racial as some kind of wedge in the black community, don't be surprised if you are called a racist.

A Washington Post/ABC News poll released this week includes some interesting findings, as Americans contemplate the possibility of the nation's first African-American president.  The survey finds, for example, that 3 in 10 Americans admit to having at least some feelings of racial prejudice.  There was little difference between whites, blacks, and "others," in their response to the question.  While social science research shows that virtually all of us carry around subconscious or implicit biases, it is surprising to see so many Americans consciously owning up to their prejudices and confessing them in a telephone survey.

As in other surveys, African Americans were more likely than whites to believe that discrimination persists as a problem, but the numbers were closer than in other recent polls.  When asked "Do you think blacks who live in your community experience racial discrimination, or not?" 54% of blacks said "yes," while 46% of whites agreed.  African-American perceptions of discrimination were lower here than in similar recent polls, but may reflect the fact that people of all races typically perceive greater mistreatment in the larger society than they do in their own community.  Interestingly, people from racial groups other than Caucasian and African American--lumped together as "others" in the survey analysis--were most likely to answer yes to this question, at 59%.

These poll results, along with other research and events on the ground, suggest that Americans may be ready for a conversation about race that goes beyond the traditional model of discrimination as violent bigotry and recognizes bias as something we must identify and overcome as a nation--through policy as well as personal behavior.  And unlike the Washington Post/ABC poll, that conversation will expand from the familiar black/white paradigm to acknowledge the full diversity of our communities.

In the weeks to come, The Opportunity Agenda will be sharing new research, as well as new tools, that can help to move that conversation forward through Election Day and beyond.

Stay tuned.

Get ready.

We've begun to see what the rethugs are rolling out for the GE and it's no great surprise.