Monday Health Blog Roundup

  • The Washington Post reports that the government's reckless overspending over the last few years, is now directly affecting the health of America's disabled and elderly.  The Republican-led Congress of 2003 created a "doughnut hole" in drug benefit coverage in order to make it more affordable for the federal government.   Nearly 3.4 billion people were affected in 2007, having to pay the entire cost of their medication until they spent, out of pocket, $3,850.  Many people in Medicare have diabetes, high blood pressure and other chronic conditions.  The result?  15 percent stopped taking their medications when forced to pay for the entirety of their prescriptions.  For example, 10 percent of diabetes patients stopped buying their medication, while 16 percent of high blood pressure patients and 18 percent of osteoporosis patients stopped as well. 

  • In its opinion section, USA Today has a posting by a primary care physician, blogging at www.kevinmd.com.  He writes about Medicare's call for a formula that would have regular decreases of more than 20% in physicians' payments by 2010.  Medicare hopes to curb the exorbitant expenses of the US health care system which now exceeds $2 trillion annually and is the most expensive system in the world.  But cutting doctor's pay by 20%, according to the author, would only cut spending by 2%, and would only drive doctors away from caring for Medicare patients.  For example, in states like Texas, the number of physicians NOT accepting Medicare exceeds 40%.

  • The Kaiser Family Foundation's blog reports on a story that appeared in the Atlanta-Journal Constitution on how HIV/AIDS advocates from Georgia, craft messages towards "urban, white, gay men" whereas "black, rural, women and young people" are the group that are at high-risk for acquiring HIV/AIDS in Georgia.  In 2006, blacks comprised 30% of the state's population, yet 71% of the state's HIV/AIDS population. 

  • Texas' Rio Grande Valley Region may be a microcosm for a potential trend in a diabetes outbreak for the U.S.'s growing Hispanic population.  Written up in The Monitor on August 18, the Rio Grande Valley region has a diabetes rate three times the national rate.  According to the chair-elect of the American Diabetes Association, "Hispanics, American Indians and blacks have a higher prevalence of the disease than other ethnic groups," while Texas state Senator Eddie Lucio said, "as many as half of minority youth across the nation will develop diabetes at some point in their lives." This statistic is compared to 8% of people nationwide that have diabetes.  Moreover, the region's medical expenses associated with diabetes neared $1.5 billion in 2007, while such costs were $74 billion nationally in the same year.  It is believed that lack of access to healthy food options is a primary factor causing this spike in cases. 

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Monday Health Blog Roundup

  • The New York times ran a story on economic inequalities in access to treatment for obese children, of which there are nine million in the United States.  While this figure has tripled since 1980, there is a dearth of comprehensive, effective, or affordable programs to address the issue. Summer weight loss programs are generally costly (some cost over $1,000 a week) as most seek to turn a profit.  Furthermore, most insurance providers do not cover this cost. Dr. Walter J. Pories, a gastric bypass surgeon, calls the lack of insurance and government financing for such programs "the single most frustrating problem in dealing with childhood obesity."

    • The TriCaucus, comprised of the Congressional Asian Pacific American caucus, the Congressional Black Caucus and the Congressional Hispanic Caucus, sent House Speaker Pelosi a letter urging the inclusion of two provisions in the SCHIP reauthorization bill to improve health care access for immigrant children: one eliminating a five-year waiting period for documented immigrants to receive government benefits and another eliminating proof of citizenship as a requirement to receive these benefits. According to the TriCaucus, the proof of citizenship requirement has led to hundreds of thousands of U.S. citizens to be denied coverage because parents could not find the required documentation. The TriCaucus wrote to Pelosi, "We urge you to include provisions in this bill which address the needs of children in communities of color and respectfully request a meeting with you to discuss this critical issue."

    • A study released last Wednesday by the Pew Hispanic Center and the Robert Wood Johnson Foundation reported that 27% of Hispanic adults in the U.S. do not have regular health care providers, although many spoke English and 45% had health insurance.  Hispanic men, younger adults, and those with little education or without health insurance were found most likely to not have regular health care providers, as reported in the Newark Star-Ledger. 41% of Hispanic adults without regular providers identified "seldom [being] sick" as the primary reason.  Given that Hispanic adults actually have disproportionate rates of diabetes and obesity, this presents a unique challenge to providing Hispanics with access to health care that demands real solutions. The authors of the article wrote that the results of the study indicate a "need for providers to encourage Hispanic adults to seek routine health care."

    • According to a recent study published in the journal Cancer Epidemiology, Biomarkers and Prevention and reported in Reuters Health, members of minority groups who have felt discriminated against by their health care providers are less likely to be screened for breast or colon cancers.  Of the 11,245 black, Hispanic, Asian and Native American adults aged 40-75 surveyed, 9% of women and 6% of men said they experienced discrimination from their health care providers in the last 5 years.  These women were approximately half as likely to have had a mammogram and only two-thirds as likely to have a colorectal cancer screening.  Men who had perceived discrimination were 70% less likely to have had a colorectal cancer screening.

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Thursday Immigration Roundup

  • Congress has passed a few bills targeting immigration: E-Verify, a voluntary government program for employers to verify whether or not employees are legally able to work, was re-authorized by the House for only five years.  This suggests that the House feels E-Verify may be a flawed system.  The House Immigration Subcommittee passed a bill recapturing employment and family-based immigrant visas that had not been allocated under existing ceilings due to bureaucratic inefficiencies. It also passed a bill that could make it easier for military personnel and their families to be naturalized.
  • ICE conducted its latest raids in Lowell, MA in the form of home arrests with warrants. Targets were green card holders with criminal records. Sweeps have been going on throughout the country under various types of programs, such as Operation Community Shield and Fugitive operations teams.
  • The Center for Immigration Studies, "an independent research institute which examines the impact of immigration on the United States," published a report documenting the impact of immigration on global CO2 emissions. The report is titled "Immigration to the United States and World-Wide Greenhouse Gas Emissions." According to the study, immigration to the US significantly increases global CO2 emissions in that immigrants move from a lower-polluting region of the world to a higher-polluting country.  While the estimated CO2 emissions of the average immigrant are 18% lower than those of native-born Americans, their emissions are estimated to be four times what they would be in their home countries.
  • The New York Times published a story responding to the release of the legal blueprint in the Postville hearings.  The blueprint, made available online by the ACLU, is a 117 page compilation of scripts that laid out step by step how the hearings should proceed.  While these documents were not binding and were framed as providing assistance to defense lawyers, many critics argue that the scripts indicate that the court endorsed the prosecutors' push to secure guilty pleas before the hearings even began. The scripts went so far as to include a sample statement the judge could make after accepting a guilty plea.  According to Lucas Guttentag, director of the Immigrants' Rights Project of the A.C.L.U, "this was the Postville prosecution guilty-plea machine. The entire process seemed to presume and be designed for fast-track guilty pleas."
  • The Times also covered the story of Hiu Lui Ng, a 34 year old immigrant who died in US custody after being systematically denied medical care in the previous months.  Mr. Ng had overstayed a visa years earlier and had been sent a letter ordering him to appear in court.  This letter was mistakenly sent to a nonexistent address and due to his inevitable failure to appear in court, ICE arrested him last summer when he went to immigration headquarters in Manhattan to apply for a green card.  Since then he has been held in various jails in three New England states.  In April Mr. Ng began to complain of debilitating back pain, however these complaints were written off as "faking it" and it was not until a judge order he be taken to the hospital in early August that he received medical attention.  This exam revealed that his spine was fractured and he had terminal cancer that had been undiagnosed and untreated for months.  He died in the custody of ICE five days after arriving at the hospital. Mr. Ng's case is not isolated, it is situated in a series of cases that have "drawn Congressional scrutiny to complaints of inadequate medical care, human rights violations, and a lack of oversight in immigration detention." Mr. Ng's case and others call for real solutions to a very real problem. Presently before the House Judiciary Committee is legislation to set mandatory standards for care in immigartion detention.

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Monday Health Blog Roundup

  • This past week, two Kaiser Health Disparities Reports documented the effects of language and cultural barriers on medical outreach and diagnosis.  The first report, on HIV/AIDS in the Texas Hispanic community, referenced a Dallas Morning News story which documented that HIV is being detected later in Texas Hispanics than in other ethnic groups.  This increases the risk of spreading the virus and decreases possibilities for treatment.  While 24% of the state's HIV-positive blacks and whites are diagnosed with AIDS within a month of testing positive for HIV, this number is 8% higher for Hispanics.  Language barriers, limited access to health care, legal issues, and cultural differences are noted among the challenges at the root of this disparity.  The second report points to language and cultural barriers as a reason many elderly Hispanics with Alzheimer's disease remain undiagnosed and untreated.  According to the Alzheimer's Association, an estimated 200,000 Hispanics in the U.S have the disease, a figure expected to grow to 1.3 million by 2050.  Experts point to a perception in the Hispanic community that symptoms of Alzheimer's are normal signs of aging, as well as a lack of health insurance and access to care as important factors in late diagnosis of the disease in Hispanics.  Solutions include earlier screening, improved access, and "targeted awareness and treatment efforts."

  • The Health Care Blog reports that Howard County, Maryland will launch the "most ambitious local effort at universal coverage" since San Francisco in April 2007. The plan, known as the Healthy Howard Plan, will offer primary, specialty, and hospital care as well as prescription drugs to 2,200 of the county's 20,000 uninsured residents beginning next month, all for $85 or less a month. According to its designers, Healthy Howard is "built on the philosophy that health care is a right and a responsibility." This language of a human right to healthcare is echoed in the Opportunity Agenda's policy brief, Healthcare, Opportunity and Human Rights at Home. Each enrollee will have to complete a health assessment and work with an assigned health coach to reach specified goals.  While the financing for the program, much of which comes from charity care from the local hospital, is not sustainable, the program will offer unprecedented insight into what does and doesn't work, valuable information for future health reformers.  An initial evaluation of the program will be available within 6 months to a year.

  • An opinion piece in The New York Times evaluated the probability of universal health care reform in the upcoming years.  It listed three hurdles to reform: the swing of political power in the upcoming election, the public's fear of change, and a loss of focus on the health care given such issues as a weak economy and foreign policy crises in the spotlight.

  • The Washington Post reported that health care costs are expected to rise 10% in 2009. Despite being the smallest increase in six years, the increase will make quality health care even more difficult to access.  Particularly hard hit will be poor communities in the U.S. already struggling to pay steep premiums.

 

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The Ramifications of Tax Shelters for America

Our friends at the American News Project have posted a video on the usage of tax shelters by the super-rich.  "Super-Rich Tax Cheats" shines a spotlight on the $1.5 trillion currently estimated to be hidden off-shore from the IRS by the very wealthiest of Americans.

Senator Norm Coleman (R-MN) estimates the resulting lost tax revenue at approximately $100 billion.  The video puts this number into context by showing what the government spends on other programs.  This is more than the federal government spends on education and training ($89.9 billion).  It's triple what is spent on the environment and natural resources ($33.1 billion) and almost five times more than what we spend on temporary assistance for needy families, or TANF ($20.9). Besides looking simply at people clearly breaking the law, the video also has a short segment with Warren Buffet, one of the world's wealthiest men, arguing for tax fairness.  This is key if our nation is to be stronger and we are to truly come together as a community.

You can watch the video at the Huffington Post.

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Thursday Immigration Blog Roundup

*    An article titled "Immigrants Facing Deportation by U.S. Hospitals" appeared in the magazine section of The New York Times on Sunday.  By telling the story of Luis Alberto Jiménez, it documents the disastrous consequences that are the result of inherent failures in the American immigration and health care systems. Below is an excerpt from the article:

Many American hospitals are taking it upon themselves to repatriate seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance. Medicaid does not cover long-term care for illegal immigrants, or for newly arrived legal immigrants, creating a quandary for hospitals, which are obligated by federal regulation to arrange post-hospital care for patients who need it.

American immigration authorities play no role in these private repatriations, carried out by ambulance, air ambulance and commercial plane. Most hospitals say that they do not conduct cross-border transfers until patients are medically stable and that they arrange to deliver them into a physician's care in their homeland. But the hospitals are operating in a void, without governmental assistance or oversight, leaving ample room for legal and ethical transgressions on both sides of the border.


*    Various ICE policies have been scrutinized in a number of news articles this week.  A DMI Blog posting discusses the ICE policy of neglecting to inform local police of its decision to conduct a raid in an area.  This ICE policy is carried out completely inconsistently - sometimes ICE notifies local law enforcement, sometimes it does not.  ICE conducted its recent raid in Sante Fe, New Mexico (where it took 30 undocumented immigrants into custody) without notifying Sante Fe Mayor Cross beforehand.  According to the posting, Cross was completely opposed to the raid.  He said:
"We know what the right thing to do is. We have political leadership that wants to keep us from doing [the right thing] because the division works for them. But it doesn't work for us. And most people know that."

ICE's notification policy is not its only inconsistent policy.  According to the Associated Press, ICE's distribution of border patrol agents is a completely political process.  The article says that many people have suggested that ICE rewards friendly Congressmen with more border patrol agents in their district:
The 60-mile San Diego sector is at the southern end of a county with roughly 3 million people...

But the sector is already heavily reinforced: Two-thirds of the border is blocked by fences or vehicle barriers. The most populous part of the boundary has nearly 10 miles of double-layer fences with stadium lights...

San Diego is represented by Rep. Duncan Hunter, a Republican who has been among the most outspoken proponents of increased border security and fences.


The Huffington Post has also criticized ICE for supporting the discredited Center for Immigration Studies report that says border patrol has been the main reason immigration to the U.S. has fallen.  Many researchers have shown that the failing economy is the main reason immigration has been decreasing:
The US needs a practical, fair, and reasonable solution to immigration that includes smart enforcement measures. Political theater and gimmicks won't constrict the supply or demand for immigrant labor.

In addition, The Sanctuary is reporting that the ACLU has obtained a copy of the manual that the government distributes to attorneys who defend those who are arrested in immigration raids:
The manual contains prepackaged scripts for plea and sentencing hearings as well as documents providing for guilty pleas and waivers of rights to be used by both the judges and attorneys in expediting procedures as quickly as possible with little regard for due process.

The ACLU has made the manual publicly available.

*    Postville update: Standing FIRM has linked to a Chicago Tribune story on the allegations of child labor law violations at the Agriprocessors plant.  The government has finally begun cracking down on the company for the horrific abuse of its employees:

State officials say the types of child labor violations at the plant included minors working in prohibited occupations, exceeding allowable hours for youth to work, failure to obtain work permits, exposure to hazardous chemicals and working with prohibited tools.

*    The National Center for Lesbian Rights has become involved in a case involving a gay HIV-positive Pakistani man who is seeking asylum in the U.S. on the grounds that he will be persecuted if he returns to his country of origin.  The Center filed an amicus brief in support of the plaintiff to the Board of Immigration Appeals:
Under Pakistani law, being gay is punishable by death and LGBT people are forced to live in secrecy and constant fear of exposure. The Immigration Judge ignored the serious risk of persecution that S.K. faces and denied his application for asylum.

*    ABC News has called attention to a recently released report on the human rights abuses that immigrants are subject to at detention centers run by private companies.  The report, conducted by the human rights group OneAmerica and the Seattle University School of Law, concludes that people held at these detention facilities, specifically one that GEO Group, Inc. runs, are routinely harassed, verbally and physically abused and subjected to poor to non-existent health care.
This is not the first time GEO has been accused of violating the rights of inmates in its care.  In 2000, when the company was known as Wackenhut Corrections Corporation, the U.S. Department of Justice sued them over "excessive abuse and neglect" of inmates at the Jena Juvenile Justice Center in Jena, Louisiana.

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Refusal To Participate in Maternal Deaths Review Shows City Has Not Learned from Brooklyn Death

The public recently witnessed the lack of basic care that people are subjected to at Kings County Hospital Center in Brooklyn, New York.  A woman was left for dead in the middle of the hospital's psychiatric ward waiting room as staff did nothing but walk away.  The evidence in the New York Civil Liberties Union's lawsuit against the city proved that this was not an isolated incident (it just happened to be one of the only ones caught on tape).  Unfortunately, New York City's government is not learning from this catastrophe and taking sufficient steps forward to examine their hospitals - Women's eNews is reporting that the city is refusing to participate in a state review of maternal deaths and racial disparities, despite the fact that New York City has the highest number of maternal deaths and one of the largest populations of African-American patients in the country.

The New York City Health and Hospitals Corporation (the same agency that is named in the NYCLU lawsuit as the agency that is responsible for the negligence at Kings County Hospital Center), has refused to participate in the review the Safe Motherhood Initiative is conducting.  Pamela McDonnell, a spokesperson for Health and Hospitals Corporation (HHC) said:

We chose not to participate in the Safe Motherhood Initiative simply because we already participate in a number of established monitoring and review processes, measures and collaboratives.

However, one of the main points in the NYCLU's complaint was that the city had insufficient monitoring and oversight measures at its hospitals - it was this lack of oversight that led to last month's death at Kings County, and it could be part of the cause of numerous maternal deaths at city hospitals.

New York's American College of Obstetricians and Gynecologists, in conjunction with the New York State Department of Health, launched the Safe Motherhood Initiative in 2001.  The Initiative was established to conduct reviews that facilitate responses to pregnancy-related deaths and eliminate racial disparities in maternal mortality in New York State.  However, HHC's refusal to participate will lead to a great deal of information, particularly information on racial disparities among pregnant women in the hospitals, being left out of the review.

The first Safe Motherhood Initiative review that came out in 2005 interpreted 33 deaths over the course of 2 years - it found that 60% of those women who died were African American.  The review examined the deaths of these women in detail and sought to determine what the cause of the racial disparity was.  According to Women's eNews:

In 2004, black women were nearly four times as likely to die in childbirth as white women nationwide, and had a maternal death rate of 34.7 per 100,000 live births compared to 9.3 deaths per 100,000 live births for white women...

Designed to discover and interpret major risk factors, [director of New York's American College of Obstetricians and Gynecologists Donna] Montalto's State Maternal Mortality Review surveys--among many data--the deceased woman's occupation, primary language, education, insurance coverage, prenatal care, method of delivery and history of sexually transmitted diseases. It asks if the pregnancy was intended or unintended. It might also help explain why African American women represent a disproportionate amount of maternal deaths.


The Opportunity Agenda's report on New York City's health care system, Dangerous and Unlawful: Why Our Health Care System Is Failing New York Communities and How To Fix It, showed the unequal and inadequate access to health care that many communities, particularly communities of color, are faced with.  This lack of access and poor quality was most evident in the absence of primary care for many New Yorkers.  Incidentally, the last Safe Motherhood Initiative review found that inadequate prenatal care was one of the main causes of the racial disparity in maternal deaths in New York State.  Prenatal care is something that many women get through their gynecologist as part of their primary care; thus, the lack of decent primary care can lead to many women in communities of color having at-risk pregnancies.

The problems in the city's health care system was exemplified by last month's disaster at Kings County Hospital.  It is to the detriment of all New Yorkers that HHC is refusing to participate in the Safe Motherhood Initiative's review - it is crucial that we address health disparities and find real solutions to the problems in the state's health care system, but the city has to play a role in doing this. HHC says its mission is:

To extend equally to all New Yorkers, regardless of their ability to pay, comprehensive health services of the highest quality in an atmosphere of humane care, dignity and respect.

The death of Esmin Green last month showed that HHC is not succeeding in its mission.  Its decision not to participate in the Safe Motherhood Initiative review is another one that could lead to an unnecessary, preventable death at a city hospital.  The city needs to work to address these problems - until it does, our communities will suffer.

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Monday Health Blog Roundup

*   This past week there have been a number of news articles about the Black AIDS Institute study on the racial disparities among those living with HIV/AIDS in the United States.  The New York Times pointed to the part of the study that said that if one only counted the African American population in the U.S., the country would have the 16th highest rate of people with AIDS:

Nearly 600,000 African-Americans are living with H.I.V., the virus that causes AIDS, and up to 30,000 are becoming infected each year. When adjusted for age, their death rate is two and a half times that of infected whites, the report said. Partly as a result, the hypothetical nation of black America would rank below 104 other countries in life expectancy.

The Washington Post's coverage of the study focused on the Institute's criticism of the federal government's approach to addressing the AIDS crisis in black communities:
African Americans with HIV -- at least 500,000 -- are more numerous than in seven of the 15 "target countries" in the Bush administration's global AIDS initiative, which has spent about $19 billion overseas in the past five years.

A DMI Blog posting last Thursday also discussed the study and questioned whether the next President would choose to focus on tackling racial disparities in the American HIV/AIDS population, or would continue to ignore the issue:
The bottom line is that the HIV epidemic in the US continues to spread, and at a rate greater than was previously thought. The real measure of political leaders and the American people is if this bad news spurs good action - the establishment of a comprehensive and accountable national AIDS strategy that will eliminate barriers to effective prevention, generate adequate resources, and hold the government accountable for ending this epidemic.

The Black AIDS Institute study can be accessed here.  To learn more about the general prevalence of health disparities in the U.S., read The Opportunity Agenda fact sheet Healthcare and Opportunity.

*   The Kaiser Health Disparities Report has pointed out that new data from the Centers for Disease Control and Prevention shows the presence of racial disparities in the current U.S. infant mortality rates.  According to the new data, black infants are 2.4 times more likely to die before they turn one year old than white infants are:

CDC officials say the higher rates in large part can be attributed to low birthweights, shorter gestation periods and premature births. Experts say that it is difficult to identify a link between race and higher infant mortality but noted that higher rates of poverty, limited access to health care and dietary differences are possible contributors.

*    An editorial in last week's Los Angeles Times discusses how rising food prices are actually likely to increase obesity rates in the U.S., not decrease them.  In many other parts of the world, an increase in food prices leads to an increase in rates of hunger (not obesity).  However, the article points out that obesity has a lot to do with the type of food people consume, not just the amount:
Obesity isn't simply about too much food. It's about the type of food, how it's prepared and the balance of calorie intake with physical activity. Stress and social conditions can also play a role.

Obesity rates have long been more prevalent in poor communities in the U.S. - the article also points out that the states that have the highest rates of obesity also have the highest proportion of families living in poverty.  People living in poor communities, particularly poor communities of color, must have access to healthy food in order to prevent these health disparities from becoming more extreme.  To learn more about inadequate health care access in communities of color, read the CERD report to the UN, Unequal Health Outcomes in the United States.

*    An essay in The New York Times discusses how the American Medical Association's apology for its past racism towards black physicians and patients brought to light the historical split between the AMA and the National Medical Association, a group that represents black physicians.  The essay pointed out that while last month's apology was an important step in bridging the gap between the two organizations, more needs to be done to overcome the inadequate representation of black physicians in the medical profession:

Yet reminders of this rancorous history persist, and the A.M.A.'s apology remains pertinent, if long overdue. Consider this statistic: In 1910, when Abraham Flexner published his report on medical education, African-Americans made up 2.5 percent of the number of physicians in the United States. Today, they make up 2.2 percent.  

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Thursday Immigration Blog Roundup

*    Department of Homeland Security officials have come out in support of a Center for Immigration Studies report that claims that border control measures are the cause of a decrease in immigration to the U.S.  However, the Center for Comparative Immigration Studies at University of California, San Diego has rebutted those claims and determined that the border patrol apprehends fewer than half of the undocumented immigrants that come into the country through the Mexico/U.S. border.  According to The Huffington Post, the Center for Immigration Studies (an anti-immigrant advocacy group) and the Department of Homeland Security failed to consider reasons other than border control measures that explain why immigration to the U.S. would naturally decline:

When citing the decrease in both apprehensions at the border and remittances sent by workers in the United States to family members in Mexico, Chertoff also failed to consider the fact that undocumented immigration naturally decreases when the U.S. economy is in recession. [Director of the Center for Comparative Immigration Studies Dr. Wayne] Cornelius' report shows that undocumented migration clearly responds to changing U.S. economic conditions, with significant decreases during economic downturns such as the one we are in now.

Moreover, Chertoff's border control measures are completely inconsistent with the fundamentally positive effect immigration has on American communities.  Providing opportunity for immigrants has been a core value in the U.S. since its founding.  To see more immigration myths dispelled, read The Opportunity Agenda fact sheet, Immigrants and Opportunity.

*    In one of last month's blog roundups on The State of Opportunity, a story about a sheriff in Maricopa County, Arizona appeared.  That same sheriff, Sheriff Joe Arpaio, is in the news once again.  An editorial in The Washington Post discusses how  "Sheriff Joe" and his officers have been continuing the "policing strategy" of locking up all Hispanic people they encounter, regardless of if they have any evidence that they are undocumented immigrants or have committed any crime.  According to Arizona Central, Phoenix Mayor Phil Gordon has had to resort to calling for a media mobilization against Arpaio:

"He (Arpaio) has become the false messiah," Gordon said. "But when the light is shined on him, people will see that he isn't helping to fight illegal immigration and he's just making the situation worse. You've got an individual with a badge and a gun who's breaking the law and abusing his authority."

We need real solutions, ones that are brought about by comprehensive immigration reform and promote opportunity for all, not a gross miscarriage of justice carried out by a rogue officer like Arpaio.

*    Thankfully, not all police officers feel the same way Arpaio does - George Gascón, a former assistant chief in the Los Angeles Police Department, has written this op-ed for The New York Times.  In it he argues that using local police officers as a means to enforce federal immigration policy will ultimately lead to the public, particularly in communities of color, distrusting the police department:

Here in Arizona, a wedge is being driven between the local police and some immigrant groups. Some law enforcement agencies are wasting limited resources in operations to appease the public's thirst for action against illegal immigration regardless of the legal or social consequences...

If we become a nation in which the local police are the default enforcers of a failing federal immigration policy, the years of trust that police departments have built up in immigrant communities will vanish. Some minority groups may once again view police officers as armed instruments of government oppression.


*    The effects from the ICE raid in Postville are still being felt, reminding us just how detrimental this raid was to the Iowa community and America as a whole.  The Des Moines Register is reporting that the new employees at the Agriprocessors plant have had a significant, negative effect on the local community:
The impact is evident: New laborers are changing Postville. The Agriprocessors Inc. meatpacking plant, the site of the immigration raid, once employed men and women with families. Now, its workers are mostly young, single people with no stake in the community and nothing to lose...

The rise in crime has strained Postville's tiny police department. One night in June, the calls were so numerous that police asked the local bar to close early.


A protest rally also took place in Postville last weekend - it was documented in a video, which is now available on YouTube.

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Monday Health Blog Roundup

*    In the past week, there have been numerous reports that call attention to the disparities among those living with HIV/AIDS in the U.S.  The Kaiser Health Disparities Report has linked to a CBS Evening News story on the disproportionate number of African Americans that have HIV or AIDS.  According to the story, blacks account for 49% of new HIV diagnoses, 69% of AIDS cases among ages 13 to 19 and 56% of AIDS cases among ages 20-24.  Despite these high percentages, blacks only make up 13% of the population:

"No matter how you look at it through the lens of gender or sexual orientation or age or socioeconomic class or level of education or region of the country where you live, black folks bear the brunt of the AIDS epidemic in this country," Phill Wilson, founder of the Black AIDS Institute, said. Wilson added that early HIV/AIDS advocates did not send the right HIV prevention and education messages to the black community. "The mischaracterization of the epidemic in the early days ... made black folks think we didn't have to pay attention to the disease," Wilson said.

*    Rates of HIV/AIDS are not only disproportionate in African American communities - The Washington Post is reporting that Hispanics represent 22% of new HIV/AIDS diagnoses, despite only making up 14% of the population.  While the Post notes that HIV rates are highest among blacks, it also claims it is harder to target enough resources towards Latinos, particularly those who are immigrants, who have been diagnosed with HIV:
Blacks still have the highest HIV rates in the country, but language difficulties, cultural barriers and, in many cases, issues of legal status make the threat in the Hispanic community unique. For those who arrived illegally, in particular, fear of arrest and deportation presents a daunting obstacle to seeking diagnosis and treatment.

*    On a more positive note, the Senate passed a bill that calls for a reauthorization of federal funding for a program that supports community health centers, the Deseret News reported last Tuesday.  The bill, sponsored by Senator Ted Kennedy (D-Mass.) and Senator Orrin Hatch (R-Utah), allows for continued support for health centers that provide affordable and quality care for many Americans, particularly  those with low income:
Hatch said that since 2001, increased funding has enabled community health centers to treat 4 million new patients in more than 750 communities across the nation. His bill reauthorizes funding for the program for five more years.

*    State governments were also discussing implementing health care measures this past week - in Massachusetts, the Council on Racial and Ethnic Health Disparities, chaired by State Senator Dianne Wilkerson and State Representative Byron Rushing, met on July 21 to discuss the recommendations of the Special Legislative Commission on Health Disparities.  According to A Healthy Blog, the Council discussed various successes and failures in the state's health care reform:
The presenters all pointed to the success of health care access expansion in Massachusetts as an important step in disparities elimination efforts, but also noted the need to continue working to address quality, cultural competence, and social context problems.

*    According to The Health Care Blog, The Century Foundation has announced that it is creating a working group to establish a blueprint for Medicare reform.  Maggie Mehar, author of HealthBeat Blog, will direct the group and plans to review issues such as:
Revising Medicare's physician fee schedule to pay more for primary care, palliative care, and co-ordination and management of chronic diseases.

Rethinking Medicare's fee-for-service system to reward doctors for quality, not volume.

Creating an independent Comparative Effectiveness Institute that reviews head-to-head testing of drugs, devices, and procedures to ensure that they are effective.

Identifying and rewarding hospitals that provide better outcomes and higher patient satisfaction at a lower cost while helping other hospitals meet benchmarks.

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