Articles
Reasons for racial disparities in infant mortality remain puzzling
Category: Health Written by Courier Newsroom

According to the Centers for Disease Control and Prevention (CDC), more than 25,000 infants die each year in the United States. Infant mortality is defined as the death of an infant before one year of age. Infant mortality rates refer to the number of infant deaths for every 1,000 live births. The infant mortality rate in the U.S. is six deaths per 1,000 live births and is worse than that of many other industrialized countries (CDC, 2013).
Infant mortality rates vary by the race of the mother. Sadly, the racial disparities seen in infant mortality rates between African Americans and Whites in Allegheny County are striking (Figure 1). In Allegheny County in 2009, there were 16 deaths per 1,000 live births among African Americans, while the rate among whites was 5.6 deaths per 1,000 births. The Allegheny County numbers for African Americans are considerably higher than both the state (14.4 deaths per 1,000 births) and national rates (11.6 deaths per 1,000 births). Disparities are also seen between African Americans and Whites on low birth weight (infants born weighing less than 5.5 pounds) and preterm birth (birth before 37 weeks of pregnancy). These are two of the major predictors of infant mortality.
The racial disparities in infant mortality rates are puzzling. It’s not clear what factors contribute to the differences. For example, take the complex problem of preterm birth. Differences in maternal characteristics, such as socioeconomic status, prenatal care, infection and nutrition, are known to contribute to disparities in preterm birth. But, in the U.S., African American women with advanced schooling are more likely to have an infant die in the first year than are White women who did not finish high school. The reasons for this disparity are not clear. Could other factors (like neighborhood environment) be contributing to the differences? Research is now focusing on the role of stress as one key contributing factor.
The Community Child Health Network (CCHN) is a large, federally funded research project currently underway to help understand how communities and families create a context that influences pregnancy and infant and child health. The goals of this research include looking at how community, family and individual stressors can influence and affect pregnancy health. Researchers are also studying whether these factors might result in health disparities in pregnancy outcomes and infant mortality. Although the CCHN study does not include Pittsburgh, the results from this research will provide valuable insights into ways to reduce infant mortality rates and to effectively address racial disparities in pregnancy outcomes. More information about the CCHN project can be found at http://www.communitychildhealthnetwork.com/index.html.
Researchers are now interested in interventions are being planned that adopt a holistic (consideration of the complete person, physically and psychologically) approach and focus on health across the entire lifespan, not just when a woman is pregnant. Reducing disparities in infant mortality and improving birth outcomes will require an increase in efforts to better understand the reality of African American women’s lives, both during pregnancy and overall.
Last Updated on Wednesday, 17 April 2013 09:50
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Dental screening that could save your life
Category: Health Written by CNN

by Dr. Mark Burhenne
(CNN) -- We all know about the importance of sleep, and we know we should be getting more of it. When we wake up exhausted, drag ourselves to work or hit that afternoon slump, we blame ourselves: "Should have gotten more sleep last night."
You can't ask yourself how well you're sleeping without considering sleep apnea. Sleep apnea is a condition that affects an estimated one in 15 Americans but often goes undetected.
Most people who suffer from sleep apnea don't know it -- they often seek out a diagnosis only if their partner can't sleep through the snoring. Since sleep apnea ranges from mild to severe, lots of cases of sleep apnea aren't noticed by sleeping partners, and people live their whole lives undiagnosed.
Sleep apnea can't usually be detected by doctors during routine office visits, but a screening from your dentist may help.
Recent studies have shown that teeth grinding, also called bruxism, is a major indicator for obstructive sleep apnea. The simple dental health screening that can improve the quality of your sleep and -- because almost everything boils down to a good night's sleep -- even save your life, begins with asking your dentist, "Do I grind my teeth?"
Q: What is obstructive sleep apnea?
A: The most common type of sleep apnea is obstructive sleep apnea. The key word is "obstructive" -- the thing "obstructing" the airway being the jaw, which falls back as the brain approaches the deepest stages of sleep and the muscles of the airway fully relax.
When the airway collapses like this, breathing becomes compromised. This is where you get snoring, which is just the sound that's made when air is getting forced through a partially obstructed airway.
Once the brain senses that breathing is dangerously compromised, it gets out of the deepest stage of sleep to regain control of the jaw muscles and reopen the airway, and keep you alive and breathing. These sleep apnea cycles can occur from five to up to 70 times per hour while you sleep -- preventing you from entering the deepest stages of sleep where the brain and body tissues can repair themselves from the wear and tear of the day.
Sufferers of sleep apnea never get the benefits of the deepest stages of sleep, which is what reverses the aging process and repairs tissue damage. After just one night of the lack of deep sleep that the body craves, you awake in a damaged state. Cumulative damage could lead to expression of the Alzheimer's gene, high blood pressure, depression, mood disorders, suppression of the immune system, diabetes, cancer and weight gain.
Q: What are the symptoms of untreated sleep apnea?
A: You feel sleepy or tired during waking hours. For every sleep apnea cycle, or apneic episode, the body goes into fight-or-flight mode with an adrenaline response to "wake up" the brain to reopen the airway. That response evolved to keep humans alive in the short term, but on a nightly basis puts extraordinary wear and tear on the body.
You're anxious or stressed during the day. What's missing from the sleep apnea discussion is the emotional toll of going into fight-or-flight mode several times each night. This stress manifests itself not only physically but also emotionally -- the exhaustion that sufferers of severe sleep apnea feel during the day is partially due to emotional stress at night as they struggle to breathe.
You grind your teeth. One of the ways the brain tries to reopen the airway in an unconscious state is by grinding and clenching the teeth. People who grind their teeth at night often have sore or clicking jaws or flat, worn-down teeth. Many times, symptoms of teeth grinding can be far less obvious -- such as earaches or sensitive teeth.
Snoring. The key here is that not everyone who has sleep apnea snores and not everyone who snores has sleep apnea. Snoring can go undetected if you don't have a bed partner or if you have a bed partner who is a heavy sleeper. Everyone, however, can ask their dentist if they grind their teeth at their next checkup.
Q: I might have sleep apnea. What should I do?
A: See your dentist. Get screened at your next dental checkup for teeth grinding. Your dentist can tell you definitively if you grind your teeth at night or not. Teeth grinding is a major indicator that you are struggling to keep your airway open at night and might suffer from obstructive sleep apnea.
Also, see a medical sleep specialist. These specialists are the only ones who can officially diagnose sleep apnea. Make sure to discuss all of your options and let your doctor know if you're grinding your teeth.
"Sleep disorders such as sleep apnea can lead to many secondary health conditions," said Dr. Kalpalatha Guntupalli, president of the American College of Chest Physicians. "When treating sleep apnea, clinicians must also recognize and address secondary health conditions, such as bruxism, in order to fully manage a patient's sleep disorder."
People who are diagnosed and treated for sleep apnea often report that the process has "given them their life back." Quality of sleep affects most of the things that help us enjoy life: appearance, well-being, outlook on life, energy level, patience, ability to cope with stress and how we interact with loved ones.
Many of us tolerate this anxiety and exhaustion every day of our lives and never get the chance to repair our bodies with the deepest stages of sleep. Asking your dentist if you grind your teeth will hopefully make the sleep apnea diagnosis a little less daunting for the millions of people who suffer from it.
Editor's note: Mark Burhenne is a practicing family and cosmetic dentist of 25 years and founder of AsktheDentist.com. He is dedicated to empowering people to take control of their dental health, stop managing symptoms and prevent chronic illnesses in the mouth. Follow him on Facebook or Twitter.
Last Updated on Tuesday, 16 April 2013 08:53
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Expert offers tips on selecting long-term health care insurance
Category: Health Written by Courier Newsroom
Thanks to Baby Boomers and modern medical marvels, more Americans than ever are heading into their senior years, and they’re expected to live longer than ever, too. Barely 50 years ago, our average life expectancy was 62.5 years; today that number has risen to 78.2 years, according to the U.S. Census Bureau.
That means that more Americans than ever will also soon be deciding how to handle their eldercare. Steve Casto, Retirement Income Specialist and author of Is Your Retirement Headed in the Right Direction? (www.stevecasto.com), says there are important questions and answers to consider before making that critical decision.
“The key thing to balance is the difference between what you think you’ll need and what you can afford between your liquid assets and insurance coverage,” Casto said. “If you don’t start by asking yourself the right questions, you’ll never get to the answers that will lead to a successful long-term care plan.”
Here are some questions—and their answers:
Q. Should I opt for nursing-home or in-home care insurance?
A. When selecting insurance plans, protect against your worst risk first. In-home care is more about maintenance, while care outside the home is focused on crises. Home care is good for when a person needs help getting around. If he has a stroke, he’d need to be cared for outside the home initially, so there is a need for both.
Q. What should I select as my daily allowance?
A. If your health deteriorates, a daily allowance of $100 per day could cover all your care outside the home, but only a third of the care inside the home. Your home-care costs could rocket to more than $400 or more per day, so plan for the worst.
Q. What is an elimination period?
A. Sometimes referred to as the “waiting” or “qualifying” period, this refers to the length of time between the beginning of an injury or illness and receiving benefit payments from an insurer. With long-term care, the typical elimination period is 90 days, which means you are responsible for covering the first 90 days of care on your own. Most people believe that Medicare covers the first 90 days, which is dead wrong. It only covers it under certain conditions, and not all patients meet those conditions, which include:
•A nursing home stay that follows a three-day hospital stay;
•Admission to a nursing home within 30 days of hospital discharge;
•A Medicare-certified nursing home;
•Physician-certified need for skilled care on a daily basis.
Your best bet is to be insured through a long-term care policy for that first 90 days.
“These are just a few of the issues,” Casto says. “A good starting point for those planning early is to completely discount the idea of getting a dime from Medicare. Even if it is still around when you need long-term care, the restrictions on Medicare are tightening. You’ll be lucky to get the program to pay for 10 percent of a nursing home stay.
“The real answer is to get a solid long-term care insurance policy that is based on a sound plan.”
(Steve Casto is founder and president of Strategic Wealth Solutions, Inc. an Omaha, Neb.-based financial firm that manages money for investors in the Midwest. Steve helps clients reduce their tax bill, minimize their risk, and ensure they don’t outlive their money. He’s the author of Is Your Retirement Heading in the Right Direction? and offers presentations on how to increase income while reducing taxes. )
Last Updated on Friday, 05 April 2013 09:35
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Alcohol may improve breast cancer survival
Category: Health Written by CNN

by Matt Sloane
(CNN) -- Although drinking alcohol is known to be a risk factor for developing breast cancer, a new study suggests that alcohol may not have any effect on whether you survive the disease. In fact, researchers found that being a moderate drinker may actually improve your chances of survival.
"The results of the study showed there was no adverse relationship between drinking patterns before diagnosis and breast cancer survival," said Polly Newcomb, director of the cancer prevention program at the Fred Hutchinson Cancer Research Center in Seattle and the lead author of the study.
"We actually found that relative to non-drinkers there were modestly improved survival rates for moderate alcohol intake."
The researchers followed close to 25,000 breast cancer patients for an average of 11 years, and found that women who drank moderately - three to six drinks per week - before developing breast cancer were 15% less likely to die from the disease.
More importantly, she says, drinking after diagnosis also didn't appear to impact survival.
"Whether you drink post diagnostically - again, moderately - doesn't appear to adversely impact your mortality," Newcomb said.
So does that mean women who have a history of breast cancer are free to drink up?
"The results of our study would suggest that moderate alcohol consumption after a diagnosis of breast cancer does not adversely impact either breast cancer-specific or overall survival," she said.
Another benefit of moderate alcohol intake - a reduction in the risk of cardiovascular disease in women with breast cancer, according to Newcomb. "Cardiovascular disease is importantly being recognized as a contributor to mortality among breast cancer survivors."
The study found that women who drank those same three to six drinks per week before being diagnosed with breast cancer were 25% less likely to develop heart disease.
The bottom line, says Newcomb? "This is good news for women because it might help direct some of their choices after their diagnosis."
Dr. Sandra Swain, president of the American Society of Clinical Oncology, which published the study Monday in the Journal of Clinical Oncology, agreed the findings are good news for breast cancer patients, but cautioned that more research should be done to confirm them.
Last Updated on Thursday, 11 April 2013 14:03
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Heroines of Jericho: Providing vital knowledge to community
Category: Health Written by Renee P. Aldrich
African-American abolitionist, journalist, physician and writer, Martin Delany, was a member of St. Cyprian Alpha Lodge #13 of the 7th Masonic District and before Rap came along there was something called “Toast” that Black men did back in the day, life saving health information and many more Black History facts and information like these were shared during the EACH ONE TEACH ONE event last month at the Prince Hall Temple in Wilkinsburg.
Hosted by the Byrdie E. Crunkleton Memorial Court, No. 3—Heroines of Jericho, it was an occasion to do more than recognize important historical facts about African-American contributions to this country. It was also to bring awareness of health issues that Blacks and older Americans face every day. Especially older Black Americans.
Activities included a presentation about “The Affects of Kidney Disease” within the African-American population presented by Cherie Peters, program manager from the National Kidney Foundation Serving the Alleghenies.
In her talk she shared the important signs of kidney failure and that kidney disease is treatable. She stressed the importance of taking the simple tests available to detect early signs of the disease, explaining that getting an early handle on this problem was crucial because the regrettable consequence of kidney damage is ending up on dialysis and or the need for a kidney transplant; neither of which is a desirable situation to be in.
Once again African-Americans suffer disproportionately from end stage kidney disease not unlike heart disease and certain cancers. Due to the amount of high blood pressure and heart disease within the Black race, they are automatically placed in front of the line for kidney failure. According to the National Kidney Foundation web site, Blacks need to be aware of the following information:
A.) African-Americans suffer from end stage Renal Disease disproportionately. The incidence of kidney failure per million populations is 998 in African-Americans, compared with 273 in White Americans. B.) African-Americans constitute about 29 percent of all patients treated for kidney failure in the U.S. but only about 14 percent of the overall U.S. population. C.) The incident rate of diabetic end stage kidney failure has increased steadily among African-Americans.
Additionally, Blacks also develop kidney failure at an earlier age than White Americans. The average age for Blacks at the start of treatment for kidney failure is 56, compared with 66 in White Americans. These were just some of the details shared by Peters at this event.
Other speakers included representatives from the Fair Housing Partnership of Greater Pittsburgh. They gave an informative presentation on the types of housing discrimination they investigate, the methods they use, and recourse that people have if they feel they’ve been discriminated against because of race or age. This organization serves a vital purpose in Pittsburgh, because their web page shows that an Urban Institute Report has given Pittsburgh a "failing grade" for its pervasive racial disparities in not only housing, but in a broad range of areas from income to homeownership rates to school testing scores. Fair Housing Partnership of Greater Pittsburgh offices are located in the Strip District. They have a number of volunteer opportunities. One such opportunity is to be a “tester” applicant. This is where they send people out to a location that has advertised vacancy space, along with a White counterpart, just to see how the management responds to both potential tenants.
Along with the health information and information on how to fight unfair housing practices in Pittsburgh, the event also provided the audience with an excerpt from a one man show presentation by local actor, writer, director Wali Jamal.
The story of Martin Delany is an expansive one. Researched, written and directed by Jamal, it presented the life of an African-American man who was an abolitionist, journalist, physician, and writer, and arguably the first proponent of American Black Nationalism. He was also was one of the first three Blacks admitted to Harvard Medical School; and became the first Black field officer in the United States Army during the American Civil War. As a trained physician, he treated patients during the cholera epidemics of 1833 and 1854 in Pittsburgh, when many doctors and residents fled the city.
Additionally, Delany was also a member of St. Cyprian Alpha Lodge #13 of the 7th Masonic District. The excerpt covered a portion of an argument Delany was having with a White Masonic order who were disputing the right of Black men to become Masons.
According to Daughter Rosalie Jones Moore, Most Ancient Matron of the Heroines of Jericho, providing the community with information they don’t usually get was their main goal. She says, “In all of our events we want to respond to the needs of our community by sharing information that will positively impact their lives.”
Last Updated on Friday, 05 April 2013 09:34
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