Yang And Sanders Use Maternal Mortality Stats To Talk About Race

In an exchange about racial inequality at December’s Democratic presidential primary debate, businessman Andrew Yang  highlighted jaw-droppingly different health outcomes between black and white women, and Vermont Sen. Bernie Sanders picked up that thread.

“If you’re a black woman, you’re 320% more likely to die from complications in childbirth,” Yang said in a discussion about racial disparities between black and white Americans.

Sanders returned moments later, arguing, “Black women die three times at higher rates than white women.”

Those figures, which are roughly equivalent, would speak to glaring inequities in the health care system. So we decided to dig in.

We reached out to both the Yang and Sanders campaigns for comment.

The Yang campaign referred us to data from a May 2019 report on maternal mortality disparities from the Centers for Disease Control and Prevention.

The Context, And The Data

Based on the context of the debate, we also interpreted Sanders as discussing maternal mortality gaps between black and white women — an issue that public health researchers say is a major concern, and one that’s garnered sizable attention on Capitol Hill.

The best data comes from the CDC report Yang’s team cited. The May report outlines maternal mortality disparities, using data from 2011 to 2015 and select data from 2013 to 2017. Per the CDC, 700 women in the United States were reported to die from pregnancy-related complications each year.

Non-Hispanic black women were 3.3 times as likely as non-Hispanic white women to die from complications in childbirth — data that roughly tracks with both Yang and Sanders’ stat.

So, while their phrasing may have been inelegant, the point is correct.

What’s At Stake

Experts say most of these deaths are preventable.

One issue: Hospitals that predominantly serve black women are often worse-performing than those that serve mostly white women — and that, researchers say, contributes to the gap.

Another issue comes from the American College of Obstetricians and Gynecologists. It released a comprehensive guide in May on preventing maternal mortality, which provided data showing that cardiovascular disease is the leading cause of pregnancy-related death, and it disproportionately affects women of color.

“Most of these deaths are preventable, but we are missing opportunities to identify risk factors prior to pregnancy and there are often delays in recognizing symptoms during pregnancy and postpartum, particularly for black women,” said ACOG former president Dr. Lisa Hollier in a press release about the guide.

Black women’s risk of dying from cardiovascular disease while pregnant is 3.4 times higher than that of white women. The American College of Obstetricians and Gynecologists said this disparity is in part due to racial bias and overt racism in the medical system, with black women’s cardiovascular disease risk not being addressed before they become pregnant.

Dr. Neel Shah, an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, said that both candidates reported the CDC statistics accurately. He also reiterated that this disparity persists irrespective of education or income and stems from medical providers’ implicit bias.

“When black women express concerning symptoms, particularly pain, the health system is slower to respond,” Shah wrote via email. “The reasons are surprising but also apparent to nearly everyone who works in health care. Clinicians are trained to profile people by race — nearly every exam question in medical school tells you the race of the patient and reinforces race-based associations.”

Our Ruling

Yang said black women are 320% more likely to die from complications in childbirth, as part of his explanation of disparities between black and white Americans.

The point tracks with non-partisan expert research. We rate it True.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Government-Funded Day Care Helps Keep Seniors Out Of Nursing Homes And Hospitals

SAN MARCOS, Calif. — Two mornings a week, a van arrives at the Escondido, Calif., home of Mario Perez and takes him to a new senior center in this northern San Diego County town, where he eats a hot lunch, plays cards and gets physical therapy to help restore the balance he lost after breaking both legs in a fall.

If he wants, he can shower, get his hair cut or have his teeth cleaned. Those twice-weekly visits are the highlights of the week for Perez, a 65-year-old retired mechanic who has diabetes and is legally blind.

“The people here are very human, very nice,” he said. “I’m gonna’ ask for three days a week.”

The nonprofit Gary and Mary West PACE center, which opened in September, is California’s newest addition to a system of care for frail and infirm seniors known as the Program of All-Inclusive Care for the Elderly.

The services provided by PACE, a national program primarily funded by Medicaid and Medicare, are intended to keep people 55 and older who need nursing home levels of care at home as long as possible and out of the hospital.

The program is more important than ever as baby boomers age, its proponents say.

“The rapidly growing senior population in California and across the country will put enormous strain on our current fragmented, and often inefficient, health care delivery system,” said Tim Lash, president of Gary and Mary West PACE. California officials consider PACE an integral part of the state’s strategy to upgrade care for aging residents.

The National PACE Association said data it collected for 2019 shows seniors enrolled in PACE cost states 13% less on average than the cost of caring for them through other Medicaid-funded services, including nursing homes.

Perez, like 90% of PACE enrollees nationwide, is a recipient of both Medicaid and Medicare. He’s part of a population that typically has low income and multiple chronic conditions.

PACE participants who do not receive government medical benefits can pay out of their own pockets. At Gary and Mary West, the tab ranges from $7,000 to $10,000 a month, depending on the level of care.

Nationally, 50,000 enrollees participate in PACE programs at over 260 centers in 31 states. In California, PACE serves nearly 9,000 vulnerable seniors at 47 locations.

PACE programs nationally offer all services covered by Medicare and Medicaid, and staff members include nurses, primary care doctors, social workers, dietitians, drivers and personal care attendants, as well as physical, occupational and recreational therapists. PACE enrollees commonly have conditions such as vascular disease, diabetes, congestive heart failure, depression and bipolar disorder.

About two-thirds of PACE participants have some degree of cognitive impairment. The Gary and Mary West center is no exception, which is why it has alarms on all the doors. If participants become agitated, they are led to the “tranquility room,” a softly lit space with an ocean soundtrack and a recliner.

On weekdays, participants can arrive at the center as early as 8 a.m. and stay until 4:30 p.m. A PACE driver provides transportation to and from the center, as well as to appointments with outside specialists.

The center goes a step further than most other PACE programs: It offers dental care. Staff dentist Karen Becerra said some of her patients have cried for joy when they learned they were going to have their teeth fixed or replaced.

“These are folks who have terrible teeth,” Becerra said. “And if they have painful mouths, they have poor nutrition.”

Perez is missing teeth, but he was all smiles when he talked about his upcoming dental appointment. “They’re going to put new ones in,” he said.

The center opened with money donated by San Diego billionaires Gary and Mary West, telemarketing and telecommunications entrepreneurs. They’ve donated about $11 million to establish PACE centers around the country.

The center in San Marcos is spacious and cheery, with sofas and chairs scattered about and plenty of natural light. It’s meant to feel “like a friendly inviting living room,” said Dr. Ross Colt, a retired Army colonel who joined Gary and Mary West PACE a year ago as the primary care physician on staff.

Enrollees can repair to a patio to get fresh air or tend herbs in planter boxes. And they can participate in activities such as bingo, coloring and Trivial Pursuit, led by a recreational therapist.

Just down the hall from the main lounge are patient exam rooms decorated with photographic murals of sunsets and seascapes.

Center participants can get physical and occupational therapy in a rehabilitation gym, and the facility has a spa where they can shower or get their hair done.

The executive director, Renata Smith, recalled a woman whose husband had been bathing her with a garden hose before she joined PACE. “We’re talking about basic human dignity here,” Smith said. “The spa makes participants feel good about themselves.”

PACE programs also send personal health care aides to the homes of participants.

Twice a week, an aide named Sylvia Muro picks up Perez at his home and takes him out to shop for groceries. Sometimes they stop at McDonald’s for pancakes and sausage.

Colt said participants come to him for checkups about once a month, but he can see anyone with a medical problem on a moment’s notice.

Unlike doctors in private practices, “I have the luxury of seeing them for an hour if I need to. And I can bring them back tomorrow if I need to,” he said.

Such access can save a diabetes patient from missing an insulin injection and avoid a costly hospital admission.

“That’s what the benefit of this model is,” Colt said. “The patient doesn’t want to go stay in the hospital, the family doesn’t want them to, and society doesn’t want them to.”

Smith, the center’s executive director, noted another important benefit: “the comfort of social interaction and something to wake up to every day.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Why Medicine is Important.

I have been taking some sort of medication to cure the symptoms of what would be autism since I was seven. At 34, I now realize the importance of having a good cocktail and being regular with it.

As a child, you do as you are told by your parents or for me there would be serious consequences. Taking my medicine was no different as in my childhood I was on a multitude of medications. However, I have been on the medication regimen I am on today, in part for twenty years now. And for 19 of those years I was pretty regimented unitl a little over a year ago.

I had lived with my parents for a little over 33 years and as such “did as I was told” and did such. Once I moved out, I began to consider as to whether or not I needed medicine.

So I started experimenting mainly because I had to know was the medicine important or a waste as a part of me adulting.

I spent many sleepless nights wondering that, I was in denial. My parents knew, those close to me knew, but they did’nt tell me.

I would lash out a people for no apparent reason, I would be nasty to people, My manias would appear off and on again and again but yet I was in denial.

I thinking I had an over abundance of meds and no clear mind decided to take them to a drop off box at the local police station. Weeks later I told my mom this and she was very disgusted to the point she hung up the phone and would talk to me for a few hours.

Nonetheless, I continued down the slippery slope for a few months, the symptoms became more and more appearant even to my therapist who came to the conclusion that this wasnt working, and on September 12 this year, I began a normal regimen – sort of.

I knew I was getting bad because I stay up all night, go to work and come home and sleep for hours and do it all over again. My superiors at work were worried about my mental health as during that relapse they said I was a little animated and asked if everything was ok. I denied it.

I became manic, and as such I was hypersexual, the mania symptom that no one wants to talk about. When I was visiting my dad when he was in the hospital I called the Hallway ad male organ and other not so nice names. Now looking back as I was trying to find my individuality, I thought I couldn’t have medicine to be me. I have learned that adequate balance is everything.

I now realize that it was stupid as working for a mental health advovacy organization that it wasnt the right thing to do or example to lead. But the trust kept coming back.

The day following that realization, a support at the place I recieve job coaching came to me and noticed the change. I told her I was working on it. Eight days later we went on a outing where I was photo bombed and she said that you couldn’t wipe that smile off my face.

A little over a month after that, I changed my PCP or family doctor and was reecucated about my physical meds and as such I have had everything back in sync for some time now and feel amazing.

It just goes to show you how importatant medicine is and what it can do to keep you well!

The Autistic Experience of Overwhelm | The Aspergian | For #AllAutistics, #NeuroLurkers, and #NeuroDiversity

An autistic exploration and breakdown of how sensory overload, meltdowns, and shutdowns feel in the moment and after the fact.

Source: The Autistic Experience of Overwhelm | The Aspergian | For #AllAutistics, #NeuroLurkers, and #NeuroDiversity

Many young autistic people harm themselves, others

Nearly one-third of autistic young people put themselves or others in danger in any given three-month period, according to a new study1. And nearly one in four of these young people will not have seen a mental health professional in that time.

The study, which looked at autistic people aged 3 to 25 years, is based on a parent survey.

The researchers sent the survey to a large database of families with autistic children; only 7 percent (462 families) completed it. The results may overestimate the prevalence of these events because families who have experienced them are more likely to respond, says Luther Kalb, assistant professor of neuropsychology at the Kennedy Krieger Institute in Baltimore, Maryland, who led the biostatistical analysis.

The researchers adjusted their analysis to account for this bias. “It’s still common enough to warrant attention,” Kalb says.

In autistic children younger than 12, the incidents tend to be related to self-injury and to wandering or running away, the researchers found. In young people aged 12 to 25, the episodes more often involve physical and verbal aggression, usually aimed at parents.

The younger an autistic person is, and the lower her quality of life, as reported by a parent, the more likely she is to have one of these incidents. Poor language skills and having a mother with depression also increase a child’s chances of having an incident.

The findings were published in October in Autism Research.

The work may help parents and clinicians develop plans to preempt and manage dangerous behaviors in autistic children. “We can start identifying populations that may need more intervention than others,” Kalb says.

References:
  1. Vasa R.A. et al. Autism Res. Epub ahead of print (2019) PubMed

Originally published on Spectrum

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