Health and Wellness 18

How One Nurse Anesthetist Is Working To Fight Racial Disparities in Healthcare

By Stacy M. Brown

NNPA Newswire Senior

As an African American and a certified registered nurse anesthetist (CRNA), Dr. Edwin Aroke has always been committed to equitable care for racial and ethnic minority patients. However, following years of providing anesthesia care in hospitals and teaching student registered nurse anesthetists (SRNAs) at the University of Alabama at Birmingham, Aroke realized that even the most conscious healthcare providers can have biased impulses.

"One day, I received a report of a 21-year-old African American male with a gunshot wound coming to my room," said Aroke. "My immediate thought was that he must be a 'gangster.' I had to stop and consider that I knew nothing about this individual and he could have been a bystander, a suicide victim, anyone. Despite being an African American, the neurocircuits in my brain made a potentially harmful judgment."

Disparities in treatment for racial and ethnic minority patients stemming from implicit biases are distinctly present in pain care. Studies show that compared to white women, racial and ethnic minority women are less likely to receive an epidural for childbirth, and Black patients are less likely to receive pain medicines in emergency rooms than white patients. Unfortunately, research suggests that these treatment disparities may be a result of false beliefs about biological differences in pain tolerance between Black and white patients.

This issue is particularly important to Aroke, and the subject of his research program. He is also educating

his students and colleagues, as well as moderating webinars alongside the American Association of Nurse Anesthetists, to educate CRNAs and SRNAs across the country.

"As a CRNA, I provide multimodal, opioid-sparing and opioid-free anesthesia and pain management services, as well as safe opioid administration to prevent the risk of addiction," said Aroke. "Additionally, CRNAs are more likely than physician anesthesiologists to work in counties with lower median incomes and denser unemployed, uninsured and Medicaid-eligible populations."

Aroke shares advice with patients to help ensure they

receive equitable treatment. "The best care experience starts with good communication between the patient and their provider," he said. "You know your body best. Don't be afraid to ask for a second opinion on diagnoses and treatment plans and express any concerns with the quality of care you are receiving."

For healthcare providers like CRNAs, Aroke has additional recommended actions:

• Learn more about minority community needs. "I encourage all of my colleagues to better understand the communities they serve and whether resources are available to address their needs," said Aroke.

• Address health literacy and linguistic barriers. Racial and ethnic minority patients are more likely to have less health literacy and English proficiency, which can impact their ability to obtain and understand health information and services.

• Incorporate training on implicit bias into practice. "This education should be evidence-based and include recommendations on how to empower patients from disadvantaged backgrounds to understand their options for care and financial and social support," said Aroke. Most importantly, healthcare providers and patients must advocate for systemic changes. "We cannot address healthcare disparities without understanding systemic racism and the structures that hold these biases in place," said Aroke. "'Not being a racist' isn't good enoughCRNAs and other providers must fight discrimination and take active steps to promote health equity." Source: BPT

Dr. Edwin Aroke

AIDS Foundation Houston Launches “Rapid Start” HIV Treatment

The START Now Project links persons living with HIV to immediate treatment and care

By d-mars.com News Provider

Beginning May 3, 2021, AIDS Foundation Houston, Inc. (AFH), in partnership with the U.S. Department of Health and Human Services, Health Resources and Services Administration, launched a rapid start anti-retroviral treatment project as a service to people diagnosed with HIV.

START Now (Strategic, Targeted, AntiRetroviral Treatment Now) is designed to provide linkage to care and treatment medication to persons newly diagnosed with HIV within the first seven days of their diagnosis. The project will also assist persons with linkage to care who have a previous HIV diagnosis who either have never been in care or have not been in treatment and care in the past twelve months. START Now aims to support patients in achieving sustained viral suppression, which prevents the transfer of HIV to another person through sex.

“We are proud to be one of 15 organizations across the nation that are funded by HRSA in this Special Project of National Significance (SPNS) to support this activity that is directly linked to our mission to end the HIV epidemic in the greater Houston area,” said John Huckaby, CEO of AIDS Foundation Houston. “START Now allows us to assist people living with HIV to be linked to care and helps patients reach viral suppression as soon as possible, which is a key goal in the CDC’s Ending the HIV Epidemic: A Plan for America.”

Persons wanting to enroll in START Now should contact the Linkage Case Manager, Antonisha Alves, at 713-6236796 x 295. In addition, individuals can be referred to the program by other HIV prevention service organizations, Urgent Care facilities, Emergency Departments or other hospitals and clinics. The START Now team will ensure that patients get their treatment medication within 7 days of enrollment and schedule the patient for their first

appointment with their long-term HIV treatment provider.

The Linkage Case Manager will also perform the following activities to support the patient:

• Assist patient with enrollment into the Texas HIV Medication Program

• Attend the first two medical appointments with the long-term HIV care provider

• Help with understanding lab reports, with a specific focus on educating about viral load and viral suppression

• Assist in getting patients linked to supportive services included but not limited to: housing, medical transportation, mental health services and food resources

• After the first two medical appointments, meet with the patient at least once a month to discuss successes and challenges related to treatment and other services that help promote healthy living

Additionally, AFH now offers a number of services online, including HIV and STI testing, as well as consultations and prescriptions for PrEP, nPEP and START Now. AFH has also partnered with Mistr and Sistr to make PrEP more accessible. Patients can talk to a doctor virtually, handle the lab work at home, and get prescriptions delivered to their homes for free.

Learn more about all services provided or make an appointment at www.AIDSHelp.org.

Source: AIDS Foundation Houston

By d-mars.com News Provider

According to a new survey, routine activities are making people feel unsafe, including walking through a parking lot or garage or even taking a run.

Conducted by SABRE personal safety brand via Ipsos.Digital, a new survey revealed that over the past three years more than 80% of Americans have, at some point, felt unsafe in everyday situations.

Polling a nationally representative random sample of 1,000 people nationwide on their personal safety habits and attitudes, the survey provided several insights including just how common it is for Americans to feel unsafe and how people try to protect themselves. A few of the most notable findings include:

while 30% stated they have pretended to be on a phone call to protect themselves. These forms of protection may be instinctual to further defend yourself but are ineffective and can provide a false sense of security. According to Gabrielle Rubin, founder of self-defense course Female Awareness, the real problem with holding keys between your fingers is that your attacker is already too close. The ideal safety protection tools can protect you from a distance while requiring minimal engagement and force.

Unsafe in daily routines

Four in every five Americans admitted to feeling unsafe in everyday situations over the past three years. Beyond this, many also shared they have been uncomfortable as they go about common day-to-day activities. Forty-two percent of people confessed that walking through an area that is not well lit made them feel unsafe.

And these anxieties are not limited to dimly lit areas, as 32% of people stated they felt unsafe walking through a parking lot or garage, nearly a quarter of those surveyed (22%) experienced similar feelings while in the stairwell of a building.

1 2

To many, spending time exploring a local forest preserve or running solo on a trail can be a way to relax and escape everyday stress, but for a large percentage of people, these types of activities and experiences have often left them feeling uncomfortable. Most notably, two-thirds of all women surveyed expressed that when spending time running, walking or hiking in isolated areas, they have felt uncomfortable at some point over the past three years.

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4) Increased confidence with effective tools

2) Uneasy during recreational activities

Walking at Night? Increased confidence with effective tools Ineffective protection methods

3) Ineffective protection methods

When presented with situations they felt were unsafe, an overwhelming majority (90%) admitted to taking steps to protect themselves. However, with only a split second to react, many of the cautionary measures being taken have been proven to be ineffective.

Among the most popular means of protection include 36% of people who have put keys between their fingers,

Ultimately, however, the majority of those surveyed (64%) stated they already own a personal safety device, and of those, the bulk (86%) admitted that carrying it with them provides an increased sense of confidence and security. Some of the most popular forms of protection are self-defense products such as pepper spray (30%) and personal alarms (17%).

Given the increased sense of confidence and security that effective personal safety tools can provide, it is a good idea to explore the options to find what device works best for your needs.

A tool such as Smart Pepper Spray is one solution for everyday use. Connected to your phone via Bluetooth, this product can share your GPS location whenever pepper spray is deployed, allowing loved ones to know your exact whereabouts the moment the product is used.

Meanwhile, a product like SABRE Runner Pepper Gel may be a better fit for those searching for on-the-go safety devices to bring along as they are out preparing for a 5K and hoping for some added confidence as they begin their running regiment this spring.

Ideally the right safety tools provide an added level of confidence for users, enabling them to continue to do everything from routine daily activities to adventurous travel excursions with assurance and ease.

Source: BPT

State of the Nation’s Mental Health:

Stress Is up, Treatment Is Not

By d-mars.com News Provider

Our nation reported more mental health stress in 2020, but there was not a corresponding increase in people seeking mental health treatment, according to the inaugural State of the Nation's Mental Health report.

However, there were two conditions for which diagnosis and treatment grew in 2020: anxiety and PTSD for adults. These findings support the results of a recent study showing that four out of 10 U.S. adults reported symptoms of anxiety or depression in 2020, up from one in 10 in 2019.

The report's findings, based on behavioral health plan claims from 27 million people in the United States, reflect the pandemic disconnect between feeling stressed and depressed and being diagnosed and seeking treatment.

Two groups had the largest overall downturn: younger children and older adults. One possible reason for the drop in children's diagnoses is that they spent less time with teachers, coaches and other mentors during the pandemic. The Silent Generationpeople 75 and older - may not have used telehealth services as much as other groups and delayed getting healthcare appointments.

The State of the Nation's Mental Health report showed the following drops in 2020 rates for those treated for mental health diagnoses compared to those treated in 2019:

• 10 percent overall drop for young children

• 5 percent overall drop for adolescents

• 5 percent overall drop for adults older than 75

• 13 percent drop for young children diagnosed with ADHD

• 8 percent drop for adolescents diagnosed with ADHD

• 8 percent drop in adults older than 75 diagnosed with dementia

• 3 percent drop for both Baby Boomers and adults older than 75 diagnosed for depression The results of the study are supported by data from IngenioRx, a pharmacy benefits manager. While the overall use for depression medications was up in 2020, much of that increase is due to existing users being better about taking their medications as prescribed, according to IngenioRx medication data. New users of these medications increased at the same rate as 2019.

"It's not surprising that the COVID-19 pandemic has affected people's mental health," commented Neil Leibowitz, MD, JD, Chief Medical Officer,

HEALTH

Behavioral Health, at Beacon Health Options, a leading behavioral health services company. "However, because people aren't seeking services at a rate we would expect them to, it's a reminder that we all need to understand what people are going through and do what we can to make sure they get care. We encourage people to get the COVID-19 vaccine to protect their physical health. Likewise, we need to encourage people to practice selfcare and get treatment to protect their mental health."

Many healthcare professionals think the pandemic will affect our nation's mental health for years to come. Nearly three out of four mental health specialists and primary care doctors estimate that the mental health effects from the pandemic will last up to three years or longer, according to an Anthem Inc.-commissioned survey.

The pandemic has highlighted the importance of mental health for doctors and patients alike. Nine out of 10 of surveyed providers reported they are more aware of their patients' mental health challenges. Also, 70 percent said their patients have been more willing to bring up mental health issues during appointments.

"There is no doubt that 2020 was the most difficult of years," said Dr. Leibowitz. "However, the year presented us with an opportunity. This reported uptick in awareness shows promise that attitudes concerning mental health are changing. I don't think we have yet to see the end to mental health stigma, but assuming this data reflects a larger national trend, 2020 led us closer to an openness around discussing mental health."

Source: BPT

Medical Debt: The Other Part of the Pandemic’s Fallout

By d-mars.com

News Provider

For Walter Coleman, an independent contractor in Washington, D.C., Samantha Robles, a hairstylist in Bethesda, Maryland, and Robin Pruitt, a loan officer who also lives in Bethesda, the coronavirus pandemic not only resulted in close calls, but the financial fallout may lead to bankruptcy.

Each says the medical bills resulting from their bouts with the virus have overwhelmed them.

In Coleman’s case, the more than $100,000 he owes to doctors, laboratories, and hospitals has him strongly considering a Chapter 7 filing.

“Don’t know what else to do,” Coleman remarked. “I did everything right. I didn’t want to get sick, and my health insurance didn’t cover a lot of things, but I guess even insurance companies were caught off guard by this pandemic,” he reasoned.

Robles and Pruitt said they have also considered their options in separate interviews, including borrowing from family

and friends or filing bankruptcy to retire mounting medical debt.

“I just worry about spending the next ten years trying to rebuild my credit,” Robles stated. “Before the pandemic, my credit score was 740, and now I don’t even want to look.”

Pruitt said family members have pitched in, but she’s wary of asking for more assistance.

“Everyone is fighting it, going through a financial pitch,” Pruitt said. “I just refuse to become a burden on anyone.”

According to the personal finance and credit monitoring company Credit Karma, medical debt continues to soar.

Debt among those signed up at Credit Karma has skyrocketed by nearly $3 billion from May 2000 to March 2021.

The number of people with past-due medical debt rose during the same period to 21.4 million from 19.6 million.

“If you’re considering bankruptcy as a solution for medical debt, you’re not alone. Unmanageable medical care debt and the hardships that often come along with it –like loss of work or reduced access to credit – can be a recipe for financial ruin,” Sarah C. Brady, a San Francisco-based financial

consultant, wrote for Credit Karma. Brady warned that filing for bankruptcy isn’t always an ideal solution.

“Although bankruptcy can help you manage or eliminate medical debt, it’s not possible to limit your claim to only one kind of debt during the process,” she wrote.

“Plus, bankruptcy has a long-term negative impact on your credit and can put your assets in jeopardy.”

The personal finance website LendingTree.com revealed that 60 percent of Americans who participated in a study in March faced medical debt.

Approximately 53 percent reported the debt was more significant than $5,000, and 72 percent said it prevented them from pursuing key financial milestones, like buying a home or having a child.

The Lending Tree researchers reported that the coronavirus is responsible for one in every ten patients with medical debt.

Interestingly, even physicians and healthcare workers have fallen prey to medical debt because of the pandemic.

Dr. Elliot Anavim, medical director at Rejuve Clinics in Sherman Oaks, Calif., said many healthcare workers live in debt.

“From physical therapists to dental hygienists, to someone like me, a naturopathic physician,” Anavim stated.

“Many of us spend hundreds of thousands of dollars to become professional healthcare workers, yet there are many cases in which we don’t have the means of paying off that debt because of how selective and limiting the field can be.”

Aside from the medical debt that stemmed from the coronavirus treatment, Coleman, Robles, and Pruitt each shared one other thing in common. Each was adamant that they didn’t want their loved ones to shoulder their debt.

“I just can’t allow my parents to spend their retirement savings on paying my bills,” Pruitt said.

Source: NNPA