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Health Outreach Foci

Black Women's Health

Cardiovascular Disease

More than 100 million Americans (41% of the U.S. population) have at least one cardiovascular disease (CVD; e.g., hypertension, coronary heart disease, heart failure, stroke). This number is projected to increase to 131 million by 2035, accounting for 45% of the U.S. population. Significant racial/ethnic and gender differences exist in CVD with African American (AA) women carrying the heaviest burden.
 
AA women have the highest prevalence of hypertension (41.5%) compared with White (26.5%) and Hispanic women (26.2%), and White (29.4%) and AA men (40.8%). In addition, almost 33% of all deaths among AA women are attributable to CVD,1 making it the leading cause of death for this minority group. Because of higher CVD rates, it is not surprising that AA women have higher rates of CVD risk factors, such as type 2 diabetes, obesity, physical inactivity, and poor diet, compared with other racial/ethnic and gender groups.

Reproductive Health

African American maternal/infant mortality and morbidity compared to the rest of the United States (US) populations. Approximately 12.5% of births in the United States are preterm (occurring before 37 weeks of gestation). In 2018, preterm birth affected 1 of every 10 infants born in the United States. Most have low birthweight. At risk for short- and long-term health complications, such as respiratory distress, failure to thrive, and hypertension as adults. Most end up staying in the hospital and some die.
 
In 2017, preterm birth and low birth weight accounted for about 17% of infant deaths. There may also be emotion and financial toll on families with a preterm infant(s).

 

Racism is strongly correlated with preterm and low birth weight among African American women. Racism is a perceived threat formed on an immutable characteristic often central to a person’s identity” resulting in unfair treatment based physical attributes that include the color of one’s skin.

 

Racism as a chronic stressor is reported as a severe threat African American women’s reproductive health and well-being and spans the social ecological spectrum.

Psychosocial Health

Psychosocial factors assess the combined that “psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. Examples include: Psychosocial stress/Chronic stress; Racism, Discrimination; Social isolation/Loneliness, Depression.

 

Adverse risk profiles in terms of psychosocial factors seem to cluster with general social disadvantage, and so it may be a major contributing factor to health inequities. Adverse psychosocial factors is associated with increased psychosocial stress, which has significant implications for physical and mental health.

 

Psychosocial stress is a perception of threat, with resulting discomfort, emotional tension, and difficulty in adjustment. Possible triggers of psychosocial stress: job loss, death of love one, financial insecurity, food insecurity, experiences of racism and discrimination, work-related stress, and other adverse life events. These psychosocial triggers (or risks) can lead to a stress response in the body.

 

Psychosocial risks can cause long-term stress, or psychosocial stress, which  has powerful effects on health. These psychosocial risks accumulate during life and increase the chances of poor mental health and premature death. Extended periods of anxiety and insecurity, and the lack of social support (social isolation) are damaging to health

 

Social isolation is defined as the subjective experience of lack of companionship and social support, and is associated with premature death, poor mental health, increased cardiometabolic risk, and poor maternal and child health outcomes. People with pre-existing health conditions may be prone to social isolation, and many chronic health conditions make socialization more challenging. There is strong evidence that social isolation may impose psychological stress on our minds and bodies, which has major implications on physical and mental health.

•Psychosocial risks can cause long-term stress, or psychosocial stress, which  has powerful effects on health

•These psychosocial risks “accumulate during life and increase the chances of poor mental health and premature death.”

•Extended periods of anxiety and insecurity, and the lack of social support (social isolation) are damaging to health

 

Combat Veteran's Health

Veterans from multiple eras who kill in war are at increased risk for post-traumatic stress disorder (PTSD), alcohol abuse, suicide, functional difficulties, and physical health challenges after returning home.

In current healthcare systems, a Veteran can receive PTSD evaluation and EBT without ever being asked about killing and its impact. Killing and its impact on the mental health and physical health of combat vets are critical to understand to improve patient care, physician/patient encounters, community-based education targeting combat vets.

Connected Care Pilot Program

The Connected Care Pilot Program will provide up to $100 million from the Universal Service Fund (USF) over a three-year period to selected applicants to support the provision of connected care services. 

CAAHDER will be assisting in the provision and set up of Telehealth technology for veterans as well as in educating veterans on the use of the the technology to connect with health providers and services.in collaboration with Spectra Care Foundation, Cooper Health, and New Jersey Hospital Association.
 

COVID-19 and Health

 Seniors and Housing

COVID-19 is devastating Non-Hispanic Black American (NHBA) communities across the United States (US) [1]. Overall, there is a disproportionate burden of COVID-19 morbidity and mortality among NHBAs compared to many Non-Hispanic ethnic groups in the US [1,2]. This predicament is especially perilous among NHBA seniors.
 
Forty-three percent have died from COVID19 compared to 16.6% of Whites. These numbers depict a dire situation for COVID-19 and NHBA seniors between the ages of 55-84+. There are large numbers of NHBA low-income seniors living in congregate public housing communities impacted by health disparities (< 62 years old: 52.8%), living within poor areas, and facing adverse social determinants with a heightened threat of COVID-

Systemic Inequities and COVID-19

The CDC has ranked COVID-19 as the leading cause of death with 2,038,344 cases and 114,625 deaths as of June 13th, 2020. The most recent census estimate of the US black population as of June 2019 in the US is a little over 13%; yet 33% of reported COVID-19 hospitalizations in the US are African Americans. John Hopkin’s research data illuminate a disproportionate black infection rate of more than 3-fold higher compared to that of whites. Mortality rates that have so far been reported show up to 6-fold higher deaths in black counties compared to white counties. These research data from 26 states indicate 34% of COVID-19 deaths.
At the core of this discussion is the impact of racial inequalities in healthcare where blacks present disparate outcomes compared to whites, alluding to structural and systemic deficiencies and inequities. The black community’s reality is often generally an assortment of generational trauma from global historical injustice ranging from colonialism to slavery, racial and a myriad of systemic inequities coupled up with presently dealing with the exponential hazard of a colossal global pandemic. COVID-19 is illuminating disparities that have been long been denied, ignored, and continue exasperating a momentous majority of the black population. 
 

Alzheimer's Disease

The Alzheimer’s Association has identified an emerging public health crisis among AfricanAmericans — the Silent Epidemic of Alzheimer’s Disease. There is accumulating body of evidence about the scope and nature of Alzheimer’s disease in AfricanAmericans. Each study is important on its own, but only when put together does the magnitude of the crisis become clear. Among the findings from research highlighted in this report :
 
• Alzheimer’s disease is more prevalent among African-Americans than among whites — with estimates ranging from 14% to almost 100% higher 
• There is a greater familial risk of Alzheimer’s in African-Americans
• Genetic and environmental factors may work differently to cause Alzheimer’s disease in African-Americans
High cholesterol and high blood pressure may be significant risk factors for Alzheimer’s. The implications of these discoveries are enormous for African-Americans, among whom vascular disease and its risk factors are disproportionately present,
The epidemic of Alzheimer’s will continue to spread over the next 30 years, as the number of AfricanAmericans entering the age of risk more than doubles to 6.9 million.
 

Transgender Health

Systemic and Interpersonal Inequities 

The transgender population face bias and discrimination from physicians and when trying to access healthcare. In 2015, a survey was completed which showed 24.31% of trans people had to educate providers on transgender needs while seeking care. Transgender people who are experiencing suicidal thoughts or depression were most unlikely to have a physician treat them with respect, and most likely having to educate their physicians on transgender needs Kattari et al. (2020). It is unfortunate trans people with mental health issues face the most discrimination because their population has the highest rates of mental health concerns, specifically depression, anxiety, or suicidal thoughts.
 
Trans people report having negative interactions with providers when they do not understand the healthcare needs of the transgender population. Providers lacking the understanding between gender, sex, and sexual orientation, can led to providers labeling their patients has having a disease or disorder, therefore, denying healthcare. A primary challenge trans people incur is when the providers rely on their patients to be the educator about their population.
 
This can be particularly harmful for the provider and patient relationships. A study concluded 88% of emergency department staff provided care to transgender people, and 82.5% of that number never received formal training with the trans population, therefore, lacked basic clinical knowledge about trans care. Providers lacking information, stigmas, mistreatment, and harassment contributes to the fear and victimization trans people experience the healthcare settings.
 
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