National Minority Health Month: Child Asthma

According to the CDC, 7 million children suffer from asthma nationwide. According to the New York City Department of Health and Mental Hygiene, children in New York City were almost twice as likely to be hospitalized for asthma as children in the United States as a whole. Even more alarming, in recent years, the Bronx has been the New York City borough with the highest overall rates of asthma hospitalizations, deaths and prevalence among children as well as adults. Clearly, disparities exist.

Asthma is a chronic lung disease that can cause the airways to become inflamed and narrow. This can result in coughing, wheezing and tightness of the chest which may make it difficult to breathe. Asthma attacks are often triggered by illness, strenuous activity and the environment; smoke, allergies, pets, mold, dust and pollution can be a trigger. Cockroaches can also trigger asthma attacks, as many children are allergic to the material associated with decaying roaches, and live roaches' excrement. Partners Healthcare, a team of doctors, nurses, respiratory therapists and other health care professionals, cites cockroaches as a bigger trigger than pet dander and dust. Though asthma cannot be cured, it can be treated with regular long-acting medications, and fast-acting medications in the event of an attack.

Children with asthma tend to have family members with asthma, implying that the condition is inherited. However, it is difficult to establish a link between inheritance and an entire race because race is a social construct that cannot be clearly defined by genetics. Asthma can be inherited by any child, regardless of their ethnic background, depending on the child's family history. However, asthma affects children from ethnic minority groups at disparate rates. For example, non-Hispanic black children have a higher prevalence of asthma and die at higher rates from asthma than non-Hispanic white children. Hispanic children have a higher prevalence of asthma compared to non-Hispanic white children.

Many ethnic minority children tend to live in areas in which smoke, mold, dust, pollution and roach infestation may be a problem. These triggers can greatly exacerbate asthma. Due to a lack of health insurance or a regular primary care physician, minority children suffering from asthma may be forced to use a hospital's emergency department for care. Also, due to lack of insurance and/or family instability, it may be difficult for children to regularly take required long-acting asthma medication, as prescribed. One study actually examined the degree to which instability within a family can negatively impact a child's health. Investigators found that family instability is related to poor child health, including asthma.

Additionally, cultural boundaries may contribute to disparities if they result in poor communication between the physician and patient or sub-par care. Poorly controlled asthma has also been linked to poorer performance in school (for example, more absenteeism), and may even help explain the academic achievement gap that exists among children from different ethnic groups. The aforementioned factors contribute to health disparities but are really symptoms of much greater social injustices. In order to rectify the problem, we must more closely examine our society.

March is Women's History Month

In celebration of Women's History Month, I would like to highlight the nation's first female and first Hispanic Surgeon General: Dr. Antonia Novello. The following information was taken from the U.S. Government Surgeon General website:

Antonia Novello was born in Puerto Rico on August 23, 1944. She received her B.S. degree from the University of Puerto Rico at Rio Piedras in 1965 and her M.D. degree from the University of Puerto Rico School of Medicine at San Juan in 1970. She then completed her internship and residency in nephrology at the University of Michigan Medical Center in Ann Arbor. Novello remained at Michigan in 1973-1974 on a fellowship in the Department of Internal Medicine, and spent the following year on a fellowship in the Department of Pediatrics at Georgetown University. From 1976 to 1978, she was in private practice in pediatrics in Springfield, Virginia.

In 1978, Novello joined the Public Health Service Commissioned Corps,. Her first assignment was that of project officer at the National Institute of Arthritis, Metabolism and Digestive Diseases of the National Institutes of Health (NIH). She held various positions at NIH, rising to the job of Deputy Director of the National Institute of Child Health and Human Development (NICHD) in 1986. She also served as Coordinator for AIDS Research for NICHD from September, 1987. In this role, she developed a particular interest in pediatric AIDS.

During her years at NIH, Novello earned an M.P.H. degree from the John Hopkins School of Hygiene and Public Health in 1982. From 1976, she also held a clinical appointment in pediatrics at Georgetown University Hospital. Novello also made major contributions to the drafting and enactment of the Organ Transplantation Procurement Act of 1984 while assigned to the Senate Committee on Labor and Human Resources.

Antonia Novello was appointed Surgeon General by President Bush, beginning her tenure on March 9, 1990. She was the first woman and the first Hispanic to hold the position.

During her tenure as Surgeon General, Novello focused her attention on the health of women, children and minorities, as well as on underage drinking, smoking, and AIDS. She played an important role in launching the Healthy Children Ready to Learn Initiative. She was actively involved in working with other organizations to promote immunization of children and childhood injury prevention efforts. She spoke out often and forcefully about illegal underage drinking, and called upon the Health and Human Services Inspector General to issue a series of eight reports on the subject. Novello also similarly worked to discourage illegal tobacco use by young people, and repeatedly criticized the tobacco industry for appealing to the youth market through the use of cartoon characters such as "Joe Camel." A workshop that she convened led to the emergence of a National Hispanic/Latino Health Initiative.

Novello remained in the post of Surgeon General through June 30, 1993. She then served as the United Nations Children’s Fund (UNICEF) Special Representative for Health and Nutrition from 1993 to 1996. In 1996, she became Visiting Professor of Health Policy and Management at the Johns Hopkins School of Hygiene and Public Health. Dr. Novello became Commissioner of Health for the State of New York in 1999.

Click this link for more information about the current female Surgeon General, Dr. Regina Benjamin.

Minor Strokes Can Lead to Major Problems

By Mohammad Shamim
Mohammad was an undergraduate premedical student at The City College of New York in 2010.

According to the National Institute of Health (NIH), three out of ten people never get the medical attention they require while having a mini or minor stroke. If left without proper medical care, these minor strokes become full-on strokes which lead to major health issues such as permanent brain damage. A major stroke occurs when the brain does not properly receive oxygen because of a blocked or ruptured blood vessel. People often do not get the help they require simply because they may not recognize the warning signs.

According to NIH the number of reports by hospitals and primary care doctors, of mini-stroke incidents have increased over the past year. Doctors refer to these strokes as Transient Ischemic Attacks (TIA). Doctors and hospitals all over the world should educate their patients about the symptoms of TIA. In addition, patients should be aware of the signs themselves. According to NIH, the symptoms of TIA are:

-weakness or an inability to move all or part of one side of the body

-feelings of numbness or tingling on one side

-visual disturbances

-trouble speaking and understanding others

-dizziness and fainting

Age and gender do not affect whether or not you are susceptible to TIA. Anyone experiencing symptoms similar to the ones listed above, should contact their physician. The earlier these signs are noticed, the easier it is for one to seek medical attention and possibly prevent a major stroke-- so spread the word!