Today is the first day of May and all is enBloom here in Washington, DC.  While many of us are continuing to enjoy the beauty of spring and get excited about the arrival of summer, there are many others out there who suffer from allergies and asthma.  May is National Asthma and Allergy Awareness Month.  All month, we will focus our attention on asthma, air quality and air pollutants, including tobacco, in addition to the normal banter around health policy, politics, health reform and ARRA.  Look out for ways to educate yourselves and participate in this month’s featured health observances.

• May 1-31. National Asthma and Allergy Month
• May 1-31. Clean Air Month
• May    31.  World “No Tobacco” Day

The prevalence for different types of cancer varies greatly according to the race and ethnicity of the population in question.  For example:

• While the gap (as compared to non-Hispanic whites has narrowed since 1991) black Americans are more likely to develop and die from cancer than any other racial or ethnic group. The most common cancers among men in 2009 are projected to be prostate (34%), lung (16%), and colorectal (10%) cancer, and among women, breast (25%), lung (12%), and colorectal (11%) cancer. For all cancer types, blacks are far more likely to be diagnosed in advanced stages of disease, when the cancer is less treatable.  Blacks are also less likely than whites to survive 5 years after a diagnosis, regardless of cancer type and stage of diagnosis.
• Cancers associated with viral infection are the most common caners in Hispanics/Latinos. Women have the second highest number of cases of cervical cancer (which is often caused by human papillomavirus) while cases of liver cancer (which is often caused by the hepatitis virus) are twice as high in Hispanic men and women as in non-Hispanic whites.
• Asian Americans/Pacific Islanders are more likely to develop and die from both liver and stomach cancers than all other racial or ethnic groups (except in the case of stomach cancer where their prevalence and death rates are second to those of blacks).

Racial and ethnic minorities have less access to cancer screening

Medical researchers focusing on areas of health care disparities continue investigations to elucidate these figures. The interrelationship between multiple factors continues to yield reasons that are complex.

“Rates are driven by social and economic factors,” says Ahmedin Jemal, PhD, ACS Department of Epidemiology and Surveillance Research. “In the African American population, there’s far less utilization of screening. For example, in 2005, 44% of African Americans were screened for colorectal cancer, compared to 51% of whites.”

Other research reveals this failure to access care through regular recommended screening is true across all racial/ethnic minority groups. Surveys show that about a third of Hispanic/Latinos and 20% of blacks have no coverage at all. The consequences are significant as people who don’t get mammograms, colon exams, and Pap tests on schedule are more likely to be diagnosed with a cancer at a later stage in the disease, when survival rates are lower.

“Having health insurance coverage is the single greatest determinant of access to health care services,” explained Eve Nagler, ACS Director of Special Populations.

Access Resources:

Use this CDC interactive map to locate National Breast and Cervical Cancer Early Detection Program low-cost and free screening resources near you.

Sources:

Cancer’s Racial Gap Narrowing yet Challenges Persist. In ACS News Center. American Cancer Society.  Cited April 22, 2009. Available at <http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Cancers_Racial_Gap_Narrowing_Yet_Challenges_Persist.asp>

Cancer Is A Burden, Finding Help Should Be. In In the Spotlight.  American Cancer Society. Cited April 22, 2009.  Available at <http://www.cancer.org/docroot/SPC/content/SPC_1_Cancer_Is_a_Burden_Finding_Help_Shouldnt_Be.asp>

Bridging the Disparity Gap.  In In the Spotlight.  American Cancer Society. Cited April 22, 2009.  Available at <http://www.cancer.org/docroot/SPC/SPC_0.0.asp>

Racial and ethnic minority populations continue to grow such that by mid-century, Latino, black and Asian populations are expected to represent the majority of people living in the US, according to the Census Bureau.  This is already the case for the nation’s largest metropolitan areas and it is increasingly becoming the case in smaller communities fueled by the growing Latino population.  In light of this fact, minority health and health disparities among racial and ethnic minorities is not a issue for special populations but rather an issue that concerns us all especially as we examine the health status of the population as a whole.  Nevertheless, the third week in April (19-25) is set aside as National Cancer Minority Awareness Week.

Do race and ethnicity affect cancer risk?

Each year, cancer statistics continue to show that minority groups are more likely than the general population to develop and/or die from certain types of cancer.  As researchers continue to unravel the multiple contributing factors to this issue there are things that individuals can do for themselves.

About fifty percent of cancer deaths can be prevented through regularly scheduled screenings, healthy eating, regular physical activity and quitting tobacco use. However, minorities continue to have lower screening rates than whites; report less leisure-time activity than recommended – less than the recommended 30 minutes of moderate-to-vigorous physical activity above usual activities on five or more days per week; and consume less fruits, vegetables and whole grains. The American Cancer Society recommends eating five or more servings of fruits and vegetables each day, choosing whole grains in preference to processed grains and limiting consumption of processed and red meats.

(click through the image link)

Despite  health disparities, race and ethnicity are only two among several factors that contribute to cancer risk.  This personal cancer risk profile tool (developed by the University of Texas MD Andersen Cancer Center) can help you begin to assess your own risk for cancer. This questionnaire will determine specific actions you can take to reduce your risks for developing cancer and/or to make sure that you identify the disease in the earliest, most treatable phase.

Learn More at The American Cancer Society website and MD Andersen Cancer Center website

Absolutely no one likes to think about sustaining a life-threatening injury or catostrophic illness.  Yet, as I wrote in an earlier post, trauma happens.  There’s also, of course Benjamin Franklin’s wisdom, “Nothing in life is certain but death and taxes.” And such was the inspiration for Nathan Kottkamp, a health lawyer who founded National Health Care Decision Day two years ago.  It will be observed this Thursday, April 16 (after tax day) and is intended to teach Americans the benefits of creating advance directives as well as encourage health care providers to recommend them to their patients.  Communication among family members and between doctors and patients has to improve.  An Agency for Healthcare Research and Quality (AHRQ) 2003 article, Advance Care Planning: Preferences for Care at the End of Life, found the following:

“No matter where you live, you can fill out an advance directive without hiring a lawyer. It’s easy to do and is free,” ~Kottkamp

Take Action:

Consult the enBloom Advanced Medical Planning Glossary and Guide for all the necessary resources to begin writing your advance directives including links to state living will forms, registries for palliative care and living wills, and definitions for all the key elements found within advanced directive documents.

Source:

April 16 Press Release. In National Health Care Decision Day. Cited April 13, 2009.  Available at <http://www.nationalhealthcaredecisionsday.org/april16.htm>

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First Friday in First Person. At the age of 16, my brother made a simple but profound decision that all too soon came to affect a vast circle of people in ways they could not have imagined.  I will never forget his excitement as he reached into his wallet to pull out his brand new driver’s license.  He was so proud, taking the time to walk me through each element as if I’d never seen one before.  He was like that; charismatic, easy-going with an infectious sense of humor.  He pointed to the big heart indicating that he was an organ donor.  “You’re an organ donor?” I interrogated.  “Yeah…I’m not gonna need ‘em when I’m dead,” he replied in a matter-of-fact kind of manner.  Such a simple phrase to encompass a basic concept.  Yet the implications, the influence, the ultimate impact was in no way simple or basic.  Needless-to-say, I never forgot those words.  Little did I know, just five short years later, they would serve as the catalyst for my brother’s incredible legacy.

from www.donatelifenc.org

Trauma happens. Just before dawn, we reached the hospital where my brother had been admitted.  He was in an ICU hooked up to a ventilator with only a minister and nurse by his side.  It was so hard to see his muscular body lie there, nearly still, save the work of the breathing machine.  I could not understand why they had not operated.  Immediately, I began making demands; requesting the admitting physician from the ER.  Instead, they brought me the chief resident.  From him, I requested to read the admitting doctor’s notes.  I needed to know everything that happened until the moment we arrived.  Ultimately, as they realized I was someone with knowledge of teaching hospitals and its hierarchy, the attending physician on duty came with the films to explain the grave prognosis.  And there it was plainly.  My once vibrant, healthy, athletic brother lay dying with a bullet lodged in his brain.  It was put there, the Virginia courts would later rule, by someone incapable of understanding the consequences of his actions.

Acceptance and Farewell. In retrospect, I realize that he lay there brain dead waiting for us to arrive, so we could say goodbye.  The minister and hospice nurse, as we later discovered, were there to request and I suppose, if necessary, help to pursued us to donate my brother’s organs.  Little did they know, he had already done all the hard work for them.  Once they made the request, I immediately remembered the conversation.  I knew without a doubt, it was what he had wanted.  He had been an athlete all his life.  He was so healthy until…but trauma is like that…robbing the young and the healthy.  The hospital was good about giving us the time we needed.  We prayed.  We consulted other family members (about half of my extended family is in the medical profession).  I demanded charts and the attending physician.  We prayed some more, all the while the nurse and the minister never left our side.  We listened to the LifeNet consultant.  We gave the consent. We prayed still more.

April is National Donate Life Month.  So in this first person feature, I wanted to highlight my beloved younger brother.  He is the one who taught me the significance of organ donation.  The legacy he created through the lives he directly saved and the broader circle of lives he has transformed has surely helped me to cope with his tragic death.  And, it is the reason why organ and tissue donation is an issue for which I passionately advocate.

Have you made the decision to donate your organs?  Has someone you love donated or received an organ?  Leave a comment and share your story so that we might recognize these heroes during National Donate Life Month.

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Featured Health Observance.  April is Cancer Control Month. Since 1938, this annual proclamation has given Americans an opportunity to focus on advances against cancer, as well as, rededicate themselves to fighting the disease both through research and prevention.  President Obama observed:

“As researchers work daily to better understand this disease, Americans can take steps to decrease their risk of developing cancer. Individuals of all ages should seek regular and appropriate check-ups. These check-ups should include [Common Screening Tests], such as mammograms, the Pap test, and tests for colorectal cancer, all of which can help detect cancer during its early stages.  Healthy personal habits can also reduce the risk of cancer. Smoking accounts for thousands of cancer deaths every year, and quitting — even after many years — can greatly reduce the risk of cancer. Physical inactivity and obesity may cause a substantial proportion of colon, breast, endometrial, kidney, and esophageal cancers in the United States, so maintaining physical activity and a healthy diet can help prevent cancer, among other diseases. Finally, moderating alcohol intake and sun exposure can help protect Americans.”

In keeping with the broader concept of primary prevention and leading lives filled with health promoting activities, enBloom will also feature the following health observances this month so keep an eye out for ways to take part and educate yourself around these issues.

• April  1-30.  National Donate Life Month (This month’s first Friday feature is a continuation of the February discussion of National Donor Day and March discussion of World Kidney Day.)
• April 16.  National Healthcare Decision Day
• April 19-25.  National Minority Cancer Awareness Week

Source: National Cancer Control Month, 2009. In The White House Blog. Available at<http://www.whitehouse.gov/the_press_office/Presidential-Proclamation-Marking-National-Cancer-Control-Month/>

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Why is Diabetes Alert Day important?

• 23.6 million children and adults in the U.S. have diabetes
• Nearly one-quarter of those do not know they have diabetes
• One in five Americans is at risk for developing type II diabetes

For many, diagnosis may come seven to ten years after the onset of the disease. Therefore, early diagnosis is critical to successful treatment and delaying or preventing some of its complications such as heart disease, blindness, kidney disease, stroke, amputation and death.

Everyone should be aware of the risk factors for type 2 diabetes. People who are overweight, under active (living a sedentary lifestyle), and over the age of 45 should consider themselves at risk for the disease. African Americans, Latinos, Native Americans, and people who have a family history of the disease are at an increased risk for type II diabetes.

Watch this video to learn more.

Source: This post was a excerpt from: 21st Annual Diabetes Alert Day. In Community Programs and Local Events. Alexandria, VA: American Diabetes Association. [cited March 22, 2009] Available at <http://www.diabetes.org/communityprograms-and-localevents/ american-diabetes-alert.jsp?WTLPromo=FNLP_alert>

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Tomorrow, March 12 is World Kidney Day. Last month we discussed how heart disease is the leading cause of death for American women. Unfortunately, too few Americans realize that chronic kidney disease is another life-threatening illness that often goes undetected until it reaches very advanced stages. Two common conditions that can lead to or exacerbate chronic kidney disease are high blood pressure and diabetes. Take some time on World Kidney Day to learn more about what your kidneys do for you and what you can do for your kidneys (to keep them healthy). Also, don’t forget as we focus on nutrition this month that both high blood pressure and type II diabetes can be significantly controlled, if not alleviated with the right type of diet and regular moderate to intense physical activity (consult your doctor for specific recommendations).

Learn More:

Take these 6 Steps for protecting your kidneys and your health.

10 Facts about Diabetes and Kidney Disease

10 Facts about High Blood Pressure and Kidney Disease

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Featured Health Observance. National Nutrition Month® is an education and information campaign created by the American Dietetic Association. This makes the month of March a good time to focus our attention on the importance of making informed food choices and developing sound eating habits. Diet and exercise create a solid foundation for our health and wellness. You may not be fully aware, however just how much diet and exercise also contribute to the presentation and progression of chronic conditions like obesity, diabetes, hypertension and heart disease. Here at enBloom, we will follow the lead of the American Dietetic Association and focus on how to eat right because healthy choices can help us all live longer and richer lives.

In keeping with the broader concept of the relationship between diet and disease, we will also feature the following health observances this month so keep an eye out for ways to take part and educate yourself around these issues.

March 12. World Kidney Day

March 24. American Diabetes Alert Day

Just how much do you already know about how to eat right? Take the quiz here.

Peruse the nutrition bookshelf for additional materials on healthy snacks for kids, smart food shopping, and healthy recipes.

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National Donor Day. On Valentine’s Day, the holiday that celebrates love, there is no more loving a gesture than to make this the day you join thousands of Americans in making the decision to give the gift of life through organ and tissue donation. Did you know?

• Almost 95,000 people are in need of an organ transplant.
• Every 12 minutes another name is added to the national organ transplant waiting list.
• An average of 18 people die each day from the lack of available organs for transplant.
• Approximately 35,000 children and adults in our country have life-threatening blood diseases that could be treated by a marrow/blood stem cell or cord blood transplant.
• Every two seconds someone in America needs blood (more than 39,000 units each day) according to the American Red Cross.

There are several steps you can take today to help alleviate some of this burden:

• Fill out an organ and tissue donor card, register with your State Donor Registry and make sure your family knows you want to be a donor.
• Join the National Registry of potential volunteer marrow and blood stem cell donors.
• Learn how you can donate your baby’s umbilical cord blood stem cells at birth.
• Donate blood.

On this Valentine’s Day, choose to give the ultimate gift of love by giving the gift of life through organ and tissue donation.

Sources: OrganDonor.gov and Donate Life America website

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