New America Media - Health tag:newamericamedia.org,2009-04-06://19 2016-03-10T23:30:24Z New America Media is a nationwide association of over 3000 ethnic media organizations representing the development of a more inclusive journalism. Founded in 1996 by Pacific News Service, New America Media promotes ethnic media by strengthening the editorial and economic viability of this increasingly influential segment of America's communications industry. Study Exposes Health Struggles for ‘Hidden Poor’ California Elders tag:newamericamedia.org,2016://19.15107 2016-03-11T08:20:00Z 2016-03-10T23:30:24Z Paul Kleyman ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=104 A new report from the UCLA Center for Health Policy Research shows that one in four Californians age 65 or older, who live alone or with only their spouse or partner, “had income in 2013 in the limbo of unofficial poverty.”

“Hidden Health Problems Among California’s Hidden Poor” is the center’s new Health Policy Fact Sheet showing that above the 50-year-old federal poverty level (FPL) but below a newer, more accurate measure of how much people actually need to make financial ends meet.

African American, Latino and Asian seniors particularly have to struggle, according to the findings.

Care Unaffordable, But Help Inaccessible

“These older adults—the ‘hidden poor’—have substantially more health problems and less access to care than those with higher incomes, but they cannot afford to pay privately for assistance and often do not qualify for public programs that could help them manage their health problems. Planners and policymakers need to pay more attention to this hidden poor population,” the report says.

Not only was the health status “substantially worse among the hidden poor than among those with higher incomes,” those with lower incomes were about twice as likely to rate their health as only fair or poor.

Not only do these seniors suffer disproportionately from ill health, but they face barriers to care. They were almost twice as likely as better off elders living above the Elder Index to report “they never or only sometimes got timely appointments
when needed,” the study found.

In addition, says the report, “Mental health problems are also higher among those living below the Elder Index.”

As a result, the research team found, “Older adults with higher health care needs are also more likely to face barriers to meeting their health care needs.”

The analysis compares the FPL to the alternative Elder Economic Security Standard Index (the Elder Index), which the State of California now uses as an official planning tool for programs serving seniors.

Rather than try to update the FPL, which was created in the early 1960s using 1955 data, the Elder Index pinpoints what seniors actually need to make “decent minimum standard of living,” say the report’s authors.

For each of California’s 58 counties, UCLA used the index to calculate the cost of such necessities as housing, food, health care and transportation. The new measure shows that the national average is about double the official poverty level of $11,770 in 2016--and triple that sum in many urban areas.

UCLA’s analysis found California has 655,000 "hidden poor" elders living alone or residing only with a spouse or partner. Seniors in the Golden State who fall between the official poverty line and the higher Elder Index threshold are almost twice as likely to identify as being in poor or fair health, feel depressed, and say they cannot get timely health care compared to more affluent seniors, says the study.

Choosing Food, Medicine or Rent

Furthermore, the researchers report, “Latino, African American and Asian older adults who lived alone or with only their spouse/partner had the highest rates of being among the hidden poor (35.4, 30.6 and 29.2 percent, respectively).

Adding these figures to those falling under the official poverty line exposes that about half of Latino, African American and Asian elders struggle to get by. And older non-Hispanic whites aren’t all that well off, either. Whites are at almost three times their official poverty rate--21.5 percent versus the government’s 8.1 percent, according to the study.

A related study by the UCLA Center published last fall  found, “In terms of sheer numbers, whites make up more than half of elders in the financially pinched group (482,000). Proportionately, grandparents raising grandchildren, older adults who rent, Latinos, women, and the oldest age group (75 and over) were the groups most affected.”

D. Imelda Padilla-Frausto, a researcher for both studies, wrote, “Many of our older adults are forced to choose between eating, taking their medications or paying rent,” said. “The state might be emerging from a recession, but for many of our elder households, the downturn seems permanent.”

The 2015 study revealed the three-quarter million of California’s elderly heads of households were among the hidden poor--or about one-fifth of seniors in the Golden State. That’s more than double the number (342,000) counted by using the FPL. Unlike the “official” poor, those in unseen poverty often do not qualify for public assistance.

To crunch the number, UCLA’s center partnered the Insight Center for Community Economic Development. They based their finding on data from the U.S. Census American Community Survey and 2013-2014 California Health Interview Survey.

Depending on the county [http://tinyurl.com/ht8rq6s], Padilla-Frausto found, 30-40 percent of those 65-plus who are single and 20-30 percent of older couples were among the hidden poor. Elders with particularly high rates of impoverishments were in rural counties.

Grandparents Among Most Vulnerable

The research showed that groups with large proportions of hidden poor seniors included grandparents raising their grandchildren, older adults housing their adult children, single women who head households, single elders age 75 and older who head households and single elders who are renters or homeowners.

According to the study, “Older couples whose adult children live with them were six times more likely to qualify as being among the hidden poor according to the Elder Index than those considered poor according to the federal poverty level (25.7 percent vs. 4.1 percent, respectively).”

“Older adults raising grandchildren or housing adult children have taken on more financial burdens with limited earning capacity and are living right on the edge of a cliff,” said Steven P. Wallace, associate director of the UCLA Center for Health Policy Research and co-author of both reports. “They have few options, and one unexpected expense can put them right over.”




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Immigrants Encouraged to ‘Take Action’ -- Apply for DACA, Get Ready for DAPA tag:newamericamedia.org,2016://19.15099 2016-03-08T21:00:00Z 2016-03-09T03:29:54Z Text: Elena Shore / Video: Michael Lozano ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 Pictured above: Joyce Noche, directing attorney at the Public Law Center, said immigrants should seek out trusted service providers to see if they are eligible for the current DACA program or other forms of administrative relief. Photo: Michael Lozano / VoiceWaves

ANAHEIM, Calif. – Immigrant rights advocates are encouraging families to get ready for the possible implementation of two programs that could go into effect later this year. Both programs provide beneficiaries with temporary relief from deportation.

Even with the death of Supreme Court Justice Antonin Scalia in February, advocates say a ruling on one of the big questions before the Supreme Court – whether Obama’s executive actions on immigration will finally go into effect – remains up in the air.

Obama’s expansion of Deferred Action for Childhood Arrivals (DACA) and launch of a new program for undocumented parents of U.S. citizens or legal permanent residents, called Deferred Action for Parents of Americans (DAPA), could provide millions of undocumented immigrants temporary relief from deportation and access to work permits.

Both programs have been on hold ever since they were announced in November 2014. Their fate now rests with the U.S. Supreme Court.

With eight justices on the court, five votes are needed to overturn an injunction put in place by a lower court, thereby allowing DACA and DAPA to move forward. In the case of a 4-4 tie, the lower court’s ruling would stand but the Supreme Court’s ruling would not be precedent.

The Supreme Court is expected to hear Texas v. United States in April and announce its decision in June. If it decides in Obama’s favor, the two programs could go into effect, possibly by late summer or early fall.

In the meantime, legal experts, advocates and DACA recipients say there are steps that families can take now to get ready for their possible implementation – and take advantage of programs that are currently available.

The litigation does not affect Obama’s original DACA program announced in 2012, which remains in effect.

Joyce Noche, directing attorney at the Public Law Center, encouraged immigrants in Orange County to seek out trustworthy service providers to see if they might be eligible for the current DACA program or other forms of administrative relief. Noche spoke at a media roundtable in Anaheim organized by New America Media and Ready California, a statewide coalition working to ensure that the maximum number of eligible Californians take advantage of DACA and DAPA.

Noche told reporters that while no one knows how the court will rule, a majority of law professors believe the president was within his power to announce his 2014 executive actions on immigration.

“We believe these programs are perfectly legal and will also be upheld,” said Hairo Cortes, program coordinator of Orange County Immigrant Youth United, who said that families should start preparing now for their implementation.

Residents can start gathering documents that prove they have been living continuously in the United States, he said. Those who have had contact with law enforcement can visit a trusted legal service provider to inquire about what is on their record.

Undocumented immigrants who came to the country as children should continue to apply for and renew DACA, said Cortes. DACA recipients who meet income requirements are eligible for full-scope Medi-Cal, California’s health care program for low-income residents.

For Avila Medrano, 23, DACA allowed her to get treatment for several health problems though Medi-Cal. When she was hospitalized recently, Medrano was able to get Medi-Cal to cover her hospital stay, medicines, and visits to doctors.

“When DACA came around, I saw hope,” said Medrano.

David Lee, a Korean American DACA recipient who was formerly homeless, said a man from church helped connect him to the local non-profit organization Korean Community Services.

“He told me I could work legally and there’s a program called DACA,” said Lee. “I didn’t believe it but I needed help. So I applied for DACA and it went through.”

Lee, who is now able to work legally, also said he now feels freer because of DACA. He explained that as a breakdancer, he used to be embarrassed to have to present a passport in order to enter a nightclub. Now he can use his ID to go out dancing.

“Thanks to DACA,” he said, “I can have more fun. I feel more free.”

Cortes said there are actions that families can take regardless of their status.

As of May 2016, all undocumented minors will be able to access full-scope Medi-Cal, so parents are encouraged to enroll their children in emergency Medi-Cal now.

Undocumented immigrants in California are encouraged to continue to apply for driver’s licenses, available to all qualifying residents regardless of immigration status, through the state law AB 60.

Eligible green card holders can apply for U.S. citizenship; and U.S. citizens can register to vote.

Concerned residents can also make their voices heard through organizing, Cortes said.

“We’re seeing a greater organizing effort now in New York, Chicago, people standing up against raids,” said Cortes, who noted that a recent protest in Santa Ana called for an end to deportations.

News of immigration raids on Central American refugees in other parts of the country has put immigrant communities on edge, noted Carlos Perea, project manager at Resistencia, Autonomia, Igualdad, lideraZgo (RAIZ)‬.

“There’s already enough fear and panic in the community,” said Perea, “that anytime the community hears about raids and [law enforcement’s] cooperation with ICE [Immigration and Customs Enforcement], the community will freak out.”

Perea said it’s important for undocumented families to have a plan of action if they come in contact with ICE agents, so they will be able to get the help they need should they be detained. Perea suggests that families have an emergency contact who will be able to take action if family members are detained; they should contact a trusted immigration lawyer or advocacy organization that will be able to mobilize on their behalf; and they should have an emergency plan for their children.

Meanwhile, Lee encouraged other undocumented immigrants in his community to see if they qualified for DACA so they could be free from the threat of deportation and be able to work legally.

“Don’t be skeptical [of applying for DACA] like I was,” he says. “Take action.”

For more information about Ready California, visit
Ready-California.org.
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One in Three Adults Don't Get Enough Sleep tag:newamericamedia.org,2016://19.15096 2016-03-07T21:20:31Z 2016-03-07T21:21:42Z Sampan ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 More than a third of American adults are not getting enough sleep on a regular basis, according to a new study in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. This is the first study to document estimates of self-reported healthy sleep duration (seven or more hours per day) for all 50 states and the District of Columbia.

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults aged 18–60 years sleep at least seven hours each night to promote optimal health and well-being. Sleeping less than seven hours per day is associated with an increased risk of developing chronic conditions such as obesity, diabetes, high blood pressure, heart disease, stroke, and frequent mental distress.

“As a nation we are not getting enough sleep,” said Dr. Wayne Giles, director of CDC’s Division of Population Health. “Lifestyle changes such as going to bed at the same time each night; rising at the same time each morning; and turning off or removing televisions, computers, mobile devices from the bedroom, can help people get the healthy sleep they need.”

Prevalence of healthy sleep duration varies by geography, race/ethnicity, employment, marital status.


 
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Random Zika Testing Urged in the Philippines tag:newamericamedia.org,2016://19.15094 2016-03-07T19:20:10Z 2016-03-07T19:25:49Z Inquirer.net ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 SOME doctors are urging the Department of Health (DOH) to start testing people in barangays with a high incidence of dengue for the Zika virus to gauge the magnitude of the problem in the country.

The main carrier of the Zika virus is the Aedes aegypti mosquito, the same vector for dengue, which is endemic in the Philippines.

RITM-0308-620x349.jpg 
ZIKA TESTING AND TREATMENT CENTER The country’s testing kits for the Zika virus are kept at the Research Institute for Tropical Medicine (RITM) in Alabang, Muntinlupa City. The RITM is the primary health facility in charge of diagnosing and treating patients with emerging infectious diseases. INQUIRER PHOTO



Dr. Willie Ong, a cardiologist and a former DOH consultant, on Monday said random testing should be done on at least 100 people in the barangays that registered the highest number of dengue cases last year, with pregnant women and those with fever and rashes as the primary targets.

The DOH last year recorded a total of 200,415 dengue cases nationwide. Most of the cases were in Central Luzon, provinces in Calabarzon (Cavite, Laguna, Batangas, Rizal, Quezon), Metro Manila, the Ilocos Region and Cagayan Valley.

“If one American visiting Luzon could get Zika, then many other Filipinos already have the virus,” Ong said.
Ong called for random testing in barangays a day after the DOH announced that an American woman, who spent four weeks in the Philippines in January, had tested positive for the Zika virus. The woman was the country’s second laboratory-confirmed case of the mosquito-borne disease.

The first documented case of the Zika infection in the Philippines was in Cebu province in 2012—a 15-year-old boy who did not have a travel history.


Read more:
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A Creative Edge Sharpens Aging Minds, Improves Health tag:newamericamedia.org,2016://19.15090 2016-03-06T09:35:00Z 2016-03-07T19:02:32Z Linda Valdez ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 Photo: Arizona Republic columnist Linda Valdez shown with one of her artworks at a Tucson gallery. Research shows creativity, she writes, is key to healthy aging.

PHOENIX, Ariz.--The young are not immune from the challenges of a graying America.
It may be about helping a parent navigate the dark at the end of the tunnel. Will Grandma remain a vital part of a family's life? Or fade into a sad shadow?

One thing I learned from the week I spent as a journalism fellow at the 68th Annual Scientific Meeting of the Gerontological Society of America: Our nation is not ready for the silver tsunami headed our way.

It was grim hearing learned scientists talk about their research into aging.

Aging by the Numbers

43.1 million: Number of Americans over 65 in 2012, a 21 percent increase since 2002.

14.1 million: Projected number of Americans over 85 by 2040.

3.9 million: Number of people over 65 who live below the federal poverty level.

Source: Administration on Aging



It was also personal. I’m 63. Like my fellow baby boomers, I have serious skin in this game. We fear a decline that could cost our children far too much in money, time and emotional investment.

Can Creativity Keep Us Healthy?

But one theme at the conference sparkled above all the discussions about chronic illness, isolation, poverty and depression.

Creativity does not dim in old age.

It can emerge with surprising brilliance--even among those who can no longer use words. It can help keep people healthy, and that’s something that benefits the old and the young.

This revelation hit home, too. A few years ago, I learned some computer graphic skills and began doing artwork that has been exhibited in a local gallery.

The artist in my soul took a nap during those years when raising a family and making a living consumed 110 percent of my energy. Now I make the time for art. It’s a personal decision. And it's deeply rewarding.

The effort to actively, systematically foster creativity in older people is becoming a popular cause on a larger scale. This has led to some wonderful programs. It could lead to what gerontologist Desmond O’Neill of the Trinity College in Dublin, Ireland, called the “mother bountiful approach” that patronizes elders.

A lot more research is necessary.

Recognizing and facilitating creativity in aging adults could make growing old a time of joyful discovery. It could add value to society and give the kids a break by keeping the older generation healthier.

The Benefits for Us

Creativity brings big benefits for aging minds and bodies. This includes older people who are healthy and those who have profound cognitive losses. That explains a push to bring dance, theater, music, writing, sculpture and painting to seniors.

But what’s the payoff for the rest of us? This is not a cynical question. The answer will determine if the budding efforts to bring arts to older adults will flower or wither. Right now, the bud appears to be opening.

In January, the Arizona Commission on the Arts launched the three-year AZ Creative Aging effort funded by a $225,000 grant from the Virginia G. Piper Charitable Trust.

The commission brought in the first group of experts to begin training local “teaching artists” who will work to “build a creative aging infrastructure” in Arizona, says the commission’s Steve Wilcox.

Jorge Merced was one of those visiting experts. An artistic director with the New York-based Pregones Theater, he found the air in Arizona particularly conducive to this task.

“From day one, you breathe a sense of artistic depth desire and openness from everyone,” he said. “The Arizona Commission--that team is just unique in this country in terms of the 

Valdez woman.jpg 

Photo: “Come Fly with Me,” a photo compilation by article author Linda Valdez. The girl is a childhood photo of her mother.

commitment and passion they have.” The task is enormous.

By 2050, 21 percent of Arizona’s total population will be 65 and older, according to the Arizona Department of Health Services. The state’s projected population of 2.4 million seniors in 2050 represents a whopping 174 percent increase in that age group over 2010.

The fastest growing segment of the United States population is people age 85 and older, and Arizona reflects that trend.

As people live longer, more of them will develop age-related and chronic diseases. As society faces the rising costs of caring for these people, the arts programs for elders may look like an unaffordable frill.

But research suggests that fostering creativity in older people is a wise investment. The arts can help people who are in good health stave off isolation and depression by encouraging creative expression and the social engagement that comes with it.

'People Who Couldn't Speak Could Compose Lyrics'

For those who are suffering from Alzheimer’s or other types of cognitive impairment, the arts can improve quality of life and provide a means of communication.

“It’s about developing a sense of mastery and accomplishment at a time of life when the rest of society tells you that you are valueless,” said Anne Davis Basting, long-time researcher in the field and author of Forget Memory: Creating Better Lives for People with Dementia (Johns Hopkins University Press, 2009).

Teresa Allison, MD, PhD, studied dementia patients at the Jewish Home in San Francisco. She spoke about the value of creative arts classes during the Gerontological Society of America’s annual scientific meeting last year.

The art classes Allison talked about were not designed to just to pass the time for elderly residents. “The explicit purpose was not therapeutic,” she said. “These are students, not patients.” The students delivered in astonishing ways.

“People who couldn’t speak could compose song lyrics,” Allison said. The ones who painted produced works for sale. She added, “During classes they could have an hour or so of normal life and grow and thrive in that context.”

That’s a big reward for the individuals, their families and even for the caregivers, whose jobs become easier as they see their patients as people with something to contribute.

Benefits for Society

But for society?

In 2006, the late psychiatrist and gerontologist Gene Cohen, MD, PhD, reported “strikingly positive” results for people over 65 who engaged in cultural activities.

Cohen’s Creativity in Aging Study found that those who had participated in community-based arts activities run by professional artists reported better health, fewer doctor visits, less need for medication, more positive mental health indicators and more involvement in other activities. The benefits endured at one- and two-year follow up assessments.

More research is necessary. But Cohen’s work suggests the arts can lead to tangible savings on health-care costs.

But it’s not the full payoff.

“Throughout the history of humanity we have seen that the wisdom that allows society to move to a different place comes from life experience. That experience is in the hands and in the souls and in the lives of older adults,” Merced explained. “Only older adults have those tools.”

He stressed, “The creative aging field is tapping that and saying . . . the arts provide that wonderful place to value your life and to question society and enrich it . . . politically and economically and artistically.”

Linda Valdez wrote this article for the Arizona Republic on a Journalists in Aging Fellowship, a program of New America Media and the Gerontological Society, supported by the Archstone Foundation.

Also read:
“Fighting Ageism in the Twitter Era (Getting Old Isn't All That Bad)”
“In Rural Arizona, Needs of Elderly Outstrip Help”  

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Public Confusion on Palliative Care vs. Hospice Limits Help at End-of-Life tag:newamericamedia.org,2016://19.15088 2016-03-04T08:30:00Z 2016-03-03T01:41:48Z Jennifer L. Boen ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 Photo: Rozanne and Gerald Hallman were introduced to palliative care services after Gerald was diagnosed with a brain tumor in late 2011. (Courtesy photo)

FORT WAYNE, Ind.--Rozanne and Gerald Hallman were thrust unexpectedly and severely into the land of the seriously ill when, in late 2011, Gerald, a retired pastor, was diagnosed with a brain tumor. He underwent surgery to remove as much tumor as possible, but the procedure left him paralyzed on one side.

“They said [his tumor] was a bad one,” Rozanne recalled. So many questions and decisions faced the rural Steuben County, Ind., couple.

When Gerald’s physicians discussed options and next steps, palliative care was among them. Rozanne, a retired teacher, was familiar with hospice, but unaware of palliative care as a specialized service.

“I didn’t have a clue,” she said, but added that through those services, “our every need was met.”

Multiple studies show that, compared to awareness of hospice, “There’s significantly less familiarity with palliative care,” said Lyle Fettig, MD, director of Indiana University School of Medicine’s Hospice and Palliative Medicine Fellowship program centered in Indianapolis.

Palliative care is now a recognized medical subspecialty, but experts in the field say lack of knowledge about it within the general public, and even among medical providers, is impeding the many benefits of these services for those who most need them.

Aids Patients at Any Stage

Palliative care, according to the New York-based Center to Advance Palliative Care, is appropriate for individuals of any age and at any stage of a serious illness, whether it is is cancer or a chronic condition, such as heart or lung disease. The goal is to improve quality of life for both patient and family through a holistic, interdisciplinary team approach.

Palliative care addresses symptom control of a medical condition, as well as side effects of treatment. Families may be connected to community services, financial resources and help for caregivers.

Hospice includes palliative, or comfort care, to relieve pain and other symptoms but, generally speaking, it is for individuals anticipated to have six months or fewer to live and who are no longer receiving active treatment.

“The reason that people get palliative care confused with hospice is that [palliative care] can be introduced earlier on,” said Kathryn Felts, a palliative care and hospice nurse practitioner with Parkview Home Health and Hospice.

Patients in palliative care services can still be receiving curative treatment. Patients access palliative care most often at a hospital or it is at least initiated there, but they can also have it provided on an outpatient basis, if it’s available.

Evidence-Based Benefits

Evidence is mounting on the multifaceted benefits of specialty palliative care services, particularly if they are introduced sooner rather than later after diagnosis. Among those benefits: lowered stress and depression in patients and caregivers; reduced pain and better control of other symptoms; and better clinical outcomes.

A landmark study, led by Jennifer Temel, MD, at Massachusetts General Hospital and published in the New England Journal of Medicine, compared outcomes among patients with an aggressive form of lung cancer. The group participants, who received both standard treatment plus palliative care, showed greater improvements in both mood and quality of life compared with the standard care-only group.

Palliative care services reduce hospital costs, say researchers. Patients receiving services have been shown to have shorter hospital stays, less time in intensive care and fewer ER visits. A study by Icahn School of Medicine at Mount Sinai in New York, led by R. Sean Morrison, MD, found Medicaid-enrolled patients who received palliative care incurred almost $7,000 less in hospital costs during a hospital admission compared to a matched group of Medicaid patients, who received standard care.

A key component of specialty palliative care is helping patients and families have discussions about the goals of care, including talking through advance directives, said Debra Geradot, palliative care coordinator for Lutheran Hospital. Lutheran’s kidney and heart transplant patients, for example, participate in palliative care consultations prior to surgery.

Patients who receive services from a palliative care team are more likely to die at home rather than in a hospital, studies show. Even those dealing with life-altering, but not necessarily life-shortening conditions are more likely to have end-of-life discussions if referred for palliative care.

Referrals Still Lag

Despite the evidence for positive outcomes, referrals for palliative care services still come too late or, in many cases, not at all, said Andrew Esch, MD, a palliative care specialist and faculty member of the Center to Advance Palliative Care (CAPC).

“Providers associate palliative care with hospice, and that’s one reason referrals come late," Esch said. "That’s why we’re trying to clarify that,” he said of CAPC’s mission. Physicians are now allowed to bill Medicare for end-of-life counseling.

Esch cites other key reasons for failure or delays in palliative care referrals. First is lack of access because of too few specialty-trained palliative care physicians. Second, physicians, in general, are inadequately trained [http://tinyurl.com/nhsvqkt] and skilled to discuss end-of-life issues.

“In medical school, the very little I got about suffering and death ill-prepared me for what I would encounter,” Esch said. “We’re trained to treat illness, not necessarily trained to treat people. We’re very much focused on treating disease.”

That is why Indiana University School of Medicine’s Fettig is passionate about teaching graduate physicians wanting to earn a subspecialty in palliative care and work in the field full time. He also wants to help medical students and new graduates “learn how to have those end-of-life conversations and help them learn to explain the risks and benefits of treatment options and goals.”

For the Hallmans, discussions with Lutheran Hospital’s hospital palliative care staff helped solidify Gerald’s goals of care. When he was discharged to a nursing home, the Lutheran team helped him access palliative care services there through Visiting Nurse.

Medicare covered Gerald’s hospital palliative care and his Medicare Advantage plan covered it in the nursing home. Most private insurers cover palliative care consults.

“And when the time came," Rozanne said, "we let them know he was ready for hospice.”

Jennifer L. Boen wrote this article for Indiana’s Fort Wayne News-Sentinel with support from the Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America, sponsored by the SCAN Foundation. Boen is a freelancer journalist who writes frequently about health and medicine.

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Living the Life: Limited Support for Adult Trafficking Survivors tag:newamericamedia.org,2016://19.15080 2016-03-03T19:43:30Z 2016-03-03T15:59:50Z Mary Annette Pember ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 WARNING: This is part of a series of stories to be published over the next few weeks that contain potentially trauma-triggering material.

Mary G., whose story as a sex trafficking survivor in Duluth was told by ICTMN in 2012 (Native Girls Are Being Exploited and Destroyed at an Alarming Rate), had terrible problems convincing the administrators of her Section 8 housing to allow her daughter Hope to live with her. Hope, also a trafficking survivor, has convictions for prostitution as well as assaulting an officer during a mental breakdown. Federal housing programs usually don’t admit tenants with histories of drug use or violent crime. Hope was sex trafficked by a brutal pimp from age 14-20. For three years, she cycled in and out of mental health institutions before Mary G. was able to convince authorities to allow Hope to live with her, only to find that housing rules prevented Hope from staying. Eventually, however, Mary G. was able to appeal the decision. When ICTMN connected with Mary G. recently, we found that Hope is now living with her and trying to recover.

RELATED:
Surviving for the Love of Hope

Hope is fortunate. During ICTMN’s search for effective solutions to the problems of rehabilitation of sex trafficking survivors in Indian country, the most immediate dilemma faced by most women was finding a safe place to stay, or a place that would have them without placing potentially onerous demands on their psychological state.

None of the women profiled in this series (see Living the Life: Little Girls Don’t Daydream of Being Prostitutes) have ever been asked if they were forced to exchange sex for housing or survival during any of the social, mental or health intake processes. Instead, medical professionals asked about Hope’s and Naivara’s (Battle at Home: Traditional Spirit v. Addiction Spirit) physical symptoms and prescribed cocktails of pills to take away their pain and anxiety. Hope receives visits from a home health care worker who dispenses medication and encourages her to apply for jobs; her mental health counseling focuses on getting her involved with job training. But Hope is utterly broken. She sits in her mother’s living room chain-smoking cigarettes; her gestures suggest she is wrapped in cotton. She wears a look of bewilderment, as though trying to recall something important but very far away.

Far too few social workers, sexual assault advocates, health care professionals and law enforcement personnel are trained in trauma informed care when it comes to sex trafficking. An example of trauma-informed mental health care would be to ask clients what has happened to them rather than ask what’s wrong with them. Indeed, despite extensive medical literature affirming the role that trauma plays in health outcomes, doctors have been slow to incorporate use of the ACE (Adverse Childhood Experience) measure to determine the impact of trauma on their patients.

Vednita Carter, founder of Breaking Free, a Minneapolis based non-profit organization that helps women escape prostitution, suggests changing the wording of the medical and social service intake processes. “Rather than directly asking if clients have been prostituted or involved with sex trafficking, they should be asked if they’ve ever had to exchange sex for things, food or a place to stay,” she said.

“Social workers and others serving this population have to have a deep understanding of the impact of sex trafficking on the human spirit,” said Sarah Edstrom a certified sexual assault advocate at the Minnesota Indian Women’s Resource Center (MIWRC). Organizations also need to be equipped to deal with the needs of trafficking survivors.

Since the release of the federal strategic action plan on services for victims of sex trafficking and the funding focus of Department of Justice on services for trafficking survivors, many programs have emerged seeking to help sex trafficking survivors. Advocates who have long-term experience working with trafficking survivors, however, express concern that many of the new programs and organizations may not be prepared to deal with the needs of their clients. “We get calls everyday from these new organizations asking for help in dealing with survivors. I don’t think many of them know what they’re letting themselves in for,” said Carter “Many of the faith based organizations have a heart to help but they have trouble dealing with the women’s attitudes and drug addiction problems. Sobriety takes a long time.”

“Most survivors have addiction problems. Every trafficking survivor I’ve ever interviewed said she had to be inebriated in order to go through with the sex act,” noted Kevin Koliner, South Dakota Asst. U.S. Attorney.

“Once she comes down from the drugs, all the painful memories will come back and she won’t know what to do. The only thing that has worked is self-medication with drugs and alcohol,” noted Carter.

Most shelters or treatment programs won’t allow intoxicated clients to remain; women may be asked to leave if they show up high. And then the cycle begins again. Edstrom, who coordinates a trafficking survivor support group at MIWRC, recalls a client who testified against her pimp, who had kidnapped and brutally raped her for several days. “She had testified in court against the pimp and showed up high at group,” Edstrom recalled.

“It seemed inhumane to expect her to refrain from using the only coping mechanism she knew,” said Edstrom, who does require that clients refrain from using or possessing drugs on the premises of MIWRC. She thinks some of the programs may have unrealistic expectations regarding the recovery process for trafficking survivors. “It takes more than some hygiene products and improving their self-esteem to start a new life. These women are so wounded that their spirits are almost inaccessible. They haven’t been allowed to grieve for what they’ve lost and all that’s happened to them,” said Edstrom.

“We have to deprogram them, in a sense. At Breaking Free, we teach our clients about the dynamics of prostitution. We reassure them they can talk about what has happened to them without being judged. They learn that this was something that was done to them; prostitution is about supply and demand and it’s a multi-billion dollar industry,” said Carter.

“Recovery from sex trafficking requires long-term care. Generally, social service agencies try to push people through but there is no quick turnaround. In serving these clients, we are building from the ground up,” said Nigel Perrote of PAVSA, Program for aid to Victims of Sexual Assault in Duluth, Minnesota.

“First they need to get sober,” he noted. After that comes the work of learning how to live sober. “Living sober means learning how to parent, gain job skills as well as getting and keeping a job.”

Mary G. described Hope’s inability to cope with the challenges of everyday life. “When Hope first came to live with me she would freak out when we ran out of toilet paper. For years she’d lived in hotels or institutions where it was always there; she didn’t know how to buy toilet paper,” Mary G. reported.

“We need wide systemic changes in social services in order to address the deep, basic needs of trafficking survivors,” Perrote noted.

Of her family’s work towards healing, Mary G. said, “Me and Hope together, maybe we can do it. We can be like one strong person.”

Sadly, survivors without strong moms like Mary G. will still have to rely on a system that is still too slow to come to terms with the reality of the experiences of women who are trying to leave ‘the life.’

Upcoming: Can new funding, shelters and tailored programs provide the model for successfully helping trafficking survivors in Indian country?


Read more at
http://indiancountrytodaymedianetwork.com/2016/02/24/living-life-limited-support-adult-trafficking-survivors-163514
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Children, Elders Hit by Common Virus That Can Turn Deadly tag:newamericamedia.org,2016://19.15083 2016-03-02T08:55:00Z 2016-03-02T18:30:06Z Mark Taylor ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 Photo: Very young children and seniors are especially vulerable to the common RSV bug. 

CHICAGO--Kristen Padavic said no one told her about respiratory syncytial virus, or RSV, when she delivered twin daughters prematurely eight years ago.

The 39-year-old architect's girls were fine upon hospital discharge, and when they were six months old their pediatrician said it was safe to take them to daycare.

Within two days the girls contracted RSV, a respiratory infection that causes cold and flu-like symptoms.

Most healthy children infected with RSV suffer runny noses, coughing and sore throats before getting better. But in children born prematurely or seniors with compromised immune systems, symptoms can escalate to breathing difficulties, pneumonia and even death.

Can Kill Young Children, Seniors

RSV is the most common cause of pneumonia and bronchiolitis, an inflammation of the lung's small airways, among children under the age of one, according to the Centers for Disease Control and Prevention. The CDC also notes:

•Almost all children will have had an RSV infection by their second birthday.

•RSV leads to 57,527 hospitalizations annually among kids under 5 and kills more than 200 U.S. children a year.

•Among adults over 65, RSV leads to 177,000 hospitalizations and 14,000 deaths annually.

"I'd never heard of it before having my children," said Padavic, who lives in Austin, Texas, with her architect husband, Michael, and their eight-year-old daughters.

Until recently, her twins contracted RSV repeatedly, necessitating emergency room visits three to four times a year.

Daycare schools "have every disgusting germ all year round," she said. "Our pediatrician didn't tell us that our twins' lungs were underdeveloped and that they were susceptible to this."

Andrew Pavia, MD, a spokesman for the Infectious Diseases Society of America, said pediatricians have known about RSV and children for decades.

"But it's flown under the radar for people who care for adults," said Pavia, chief of pediatric infectious diseases at the University of Utah. "It's the Rodney Dangerfield of the viral world. It gets no respect."

Children’s Hospitals and Nursing Homes

A vaccine for children would be a tremendous help, he added.

"Every winter, hospitals across the country are overwhelmed with children hospitalized with RSV," he said. "Having a vaccine would mean we wouldn't have to build more beds in children's hospitals."

Thomas Yoshikawa, MD, of the VA Greater Los Angeles Healthcare System said geriatricians in recent years have learned many older patients thought to have had the flu really had RSV.

"The problem is that most people don't consider RSV as a cause of respiratory infections in older people, especially in nursing home residents," he said.

Until recently, diagnosis was through serology tests that took weeks to get results.

"Now we can take nasal secretions and test in the office for the RSV antigen," he said.

Yoshikawa said most health care providers are knowledgeable about flu infections but less familiar with RSV.

"We all tend to consider the diseases we know most about," he said, urging public health officials to better spread the word about the virus.

"When the CDC puts out a health notice, most physicians pay attention," Yoshikawa said.

Geriatricians, Pediatricians See Threat

Otherwise healthy older adults usually suffer mild RSV symptoms, said Marie A. Bernard, MD, deputy director of the National Institute on Aging. But adults with weakened immune systems — particularly those in nursing homes — often experience more severe symptoms.

Bernard said RSV is now recognized in geriatric circles as a threat.

"We're in an evolving landscape," Bernard said. "Soon we may be able to say what to do to prevent RSV."

Pediatrician H. Cody Meissner of the American Academy of Pediatrics [http://tinyurl.com/gmj3rca] said RSV is the most common cause of hospitalization during a child's first year of life.

"At the other end of the age spectrum, RSV is an important cause of hospitalization and even death in elderly people," added Meissner, a professor at Tufts University School of Medicine in Boston.

He said that until a few years ago, CMS, the federal agency that administers Medicare, didn't even list a treatment for RSV.

Meissner said an experimental RSV vaccine is being tested for pregnant women, who can then pass on immunity to their children.

"A maternal vaccine would be fantastic because it will protect everyone, not just the ill or at risk," he said.

Mothers who smoke while pregnant are more likely to have children with more severe RSV disease and second-hand smoke puts babies at high risk, Meissner said.

Just like the flu, RSV outbreaks are more common during the winter, said Benjamin Schwartz, MD, deputy chief of the acute communicable disease control program at the Los Angeles County Department of Public Health.

"Similar to other respiratory diseases, it can be prevented by hand washing and sick people staying away and avoiding contact with others," Schwartz said.

Limited Preventive Options

There currently aren't any antiviral drugs targeting RSV.

"There is a medication used for prevention that is recognized by the American Academy of Pediatrics for particular groups of children: those born prematurely or with congenital heart disease," Schwartz said.

He said the FDA-approved injectable drug palivizumab, known as Synagis, is only recommended for infants born before 29 weeks. Individual doses cost between $1,500 and $3,000 and a full regimen can run up to $15,000, making it unaffordable for many families.

He urged public health officials and doctors to focus on RSV education and to help ensure that children eligible for preventive medicine can get those drugs.

"Parents of children, physicians and hospital staff where children are born prematurely need to be informed about RSV and make sure their families know," he said.

Mark Taylor wrote this article for the Chicago Tribune with support from the Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America, sponsored by the Silver Century Foundation.


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For Arab Americans, Elders Pave The Future tag:newamericamedia.org,2016://19.15064 2016-02-25T08:15:00Z 2016-02-24T23:46:12Z Julian Do ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 It sounds counter-intuitive, but how we are preparing to care for our largest aging population in history today will shape our society tomorrow. In the 21st century, the aging population, though not yet front and center in national conversations, has been quietly impacted in a wide range of areas, such as economics, politics, healthcare, technology and even immigration.

For Arab Americans, elders have always held a special position in the community and are inseparable from their family life and cultural traditions.

Elders’ Digital Divide

What’s the future of aging? Technology is bringing may changes said experts who spoke at the Gerontological Society of America (GSA) 68th Annual Scientific Meeting in Orlando, Fla., last fall.

For many elders, using cell phones and computer tablets might be the closest things to technology in their daily usage. But the “ Internet of Things,” is a high-tech term for a network of embedded electronic sensors in devices that promises to play a big role in how we live as we age. Such sensors will be used in people’s beds (did you get enough sleep?), refrigerators?) what are your eating and how often?), even toilets to monitor a range of medical conditions.

For example, in a GSA research presentation, Allessandro Ble of the University of Exeter Medical School and his colleagues, showed that by connecting health monitoring devices to big data (information stored at a data center with real-time access), which also includes electronic medical records, healthcare providers will be able to fine tune patient care.

For instance, Ble noted, doctors could prescribe certain statins, drugs designed to lower cholesterol in blood, to patients in such a timely and effectively manner that it would help prevent cardiovascular disease and reduce mortality rates, especially in people ages 75 and older.

Another emerging advancement uses portable computer-based devices in both the public and the private sector to enable ailing seniors to relay their medical information and needs to healthcare providers. For example, a patient with impaired speech, such as from a stroke, could receive expert speech therapy sessions online and also have more effective ways available to communicate with their loved ones.

Experts at the GSA conference also discussed issues arising with these technologies, particularly privacy issues. But it was clear that our aging world has more to do with sci-fi than rocking chairs.

--Julian Do

Therefore, many Arab Americans may find some issues confronting seniors in the United States, such as the challenges to Social Security and Medicare, unsettling.

But at the same time, they might also feel excited about a growing national movement to integrate the aging population as part of the community, instead of more separate senior retirement developments.

‘Invisible’ Arab Americans

Sociologist Kristine Ajrouch of Eastern Michigan University, makes the case that in general Arab Americans, though they’ve been an important part of American social fabric, are “invisible.”

Speaking at the Gerontological Society of America (GSA) 68th Annual Scientific Meeting in Orlando, Fla., last November, Ajrouch said that is because they’re often overlooked in most health research, even when there’s a focus on minorities. That’s a significant concern in a rapidly aging and increasingly diverse nation.

Ajrouch also joined Wayne State University professors Faith Hopp, Jennifer Mendez and researcher Amne Darwish-Talab to discuss their research on how a cross-cultural adult day care center would be a welcome addition to many Arab Americans living in the Detroit area.

Such centers provide social and health care to frail elders enabling family caregivers to continuing going to work, for instance, so they can keep the older person at home rather than in a nursing home.

Their findings show that besides offering many essential healthcare services, the adult day care center would benefit older adults by providing transportation, help in navigating systems through language translation, and creating a safe and enjoyable environment to socialize and celebrate their cultures and arts.

Senior Issues and 2016 Campaign

More broadly, according to 2015 U.S. Census Bureau figures, one out of five Americans is projected to be over 65 by 2030 with average life expectancy approaching 85.

It’s good news that we are living longer, but experts at the GSA conference raised looming questions about what will sustain us as we grow old.

For example, how well Social Security will be able to pay its future retirement obligations has long been controversial. Since the issue is so divisive across the political spectrum, it has been placed on the back burner ever since the 2007 economic crisis explosion.

Nevertheless, expect another round of debate over this country’s old-age pension program as the 2016 presidential election heats up, with the Republicans arguing to cut future benefits and Democrats calling for increases to protect middle- and lower-income seniors.

Since the issue is so divisive across the political spectrum, it has been placed on the back burner ever since the 2007 economic crisis exploded. Nevertheless, we can expect another round of debate in 2016 when the presidential election heats up as the aging population have among the highest voter turnout rates.

Speaking at a workshop for journalists at the GSA conference, UCLA health policy professor Steven P. Wallace noted a related demographic change.

Wallace, who also directs the national center for the federally-funded Resource Centers for Minority Aging Research, explained that because the current non-Hispanic white majority have has had fewer children, the combined minorities would eventually become the majority in the U.S. around 2050, due to their higher birthrates and immigration flow.

Also, he said, the proportion of ethnic elders alone will double by then to more than four out of 10 seniors.

As a result, Wallace stated that any future national conversation about the aging should include minority and immigration issues.

World Alzheimer Report 2015

Among the greatest health threats to the aging population is the increase of Alzheimer’s disease and other kinds of dementia. At the GSA conference, Maelenn Guerchet, MD, of King’s College, London, presented the World Alzheimer Report 2015 that she and her colleagues published last summer.

They found that currently “46.8 million people worldwide are living with dementia in 2015. This number will almost double every 20 years, reaching 74.7 million in 2030 and 131.5 million in 2050.”

The global costs of dementia, which includes both paid professional and informal care, totaled $818 billion in 2015. Informal care, a little more than one-third of that amount, is provided by family members, friends and neighbors.

In the U.S., based on research from the Alzheimer Association, Alzheimer’s disease is the country’s sixth-leading cause of death. About 5.1 million, or one-in-nine people 65 and older, have dementia. In the U.S., about 15 million people provide unpaid care for these patients, and direct healthcare payments are estimated to be $226 billion in 2015.

These costs and the informal care represent an enormous challenge for the healthcare system, American families, and the government in the near future.

Elders’ Shifting Role

Many issues for ethnic elders and their families were also addressed at the GSA meeting, such as economic and healthcare disparities, cross-cultural caregiving and family and intergenerational relations

Perhaps the most illuminating discussion at the conference was on the shifting role of the aging population. Seniors no longer see themselves as passive retirees whose focus is on enjoying their golden years separate from the society. That stereotype is often seen by some as a resource drain on the economy.

In his book Aging in the Right Place (Health Professions Press, 2015) University of Florida, Gainesville, researcher Stephen Golant, said a the conference that many older adults are neither merely relying on their family members or professionals, nor simply aging in their homes with little or no assistance. Instead, many are forming local support groups and networks to help them with easier access to health care and social services.

Around the country, nonprofits like organizations in the Village to Village Network have sprung up. The nearly 200 Villages around the country help their member senior access affordable services, such as transportation, health and wellness programs and home repairs.

Other groups at GSA’s program are advocating for senior rights and supporting a wide range of efforts, such as designing more desirable “age friendly” community settings to age in, conserving the environment, and enabling elders to continue being productive contributors in society through paid and volunteer work.

These ideas and developments exemplify how culture, family, friends and colleagues interact with environments that are better designed for living with dignity as we age.

These goals also reflect values Arab Americans have brought with them from their motherlands, where they have been practiced for millennia. As professor Kristine Ajrouch emphasized, increased health research on Arab Americans is not only important, but it may offer unique insights that could be valuable to the preparation of caring for the aging population.

Julian Do wrote this article for Al Enteshar with support from a Journalists in Aging Fellowship, a program of New America Media and the Gerontological Society of America, and sponsored by The SCAN Foundation.

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Federal Task Force Takes Major Step to Unite Care of Body and Mind tag:newamericamedia.org,2016://19.15041 2016-02-18T19:08:29Z 2016-02-18T19:12:13Z Sandra R. Hernandez, President and Chief Executive Office ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 The American health care system has just moved closer to a goal that I and many of my physician colleagues have long desired. Recognizing that depression is a prevalent condition that's inextricably linked to patient outcomes for physical diseases, the US Preventive Services Task Force on January 26 recommended that health care providers routinely screen patients 18 and over, including expectant and new moms, for depression. For those who are working toward the vision of a high-functioning health care system that assesses and treats the whole patient — both mind and body — this is a great moment.

Screening is a powerful tool. The Affordable Care Act (ACA) gives the task force recommendation the force of law, requiring health plans to waive copayments and deductibles for depression screenings. Millions of people with common, treatable behavioral health problems will be able to get the help they need.

This recommendation could not have come at a better time. The burden of untreated mental illness is a major public health problem that weighs heavily on our society; many people with mental illnesses do not receive the treatment they need. Several years ago, federal statistics showed that more than 60% of patients with any mental illness and 40% of those with a serious mental illness did not receive any outpatient care, inpatient care, or medication treatment to address their condition. Mental health disorders are the leading cause of disability in the US. In 2014, nearly 16 million Americans had at least one bout with serious depression, and about 30,000 Americans die each year from suicide. For the 15% to 20% of women who suffer from depression during pregnancy or in the months after giving birth, the consequences of their mental health issues are significant. A mother with untreated postpartum depression is less likely to talk to, sing to, read to, or bond with her newborn, all of which can have a negative impact on her baby's emotional and intellectual development.

If we are going to achieve the Triple Aim — better health, better care, and lower costs — we have to recognize that mental health and physical health are indivisible. Patients can't maintain good physical health and practice wellness and healthful behaviors if they suffer from anxiety or depression. Likewise, patients with chronic physical diseases and conditions often have underlying mental health issues that make it harder for them to comply with needed treatments and behavior changes.

By treating the whole person, we can help a patient better manage chronic diseases and comply with the advice of his or her doctor. I have seen this repeatedly. Not long ago, a patient in my practice at the HIV clinic told me she stopped taking the anti-retroviral medications that enable her to live a relatively normal life. This patient, who had always been good about taking her medication, gave a vague reason for her decision to stop the drugs. As I probed for details, she explained that she had been deprived of sleep and depressed because her mother had been hospitalized after a stroke. Although her mother had been abusive, my patient was the only relative to visit her at the hospital. Her mother's hospitalization had destabilized my patient. I unexpectedly found myself in a conversation with her over something that had nothing — and everything — to do with the course of her HIV. Finding out about the depression was as important to ensuring she got the care she needed as were her lipids or viral load. As a result of our conversation, I referred her for psychiatric care. She joined a peer-led grief support group, enabling her to express her complicated feelings without taking antidepressants. The situation reinforced the idea that if you are apathetic, hopeless, dark, and don't eat or sleep, it doesn't matter what treatments a physician offers or suggests for physical ailments — they will have limited impact. We can no longer dismiss patients as noncompliant without learning more about why. This is what patient-driven care management is all about.

Beyond identifying patients who need help and reducing the stigma of mental illness, screening will yield valuable data about the prevalence of behavioral illness, risk factors, and protective factors. It will also require that primary care physicians accelerate efforts to keep up with evidence-based treatment. If I learn from the data that 30% of my patients are clinically depressed, I'm going to want to become a lot more knowledgeable about managing depression.

There are very real concerns that the task force's screening recommendation could identify more behavioral health patients than existing resources can handle. New Jersey, currently the only state with mandatory screening for postpartum depression, had disappointing outcomes among women on Medicaid because of lack of continuity of care across providers and the lack of integration of mental health services and support into prenatal, postpartum, and pediatric care.

I believe the task force's national standard will help to change that dynamic and lead to concrete steps to address workforce and other access challenges that are obstacles to care of depression. The new recommendation says screening should be implemented with adequate systems in place to ensure appropriate follow-up. Faced with increased demand, quality improvement programs will figure out how to better integrate care and thereby become more responsive to patients' needs. We need to band together and make it a priority for payers and stakeholders to use all the available tools — the technology, diverse staff resources, and payer incentives — to make this succeed.

Routine screening will strengthen the inner lives of patients and reduce the chances that any chronic health condition will progress into a life-threatening acute episode because the patient is experiencing depression.

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Senior Malnutrition Grows in Ohio With 411,000 Hungry Last Year tag:newamericamedia.org,2016://19.15037 2016-02-17T08:15:00Z 2016-02-17T00:15:22Z Encarnacion Pyle ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 Photo: Volunteer Juan Montalvo fills senior nutrition boxes for a federal food program at an Ohio foodbank. The Salvation Army distributes the boxes. (Adam Cairns/Columbus Dispatch)

COLUMBUS, Ohio--The United States has done a good job of making the obesity epidemic a public-health priority. But it has largely ignored an equally important threat: senior malnutrition, according to many advocates.

“Malnutrition is a serious, prevalent, growing problem for many older adults in our nation,” said Ainsley Malone, a nutrition-support dietitian at Mount Carmel West hospital in Columbus, Ohio. “But many other countries have really been working much harder to address it.”

$157 Billion a Year Problem

Malnutrition costs the U.S. an estimated $157 billion annually — $51.3 billion for those 65 or older, Malone said. Poor nutrition has been associated with a 300 percent increase in health-care costs.

One-in-three hospital patients is malnourished when admitted, Malone said. Nearly one-third experience declines in nutrition during their hospital stays, putting them at risk of other complications.

With people living longer and the number of older adults set to explode, the problem is expected to get worse, advocates say.

Patients who don’t get proper nutrition have a higher rate of depression, are at increased risk of infections and are less likely to be discharged.

Malnutrition often is caused by an insufficient or imbalanced diet and/or clinical conditions that impair the body’s absorption or use of foods, said Debra BenAvram, chief executive officer of the American Society for Parenteral and Enteral Nutrition.

Despite what people might think, those who weigh too much, not enough or the right amount all can fall short of their body’s necessary nutrients, she said.

Last spring, BenAvram’s 69-year-old father was admitted to the hospital because of a high fever and general malaise. He had lost 12 percent of his body weight, but because he wasn’t underweight, he didn’t appear malnourished, BenAvram said.

He should have received a nutritional assessment and been placed on a care plan within 48 hours. Instead, he was placed on a diet of clear liquids, amounting to only about one-third of his required dietary needs, she said.

Although his condition continued to deteriorate, it wasn’t until day 10 of an 11-day hospital stay that he was started on a nutritional intervention. That was after he underwent an emergency gall-bladder removal because of diverticulitis.

“Because I know the signs of malnutrition, I was able to insist on a nutrition consult for Dad,” BenAvram said. “But not everyone has the information they need.”

More Than a Good Meal Needed

Patients who enter a hospital malnourished also are at greater risk of longer stays, complications and higher readmission rates, BenAvram said. They also have a more difficult time fighting infections and are at greater risk of dying.

“We need to change people’s understanding of nutrition and health as more than just a good meal,” Robert Blancato, executive director of the National Association of Nutrition and Aging Services Programs, said in November at a gathering of gerontological experts in Orlando, Fla.

During the past several months, several health-related groups have made recommendations that include promoting increased and better screening for everyone 65 or older who has been admitted to a hospital, Blancato said.

Also needed are assessment tools and intervention programs for other health-care settings such as primary-care practices and nursing homes, plus standards to ensure that people’s nutritional needs are met even if they move to another setting, Blancato said.

Increasing funding for state and federal programs that help older adults remain in the community and out of the hospital also would help, Blancato said. Examples are food pantries and Meals on Wheels programs.

Ohio State Sen. Gayle Manning, a Republican, has introduced a bill to establish a Malnutrition Prevention Commission in an effort to find out the extent of the problem in Ohio.

If the bill passes, the 17-member group would include a physician, two registered nurses, three dietitians and a hospital representative. It also would have designees from the state departments of aging, agriculture, health and bob and family services, plus an Ohio Association of Area Agencies on Aging representative and a university researcher with expertise in gerontology or nutrition.

The commission would look for evidence-based solutions, such as increased access to registered dietitians, community nutrition programs and oral nutrition supplements, and it would develop strategies for improving data collection and analysis.

“We see senior hunger as a big part of the problem,” said Beth Kowalczyk, chief policy officer of the Ohio Association of Area Agencies on Aging. “A lot of people make do with what they have,” even if it amounts to only a 400-calories-a-day diet.

Some older adults don’t have enough to eat because they are on limited incomes but don’t qualify for home-delivered meals. Others lack transportation to a grocery store or the ability to cook a hot meal.

Senior Hunger Jumped 160%

The number of seniors who used food banks, soup kitchens and pantries in Ohio has jumped dramatically in the past eight years, and most live solely on small monthly Social Security checks, said Lisa Hamler-Fugitt, executive director of the Ohio Association of Foodbanks.

In the last quarter of 2007, 158,599 older Ohioans depended on the supplemental food services; in the last quarter of 2015, 411,570 did — a nearly 160 percent increase.

“Seniors are always the last ones to show up, and when they do, they’re usually in desperate need,” Hamler-Fugitt said.

More support for preventive programs would help, she said.

“We know what needs to be done to address hunger, food insecurity and malnutrition for seniors,” Hamler-Fugitt said. “The question is: Do we have the political will?”

Encarnacion Pyle wrote this article for The Columbus Dispatch with support from the Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America, sponsored by the Commonwealth Fund.

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Eat, Pray, Gain--Black Church Meals May Serve Fellowship With Obesity tag:newamericamedia.org,2016://19.15018 2016-02-09T09:00:00Z 2016-02-09T00:13:40Z Frederick H. Lowe ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 CHICAGO--After the Fourth Sunday of Advent Service in December, members and guests of St. Martin's Episcopal Church, a mostly African American church on Chicago's West Side, celebrated by hosting a special Advent brunch.

And special it was. Spread out on two long tables were big aluminum containers of ham, turkey, fried chicken, spaghetti, mashed potatoes, gravy, slices of white bread, salad, salad dressings and collard greens. For dessert, there were peach cobbler and several varieties of cookies, along with hot coffee, tea, sodas and water.

Church members sat on folding chairs, balancing their plates on their laps, eating, talking and laughing, often going for seconds.

Father Christopher Griffin, St. Martin's pastor, held a plate overflowing with food in one hand. His stomach sticks out well over his belt buckle. When I asked him if he was concerned about his weight, he said, "Sure, I’d like to lose weight. Doesn't every American?"

The gathering went on for several hours before members, who also include Asians, Hispanics and whites, washed the plates, pots and pans before cleaning the kitchen to go home.

There was so much food, church members saved the leftovers for the dinner that would be served after the Christmas Eve service. In addition to the special meals, there’s coffee hour, held most Sundays, at which large amounts of food are also served.

High Obesity Rate

Dinners served after church services have been used by some to explain the high obesity rates among blacks.

At the same time, the calorie-laden dinners also provide fellowship for African Americans, a sense of easy community they may not experience elsewhere during the week, particularly given the prevalence of racially motivated slights, the tense anticipation of slights, or worse, the possibility of violent physical assault.

African American men and women who eat high-fat comfort foods, such as macaroni and cheese, register higher rates of obesity than most other groups in the United States.

These men and the women, however, took different paths on the road to excessive girth.

In both cases, many African Americans end up suffering from such debilitating physical ailments as diabetes, high blood pressure and heart disease that shorten their lives compared with other racial and ethnic groups.

Eating to Reduce Stress

African Americans eat high-fat foods as a way to reduce stress, which comes from living in poverty and residing in neighborhoods with inadequate housing and high crime rates, said James S. Jackson, Ph.D., of the Institute for Social Research at the University of Michigan, during a seminar at November’s Gerontological Society of America conference that was held in Orlando, Fla.

He explained that even middle-class or wealthy blacks suffer from daily microaggressions--subtle or not so subtle racist insults---in which they are unjustly viewed as thieves or suspected criminals because of their skin color.

Women clutch their purses in fear when they see black men. Armed security guards follow black male shoppers throughout stores believing black men may be there to steal, not to shop. A cop in a retail store gripping the butt of his gun at the sight of a black man who is minding his own business sends an unambiguous message of threat.

Security guards at the former Marshall Field's Department Store on Chicago’s State Street called black men "88s." That’s a white-supremacist term for "Heil Hitler," a black security guard told me. "The letter "H" is the eighth letter of the alphabet; thus the term“88.”

"Many black Americans live in chronically precarious and difficult environments," according to the study "Race and Unhealthy Behaviors: Chronic Stress, the HPA [hypothalamic pituitary adrenal cortical] Axis and Physical and Mental Health Disparities Over the Life Course."

Jackson and coauthors Katherine M. Knight, Ph.D., and Jane A. Rafferty, Ph.D., wrote, "These environments produce stressful living conditions, and often the most accessible options for

Lowe Food.png 

PhotoFather Christopher Griffin of St. Martin's greeting guests.


addressing stress are various unhealthy behaviors, e.g., smoking, drinking, drug use and so on.”

They continue, “These unhealthy behaviors may have a salubrious effect by helping stave off mental health disorders among some race groups.” But, they found, those behaviors combined with stressful living “create large physical disparities that are unfavorable to blacks."

Women Seek Comfort, Men--the Gym

Black women often reduce stress by overeating comfort foods, beginning at an early age, largely because they are encouraged to do so by their mothers, female relatives and friends.

“Overeating is an effective, early, well-learned response to chronic environmental stressors that only strengthens over the life course,” Jackson said.

African American women may not exercise because they don’t want to mess up their hair. It is expensive to have it straightened and styled with a hot curling iron. White women, on the other hand, can wash and blow-dry their hair daily and usually do this without the assistance or the expense of a hair stylist.

Black men, though, begin exercising at a young age to maintain their strength and weight. If they become competitive athletes, they have opportunities to win college scholarships and possibly play professional sports.

However, when they reach middle age, they gain weight because their bodies begin to break down, making exercise much more difficult. Unable to exercise like when they were younger to reduce stress, the men smoke cigarettes, drink alcohol and self medicate with illegal drugs.

Low-Income White Women on Drugs

Middle-age black men are not the only ones who are smoking, drinking and using illegal drugs in growing numbers.

These behaviors are occurring with much greater frequency with lower-class white women especially in rural areas because they have been pushed out of traditional low-wage jobs that require little to no education, Jackson explained. Those jobs often go to cheaper migrant labor.

The Sentencing Project, a Washington, D.C.-based think tank concerned with judicial reform, reported that the numbers of white women sentenced to prison rose 48 percent from 2000 to 2009.

In Ohio, for example, white women, many from the state's rural areas, are the fastest-growing population in Ohio prisons, according to state records.

"There's high meth use in rural white areas," Jackson said.

The growth in the use of methamphetamines and opioids has gotten the attention of Congress, which at one time wanted to lock up inmates and throw away the key when most, if not all, were black men.

With hard drug use spreading now among the white middle class and in rural areas, congressional support is growing for declaring drug abuse a health issue.

“This shows you how policy blinds you to what is going on in front of your face,” Jackson said.

Nearly 40% of Black Men, 60% of Black Women Obese

According to 2012 figures from the U.S. Centers for Disease Control and Prevention, nearly four-in-10 black men and six-in-10 black women age 20 and older were obese.

Obesity, a medical term, is characterized by excess body fat. It is calculated based on a person's height and weight, according to the National Institutes of Health, Jackson said.

"This is a very complicated issue," he explained "You have the perfect storm factors. You have gender and cultural issues.

Girls learn this behavior from their mothers who often eat big meals following Sunday church service or even daily. In so doing, mothers signal to their daughters it's OK to be overweight.”

African-American men also encourage black women to be obese.

"Being skinny isn't valued," Jackson said.

In the acclaimed 2014 movie "Top Five," starring comedian Chris Rock, the character “Silk,” played by actor J. B. Smoove, constantly hits on heavyset black women.

Complaining that women who are trim are too skinny for him, Silk even targets a policewoman, whom he suggestively urges to lock him up. When he sees another obese black woman, Silk says, "Ooh. I love a big girl. You move with a lot of confidence." A big smile lights up her face.

Such incidents are taken from real life and inevitably make their way into reel life.

Along the Chicago’s Red Line, its subway, and the elevated train, black men call obese black women beautiful, snapping their fingers in delight.

Church Dinners Provide Food and Fellowship

Sunday church dinners provide fellowship for African Americans, refuge from a world where feeling accepted is not always possible.

A half-century after the civil rights movement sit-ins, blacks may not be served in Chicago restaurants or may receive poor service to discourage their return. This reporter Chicago-based reporter was turned away from a local restaurant, even though there were plenty of empty tables. And was placed in a seating area with no service at another restaurant. The hostess wanted me to leave. I did.

But black churches along with their big meals provide a place for fellowship, a custom that began in slavery.

People are welcomed.

"Sunday was the only day blacks were free. At church, black people were somebody. They held positions in the church, such as deacon. They were honored and welcomed," Father Griffin said. "They then sat down to eat and enjoy their day."

This article was written for NorthStar News Today. com and Blackmansstreet.Today with support from a journalism fellowship awarded by New America Media and the Gerontological Society of America, sponsored by the Retirement Research Foundation.

Other Stories from New America Media:

Older Black Lives Matter--Says Top Researcher”: Racism--not one’s skin color--matters most as African Americans age, says a top gerontologist. 

“Black Health Expert Views New CA Program From the Pew,”: A former San Diego health official—a stroke patient—stresses the health role of family and black churches.

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Study Links Filial Piety to Caregiver Stress, Depression in Chinese Americans tag:newamericamedia.org,2016://19.15015 2016-02-04T08:40:00Z 2016-02-04T18:38:14Z Lotus Chau ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 Photo: Elders at Chicago’s Chinese American Service League enjoy many physically and mentally healthy activities.

Read in Chinese.

ORLANDO, Fla.--Almost three in four Chinese American family caregivers said they feel the stress and burden of caring for their elderly parents, according to a recent study from Rush University Medical Center and Northwestern University Feinberg School of Medicine in Chicago.

According to the lead researcher of the “Filial Piety Report,” Dong Xinqi, MD, MPH, who directs the Chinese Health, Aging and Policy Program at Rush, “Traditional Chinese values center around the family, and they have major effects in the organization and arrangements for the care of Chinese elderly people. As an important part of Chinese culture, filial piety determines the obligation for adult children to take care of their parents.”

Report, which Dong described at the recent conference of the Gerontological Society of America in Orlando, focuses on “filial piety and the relationship between two generations” among intergenerational Chinese families in America, he said.

Not only did the study find that 73 percent of the adult children in the survey saying they feel stress from their eldercare duties, and even depression and anxiety, but 60 percent admitted facing the potential crisis of abusing or neglecting their elder parent.

Two Generations in Conflict

The report aims to extend understanding of Chinese American family wellbeing, and is the sequel to the PINE Study, the first population-based study of Chinese older adults. The PINE Study (an acronym derived from Population study of ChINese Elderly) included 3,100 adults in the Chicago area.

For the new follow-up research, "We invited adult children aged 21 and older of the PINE participants in Chicago to participate in the piety study," said Melissa A. Simon, vice chair of clinical research at Northwestern University's Feinberg School of Medicine's Department of Obstetrics and Gynecology and the study's co-principal investigator.

Also on the research team were Bernarda “Bernie” Wong and Esther Wong, president and executive director, respectively, of the Chinese American Service League.

From 2012 to 2014, they interviewed 548 adult children, whose average age was 48. They had at least one parent of age 60 or more, who needed care. Sixty percent were female, 80 percent were married and one-third of them lived with their parents.

There are about 4 million Chinese people living in the United States. Chinese Americans are among the fastest growing ethnic groups in the U.S. Just over a half million of them are age 65 or older.

Although family-oriented values remain important in U.S. Chinese families, researchers said, Chinese adults may experience significant health problems as a result of caregiving stress. About 40 percent of family caregivers in the study rated their health as fair or poor.

'Chinese Meaning' of Filial Piety

The “Filial Piety Report” indicates that the Chinese American adult children, under the influence of the Western culture, do not fully understand the “Chinese meaning” of filial piety. At the same time, their aging parents tend to have high expectation of “filial piety.”

Because of the difference in mindset between the generations, the Chinese American adult children face much higher pressure from taking care of elders compared to other ethnic groups.

According to the report, those serving as family caregivers found one of their most difficult responsibilities to be that “parents need their children to spend an enormous amount time in providing care.”

More than half of the research respondents said they need to provide assistance for their parents’ daily living, or to find paid homecare providers. One in nine of the adult children say that they “don’t have time for rest because of the need to take care of the parents.”

In addition, because many older Chinese immigrants speak little or no English. So they face a language barrier and must rely on the children for their care while other American seniors can look to medical services to maintain their wellbeing and control their chronic illnesses.

Elder Abuse Potential

Because so many Chinese adults live with their parents or within a short distance from their parents’ home, in order to show family love or to provide care, the researchers found that six in 10 of the study participants have a “potential [for] abuse or neglect of the elderly.”

The most common issues for the adult children was their “inability to get their parents to control their temper,” “taking care of the financial affairs for their parents,” and “the inability to meet the parents’ needs.” The possibility for these behaviors to trigger an abusive reaction against an elderly parent increases substantially.

More than one of the Chinese adult children said they feel isolated, a much larger proportion than the overall American population.

Also, the researchers found anxiety to be very common among the adult children. Statistics show that more than half of Chinese adult children have such symptoms of clinical anxiety generally negative feelings or worries, agitation, chronic insomnia, feeling distraught, and restlessness.

To escape from these pressures, people who expressed a positive attitude look for emotional support in religion or in community support groups. Others turn to gambling, drinking or even playing mahjong. However, the research team emphasized that many merely utilize these devices as means of relaxation.

Dong emphasized, as well, that between 40 to 70 percent of Chinese adult children who deal with both childcare and eldercare at the same time show symptoms of clinical depression. These cases have led to their own physical illnesses, and even suicide.

Lotus Chau wrote this article for Sing Tao Daily (New York) with support from the Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America, sponsored by the Silver Century Foundation.

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Flint Water Crisis: Shameful And Deadly tag:newamericamedia.org,2016://19.15007 2016-02-02T10:05:00Z 2016-02-02T18:10:40Z Richard B. Muhammad, Audrey F. Muhammad ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103
FLINT, Michigan—Arthur Woodson, a longtime resident, sees great irony in the state’s “Pure Michigan” slogan in efforts to draw visitors in light of the pure hell residents are facing with an unhealthy water supply.

In interviews and in writing, he expressed his disgust, anger and outrage at watching residents lug bottles of water shipped in from around the country and sometimes distributed by the National Guard.

Flint’s contaminated water is unsafe to drink because of high lead levels driven by what many see as efforts to save money with too little respect for saving and preserving lives.

“The nightmare is real. The pain is real. The struggle is real for everyone living and working in Flint, Michigan. Pure Michigan? Well, not in Flint. A state surrounded by five Great Lakes has a city within it that does not have an ounce of pure water. No water that is fit to drink, cook with or even bathe in for that matter,” he said.

“Poisoned water full of lead, Legionnaire's and coliform bacteria and who knows what other contaminate is living in it. Bad water. Smelly, discolored, bad tasting, certainly not pure.”

Mr. Woodson recalls advisories to boil water to make it safe, a GM plant that stopped using Flint water because it rusted parts, alongside 18 months of residents suffering rashes, hair loss, anemia, death from Legionnaire’s disease and lead poisoning and abject failures by the governor and state agencies.

“In April 2014, Flint was forced to change it's 50 year water source from the Detroit water system back to the Flint River. That decision was made by an unelected emergency manager appointed by state of Michigan Governor, Rick Snyder. You see, since being unconstitutionally taken over by the state, elected officials in Flint have absolutely no power to make decisions,” said Mr. Woodson.

“That power belongs to Rick Snyder under his newly-created Emergency Manager Law he and the Republican-led government forced through the legislature even after it was voted down by the people of Michigan. So to save money, corrosion controls were not implemented to treat the water and this resulted in lead from old pipes leaching into the water supply creating a man-made disaster of epic proportions,” he noted.

Next came unheeded complaints about the water and incredibly in June 2015, Flint residents were paying some of the highest water bills in the country; almost eight times the national average, according to Mr. Woodson.

After legal battles water rates decreased but no money has been returned to those who over-paid for water, he said. “Still today, month after month, residents are billed for their monthly poison. In fact, as of September 2016, if residents refused to pay or can't pay for the poisoned water, shut-off notices were sent out to those households,” adding Mr. Woodson, who has been active in mounting protests about the failures in Flint.

The governor has switched Flint back to using Detroit as of Oct. 1, but Flint’s infrastructure is destroyed and $6 million from the state and a $4 million grant from the Charles Stewart Mott Foundation, with a discount on water from Detroit, will offset water costs for one year, he said.

“So tell me why are the people in Flint being charged each month for contaminated water when the water bill is already fully covered for 12 months? What's wrong with this picture?” Mr. Woodson asked.

Then there is the trauma of residents turning on faucets or showers knowing the water is poison, carrying the burden of paying for bottled water while paying a water bill, and knowing water fountains at public schools are full of lead, which is especially dangerous to children, Mr. Woodson noted.

“Can you imagine having a governor who waited almost another 60+ days to declare a Federal State of Emergency only after the nation's eyes and ears were opened when 150 protestors from Flint and Detroit showed up at the State Capitol on January 14, 2016, calling for his resignation? The State ignored all warning signs. They ignored rising complaints, ignored factual scientific data from Erin Brockovich and Virginia Tech scientist, ignored Dr. Mona Attisha after she initially discovered elevated lead levels in kids. The MDEQ ignored the process and used the wrong formula to calculate lead rates in the water,” he said.

“Governor Snyder is saying he is sorry? Tell that to all of the people of all ages that are sick, not perfectly healthy people, for example 16 and liver problems,” said Keri Webber, a Flint resident.

“He has not broken toys for these children or just overcharged a tax a little bit! No. He has poisoned 100,000 people. Snyder will be long dead and all these children and families will still be suffering from the actions of his EFM, the MDEQ, EPA and Snyder himself.”

The governor should face incarceration, “prison, yes, for reckless endangerment at the very least,” she said.

Other Flint residents are afraid because they used bottled water for years for drinking and cooking, but now showering in the water may have been unsafe.

Many want Governor Snyder to resign and face criminal charges and want others, including former Emergency Manager Darnell Earley, jailed along with the governor.

Many are upset that those local elected officials they voted for had their power usurped while the political and beauacratic overseers failed to serve and protect voters.

“As Flint has suffered yet another blow to its heart, you think the heart of Flint’s citizens is awash in poverty and blight, surrounded by land so polluted, you can't rip out the concrete slabs left in the wake of General Motors abandoning the city that gave it its birth,” added another resident, writing about the plight of the city.

“You probably think the cesspool of toxicity in the Flint River alone is the reason 100,000 people living in 30,000 homes are now facing the life threatening illnesses they each must endure, that these citizens themselves are to blame because they should have known better than to drink the water you said was safe. Mr. Snyder, the people of the Great

“This actually is an Environmental Catastrophic Disaster of a magnitude beyond explanation,” the writer said.

Flint is nearly 60 percent Black and some of the harder hit areas are overwhelmingly Black and median household income was less than $15,000 in 2014. According to census data, over 41 percent of the city population lived below the poverty level between 2009-2013.

But in Flint the catastrophe is seen as a wide one with little discrimination and little regard for poor people regardless of race and little regard for anyone regardless of race, education or income.

The catastrophe has brought people together in a struggle and there are questions also about current and future property values and income for the city—in addition to the health worries. Who wants to buy a home in Flint considering these issues?

An apology from the governor has done little to assuage fears and emails released by the governor raise the specter of buck passing and blame casting.

A day after doctors reported high levels of lead in Flint children, Gov. Snyder's top aide told him the “real responsibility” for the city's water issues rested with local government officials, emails show.

Then-chief of staff Dennis Muchmore later told the governor that residents were “caught in a swirl of misinformation” about lead contamination and that it was up to city and county leaders to confront the issue, according to the emails, which were released Jan. 20.

“Of course, some of the Flint people respond by looking for someone to blame instead of working to reduce anxiety,” Mr. Muchmore wrote. “We can't tolerate increased lead levels in any event, but it's really the city's water system that needs to deal with it.”

In a Sept. 25 email, Muchmore said he could not "figure out why the state is responsible” before noting that former state Treasurer Andy Dillon had signed off on the city’s plans to build a water pipeline from Lake Huron, which required a temporary switch to the Flint River during construction. So, he explained, “we’re not able to avoid the subject.”

Mr. Muchmore also said two state agencies and the U.S. Environmental Protection Agency could not “find evidence of a major change” in lead levels.

By early October, the Snyder administration was forced to acknowledge the validity of the lead concerns and help Flint return to the Detroit water system.

The two-term Republican released more than 270 pages of emails a day after his annual State of the State speech in which he apologized again for the emergency and pledged to act. He called the release of the messages—which are exempt from Michigan's public records law—“unprecedented” but necessary so people “know the truth.”

He did not release the emails of his staff, drawing criticism from Democrats and open-government advocates. The rest of the administration is subject to the Freedom of Information Act.

According to Muchmore's emails to Snyder, officials at the Department of Environmental Quality and the Department of Health and Human Services felt some people in Flint were trying to turn the lead issue into "a political football," claiming the agencies were underestimating the danger and trying to shift responsibility to the state.

Gov. Snyder has said he was first briefed on the “potential scope and magnitude” of the crisis on Sept. 28. State epidemiologists validated local physicians’ findings on Oct. 1, and the governor said he immediately ordered the distribution of filters along with water and blood testing.

In December, Gov. Snyder learned that the task force he appointed to investigate the crisis had concluded that the Department of Environmental Quality was primarily to blame.

The task force chairman, Ken Sikkema, said in a separate message that the finding was “critical and urgent” and could not be delayed until the group completed its report.

Snyder aide Jarrod Agen told the governor on Dec. 28 that the task force’s “harsh” verdict suggested that personnel changes at the environmental department scheduled for after the holidays should not wait. Agency Director Dan Wyant’s resignation—and the firing of three other staffers—should take effect the next day.

Gov. Snyder has asked President Barack Obama to reconsider the denial of a federal disaster declaration to address the crisis, saying it poses an “imminent and long-term threat” to residents.

President Obama declared an emergency—qualifying the city for $5 million—but concluded that the high lead levels are not a disaster based on the legal requirement that disaster money is intended for natural events such as fires or floods. Gov. Snyder had estimated a need for up to $95 million over a year.

The lead—which can lead to behavior problems and learning disabilities in children and kidney ailments in adults—has left Flint residents unable to drink unfiltered tap water.

Flint Mayor Karen Weaver refused to call for Mr. Snyder’s resignation while at the U.S. Conference of Mayors meeting in Washington, D.C., saying investigations should go forward.

“I’m staying focused on what I need to get from him right now,” Gov. Weaver said Jan. 20.

The Michigan House approved Gov. Snyder’s request for $28 million more in the short term to pay for more filters, bottled water, school nurses and testing and monitoring—on top of $10.6 million allocated in the fall. The money would also replace plumbing fixtures in schools with lead problems and help Flint with unpaid water bills. The measure moves to the Senate for expected action within a week.

Gov. Snyder plans to make a bigger request in his February budget proposal. He also announced the deployment of roughly 130 more National Guard members to the city.

(The Associated Press contributed to this report.)



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Happy Hearts: Study Shows Owning Pets Can Lower Seniors’ Blood Pressure tag:newamericamedia.org,2016://19.15005 2016-02-02T09:15:00Z 2016-02-01T20:58:55Z Erica Curless ]> http://publisher.namx.org/mt-cp.cgi?__mode=view&blog_id=19&id=103 Photo: Evelyn Schmidt’s dog Pauley is always close by her side at Moran Vista Senior Living, a pet-friendly facility that even built a dog park. (Colin Mulvany/Spokane-Review)

SPOKANE, Wash.--The black and white papillon snuggled his freckled nose against Evelyn Schmidt’s leg. Her hand patted him gently while she talked. Precious Pauley is her constant companion since her husband, Edward, died.

“He lays on my feet with his head,” Schmidt, 94, said. “If I doze off and wake up he’s still staring at me. I wouldn’t be doing as well as I’m doing now without him.”

Pauley looked up with his big eyes, as if he knew Schmidt was praising him for his good medicine -- the kind that comes in a fluffy ball of love instead of a capsule of drugs.

Love Since 10,000 BC

The benefits of animal companionship have been obvious to animal lovers for thousands of years – in fact an elderly human from 10,000 BC was found buried in northern Israel cuddling a puppy, the first find suggesting a close relationship between humans and dogs.

According to the Humane Society of the United States, Americans own about 78.2 million dogs and 86.4 million cats.

But now science--hard science, not just social science--is proving the connection’s benefits.
Researchers at Oregon State University in Corvallis recently concluded that older dog owners have significantly lower systolic blood pressure than non-dog owners. And it’s not because people with dogs get more exercise.

That means owning a dog may be a lifestyle factor that actually lowers the risk for cardiovascular disease. After publishing these findings, the team wants to investigate the why -- what the actual biomarkers are--of how dog ownership improves cardiovascular health in people 60 and older. Potential reasons are lower levels of stress, anxiety and loneliness.

Cardiovascular disease is the leading cause of death in America. By 2030, about 40.5 percent of the population is projected to have some form of the disease, according to the study.

Healthier for Hearts

The American Heart Association website states that owning pets is associated with reducing risks of heart disease, but the reasons haven’t been specifically pinpointed.

“Owning a dog may be providing companionship or a sense of purpose for older Americans,” said Eric Cerino, a doctoral student who worked on the research with a professor and five other students from varying disciplines, from human development and nutrition to biochemistry and public health. It’s part of the Integrative Graduate Education and Research Training at OSU’s Center for Healthy Aging Research and is partially funded by the National Science Foundation.

In November, the group traveled to Florida to present their findings at the Annual Scientific Meeting of the Gerontological Society of America. Cerino said the feedback was tremendous and they got encouragement to pin down the “true mechanics” of why dog ownership actually improves cardiovascular health.

“Animal-assisted therapy is really taking off as of late and we wanted to add to the literature,” said Cerino. He mentioned his own bichon named Fettuccini has helped his mental health through these tough graduate school years. The same goes for the other doctoral students on the project who have dogs, cats and even an African grey parrot named Side Kick. OSU research-team member Melissa Conley, a doctoral student in nutrition, owns a cat named Al.

Pet-Friendly Senior Living

Crystal Lorenzen, a gerontologist and marketing director of Moran Vista Senior Living on Spokane’s South Hill, wasn’t aware of the specific OSU study, but she fully encouraged the community to go 100 percent pet-friendly several years ago.

That’s one of the reasons Schmidt and her husband, along with their miniature poodle Zeus, moved there in 2010. The community even has an established dog park on a small plot of land south of the parking lot that’s fenced and includes benches for the humans and watering stations for the pups.
“We started accepting pets because they are basically part of the family,” Lorenzen said while watching Schmidt pet Pauley. “We put in the dog park because we wanted to be even more pet-friendly.”

About 17 other dogs and cats live with the 131 residents of Moran Vista.

At least once a month, a Labrador named Clark visits the residents in their Memory Care program for pet therapy. Lorenzen said the residents immediately seem calmer and more relaxed as they pet the dog and talk with him.

Schmidt perked up at the idea. “I’d like to do that,” she said, offering to bring Pauley for visits. Done.
Lorenzen agreed that it’s a great volunteer opportunity for Schmidt and Pauley. Schmidt smiled, pleased. Then she brought it up several other times during the afternoon conversation.

Cerino, whose doctoral focus is cognition in older adults, primarily those with Alzheimer’s and dementia, was thrilled to hear of such animal therapy programs in Spokane.

“I can’t tell you how important taking a dog into a memory-care unit is,” he said. “With the smiles and the laughs, it’s really increasing well-being.”

A Buffer Between Family Visits

Schmidt shrugged at the information about studies and pet ownership. She knows Pauley makes her life better. The Spokane-area native has family nearby--kids, grandkids and great-grandkids--but they are busy and visit only occasionally. Pauley, who her son found at the shelter after Zeus the poodle died, is always there.

“My family can’t be with me all the time so he’s my buffer,” Schmidt said.

Pauley licked his lips and rested his head on Schmidt’s leg. A job well done.

Erica Curless wrote this article for The Spokesman-Review in Spokane Wash., where she covers aging, with support from the Journalists in Aging Fellows Program of the Gerontological Society of America and New America Media, sponsored by The SCAN Foundation. She is a veteran journalist, who is also a certified equine massage therapist, or “horse whisperer.”

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