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Biomedical subjects

David Satcher

Publications and source records attributed to David Satcher.

At least 19 recordsLinked to original sources
PubMed2006

Enhancing cancer control programmatic and research opportunities for African-Americans through technical assistance training.

African-Americans remain severely underrepresented in cancer control program delivery and research. Community-based organizational leaders and minority junior investigators have received little attention as representatives of target populations, or as agents to deliver and evaluate efforts to eliminate cancer health disparities. This paper describes activities of the National Black Leadership Initiative on Cancer II: Network Project, which has sought to address these issues. Community leaders and junior investigators received technical assistance (TA) and mentoring to develop applications for cancer education and community-based participatory research (CBPR) projects. TA was provided to 35 community leaders and 32 junior investigators. Twenty-nine community leaders won funding through the Community Partners for Cancer Education Program. Three pilot research applications were funded. Technical assistance may improve minority recruitment/retention in CBPR cancer control research and enhance understanding and elimination of cancer health disparities among African-Americans. Cancer 2006. (c) American Cancer Society.

Black or African American↗
PubMed2006

A three-dimensional approach to the elimination of racial-ethnic disparities in lung health.

Significant racial, ethnic, and socioeconomic health disparities have been documented in asthma, lung cancer, sarcoidosis, vaccine-preventable pneumonias, tuberculosis, and HIV-related pulmonary infections. Given the complex causation of health disparities,and their resistance to simple interventions, the authors propose a three-dimensional approach for eliminating racial and ethnic health disparities in America. The three dimensions include surveillance and monitoring, research into causes and potential cures, and rapid-cycle testing of interventions to reduce or eliminate disparities.

Clinical Trials as Topic↗
PubMed2006

Achieving health equity in America.

Health disparities are both real and deadly, but disparities are not inevitable. The causes of health disparities are complex, and their elimination will require multi-dimensional interventions. We have developed a three-dimensional model for the elimination of health disparities. The foundation of public health is surveillance, which is the first dimension. We must continually measure racial-ethnic disparities in each specific disease, in its risk factors, and in outcome-relevant quality of care. The second dimension is research into the causes of disparities and potential intervention points to eliminate disparities. These causes and potential intervention points can be in the individual's biology or their behavior, or in their physical and social environment, or in the healthcare arena (quality and access). The third dimension is intervention, which requires moving from what we know to what we do. Translation must not only take knowledge from the bedside, but to the curbside and the countryside, into each community and into each home. We can achieve health equity in America, but first, we all must care enough, know enough, do enough, and persist long enough.

Cultural Characteristics↗
PubMed2005

Disparities in antidepressant treatment in Medicaid elderly diagnosed with depression.

OBJECTIVES: To determine whether there were racial or ethnic disparities in the use of antidepressants in low-income elderly patients insured by Medicaid. DESIGN: Examination of 1998 Medicaid claims data. SETTING: Centers for Medicare and Medicaid Services Medicaid claims data for five U.S. states. PARTICIPANTS: All Medicaid recipients aged 65 to 84 with a diagnosis of depression. MEASUREMENTS: Treatment versus no treatment; in those treated, treatment with drugs was classified as old- or new-generation antidepressants. RESULTS: In 1998, 7,339 unique individuals aged 65 to 84 had at least one outpatient encounter with depression as the primary diagnosis. Nearly one in four (24.2%) received no antidepressant drug therapy, and 22% received neither psychotherapy nor an antidepressant. African-American individuals were substantially more likely to be untreated (37.1%) than Hispanic (23.6%), white (22.4%), or Asian (13.8%) individuals. In logistic regression models adjusting for sex, state, long-term care status, and age group, African Americans with a primary diagnosis of depression were almost twice as likely as whites not to receive an antidepressant within the study period (odds ratio=1.91, 95% confidence interval=1.62-2.24). Patients in long-term care facilities and those aged 65 to 74 were less likely to receive treatment. CONCLUSION: Substantial numbers of elderly Medicaid enrollees with a primary diagnosis of depression did not receive antidepressants or behavioral therapy. This gap in care disproportionately affected African-American patients.

Aged↗
PubMed2005

The expanding role of the pediatrician in improving child health in the 21st century.

Children in the United States increasingly are at risk for health problems that are precipitated or exacerbated by social, community, and environmental factors. Currently, pediatricians are unable to sufficiently address these health conditions without expanding their roles beyond that of providing health care to individual patients. Thus, to improve child health, physicians must work within their communities to identify the needs of the population they serve and take appropriate action to influence the private and public policies that address these needs. Healthy People 2010 establishes a well-supported framework that confronts the social and community factors that affect children's health and serves as a resource for community-minded pediatricians. In addition to Healthy People 2010, other successful initiatives have been created by pediatricians, and they must be expanded if the pediatric community is to alleviate the social, community, and environmental factors that negatively affect child health.

Child↗
PubMed2005

Adult immunization disparities: a challenge for the public health/primary care partnership.

Vaccine preventable pneumonias account for 5% of all the years of potential life lost (YPLL) attributable to racial and ethnic health disparities. Eliminating disparities in influenza and pneumococcal vaccination rates could eliminate many of these pneumonia deaths and hospitalizations among at-risk individuals. This represents one of the most focused and achievable targets within the broader agenda of eliminating racial and ethnic health disparities, which is one of two major health goals for the nation outlined in Healthy People 2010. A broad, three-dimensional conceptual framework guiding a strong public health/primary care partnership will be required to achieve this goal.

Adult↗
PubMed2004

The health impact of resolving racial disparities: an analysis of US mortality data.

The US health system spends far more on the "technology" of care (e.g., drugs, devices) than on achieving equity in its delivery. For 1991 to 2000, we contrasted the number of lives saved by medical advances with the number of deaths attributable to excess mortality among African Americans. Medical advances averted 176,633 deaths, but equalizing the mortality rates of Whites and African Americans would have averted 886,202 deaths. Achieving equity may do more for health than perfecting the technology of care.

Black or African American↗
PubMed2004

Preventing 3 million premature deaths and helping 5 million smokers quit: a national action plan for tobacco cessation.

In August 2002, the Subcommittee on Cessation of the Interagency Committee on Smoking and Health (ICSH) was charged with developing recommendations to substantially increase rates of tobacco cessation in the United States. The subcommittee's report, A National Action Plan for Tobacco Cessation, outlines 10 recommendations for reducing premature morbidity and mortality by helping millions of Americans stop using tobacco. The plan includes both evidence-based, population-wide strategies designed to promote cessation (e.g., a national quitline network) and a Smokers' Health Fund to finance the programs (through a 2 US dollar per pack excise tax increase). The subcommittee report was presented to the ICSH (February 11, 2003), which unanimously endorsed sending it to Secretary Thompson for his consideration. In this article, we summarize the national action plan.

Cause of Death↗
PubMed2004

Modifiable determinants of healthcare utilization within the African-American population.

BACKGROUND: Significant health disparities directly affect the African-American population. Most previous studies of disparities in access to and utilization of healthcare have focused on black-white differences rather than focusing on "within-group" analysis of African Americans. OBJECTIVE: To tease out the differential effects of modifiable risk factors (such as health insurance, usual source of care, and poverty) from personal characteristics (age, gender, rural residence) on healthcare utilization within the African-American population. METHODS: Secondary data analysis of 3462 records from African-American respondents to the 1999 Medical Expenditure Panel Survey (MEPS) Household File, a nationally representative survey of the civilian, noninstitutionalized U.S. population in 1999. RESULTS: We found significant variation in the number of office visits, outpatient clinic visits, hospital discharges, days hospitalized, and fills of prescribed medication among 3462 African-American respondents who represent a U.S. population of 36,538,639 persons. Personal nonmodifiable characteristics such as age and gender were significantly related to healthcare utilization. Poverty and rural residence were also significantly correlated, but the strongest modifiable predictors of healthcare utilization for Afrcan-American persons in 1999 were whether or not individuals had health insurance and/or a usual source of care. Emergency department visits were the only form of care that showed remarkably little variation based on these modifiable risk factors. CONCLUSIONS: The three modifiable factors of poverty, uninsurance, and having a primary care medical home have a dramatic effect on patterns of care for African-American patients and could be independently targeted for intervention.

Adolescent↗
PubMed2003

Use of sentinel sites for daily monitoring of the US blood supply.

BACKGROUND: This report describes the first year of a government-sponsored program that uses daily reports from 29 sentinel sites to monitor the capacity of the US blood supply to meet demand. STUDY DESIGN AND METHODS: From August 15, 2001, to August 14, 2002, 29 sentinel sites provided daily reports of the number of units of RBCs in inventory, transfused, exported, and outdated by ABO and Rh, and platelets by random or apheresis donor. Days supply of each component category was calculated as the number of units in inventory reported on a day divided by the sum of units transfused, exported, and outdated on that day. Sites also provided daily responses to questions about threatened or actual shortages. RESULTS: The median of the days supply of RBCs at the 26 hospital transfusion services was 7.2 days. However, median days supply varied substantially by site and by day of the week. A+, O+, and O- units accounted for 30, 35, and 12 percent of total inventory and were maintained at a median supply of 7.4, 6.4, and 9.5 days, respectively. Reports of threatened RBC shortages peaked in early January 2002 and again in early July 2002. The July 2002 peak was about twice the January 2002 peak. Inventories at community-based centers were similar to those at hospital transfusion services. Hospitals maintained only a 1-day supply of platelets. Eight percent of random and 4 percent of apheresis platelets were outdated. There were 20 reports that surgery had to be postponed or canceled because platelets were unavailable. CONCLUSIONS: Inventories of RBCs maintained at the participating sites were sufficient, with only one brief exception, to meet local demand during the first year of this monitoring program. The weekly rate of threatened shortage reports was more sensitive than days inventory as a predictor of actual shortages of RBCs. Unlike RBCs, platelet days supply, reports of threatened or actual platelet shortages, and platelet outdate rates did not vary seasonally.

Blood Banks↗