Disease Management Update
Volume IV, No. 43
February 21, 2008

Dear Healthcare Intelligence Network Client,

Disparities — whether they are due to race, income, age or other factors — are a serious problem in healthcare. An average of 84,000 deaths occurred in the United States alone due to healthcare disparities, and studies show that racial and ethnic minorities receive lower-quality healthcare than non-minorities, even when insurance status, income, age and severity of conditions are comparable.

This week's Disease Management Update features one study about disparities that minority children face, while another study deals with disparities in health coverage and cancer diagnoses.

Visit HIN's blog to read more about health disparities among racial and ethnic groups.

Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at:

Table of Contents

  1. Minority Children Experience Multiple Disparities in Healthcare
  2. Disease Management Q&A: Recommended Reading Levels for Translated Materials
  3. HealthSounds Podcast: Cultural Competence in Healthcare
  4. People With Private Health Insurance More Likely To Receive Early Cancer Diagnosis
  5. Survey of the Month: Health and Wellness Coaching
  6. Cultural Diversity in Healthcare Addressing the Challenges of a Multicultural Society

1. Minority Children Experience Multiple Disparities in Healthcare

There is a lack of equity in healthcare for minority children in America, according to data gathered in a nationwide survey and analyzed by a University of Texas Southwestern Medical Center (UT Southwestern) researcher. The analysis, available online and published as an abstract in the February issue of the journal Pediatrics, suggests certain disparities are particularly pronounced for specific racial and ethnic groups. Awareness of these disparities may be useful for clinicians, health systems and policymakers to address the needs of diverse populations, said Dr. Glenn Flores, professor of pediatrics at UT Southwestern and lead author of the study.

“Greater attention needs to be paid to disparities in minority children, not just because of their striking frequency and magnitude, but also because of their potential to become disparities in adults,” said Dr. Flores. “Conservative estimates indicate that minorities will comprise half of U.S. children by 2040. In Texas, more than 62 percent of children currently are non-white. Although increasing attention is being paid to racial and ethnic disparities in health care, very little attention is directed toward children.”

To learn more about this analysis, please visit:

2. Disease Management Q&A: Recommended Reading Levels for Translated Materials

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's experts are Loretta Estes, coordinator, cultural and linguistics services, Passport Health Plan, and Elsa Batica, cross-cultural health development and training manager, Children's Hospital and Clinic in Minneapolis.

Question: Do you have a recommended reading level for written materials for preventative services in either low socioeconomic status populations or for children? Also, is there a Web site or written reference indicating how to go about doing that?

Response: (Loretta Estes) Since we're a managed care organization for Medicaid, all of our material, English or Spanish, has to be written at a sixth-grade reading level. I do not know of any referential Web-based tools, but I've been doing more research on health literacy and that would be one way to try to find some. We do check the grade level in Microsoft Word when we're working on the information.

(Elsa Batica) At Children's we include “age-appropriate communication” as part of the first day of orientation. It's a very well-developed curriculum. As a pediatric hospital, we have to relearn to communicate at the children's level and how to communicate to the parents. For most of our materials, we follow the guidelines for Medicaid. Our materials are written at anywhere from a sixth- to a tenth-grade level.

For more information on cultural competency in healthcare, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: Cultural Competence in Healthcare

In this week's Disease Management podcast, Elsa Batica, cross-cultural health development and training manager with Children's Hospitals and Clinics of Minnesota, gives her personal perspective on cultural competence and discusses how her organization takes advantage of community resources. Patti Ludwig-Beymer, administrative director for nursing research and education, Edward Hospital and Health Services, discusses the importance of staff education in building a culturally competent organization and viewing cultural competence as a process rather than an outcome.

To listen to this complimentary HIN podcast, please visit:

4. People With Private Health Insurance More Likely To Receive Early Cancer Diagnosis

Uninsured U.S. residents and Medicaid beneficiaries are more likely than people with private health insurance to be diagnosed with cancer in late stages, which reduces their chances for survival, according to a recent study by the American Cancer Society. The study, which examined data from the National Cancer Database on 3.7 million people who were diagnosed with 12 types of cancer from 1998 to 2004, found that among cancers that could be detected early through standard screening or assessment of symptoms, uninsured patients were two to three times more likely than those with private coverage to be diagnosed in Stage III or Stage IV rather than Stage I. Smaller disparities were found in the diagnosis of non-Hodgkins lymphoma and cancers of the bladder, kidney, prostate, thyroid, uterus, ovary and pancreas.

The study also found that blacks have a higher risk of being diagnosed in later stages compared with whites, regardless of insurance status. The disparities in diagnoses for 10 of the 12 cancers examined were statistically significant for blacks when compared with whites. Hispanics also had higher risks than whites for later diagnoses, but not as high as blacks. The study's authors attributed racial disparities in cancer diagnoses to a lack of health literacy and an inadequate number of healthcare providers in minority communities.

To see more of this study's results, please visit:

5. Survey of the Month: Health and Wellness Coaching

Complete our online survey on health and wellness coaching by February 29, and you'll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Cultural Diversity in Healthcare Addressing the Challenges of a Multicultural Society

Changing demographics, extensive mobility and upsurges in ethnic diversity present new demands for cultural competency in healthcare. Often, organizations are ill-equipped to handle specific challenges associated with such increases, including surpassing linguistic barriers and paying adequate attention to cultural sensitivities. To that effect, some progressive organizations are implementing diversity training to teach professionals how to better accommodate the needs of an increasingly socially and ethnically stratified population.

To download this complimentary white paper, please visit:
Please forward this news announcement to your colleagues who might find it useful.
Contact HIN: For more information on the products and services available through the Healthcare Intelligence Network, contact us at (888) 446-3530 / (732) 528-4468, fax (732) 292-3073 or email us at info@hin.com.
All contents of this message Copyright 2008