tag:blogger.com,1999:blog-14431783818469343122024-03-13T12:29:44.669-07:00Mission: Health Equity sorayahttp://www.blogger.com/profile/14780792746786453756noreply@blogger.comBlogger40125tag:blogger.com,1999:blog-1443178381846934312.post-71551254777759241652016-12-19T08:57:00.000-08:002016-12-19T10:52:32.930-08:00Confronting Complacency in the Face of Calamity: Mobilizing for the Home Front War Against Diabetes<span style="font-family: "verdana" , sans-serif;"><span style="font-size: small;"><b>by Dean Schillinger, MD</b></span></span><br>
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: small;"><br></span></span>
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<span style="font-family: "verdana" , sans-serif;"><span style="font-size: small;">Please see the recent <a href="http://symbiosisonlinepublishing.com/endocrinology-diabetes/endocrinology-diabetes63.pdf" target="_blank">th</a><span style="font-family: "verdana" , sans-serif;"><a href="http://symbiosisonlinepublishing.com/endocrinology-diabetes/endocrinology-diabetes63.pdf" target="_blank">ought</a><span style="font-family: "verdana" , sans-serif;"><a href="http://symbiosisonlinepublishing.com/endocrinology-diabetes/endocrinology-diabetes63.pdf" target="_blank">piece in the Journal of End</a><span style="font-family: "verdana" , sans-serif;"><a href="http://symbiosisonlinepublishing.com/endocrinology-diabetes/endocrinology-diabetes63.pdf" target="_blank">ocrinology and Diab</a><span style="font-family: "verdana" , sans-serif;"><a href="http://symbiosisonlinepublishing.com/endocrinology-diabetes/endocrinology-diabetes63.pdf" target="_blank">etes. </a></span></span></span></span></span></span><span style="font-family: "verdana" , sans-serif;"></span><br>
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: small;"></span></span><br>
<a href="http://mission-healthequity.blogspot.com/2016/11/confronting-complacency-in-face-of.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-24792136027657888102016-12-13T12:06:00.002-08:002016-12-13T12:18:29.577-08:00Their Values and Ours<b>By Alicia Fernandez, MD</b><br>
<br>
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A really important <a href="http://www.nejm.org/doi/full/10.1056/NEJMp1608326#t=article" target="_blank">Perspective piece was published recently in the NEJM</a>, and I am proud to say that one of our colleagues,
Margot Kushel, was senior author. </div>
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<br>
</div><a href="http://mission-healthequity.blogspot.com/2016/12/their-values-and-ours.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-27837952266831923942016-08-30T09:22:00.003-07:002016-08-30T09:22:31.274-07:00Cautionary tale of health disparities in the age of precision medicine <!--[if gte mso 9]><xml>
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><b>by Kirsten
Bibbins-Domingo, PhD, MD, MAS</b></span></span></div>
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><b> </b>
</span></span></div>
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Many of us do not routinely read the genetic literature, but
for those of us interested in health disparities, a study in <a href="http://www.nejm.org/doi/full/10.1056/NEJMsa1507092" target="_blank">this week’s NEJM</a> and its implications are critically
important. </span></span></div>
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<a href="http://mission-healthequity.blogspot.com/2016/08/cautionary-tale-of-health-disparities.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-6442085717373688742016-08-01T14:58:00.001-07:002016-08-01T14:58:38.938-07:00Science and Public Health on Trial<!--[if gte mso 9]><xml>
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><b>by Dean Schillinger, MD </b></span></span></div>
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<br /></div>
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Our purpose in writing this piece was to alert the
scientific, clinical, and public health communities about the outcome of the
landmark decision<span> </span>regarding warning
notices on advertisements for sugar sweetened beverages (SSBs) and explain its
legal underpinnings. We also wanted to show this as an exemplar of how industry-misappropriated scientific language and scientific methods to hijack science
and public health and obfuscate scientific truth and introduce controversy
regarding associations between their products (in this case SSBs) and health
harms (in this case obesity, diabetes, and tooth decay). Finally, we wanted to
highlight the importance of such policy efforts for improving the health of
at-risk populations, including children, ethnic minorities, and individuals with
limited health literacy.</span></span></div>
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<br /></div>
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Click below to read the full JAMA viewpoint: </span></span></div>
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><a href="http://jama.jamanetwork.com/article.aspx?articleID=2542158">http://jama.jamanetwork.com/article.aspx?articleID=2542158</a></span></span> </div>
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<![endif]-->courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-2212978855302681752016-06-13T09:09:00.000-07:002016-06-13T09:09:14.892-07:00Citizen Engagement in Precision Public Health<div class="MsoNormal">
<b><span style="font-family: Verdana, sans-serif;">By Courtney Lyles, PhD and Kirsten Bibbins-Domingo, MD, PhD<o:p></o:p></span></b></div>
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<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif;">At the <a href="https://www.ucsf.edu/news/2016/05/403091/white-house-and-gates-foundation-convene-precision-public-health-summit-ucsf">Precision
Public Health Summit</a> held this week at UCSF (sponsored by the Bill and
Melinda Gates Foundation and the White House Office of Science, Technology, and
Policy: see), we were inspired by many great discussions and ideas. While the field is still figuring out how to
define and conceptualize the core elements of “precision public health,” a
broad interpretation that is relatively simple and straightforward includes: a discipline for using the best methodologies
and datasets to tailor interventions (from medical screenings and treatments,
to community wellness and prevention programs, to science-informed advocacy and
policy) that better meet the needs and priorities of local communities and
individuals. </span></div>
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<span style="font-family: Verdana, sans-serif;"></span></div>
<a href="http://mission-healthequity.blogspot.com/2016/06/citizen-engagement-in-precision-public.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com1tag:blogger.com,1999:blog-1443178381846934312.post-80302115120752557582016-02-19T08:51:00.001-08:002016-02-19T11:49:15.234-08:00 Dean Schillinger Receives 2016 James Irvine Foundation Award <span style="font-family: "verdana" , sans-serif;"><span style="font-family: "verdana" , sans-serif; font-size: small;"><span style="font-size: x-small;">Congratulations to our Chief of the Division of General Internal Medicine on receiving the prestigious James Irvine Foundation Award!</span></span></span><br>
<br>
<span style="font-family: "verdana" , sans-serif;"><span style="font-family: "verdana" , sans-serif; font-size: small;"><span style="font-size: x-small;"><span style="font-family: "verdana" , sans-serif;">B<span style="font-family: "verdana" , sans-serif;">elow</span></span> is his acceptance speech and a link to th<span style="font-family: "verdana" , sans-serif;">e UCSF article about the award</span>:</span></span></span><br>
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</div><a href="http://mission-healthequity.blogspot.com/2016/02/dean-schillinger-receives-2016-james.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com1tag:blogger.com,1999:blog-1443178381846934312.post-11654791222997256942015-11-05T11:50:00.000-08:002015-11-05T11:50:15.129-08:00Digital literacy and what it means for healthcare<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif;"><b>by Courtney Lyles, PhD</b></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif;"><br></span></div>
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<span style="font-family: Verdana, sans-serif;">Should healthcare organizations be taking a major role in
increasing the overall digital literacy of their patients? <o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif;"><br></span></div>
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<span style="font-family: Verdana, sans-serif;">In my last post I talked about how most patients in our
health system, the SFHN, want to use the internet to manage their health care
and health, but don’t have the proficiency they need to be able to do so. I
wanted to take that idea one step further. If our patients often can look
something up on Google but don’t know how to use an email account (which is
often required for signing up to access your electronic health record online) –
should we be providing them with basic technology classes? The answer I keep coming back to is “yes,”
and here are a few reasons why:</span></div>
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<span style="font-family: Verdana, sans-serif;"><o:p></o:p></span></div>
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<a href="http://mission-healthequity.blogspot.com/2015/11/digital-literacy-and-what-it-means-for.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com2tag:blogger.com,1999:blog-1443178381846934312.post-53137503271673950742015-10-14T13:07:00.000-07:002015-10-15T08:52:26.161-07:00Partnerships to Prevent Violence: ARISE<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif;"><b>By Leigh Kimberg, MD</b></span></div>
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<span style="font-family: Verdana, sans-serif;"><br></span></div>
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<span style="font-family: Verdana, sans-serif;">Each day, an overwhelming majority of our patients arrive in
clinic wishing that their healthcare providers would ask them questions about
how their personal relationships affect their health and, more specifically,
whether an intimate partner, family member or other person has hurt or threatened
them. And, despite the requirement by
the <a href="https://www.womenshealth.gov/publications/our-publications/fact-sheet/screening-counseling-fact-sheet.html">Affordable
Care Act</a> that all women and girls be offered interpersonal violence (IPV)
(intimate partner violence and sexual assault) screening, brief counseling and
referral, healthcare providers and healthcare systems have not institutionalized
this practice. “Aspire to Realize
Improved Safety and Empowerment” (ARISE), a partnership program newly funded by
the <a href="http://womenshealth.gov/violence-against-women/government-in-action/index.html">Office
of Women’s Health</a> in the US Department of Health and Human Services, will
fully institutionalize these life-saving practices in the San Francisco Health
Network primary care system.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif;"></span><br>
</div><a href="http://mission-healthequity.blogspot.com/2015/10/partnerships-to-prevent-violence-arise.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com1tag:blogger.com,1999:blog-1443178381846934312.post-17327634784405054532015-09-02T21:01:00.000-07:002015-09-17T22:30:49.305-07:00“Where Can This Person Go?”: A Plea for the Expansion of Medical Respite Services <br>
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<span style="font-size: 13.3333330154419px;"> </span><img src="http://img.scoop.it/6KB7dEPYrNtgpLg-ch0q5jl72eJkfbmt4t8yenImKBVvK0kTmF0xjctABnaLJIm9" height="125" width="200"><br>
<br></div>
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<span style="color: #999999; font-size: 13.3333330154419px;"><span style="background-color: white; font-size: 13.3333330154419px;"><b>by Soraya Azari, MD</b></span></span><br>
<span style="font-size: 13.3333330154419px;"><br></span>
<span style="font-size: 13.3333330154419px;">While recently working in the hospital I was often asked by my interns and medical students: “so where can this person go?”</span><span style="font-size: 13.3333330154419px;"> </span><span style="font-size: 13.3333330154419px;"> </span><span style="font-size: 13.3333330154419px;">An example: a 53 year old homeless man, wheelchair-bound from prior injuries, who had his wheelchair stolen during an assault, which led to pneumonia and hospitalization.</span><span style="font-size: 13.3333330154419px;"> </span><span style="font-size: 13.3333330154419px;"> </span><span style="font-size: 13.3333330154419px;">He quickly improved with intravenous antibiotics, was medically stable, and no longer met criteria for inpatient hospitalization.</span><span style="font-size: 13.3333330154419px;"> </span><span style="font-size: 13.3333330154419px;"> </span><span style="font-size: 13.3333330154419px;">So then the question is where should he go?</span><span style="font-size: 13.3333330154419px;"> </span></div>
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<span style="font-size: 13.3333330154419px;"></span><br>
</div><a href="http://mission-healthequity.blogspot.com/2015/09/where-can-this-person-go-plea-for.html#more">Read more »</a>sorayahttp://www.blogger.com/profile/14780792746786453756noreply@blogger.com2tag:blogger.com,1999:blog-1443178381846934312.post-63476320249504609152015-07-23T14:54:00.001-07:002015-07-28T09:51:19.910-07:00Moral Compass<b><span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">By Dean Schillinger, MD</span></span></b><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Dear Colleagues,</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Today we are releasing a new film, "Biker with a Moral Compass: Dr. Dick Fine and the Evolving Culture of SFGH", a documentary portraying and paying tribute to the life, times and contributions of UCSF and SFGH physician Dick Fine MD, Founder and Former Director of the General Medicine Clinic, among many things.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Please feel free to share this film with colleagues, friends, and family, and consider using it as part of your health professions trainings. </span></span><br />
<br />
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><u>Finally,
I would like to take this opportunity to ask you to consider making a
donation on behalf of Dick, and in support of the many causes he has
steadfastly stood for</u>.
The San Francisco General Hospital Foundation has created the Richard
H. Fine Fund, whose purpose is to support education, clinical
innovation, and discovery in The Richard H Fine People's Clinic. You can
donate here:</span></span></div>
<ul>
<li><span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Go to </span></span><span style="color: #0000ee; font-family: Verdana, sans-serif;"><u><a href="https://sfghf.org/support-us/donate/">https://sfghf.org/support-us/donate/</a></u></span></li>
<li><span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Under
the “Please use my Gift” section select “For the following Program or
Department” and write in “In Honor of Richard H Fine DGIM Fund”</span></span> </li>
</ul>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"> Now....ENJOY THE SHOW !</span></span><br />
<br />
<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/pk_cmPS_zaA" width="560"></iframe>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-76050368899536658932015-07-14T11:03:00.001-07:002015-07-14T11:03:40.020-07:00Connecting the dots: Health information technology expansion and health disparities<b>By Courtney Lyles, PhD, Dean Schillinger, MD and Urmimala Sarkar, MD, MPH</b><br />
<br />
Check out our newest essay in PLOS Medicine outlining how health technology could be better designed and implemented to meet the needs of diverse patient populations:<br />
<br />
<span lang="EN-GB" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-ansi-language: EN-GB; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><a href="http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001852">http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001852</a></span>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-5791913850772364812015-06-18T09:31:00.001-07:002015-06-18T09:33:07.095-07:00Making Older Homelessness a Never Event<div class="profiletweet-text">
<b><span style="font-family: Verdana, sans-serif;">by Margot Kushel, MD</span></b></div>
<div class="profiletweet-text">
<br></div>
<div class="profiletweet-text">
<span style="font-family: Verdana, sans-serif;"><span lang="EN">On April
2, Bevan Dufty, (@BevanDufty) the director of the <a href="http://www.sfmayor.org/index.aspx?page=904">HOPE program</a> (Housing
Opportunity, Partnerships and Engagement) for San Francisco (aka the official
responsible for addressing homeless services and outcomes), posted the <a href="https://twitter.com/BevanDufty/status/583741862797684736">following
message</a> to his 4500 followers on twitter: “86-year old staying </span><a href="https://twitter.com/ECS_SF"><s><span lang="EN">@</span></s><b><span lang="EN">ECS_SF</span></b></a><span lang="EN"> Next Door Polk/Geary shelter needs help
walking/feeding small dog. Without dog, client likely returns to street.”<o:p></o:p></span></span></div>
<div class="profiletweet-text">
<span lang="EN"><span style="font-family: Verdana, sans-serif;"></span></span><br>
</div><a href="http://mission-healthequity.blogspot.com/2015/06/making-older-homelessness-never-event.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-43704475000795010412015-05-18T11:09:00.000-07:002015-05-18T11:12:03.838-07:00The future is already here, it just not very evenly distributed. <div class="MsoNormal">
<b><span style="font-family: Verdana, sans-serif;">By Courtney Lyles, PhD</span></b></div>
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<span style="font-family: Verdana, sans-serif;"><br></span></div>
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<span style="font-family: Verdana, sans-serif;"><o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif;">The title of this blog post is a quote by science fiction
author William Gibson (who coined the phrase many years ago, by the way). And I think it is spot on in a number of
ways. It is clear that so many seemingly
futuristic technologies have already been developed: from using your smartphone
to <a href="https://ginger.io/static/docs/Ginger.io%20Overview%20for%20Providers.pdf">passively
track</a> your activity and mood, to the development of a sensor to test blood
glucose <a href="http://www.cnbc.com/id/102337534">through the skin</a> without drawing blood. But the reality that is so clear to us
working in the safety net is that most of these tools are not distributed to
those who need it most, and sometimes even only make their way to our settings
after they become somewhat obsolete in the tech space.<o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif;"></span><br>
</div><a href="http://mission-healthequity.blogspot.com/2015/05/the-future-is-already-here-it-just-not.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-37971063795034185032015-05-12T13:22:00.001-07:002015-05-12T13:23:37.157-07:00Primary Care residency alumnae in UCSF Frontiers of Medicine for work in Navajo NationTwo of our recent graduates from the <a href="http://dgim.ucsf.edu/education/sfgh/history.html" target="_blank">SFPC residency program</a>, Drs. Mia Lozada and Jennie Wei, were featured in an article, "You Will Become Well", in the UCSF Frontiers of Medicine spring issue. The article highlighted their dedicated work caring for patients in Navajo Nation in New Mexico at the Gallup Indian Medical Center.<br />
<br />
Click <a href="https://medicine.ucsf.edu/news/fom/frontiers.html?key=101&title=You+Will+Become+Well" target="_blank">here</a> to read more about their work improving health for underserved patients without running water or electricity, in rural and inaccessible communities, and with hugely different cultural expectations and references.<br />
<br />
We are so proud of the work they are doing, including starting the first transgender clinic in Navajo Nation and diving into the quality improvement work at their health center! <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXpaqN594V8NrA1xkE5H2NZ5hDqwnte7XqVPRaBJuvze-wUwxTEnAJNdAxeolWcwyK3QwHWDSRznY53wkM7aZ0PKDnBynWPlf6-u__uC-y24tH8o6E08JfZklbbp1sTiY5NogEvnfBfVis/s1600/spring15_alumni.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXpaqN594V8NrA1xkE5H2NZ5hDqwnte7XqVPRaBJuvze-wUwxTEnAJNdAxeolWcwyK3QwHWDSRznY53wkM7aZ0PKDnBynWPlf6-u__uC-y24tH8o6E08JfZklbbp1sTiY5NogEvnfBfVis/s320/spring15_alumni.jpg" width="135" /></a></div>
<br />Annahttp://www.blogger.com/profile/12166775761465213662noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-46315723821897692572015-04-27T09:07:00.003-07:002015-04-27T09:07:46.198-07:00From e-patients to all patients<h2>
by Urmimala Sarkar, MD MPH</h2>
As a primary care provider practicing in the safety net, I
work with incredibly diverse patients with chronic illness. My patients have a
wide range of beliefs and preferences about how to best manage their health. I believe
their varied perspectives, if more widely shared, could meaningfully improve
health care.<br>
<br>
<a href="http://mission-healthequity.blogspot.com/2015/04/from-e-patients-to-all-patients.html#more">Read more »</a>Anonymoushttp://www.blogger.com/profile/08109899774867205294noreply@blogger.com1tag:blogger.com,1999:blog-1443178381846934312.post-72694318117510061092015-03-23T21:00:00.002-07:002015-03-23T21:05:01.088-07:00Introducing the Next Generation of Primary Care Leaders for the Under-served!<span style="font-family: inherit;">For those of your that may not know, Friday, March 20 was <a href="http://www.nrmp%2Corg/">Match Day</a> - the much-anticipated day in which medical students find out where they will do their residency training. For those that may not be in medicine, the path to an MD (medical doctor) degree includes (typically) - 4 years of college, then 4 years of medical school, and then 3-7 years of residency training, depending on what field you decide to pursue.</span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">I am fortunate to be the Associate Program Director for a residency track called the San Francisco General Primary Care program, or </span><a href="http://dgim.ucsf.edu/education/sfgh/history.html" style="font-family: inherit;">SFPC</a><span style="font-family: inherit;">, which is a track within the University of California, San Francisco Internal Medicine </span><a href="http://medicine.ucsf.edu/education/residency/program/tracks.html" style="font-family: inherit;">residency program</a><span style="font-family: inherit;">. Every year we recruit eight outstanding individuals that exhibit a true commitment to primary care for under-served populations. </span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Given the leadership roles that our graduates go on to play in caring for vulnerable populations, it gives me great privilege to introduce the newest 8! </span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNnRpOOOP2NcALobYaD6xno-f89_JVVGjuCxU9POnFU9dr2Wy_k6UzSRFvhWYmPYFEOosYpdbsc6l4d0x3ZH69b_jamepHYGCuD-8JHw9KJU19VVYCQpmPgoXTCLRZekLzsbfBVffh/s1600/interns.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="color: black;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNnRpOOOP2NcALobYaD6xno-f89_JVVGjuCxU9POnFU9dr2Wy_k6UzSRFvhWYmPYFEOosYpdbsc6l4d0x3ZH69b_jamepHYGCuD-8JHw9KJU19VVYCQpmPgoXTCLRZekLzsbfBVffh/s1600/interns.png" height="301" width="400" /></span></a><br />
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<b><span style="font-family: inherit;">Chloe Ciccariello </span></b></div>
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<span style="font-family: inherit;">Chloe is finishing medical school at Mt. Sinai's Icahn School of Medicine. She worked previously as a peer educator, and elaborated on those skills while at Mt. Sinai taking on several leadership positions within the East Harlem Health Outreach Partnership (EHHOP) Clinic. She has also been involved in Primary Care Progress, working towards the goal of having more trainees pursue careers in primary care. </span></div>
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<b><span style="font-family: inherit;">Matt Hickey</span></b></div>
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<span style="font-family: inherit;">Matt is completing medical school at the University of California, San Francisco. He has a strong, long-standing interest in global health and HIV care, most recently working on a project about engaging social networks to aid in HIV treatment. He has also worked on decreasing conflict of interest among academic educators, and education programs for youth. </span></div>
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<b><span style="font-family: inherit;">Ashley McMullen </span></b></div>
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<span style="font-family: inherit;">Ashley will be coming from the University of Texas, Houston School of Medicine. She has significant experience in basic science research on tuberculosis, but has developed increasing interest in HIV primary care, working with homeless adults, and advocacy. She has also developed educational opportunities for peers on the topics of street medicine and HIV care.</span></div>
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<b><span style="font-family: inherit;">Alicia Morehead-Gee</span></b></div>
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<span style="font-family: inherit;">Alicia is currently enrolled at the University of California, Los Angeles (UCLA) Drew School of Medicine. Alicia has researched several underserved populations, including HIV-positive adults in South Los Angeles suffering from mental illness and rural Ghanaians. She also has served in leadership roles with the Student National Medical Association (SNMA) and has consistently worked on mentorship and pipeline programs for youth. </span></div>
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<b><span style="font-family: inherit;">Kenny Pettersen</span></b></div>
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<span style="font-family: inherit;">Kenny is finishing medical school at the University of California, San Francisco. Kenny has been a leader in UCSF's student-run Homeless Clinic and has established several programs and performed research in Haiti. He is particularly interested in the role of informational technology in aiding chronic disease management abroad. </span></div>
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<b><span style="font-family: inherit;">Arjun Suri</span></b></div>
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<span style="font-family: inherit;">Arjun will be graduating medical school from Harvard. He has extensive experience working abroad - most recently in Cuba to understand primary care and social medicine training, but also in Peru related to community-driven approaches to quality improvement, and India studying neonatal and maternal health. He is also very interested in systems improvements within urban, public hospitals. </span></div>
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<b><span style="font-family: inherit;">Emily Thomas</span></b></div>
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<span style="font-family: inherit;">Emily is completing medical school at Yale University. She has been particularly interested in studying incarcerated populations and characterizing the health disparities that exist among these individuals. She has also been involved in the student-run free clinic (HAVEN) and supporting fellow students to participate in service activities while at Yale. </span></div>
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<b><span style="font-family: inherit;">Jessica Wang</span></b></div>
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<span style="font-family: inherit;">Jessica is finishing medical school at Yale University, as well. She is interested in improving patient safety by decreasing medication errors. She has also been an active leader in several student-run free clinics at Yale (HAVEN, Neighborhood Health Project). She aims to be a provider and educator in the service of vulnerable patients. </span></div>
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<span style="font-family: inherit;">We feel incredibly fortunate to have this group joining our community - Congratulations and Wel</span><span style="font-family: inherit; font-size: x-small;">come!! </span></div>
sorayahttp://www.blogger.com/profile/14780792746786453756noreply@blogger.com1tag:blogger.com,1999:blog-1443178381846934312.post-65126123838478361382015-03-13T14:59:00.003-07:002015-03-13T20:12:16.205-07:00State of the research on online patient portals<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif;"><b>By Courtney Lyles, PhD</b></span></div>
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<span style="font-family: Verdana, sans-serif;"><br></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif;">My main area of research over the past few years has focused
on getting diverse patient groups to engage in accessing their medical record
information online, through websites called online patient portals that are
linked to electronic health record systems in hospitals/clinics. Portals
typically involve allowing patients access to viewing their test results, visit
summaries, and sometimes emailing with providers. Because most healthcare
systems (with the exception of places like Kaiser) have only just recently
created these portal websites as a part of the Meaningful Use certification
process, there is a huge need for research studying their use and
effectiveness. <o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif;"><br></span></div>
<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif;">This post includes my thoughts about what we know and don’t
know from the research to date, especially in light of two recent systematic
reviews on 1) <a href="http://www.jmir.org/2015/2/e44/">the effect of portals
on outcomes</a> and 2) <a href="http://www.jmir.org/2015/2/e40/">how patients with chronic disease and
their providers</a> view using an online portal. (Apologies in advance that it is a very
research-specific post!)<o:p></o:p></span></div>
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<a href="http://mission-healthequity.blogspot.com/2015/03/state-of-research-on-online-patient.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com3tag:blogger.com,1999:blog-1443178381846934312.post-79645775857958116272015-03-09T09:12:00.000-07:002015-03-09T09:12:50.307-07:00Achieving Health Equity is Risky Business: Secondhand Smoke and Vulnerable Populations<span style="background-color: white;"><b><span style="font-size: large;"><a href="http://profiles.ucsf.edu/dean.schillinger">By Dean Schillinger, MD</a></span></b></span><br>
<span style="background-color: white;"><b><span style="font-size: large;"><br></span></b></span>
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The constructs of “vulnerable populations” and “vulnerability” have increasingly gained a foothold in the fields of Clinical Medicine, Genetics, Epidemiology and Public Health. <i>Vulnerability</i>, outside of the health context, is broadly defined as <i>susceptibility to attack or to physical or emotional damage</i>. In Public Health, vulnerable populations are typically conceptualized as culturally, economically, geographically or socially defined groups who experience health disparities in relation to a pre-defined dominant (e.g. less vulnerable or invulnerable) group. In Epidemiology, however, vulnerable populations are characterized as groups who experience “<i>greater risk of risk</i>s.” This framing of vulnerability acknowledges that (a) health or illness is often a result of social risks that give rise to environmental exposures (or risks), and (b) these social and environmental risks compound one another to generate a higher and higher risk of being exposed to a causative agent, either at one point in time, or over the life course. <o:p></o:p></div>
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<a href="http://mission-healthequity.blogspot.com/2015/03/achieving-health-equity-is-risky.html#more">Read more »</a>Anonymoushttp://www.blogger.com/profile/08109899774867205294noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-30404599009884079052015-02-13T14:18:00.000-08:002015-02-19T12:17:33.681-08:00A Trip to Rikers Island: The Community Aging Health Project and Aging Criminal Justice Populations<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Geriatrics
may seem tame, but so far it has taken me to SF County Jail and, recently, to
Rikers Island. </span></span><br />
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLMkR_EOt3NbOUxOlouuADPQGFDbgt6dkLyS81v76j_2tvPRxmMAggooQtUuZ4QC9Eepbl6QNzX3CVl918he74kEnkFXnXMhIeLdQSWAaWJ097Zqu_SU-Iwy4c7qZRKJf-KAMOhdzwk_6n/s1600/timgruberservedout09-630.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLMkR_EOt3NbOUxOlouuADPQGFDbgt6dkLyS81v76j_2tvPRxmMAggooQtUuZ4QC9Eepbl6QNzX3CVl918he74kEnkFXnXMhIeLdQSWAaWJ097Zqu_SU-Iwy4c7qZRKJf-KAMOhdzwk_6n/s1600/timgruberservedout09-630.jpg" height="213" width="320" /></a></span></span></div>
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I and several other geriatricians were hosted by the medical services and the Deputy Medical Director, Dr. Zachary
Rosner, our guide through multiple checkpoint and buildings. With this crew of geriatricians, we spent a day and
a half doing trainings for about 30 health services staff and 30 correctional
officers as part of <a href="http://profiles.ucsf.edu/brie.williams">Dr.
Brie Williams</a>' <a href="http://www.tideswellucsf.org/community-aging-health-project/">Community
Aging Health Project</a> (CAHP). We did hands-on exercises on geriatric
syndromes such as hearing and vision loss, dementia, incontinence, medication
issues, mobility impairment and assistive devices, and we even taught exercises for
inmates to do in their cells to prevent falls. We helped them think about critical issues,
such as when “behavior” could be a sign of dementia, or failure to follow an
order may be a sign of hearing loss.</span></span></div>
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">There
is no corner of U.S. society that is not affected by growing numbers of older
adults in our population. <a href="http://www.citylab.com/crime/2014/09/prisons-are-facing-aging-populations-too/379972/">This
includes jail and prison populations.</a> While the US population saw a
doubling of adults over 55 years old from 1990 to 2009, in prisons<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374923/"> the number more
than tripled</a>. </span></span></div>
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">This
presents problems for many who serve criminal justice-involved
populations. Older criminal justice populations have more chronic health
conditions and different social service needs. Functional impairments can
impact their ability to care for themselves independently, inside and
outside of correctional environments. On all fronts-- "inside" and
"outside"-- the need is growing for geriatrics training and
sensitivity.</span></span></div>
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixmQukZmVn2iguKiLCEf9gyN8JnB44Smj1QYwDG3w1J0fqafJlumJZRdkj9ZFVUme4NhYykAAnN49pTsIOXC3aFmN9faOWZ6siiQR8mlljOf0E5805gcjVk6uuYqZUgFMsbSZ5kyZ9gc6a/s1600/800px-USGS_Rikers_Island.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixmQukZmVn2iguKiLCEf9gyN8JnB44Smj1QYwDG3w1J0fqafJlumJZRdkj9ZFVUme4NhYykAAnN49pTsIOXC3aFmN9faOWZ6siiQR8mlljOf0E5805gcjVk6uuYqZUgFMsbSZ5kyZ9gc6a/s1600/800px-USGS_Rikers_Island.png" height="262" width="320" /></a></span></span></div>
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Dr.
Willams has made this need her mission. CAHP, supported by <a href="http://www.tideswellucsf.org/">Tideswell at UCSF</a> and the <a href="https://www.langeloth.org/grants_more.php?id=2012">Langeloth Foundation</a>,
developed geriatrics training for a spectrum of professional networks that face
the reality of an aging criminal justice population-- social workers,
correctional offers, police, and jail and prison health service providers. They
have already delivered many trainings across California to jail and prison health
services staff, correctional officers, and SF police. </span></span></div>
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Rikers
Island was the first dissemination site.
“The Island” is New York City's main jail though it is actually a huge
complex of buildings, accessed by only one bridge. It has many buildings;
one is a woman's facility ("Rosie's") and the rest of the 10 jails
are for men. Rikers also has an extra prison on a barge that is floating
just off the Bronx. All in all, they house over 11,000 people a day.</span></span></div>
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">On
top of our trainings, we were able to see the Geriatrics housing unit with a
capacity for 30 men over 50 years old. At the time we visited they were
all lying in bed. The communal room was not open and dinner was not yet
served (at about 4:30pm to mirror the 4:30am breakfast). One older
gentleman who appeared about 80 listened quietly to something on his headphones
and several others greeted us and briefly asked us for medical advice.
One of the biggest problems: the low toilet seats and wet floors in the
communal, one-room bathroom. It was hard to get on and off of them and
even scarier to contemplate a serious fall. They can have canes, but not
walkers or wheelchairs in most units (one medical unit allows these if needed). The policy varies across jails and units, but even a raised toilet seat, a common remedy in the community, could be
a weapon here. For mobility and frailty issues, no solutions are simple or obvious in a correctional setting.</span></span><br />
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">We
also saw the women's jail and attached clinics (medicine, specialty, dentistry)
and infirmary where sicker inmates are housed. Among the women there was
one, just over 50, who described myriad medical problems, including a wound
that was so difficult to heal she had been in the infirmary for weeks.
Another approached us to ask about what could be done for her- she fell on a
wet floor after a property search left debris and food on the ground on her
unit, and she said she still did not know what was wrong with her back. </span></span><br />
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">After
our visit, we all agreed that the staff and officers were one of the most
engaged group of people we had ever trained. While Rikers is a huge
place, and the aging of the population will continue to put huge pressure on
their system, I feel hopeful that this training made an impact and may help
this particularly vulnerable and incarcerated population.</span></span></div>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Photos: </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">1) Tim Gruber (http://www.motherjones.com/politics/2012/09/massachusetts-elderly-prisoners-cost-compassionate-release) </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">2) Rikers Island, wikipedia: http://commons.wikimedia.org/wiki/File:USGS_Rikers_Island.png#mediaviewer/File:USGS_Rikers_Island.png</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">by Anna Chodos, MD</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<div class="lead">
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><b><span style="font-weight: normal;"><br /></span></b></span></span></div>
Annahttp://www.blogger.com/profile/12166775761465213662noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-23584490678429736162015-02-04T09:18:00.001-08:002015-02-04T09:21:09.505-08:00Nutrition and the Tax Code<div class="MsoNormal" style="background-color: white; background-position: initial initial; background-repeat: initial initial;">
<span style="color: #222222;"><span style="font-family: Verdana, sans-serif;"><b>By Hilary Seligman, MD & Marydale Debor,
JD</b></span></span></div>
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<span style="color: #222222;"><span style="font-family: Verdana, sans-serif;">On December 31, 2014, the Internal Revenue
Service issued the long-awaited final ruling implementing Section 501 (r) of
the Patient Protection and Affordable Care Act of 2010 (ACA). This section of
the Internal Revenue Code deals with the conditions hospitals must meet in
order to retain their nonprofit health status.
In an exciting development, this new code directs attention to the
elimination of “root causes of disease,” especially among medically
underserved, minority, and vulnerable populations.<o:p></o:p></span></span></div>
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</div><a href="http://mission-healthequity.blogspot.com/2015/02/nutrition-and-tax-code.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-25010055312368306332015-01-23T11:34:00.000-08:002015-02-04T09:19:49.940-08:00Martin Luther King Day, 2015<span style="font-family: Verdana, sans-serif; font-size: large;"><b>By Margaret Wheeler, MD</b></span><br>
<span style="font-family: Verdana, sans-serif;"><b><br></b></span>
<br>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgt-Ni4eeIp-2imvKcynwn4fheVLsxUin1qvdAM6BuIF48Yp-XpjSph3L8Y3dqDxRij1UVpYAp6aambLRUaczLGxie5OatCwC9DNEEmCjbUYVLQ1PRnR8XhZtnH1mDs3BjaTFULdUEBpzo/s1600/mlk.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Verdana, sans-serif;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgt-Ni4eeIp-2imvKcynwn4fheVLsxUin1qvdAM6BuIF48Yp-XpjSph3L8Y3dqDxRij1UVpYAp6aambLRUaczLGxie5OatCwC9DNEEmCjbUYVLQ1PRnR8XhZtnH1mDs3BjaTFULdUEBpzo/s1600/mlk.jpg" height="213" width="320"></span></a></div>
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<span style="font-family: Verdana, sans-serif;">For this Martin Luther King Jr. Day, in the fiftieth anniversary year of the Voting Rights Act and the Selma to Montgomery March, it is hard not to draw comparisons between those days and ours. </span></div>
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<a href="http://mission-healthequity.blogspot.com/2015/01/martin-luther-king-day-2015.html#more">Read more »</a>Anonymoushttp://www.blogger.com/profile/08109899774867205294noreply@blogger.com0tag:blogger.com,1999:blog-1443178381846934312.post-10825993473915624592015-01-16T09:56:00.002-08:002015-01-16T09:56:20.051-08:00Prostate Health Support Group for African American Men<b><span style="font-size: 12pt; line-height: 115%;"><span style="font-family: Verdana, sans-serif;">By Nynikka R. A. Palmer, DrPH, MPH</span></span></b><br>
<b><span style="font-size: 12pt; line-height: 115%;"><span style="font-family: Verdana, sans-serif;"><br></span></span></b>
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<span style="font-size: 12pt;"><span style="font-family: Verdana, sans-serif;">Prostate cancer among African American men is one of the most intractable cancer disparities. African American men bear an <a href="http://www.cdc.gov/cancer/prostate/statistics/race.htm">excess burden of prostate cancer</a> across all stages of management, including <a href="http://www.ncbi.nlm.nih.gov/pubmed?cmd=Retrieve&list_uids=21541975">presentation, diagnosis, treatment, survival, and quality of life</a>.</span></span></div>
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<a href="http://mission-healthequity.blogspot.com/2015/01/prostate-health-support-group-for.html#more">Read more »</a>Anonymoushttp://www.blogger.com/profile/08109899774867205294noreply@blogger.com1tag:blogger.com,1999:blog-1443178381846934312.post-655048435830592792015-01-12T09:31:00.002-08:002015-01-14T15:44:45.969-08:00On point: Broadening pain management options with acupuncture <div class="MsoNormal">
<span style="font-size: 11pt;"><b><span style="font-family: Verdana, sans-serif;">By Maria T. Chao, DrPH, MPA</span></b></span></div>
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<span style="font-family: Verdana, sans-serif;"><span style="font-size: 11pt;">As I think about the year ahead, one change that I’m really excited about is the prospect of acupuncture for patients at San Francisco General Hospital (SFGH). In the US, pain management is the leading reason that patients seek care from acupuncturists. Acupuncture utilization has </span><a href="http://nccam.nih.gov/sites/nccam.nih.gov/files/news/nhsr12.pdf"><span style="font-size: 11pt;">increased by 50%</span></a><span style="font-size: 11pt;"> over the past decade, but is not commonly used by non-Asian minority populations and those with limited income. Barriers to use include high out-of-pocket costs and limited access to services. <o:p></o:p></span></span></div>
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<a href="http://mission-healthequity.blogspot.com/2015/01/on-point-broadening-pain-management.html#more">Read more »</a>Anonymoushttp://www.blogger.com/profile/08109899774867205294noreply@blogger.com3tag:blogger.com,1999:blog-1443178381846934312.post-88458212018541708562014-12-18T10:32:00.000-08:002014-12-18T10:32:33.854-08:00How Can Non-English Speaking Patients 'Meaningfully Use' Patient Portals?<div class="MsoNormal">
<span style="font-family: Verdana, sans-serif;"><b>By Neda Ratanawongsa, MD, MPH</b></span></div>
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<span style="font-family: Verdana, sans-serif;"> </span><span style="font-family: Verdana, sans-serif;">“For Spanish press 1, for Cantonese press 2, for Mandarin
press 3, for Taishanese press 4, for Vietnamese press 5 …” </span></div>
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<span style="font-family: Verdana, sans-serif;">My exam room phone
doesn’t have enough buttons for all the languages I need to serve my
patients. In a typical clinic session,
I use an interpreter for half of my clinic visits and phone calls to
patients. It is this amazing linguistic
and cultural diversity that drew me to be a primary care provider at the </span><a href="http://www.sfhealthnetwork.org/primary-care-3/general-medicine-primary-care/" style="font-family: Verdana, sans-serif;">General
Medicine Clinic</a><span style="font-family: Verdana, sans-serif;">.</span></div>
<a href="http://mission-healthequity.blogspot.com/2014/12/how-can-non-english-speaking-patients.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com2tag:blogger.com,1999:blog-1443178381846934312.post-83904413351599723512014-12-12T13:48:00.000-08:002014-12-12T13:48:27.212-08:00The Center of the Storm: Homelessness and Health<div class="MsoNormal" style="margin-top: 12.0pt;">
<b><span style="font-family: Verdana, sans-serif;">by Margot Kushel, MD</span></b></div>
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<span style="font-family: Verdana, sans-serif;">As the Bay Area is deluged with
the biggest rainstorm in a decade, most of the region’s schools were cancelled
and many workplaces allowed for flexibility, so that people could stay safe and
dry in their homes. Churches and homeless service agencies <a href="http://www.sfgate.com/bayarea/nevius/article/When-it-pours-St-Anthony-s-pours-on-care-for-5951348.php">opened
their doors</a> to provide temporary shelter for members of our community who
are homeless. But the storm of the decade was another blow to those who have
already been struck by the perfect storm of rising housing prices, loss of
support for affordable housing, and lack of availability of living wage jobs for
those without specialized skills. <o:p></o:p></span></div>
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<a href="http://mission-healthequity.blogspot.com/2014/12/the-center-of-storm-homelessness-and.html#more">Read more »</a>courtneyhttp://www.blogger.com/profile/03807667038134284531noreply@blogger.com0