On the Home Front
Eliminating Health Disparities
Altarum Institute has an extensive and longstanding commitment to eliminating health disparities. The eight members of the Altarum Health Disparities Team are experts who have dedicated their careers to prevent and treat the diseases and health outcomes with the greatest health inequities. They work extensively with high needs populations facing the biggest inequities and with housing authorities, Women, Infants, and Children (WIC) agencies, park departments, and others to improve the underlying factors that influence health.
From strategic planning to implementation, Altarum is at the forefront of developing, implementing, supporting, and evaluating the policies and programs that are the most effective in eliminating disparities. To learn more about the efforts of Altarum Institute to address health disparities, visit our Health Disparities and Health Equalities page.
Stories of Recovery
The following stories of recovery are part of the #WeAreRecovery campaign. Submit your story here to be shared on social media for the #WeAreRecovery project, or here for the #WeAreRecoveryAllies campaign. All stories are unique, and yours can inspire others. Your story may be featured in an upcoming issue of BHchat Corner: News You Can Use. If you have questions, email the BHTAC team.
Rwenshan from Charlotte, North Carolina, writes: “#MyRecovery began when the gun didn't discharge when I pulled the trigger as the barrel touched my temple during this third attempt. I was diagnosed with bipolar disorder 7 years prior and did not know how to handle it because I did not understand what it meant. As a Black man, I allowed fear, ignorance, and ego determine my actions by not pursuing the help that I needed to manage my symptoms and learn how to live with this mental illness. When the bullet did not leave the chamber, my eyes opened and I got the help that I needed. Each day is not the best but I realize that it is not the worst. I take it one step at a time as I try to help others acknowledge, address, and deal with their own mental health challenges.”
Gregory from Kansas City, Missouri, writes: “#MyRecovery saved my life! I was homeless over 3 years and arrested 97 times in Kansas City, Missouri. I never said to myself I'm going to be an addict when I grow up. I have enjoyed 22 years of long-term recovery. My family, myself, and the police are happier I'm sober. I been fortunate to have taken over 2,000 people to drug treatment centers in 22 years! I'm here to tell everyone that drugs don't discriminate and flunked geography. My goal is to help as many that suffer from addictions find the way out! I shall keep sharing this gift God gave me with all that will listen.”
Spotlights and Highlights
The Health Equity Change Makers project is an effort by the United States Office of Minority Health to showcase stories of everyday people facing health disparities and who are using their experiences to raise awareness and inspire change. In addition to inspirational stories of people who have been conduits of change, the project offers a toolkit of ideas and resources for activities that can be done at home, at work, and in the community to help end health disparities and accelerate health equity.
The 10th Annual National Conference on Health Disparities will be held May 4–6, 2017 (with preconference sessions on May 3) at the JW Marriott in New Orleans, Louisiana. This 2.5-day conference will cover topics such as social determinants and health disparities, community-based programs that work, translational research and public policy, prevention and personal responsibility, and the disproportionate effects of climate change on minority communities. It will feature a congressional roundtable discussion on the status of health legislation, including legislation that addresses social determinants of health.
Additionally, the National Institute on Minority Health and Health Disparities (NIMHD) provides a listing of upcoming events and conferences as well as other important dates related to minority health and health disparities research. Although the site has not yet been updated with 2017 data, some past events are available as an on-demand webinar series. Funding opportunities are also linked to the NIMHD.
National Healthcare Disparities Report
The 2012 National Healthcare Disparities Report states that “health care quality and access are suboptimal, especially for minority and low-income groups [and while] overall quality is improving, access is getting worse, and disparities are not changing.” With respect to mental health care, disparities across race and ethnicity, geographic regions, and socioeconomic domains continue. Compared with the majority population, members of racial and ethnic minority groups in the United States are less likely to have access to mental health services, less likely to use community mental health services, more likely to use inpatient hospitalization and emergency rooms, and more likely to receive lower quality care.
 Wang, P. B., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 603-613.
 Samnaliev, M., McGovern, M. P., & Clark, R. E. (2009). Racial/Ethnic Disparities in Mental Health Treatment in Six Medicaid Programs. Journal of Health Care for the Poor and Underserved, 20(1), 165-176. The Johns Hopkins University Press. Retrieved July 31, 2012, from Project MUSE database.
 Alegría, M., Chatterji, P., Wells, K., Cao, Z., Chen, C., Takeuchi, D., et al. (2008). Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric Services, 59(11), 1264-1272.
Latest in Research
Cultural Differences May Leave Their Mark on DNA
In a recent study of a group of diverse Latino children, researchers identified several hundred differences in their methylation DNA-one type of “epigenetic mark” that previous research has shown can be either inherited or altered by life experience. Researchers identified several hundred of these genetic differences associated with either Mexican or Puerto Rican ethnicity but were only able to account for 75% of these differences by differences in the children’s ancestry (inherited), suggesting that the remaining 25% of these differences may reflect a “biological stamp” of different experiences, practices, and environmental exposures distinct to the two ethnic subgroups. The discovery could help scientists understand how social, cultural, and environmental factors interact with genetics to create differences in health outcomes between different ethnic populations.
According to co-senior author Esteban Burchard, M.D., M.P.H., a professor of bioengineering and therapeutic sciences and of medicine in the Schools of Pharmacy and Medicine at the University of California, San Francisco (USCF) and the Harry William and Diana V. Hind Distinguished Professorship in Pharmaceutical Sciences II at UCSF, "This is a big advancement of our understanding of race and ethnicity. There's this whole debate about whether race is fundamentally genetic or is just a social construct. To our knowledge, this is the first time anyone has attempted to quantify the molecular signature of the non-genetic components of race and ethnicity. It demonstrates in a whole new way that race combines both genetics and environment."
Researchers Identify Factors Associated with Stopping Treatment for Opioid Dependence
Understanding the reasons why many individuals who participate in Office Based Addiction Treatment (OBAT) with buprenorphine discontinue treatment less than 1 year after initiation is critical in building strategies and service options to appropriately retain individuals in this treatment option.
In a recent study from Boston University Schools of Medicine (BUSM) and Public Health, researchers conducted an observational study over the course of 12 years with 1,200 participants receiving OBAT at Boston University Medical Center (BMC), with the goal of identifying specific factors associated with retention in the treatment program for longer than 1 year. Factors such as age, gender, race/ethnicity, education level, employment, infection with hepatitis C virus, co-morbid psychiatric conditions, and prior or current use of drugs or alcohol were all evaluated.
While the study found that older age, female, and co-morbid psychiatric diagnosis were associated with greater odds of treatment retention beyond one year, individuals who were black or Hispanic, unemployed, and had evidence of hepatitis C viral infection were associated with decreased odds of treatment retention beyond one year.
According to lead author Zoe Weinstein, M.D., assistant professor of medicine at BUSM, director of the Addiction Consult Services at BMC, and lead author, "This study highlights some important disparities in treatment outcomes, especially racial/ethnic disparities in outcomes, which reflect a larger issue in medical care in general as well as in society at large." She points out that identifying these risk factors for disengagement is especially important given the current opioid epidemic and that this study highlights the need for improved strategies in supporting retention in OBAT services, such as employment assistance programming.
Altarum’s Twitter chat on behavioral health will be occurring quarterly instead of monthly during 2017. The topic of the next Behavioral Health Twitter Chat, at 1 p.m., ET, on March 30, 2017, will be bipolar disorder. More details will be available in the March BHchat Corner newsletter.
Follow Altarum on Twitter for the latest in behavioral health news and notifications about upcoming discussions. Visit BHTAC for a list of Altarum’s previous Twitter chat guests and Storify to view the full conversations. Also, the Altarum Behavioral Health team is on Facebook and Instagram. Be sure to “like” the pages to stay connected with the behavioral health community.