Tag Archives: healthcare disparities

Straight, No Chaser: STDs – Multidrug Resistant Gonorrhea

April 28, 2016Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Conditions and Diseases, ectopic pregnancy, healthcare disparities, HIV, human immunodeficiency, infertility, multidrug resistant gonorrhea, neisseria gonorrhea, Pelvic inflammatory disease, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This post is the second of two discussing gonorrhea. Today we discuss multidrug resistant gonorrhea. That’s right. There are new strains of gonorrhea emerging and spreading, as if the existing strains weren’t devastating enough already.
The development of multidrug resistant gonorrhea has occurred. Gonorrhea has affected humans for centuries, and the organism causing it has been identified for over one hundred years. According to the Center for Disease Control and Prevention (CDC), there were over 300,000 cases of gonorrhea in the U.S. alone in 2011. It is estimated that over 800,000 infections are currently present (On a tangential note, this represents another significant cause of health care disparities; Blacks are 17 times more likely to be affected that Whites. This isn’t just due to behavioral patterns. In fact, it’s largely due to the asymptomatic nature of gonorrhea and the relative lack of access to care among Blacks, impacting ability to get treated).
Gonorrhea has proven itself to be especially wily. We’ve had access to effective antibiotics against it since the 1930s. Still, it continues to plague us. In the 1940s, the 1970s, and again in the 1990s, gonorrhea mutated and developed immunity to treatments that had been effective. In addition most cases of gonorrhea don’t cause symptoms, allowing itself to be spread in a “stealth” manner (Read: get checked).

Even more so than other instances of gonorrhea resistance, this instance poses especially concerning dangers. Treatment of multidrug resistant gonorrhea infections (particularly those resistant to the standard of care medicine ceftriaxone) will be much more complicated that it had been previously. Specifically, there is no ready replacement on standby that can be administered in emergency rooms, offices and clinics as easily as a simple shot of ceftriaxone is. Our most recent magic bullet is going by the wayside. Other available treatments also have varying degrees of emerging resistance and thus are likely to be sporadically ineffective. Until on-site testing is put in place that allows determination of susceptibility to various treatment regimens, patients infected with gonorrhea will run the risk of receiving medicines that are no longer effective. Current and future treatment regimens will involve the use of more than one medicine and higher doses of medicine than had previously been effective.

This brings to mind two important points. Gonorrhea is not just an infection that affects sexual organs. It produces devastating consequences throughout the body, including the facilitation of human immunodeficiency virus (HIV) transmission (i.e. the presence of gonorrhea makes acquiring HIV easier). It also causes serious reproductive complications in women, such as pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. It causes eye infections in newborns (they pick it up from mom) and infected persons who rub their eyes or otherwise place their fingers in their eyes without appropriate hand washing. Either failure to get treated or receiving ineffective treatment is a precarious situation.

Of course, this also creates and reinforces the urgency of practicing safe sexual behaviors. Straight, No Chaser has multiple postings on safe sex and best practices of preventing sexually transmitted infections. Here is a summary post for your review. Of course you can type any topic in the search engine for greater ability to explore these topics.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Healthcare Disparities

April 17, 2016General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, Behind the Curtain, colorectal cancer, Conditions and Diseases, death rates, Diabetes, healthcare disparities, HIV, Hypertension, immunizations, infant mortality, Influenza, life expectancy, Obesity, periodontitis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

In large part, this blog exists to inform individuals of all backgrounds about the risks that lead to abnormal health outcomes. Our hope is that once you discover the risks, you’ll be sufficiently equipped and incentivized to take the simple steps provided to improve your health.
Disparities are abnormal outcomes of a different variety. Disparities in healthcare lead to premature development of disease and death. The culprits are often insufficient access to care, culture barriers, habits and even discriminatory practices. It is critical for all involved, i.e., individuals, healthcare planners and practitioners, to understand these causes so that everyone can adjust habits and apply resources to combat this health hazard affecting both individuals and communities.
For the last 25 years of my career, I’ve had the unfortunate privilege of addressing this topic in national forums, including before the National Urban League, before the National Medical Association, recently, in the NAACP’s The Crisis magazine and in Straight, No Chaser to extent that our service provides you with the information that can make a difference in your lives. Unfortunately for some, it’s almost never that easy.

As a statement of fact, according to the Center for Disease Control and Prevention (CDC) Health Disparities & Inequalities Report  of 2013, African-Americans suffer global health disparities that result in the following outcomes.

Life expectancy: In 2011, the average American could expect to live 78.7 years. The average African-American could only expect to live 75.3 years, compared with 78.8 years for the average White American.
Death rates: In 2009, African-Americans had the highest death rates from homicide among all racial and ethnic populations. Rates among African-American males were the highest for males across all age groups.
Infant mortality rates: In 2008, infants of African-American women had the highest death rate among American infants with a rate more than twice as high as infants of white women.

The following disparities were also reported:

Heart disease and stroke: In 2009, African-Americans had the largest death rates from heart disease and stroke compared with other racial and ethnic populations, with disparities across all age groups younger than 85 years of age.
High blood pressure: From 2007-2010, the prevalence of hypertension was among adults aged 65 years and older, African-American adults, US-born adults, adults with less than a college education, adults who received public health insurance (18-64 years old) and those with diabetes, obesity or a disability compared with their counterparts. The percentages of African-Americans and Hispanics who had control of high blood pressure were lower compared to white adults.
Obesity: From 2007-2010, the prevalence of obesity among adults was highest among African-American women compared with white and Mexican American women and men. Obesity prevalence among African-American adults was the largest compared to other race ethnicity groups.
Diabetes: In 2010, the prevalence of diabetes among African-American adults was nearly twice as large as that for white adults.
Activity limitations caused by chronic conditions: From 1999-2008, the number of years of expected life free of activity limitations caused by chronic conditions is disproportionately higher for African-American adults than whites.
Periodontitis: In 2009-2010, the prevalence of periodontitis (a form of dental disease) was greatest among African-American and Mexican American adults compared with white adults.
HIV: In 2010, African-American adults had the largest HIV infection rate compared with rates among other racial and ethnic populations. Prescribed HIV treatment among African-American adults living with HIV was less than among white adults.
Access to care: In 2010, Hispanic and African-American adults aged 18-64 years had larger percentages without health insurance compared with white and Asian/Pacific Islander counterparts.
Colorectal cancer: In 2008, African-Americans had the largest incidence and death rates from colorectal cancer of all racial and ethnic populations despite similar colorectal screening rates compared to white adults.
Influenza vaccination: During the 2010-11 influenza season, influenza vaccination coverage was similar for African-American and white children aged six months to 17 years but lower among African-American adults compared with white adults.
Socioeconomic factors: In 2011, similar to other minority adults aged 25 years or older, a larger percentage of African-American adults did not complete high school compared with white adults. A larger percentage of African-American adults also lived below the poverty level and were unemployed (adults aged 18-64 years) compared with white adults of the same age.

Identifying disparities is a good start. However, to reduce them it is necessary to identify and implement solutions, both individually and institutionally. To this end, we will explore best practices in future Straight, No Chaser posts. Feel free to ask any questions you have on this topic.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Healthcare Disparities

April 24, 2015General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, colorectal cancer, Conditions and Diseases, death rates, Diabetes, healthcare disparities, HIV, Hypertension, immunizations, infant mortality, Influenza, life expectancy, Obesity, periodontitis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Life expectancy: In 2011, the average American could expect to live 78.7 years. The average African-American could only expect to live 75.3 years, compared with 78.8 years for the average White American.
Death rates: In 2009, African-Americans had the highest death rates from homicide among all racial and ethnic populations. Rates among African-American males were the highest for males across all age groups.
Infant mortality rates: In 2008, infants of African-American women had the highest death rate among American infants with a rate more than twice as high as infants of white women.

The following disparities were also reported:

Heart disease and stroke: In 2009, African-Americans had the largest death rates from heart disease and stroke compared with other racial and ethnic populations, with disparities across all age groups younger than 85 years of age.
High blood pressure: From 2007-2010, the prevalence of hypertension was among adults aged 65 years and older, African-American adults, US-born adults, adults with less than a college education, adults who received public health insurance (18-64 years old) and those with diabetes, obesity or a disability compared with their counterparts. The percentages of African-Americans and Hispanics who had control of high blood pressure were lower compared to white adults.
Obesity: From 2007-2010, the prevalence of obesity among adults was highest among African-American women compared with white and Mexican American women and men. Obesity prevalence among African-American adults was the largest compared to other race ethnicity groups.
Diabetes: In 2010, the prevalence of diabetes among African-American adults was nearly twice as large as that for white adults.
Activity limitations caused by chronic conditions: From 1999-2008, the number of years of expected life free of activity limitations caused by chronic conditions is disproportionately higher for African-American adults than whites.
Periodontitis: In 2009-2010, the prevalence of periodontitis (a form of dental disease) was greatest among African-American and Mexican American adults compared with white adults.
HIV: In 2010, African-American adults had the largest HIV infection rate compared with rates among other racial and ethnic populations. Prescribed HIV treatment among African-American adults living with HIV was less than among white adults.
Access to care: In 2010, Hispanic and African-American adults aged 18-64 years had larger percentages without health insurance compared with white and Asian/Pacific Islander counterparts.
Colorectal cancer: In 2008, African Americans had the largest incidence and death rates from colorectal cancer of all racial and ethnic populations despite similar colorectal screening rates compared to white adults.
Influenza vaccination: During the 2010-11 influenza season, influenza vaccination coverage was similar for African-American and white children aged six months to 17 years but lower among African-American adults compared with white adults.
Socioeconomic factors: In 2011, similar to other minority adults aged 25 years or older, a larger percentage of African-American adults did not complete high school compared with white adults. A larger percentage of African American adults also lived below the poverty level and were unemployed (adults aged 18-64 years) compared with white adults of the same age.

This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK (844-762-8255) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd. Please like and share our blog with your family and friends. We’re here for you 24/7 with immediate, personalized information and advice. Contact your Personal Healthcare Consultant at http://www.SterlingMedicalAdvice.com or 1-844-SMA-TALK.

Straight, No Chaser: STDs – Multidrug Resistant Gonorrhea

November 11, 2014Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Conditions and Diseases, ectopic pregnancy, healthcare disparities, HIV, human immunodeficiency, infertility, multidrug resistant gonorrhea, neisseria gonorrhea, Pelvic inflammatory disease, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Straight, No Chaser: Introducing "Superbugs" – Multidrug Resistant Gonorrhea

May 16, 2014General Health and Wellness844-SMA-TALK, Conditions and Diseases, ectopic pregnancy, healthcare disparities, HIV, human immunodeficiency, infertility, multidrug resistant gonorrhea, neisseria gonorrhea, Pelvic inflammatory disease, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This post is the first of two that identifies relatively new and massive occurrences in medicine. Today we discuss multidrug resistant gonorrhea. That’s right. There are new strains of gonorrhea emerging and spreading, as if the existing strains weren’t devastating enough already.
The development of multidrug resistant gonorrhea has occurred. Gonorrhea has affected humans for centuries, and the organism causing it has been identified for over one hundred years. According to the Center for Disease Control and Prevention (CDC), there were over 300,000 cases of gonorrhea in the U.S. alone in 2011. It is estimated that over 800,000 infections are currently present (On a tangential note, this represents another significant cause of health care disparities; Blacks are 17 times more likely to be affected that Whites. This isn’t just due to behavioral patterns. In fact, it’s largely due to the asymptomatic nature of gonorrhea and the relative lack of access to care among Blacks, impacting ability to get treated).
Gonorrhea has proven itself to be especially wily. We’ve had access to effective antibiotics against it since the 1930s. Still, it continues to plague us. In the 1940s, the 1970s, and again in the 1990s, gonorrhea mutated and developed immunity to treatments that had been effective. In addition most cases of gonorrhea don’t cause symptoms, allowing itself to be spread in a “stealth” manner (Read: get checked).

Straight, No Chaser: Health Disparities

April 14, 2014General Health and Wellness, Public Health844-SMA-TALK, colorectal cancer, Conditions and Diseases, death rates, Diabetes, healthcare disparities, HIV, Hypertension, immunizations, infant mortality, Influenza, life expectancy, Obesity, periodontitis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Life expectancy: In 2011, the average American could expect to live 78.7 years. The average African-American could only expect to live 75.3 years, compared with 78.8 years for the average White American.
Death rates: In 2009, African-Americans had the highest death rates from homicide among all racial and ethnic populations. Rates among African-American males were the highest for males across all age groups.
Infant mortality rates: In 2008, infants of African-American women had the highest death rate among American infants with a rate more than twice as high as infants of white women.

The following disparities were also reported:

Heart disease and stroke: In 2009, African-Americans had the largest death rates from heart disease and stroke compared with other racial and ethnic populations, with disparities across all age groups younger than 85 years of age.
High blood pressure: From 2007-2010, the prevalence of hypertension was among adults aged 65 years and older, African-American adults, US-born adults, adults with less than a college education, adults who received public health insurance (18-64 years old) and those with diabetes, obesity or a disability compared with their counterparts. The percentages of African-Americans and Hispanics who had control of high blood pressure were lower compared to white adults.
Obesity: From 2007-2010, the prevalence of obesity among adults was highest among African-American women compared with white and Mexican American women and men. Obesity prevalence among African-American adults was the largest compared to other race ethnicity groups.
Diabetes: In 2010, the prevalence of diabetes among African-American adults was nearly twice as large as that for white adults.
Activity limitations caused by chronic conditions: From 1999-2008, the number of years of expected life free of activity limitations caused by chronic conditions is disproportionately higher for African-American adults than whites.
Periodontitis: In 2009-2010, the prevalence of periodontitis (a form of dental disease) was greatest among African-American and Mexican American adults compared with white adults.
HIV: In 2010, African-American adults had the largest HIV infection rate compared with rates among other racial and ethnic populations. Prescribed HIV treatment among African-American adults living with HIV was less than among white adults.
Access to care: In 2010, Hispanic and African-American adults aged 18-64 years had larger percentages without health insurance compared with white and Asian/Pacific Islander counterparts.
Colorectal cancer: In 2008, African Americans had the largest incidence and death rates from colorectal cancer of all racial and ethnic populations despite similar colorectal screening rates compared to white adults.
Influenza vaccination: During the 2010-11 influenza season, influenza vaccination coverage was similar for African-American and white children aged six months to 17 years but lower among African-American adults compared with white adults.
Socioeconomic factors: In 2011, similar to other minority adults aged 25 years or older, a larger percentage of African-American adults did not complete high school compared with white adults. A larger percentage of African American adults also lived below the poverty level and were unemployed (adults aged 18-64 years) compared with white adults of the same age.