(Press-News.org) CHICAGO – The odds of individuals with open-angle glaucoma undergoing visual field testing decreased for all racial/ethnic groups from 2001 through 2009, but the odds decreased the most for Hispanic men and women in a study of enrollees in a large U.S. managed care network, according to a report published in the December issue of Archives of Ophthalmology, a JAMA Network publication.
Open-angle glaucoma (OAG) affects more than 3 million individuals in the United States and is a major cause of visual impairment. Studies have found the condition is more prevalent in racial minorities compared with whites, and that racial minorities are more likely to experience vision loss and blindness from OAG, according to the study background.
Joshua D. Stein, M.D., M.S., and colleagues at the University of Michigan, Ann Arbor, examined whether racial disparities exist in the use of ancillary testing to evaluate individuals with open-angle glaucoma. Researchers identified all enrollees age 40 years and older in a large managed care network who had retinal or optic nerve conditions that could warrant ancillary testing.
Among the 797,879 eligible enrollees, 149,018 individuals had open-angle glaucoma. Researchers performed statistical analyses to determine the odds and probabilities each year of undergoing visual field testing and other procedures for black (n=15,905), white (n=118,062), Hispanic (N=9,376) and Asian American (n=4,350) men and women and then compared the groups, according to the study.
The odds of undergoing visual field testing decreased for all groups from 2001 through 2009, decreasing most for Hispanic men and women (63 percent and 57 percent, respectively) and least (36 percent) for Asian-American men. By comparison, the odds of undergoing other ocular imaging increased for all groups from 2001 through 2009, increasing most (173 percent) for black men and women and least (77 percent) for Hispanic women, according to the study results.
"While it is encouraging that black individuals are receiving similar or greater levels of monitoring of OAG relative to white individuals, it is disconcerting that there are significant disparities in glaucoma testing among the Hispanic population, the fastest growing racial minority in the United States," the authors comment.
The authors note further research should focus on reducing racial disparities.
"Although increases in glaucoma testing have been noted in recent years among Hispanic men and women for some types of ancillary tests, efforts should be made to better understand and overcome some of the persistent barriers to monitoring for glaucoma in this group," they conclude.
(Arch Ophthalmol. 2012;130[12]:1579-1588. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: This study was funded by an award from the National Eye Institute, a grant from the American Glaucoma Society, a grant from the Blue Cross Blue Shield of Michigan Foundation and a grant from Research to Prevent Blindness. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Navigating the Storm Contributing to Health Disparities
In an accompanying editorial, Eve J. Higginbotham, S.M., M.D., of the Association of American Medical Colleges, Washington, D.C., writes: "Yes, this is a perfect storm in which the stakes are high; however, our capacity to navigate this storm and unravel this puzzle of health equity has never been greater."
"Although there were increases across all ethnic groups for ocular imaging testing, Latinos and Latinas evidenced no significant differences in the odds of undergoing these tests from 2001 to 2009. Moreover, there was a decrease in visual field testing during the observation period for all groups, but the greatest decrease in testing was noted among Latinos and Latinas," Higginbotham continued.
"There is light at the end of the tunnel despite a confluence of factors, such as inequalities among populations related to education and income. However, unless we pay continued attention to the adverse trends that have persisted for several years, disparities in health care will continue," Higginbotham concludes. "If, in our discipline, we place a priority on reducing inequity in testing and, by extension, treatment across all populations, we can lead the rest of the house of medicine to achieve health equity."
(Arch Ophthalmol. 2012;130[12]:1601-1602. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
###
To contact Joshua D. Stein, M.D., M.S., call Betsy Nisbet at 734-647-5586 or email bsnisbet@umich.edu. To contact editorial author Eve J. Higginbotham, S.M., M.D., call Lesley Ward at 202-828-0655 or email lward@aamc.org.
Study suggests odds of visual field testing for glaucoma decreased most for Hispanics in past decade
2012-12-11
ELSE PRESS RELEASES FROM THIS DATE:
Addition of technology to standard weight loss plan appears beneficial for greater weight loss
2012-12-11
CHICAGO – Use of a personal digital assistant (PDA) and telephone coaching appears to enhance short-term weight loss when used in conjunction with an existing physician-directed weight loss treatment program, according to a report posted Online First by Archives of Internal Medicine, a JAMA Network publication.
"Little is known about whether the outcome of physician-directed weight loss treatment can be improved by adding mobile technology," the authors write as background. However, "self-monitoring of diet and physical activity is associated with weight loss success ...
Study suggests vision insurance associated with eye-care visits, better reported vision
2012-12-11
CHICAGO – Vision insurance for working-age adults appears to be associated with having eye care visits and reporting better vision, compared with individuals without insurance, according to a report published Online First by Archives of Ophthalmology, a JAMA Network publication.
Millions of Americans experience vision loss or impairment due to age-related eye diseases, including glaucoma, age-related macular degeneration (ARMD) and cataracts. Periodic checkups are recommended for timely detection of eye conditions to prevent irreversible vision loss. Having vision insurance ...
Diabetes prevention program interventions lead to reduced BMI over usual care
2012-12-11
CHICAGO – Two adapted diabetes lifestyle interventions resulted in weight loss, as well as improvements in waist circumference and fasting plasma glucose level, for overweight or obese adults compared with usual care over a 15-month period, according to a report of a randomized trial published Online First by Archives of Internal Medicine, a JAMA Network publication.
An estimated 69 percent of U.S. adults are overweight or obese and lifestyle modifications that focus on modest weight loss (5 percent to 10 percent) and moderate-intensity physical activity are associated ...
Point-of-care ultrasound is more accurate than the stethoscope in diagnosing pneumonia in children
2012-12-11
Point-of-care ultrasound is more accurate than the traditional method of auscultation by stethoscope in diagnosing pneumonia in children and young adults, and can even detect small pneumonias that a chest x-ray may miss, a Mount Sinai researcher reports in an article titled, "Prospective Evaluation of Point-of-Care Ultrasonography for the Diagnosis of Pneumonia in Children and Young Adults" in the online edition of Archives of Pediatrics & Adolescent Medicine published December 10, 2012.
These findings have important public health implications, especially in the developing ...
Tobacco smuggling in Europe lower than industry figures suggest
2012-12-11
The prevalence of tobacco smuggling in Europe is lower than industry figures suggest, reveals the largest study of its kind, published online in Tobacco Control.
Significantly, it is availability, rather than price, that seems to determine the level of illicit trade, the research suggests a finding that runs directly counter to the arguments proffered by the tobacco industry say the authors.They base their findings on a representative population sample of 1000 people from each of 18 European countries: Albania; Austria; Bulgaria; Czech Republic; Croatia; England; Finland; ...
Feeling lonely linked to increased risk of dementia in later life
2012-12-11
Feeling lonely, as distinct from being/living alone, is linked to an increased risk of developing dementia in later life, indicates research published online in the Journal of Neurology Neurosurgery and Psychiatry.
Various factors are known to be linked to the development of Alzheimer's disease, including older age, underlying medical conditions, genes, impaired cognition, and depression, say the authors.
But the potential impacts of loneliness and social isolation—defined as living alone, not having a partner/spouse, and having few friends and social interactions — ...
Pre-diabetic patients respond to self-directed lifestyle interventions, Stanford researcher says
2012-12-11
STANFORD, Calif. — Efforts to help overweight patients avoid diabetes through lifestyle changes need not rely on intensive, one-on-one focused programs, a new clinical study from the Stanford University School of Medicine and the Palo Alto Medical Foundation Research Institute has found.
The study, to be published Dec. 10 in the Archives of Internal Medicine, opens up a practical way for primary care physicians to help their patients at high risk for developing diabetes.
Researchers have known for 10 years that intensive intervention programs led by lifestyle coaches ...
Educational video helps terminal cancer patients decide whether to receive CPR
2012-12-11
Patients with terminal cancer who viewed a three-minute video demonstrating cardiopulmonary resuscitation (CPR) were less likely to indicate a preference for receiving CPR in the event of an in-hospital cardiac arrest than were patients who only listened to a verbal description of the procedure. The study that will appear in the Journal of Clinical Oncology and is being released online today is a follow-up to a smaller, 2009 study and includes a more diverse group of patients with many forms of cancer.
"It really is incumbent on us, as physicians, to help our patients ...
Inspiration from a porcupine's quills
2012-12-11
CAMBRIDGE, MA -- Anyone unfortunate enough to encounter a porcupine's quills knows that once they go in, they are extremely difficult to remove. Researchers at MIT and Brigham and Women's Hospital now hope to exploit the porcupine quill's unique properties to develop new types of adhesives, needles and other medical devices.
In a new study, the researchers characterized, for the first time, the forces needed for quills to enter and exit the skin. They also created artificial devices with the same mechanical features as the quills, raising the possibility of designing ...
Mayo Clinic researchers uncover toxic interaction in neurons that leads to dementia and ALS
2012-12-11
JACKSONVILLE, Fla. — Researchers at Mayo Clinic in Florida have uncovered a toxic cellular process by which a protein that maintains the health of neurons becomes deficient and can lead to dementia. The findings shed new light on the link between culprits implicated in two devastating neurological diseases: END ...