gdp's Comments

Change.gov : Healthcare Policy Stakeholders Meeting | Change.gov: The Obama-Biden Transition Team

Fri, 9 Jan 2009 17:09:14 +0000

Data monitoring is also important for civil rights enforcement. It is important to improve data collection for Health IT. We need to have standardized health IT, and particularly broaden health IT in outpatient settings to monitor the circumstances under which quality or inequality of health care occurs. So while we need to encourage responsibility for one's own care, when it comes to monitoring health care and equity of health care, health IT is important.

Change.gov : American Public Health Association | Change.gov: The Obama-Biden Transition Team

Fri, 9 Jan 2009 17:06:05 +0000

Structural problems such as residential segregation cause disparities in health and health care access. People of color concentrated in residential communities of lower economic status, with resource barriers and constraints that make it difficult to provide the same quality of care you will find in higher socioeconomic communities. This makes it difficult to access quality health care for people of color, so while we rebuild and renovate communities, the system has not considered the way in which this often excludes major communities from accessing health care.

Change.gov : AIDS Drug Assistance Programs (ADAP) | Change.gov: The Obama-Biden Transition Team

Fri, 9 Jan 2009 17:01:57 +0000

If you look at the number of uninsured, non-Medicaid eligible people living with HIV has steadily grown, funding for the Ryan White CARE Act has barely increased over the last six years. As a result, states are creating waiting lists or imposing other cost containment measures for access to medical care and the AIDS Drug Assistance Program, which serves as a lifeline for people living with HIV. In the new administration, we need to reconsider excluding Ryan White from the overal treatment picuture and it must be fully funded. Communities of color affected by HIV also have an urgent stake in broader health care reform efforts; universal access to health care is a human right which recognition in U.S. law is long overdue.

Change.gov : Partnership to Fight Chronic Disease | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 18:51:12 +0000

Yes, I see your point, but note that I spoke of behavioral determinants before diets. Those determinants actually also include environmental determinants which predispose some communities more than others. There is a lot that needs to be done but the diet is and will always remain a large part of our dilemma. I was raised in Europe and the Caribbean, where we do eat but not to just stuff ourselves. While in the US, I have never seen another place with such huge portions that two people can really eat. On top of that we do not teach our children to eat to be satisfied, we teach them to get stuffed and that is not necessarily good for our digestive system. Many doctors will tell you that eating smaller portions on a regular basis may actually be more beneficial and more nutritious than eating two or three huge portions and get so stuffed that you cannot move.
I also believe that we have created an environment where our children cannot enjoy the outdoors as much as the indoors with a Wii game infront of the television. Although the game does require a bit of physical activity, I cannot imagine that regular physical activity can be replaced by a game played on TV. Socializing is cut out and causes people to become more self directed. For young children this is not healthy, just my opinion. Why create games that no longer require youth to socialize and thereby cut out the influence a healthy social environment? We have a lot of work to do but I still contend that diet is an important part of our reason for this epidemic. People do not need sugar to be physically active.

Change.gov : Health for Life | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 17:22:22 +0000

Let's not forget that there is more to health than healthcare. We need to move beyond the conversation of medical care and affordability and personal responsibility and access and coverage. All of these are important but these are not sufficient. Citizens also need to think of living and working conditions and homes and communities and opportunities and resources to broadly address the problems of inequalities we see in communities across the country. Racial and ethnic differences in health outcomes exist and they are not being addressed but they are real. a Simple card will not erase those differences. The MacArthur Network on Socioeconomic Status issued an important report on facts on socioeconomic status and what you can do to improve health.The Unnatural Causes Series is another source for community leaders and can use to provide resources to address health, not simply access to care. Healthy communities are about more than just health care and each policy that affects health is a health policy, which means that we have a wide range of stakeholders to work with, not just the health care industry.

Change.gov : Healthy Communities: A Human Rights Blueprint | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 17:07:28 +0000

The Yonkers housing intervention also showed that improving neighborhood quality led to improved health. There are also studies from outside the United States that showed the same thing. There is also evidence that reducing poverty, improving living standards, enhancing income with no health intervention leads to improved health. A study done, very carefully done experimental design in the 1970s showed that providing mothers additional income led to improved birth weights for their children. A natural experiment found that providing American Indian households additional income led to improved outcomes for their children.The New Hope experiment in Milwaukee, Wisconsin also found that by providing additional income to households helping them to improve their living standards led to improvement in both educational and health outcomes. The Conditional Cash Transfer program from Latin America also document that providing low-income communities and households additional income leads to improved health for income. So we have evidence.

Change.gov : Healthy Communities: A Human Rights Blueprint | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 17:05:49 +0000

There is good research now from the Movement Opportunity Program, for example, that randomized families that found that improving neighborhood quality with no intervention in health led to improved health. The Yonkers housing intervention also showed that improving neighborhood quality led to improved health. There are also studies from outside the United States that showed the same thing. We also have evidence that reducing poverty, improving living standards, enhancing income with no health intervention leads to improved health. A study done, very carefully done experimental design in the 1970s showed that providing mothers additional income led to improved birth weights for their children. A natural experiment found that providing American Indian households additional income led to improved outcomes for their children.

Change.gov : Healthy Communities: A Human Rights Blueprint | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 17:05:35 +0000

Recently D. A. Garcia and D. Williams published a paper in which they looked at the impact of segregation on poor kids in the United States. They asked a simple question. What percentage of Black and minority kids live in worst conditions than the worst of White kids? To decide the quintile of White kids that did worst in residential conditions, found in all metro areas studied, 76-percent of African American kids and 69-percent of Latino kids were doing worst than the worst-off White kids in the United States. These levels were even higher in highly segregated metropolitan areas. So Transition Team, what can we do about segregated areas, about equality of poor life in areas?

Change.gov : Healthy Communities: A Human Rights Blueprint | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 17:01:48 +0000

At the NIH Summit on Health Disparities, Dr. Wiliams actually discussed the fact that geography is a huge predictor of opportunity in American society and a huge predictor of health outcomes. A closer look at Indian reservations and by looking at the high levels of residential segregation in the United States, you will see that in 2000, most of America’s major cities were only slightly less segregated than South Africa was on the legally mandated apartheid in 1991. Environmental segregation matters. David Cutler and his colleagues showed that if we could eliminate the effect of segregation in the United States, you would completely wipe out racial, namely Black/White differences in income, in education, and unemployment, and reduce Black/White differences in single motherhoods by two-thirds, all of that driven by residential segregation. William Julius Wilson and Robert Sampson concluded that the worst urban context in which Whites reside in the 171 largest cities in the United States is considerably better than the average context of Black communities.

Change.gov : Voices for America's Children | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 16:50:56 +0000

We have to also address the disparities currently existing between socioeconomically diverse groups further fueled by racial and ethnic differences, something very few have addressed here if at all. Dr. Wiliams at Harvard University spoke very eloquent when he stated that investments in early childhood programs have decisive benefits for the wellbeing, the educational performance, the educational success of children as well as for their health. There’s growing body of evidence that shows that the brain circuits in fetal and early childhood periods are affected by exposure to stress. When infants are exposed to toxic stress, there’s damage to the brain architecture that makes them incapable of functioning, of learning well, of achieving the socioeconomic status that will put them on a path of good health. So when a child can’t read in grade one, it’s not that child just has behavioral problems but his/her brain has been damaged by the toxic stress that he has faced. We can do more to reduce the stress that children face.

Change.gov : American Association of Port Authorities | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 16:32:08 +0000

That sounds like a great idea. Currently the only way that I am noticing this forum for public opinion is on major media channels such as CNN and only in the event that policies introduces are such that they actually receive major media attention. However, CSPAN runs the full length of the floor proceedings and would be a good venue for this. Who will pay for this? Who will initiate this? It will require a community forum such as this to begin initiating the initiative and hopefully the transition team is reading these ideas to begin exploring (surely they have a lot on their plate and this might take a while but better late than never).

Change.gov : Partnership to Fight Chronic Disease | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 15:18:01 +0000

This is an interesting idea, however, with the shortage of the current health care workforce, how do you foresee asking health care workers to volunteer time in addition to what they have been trained to do "treatment" which already is compromised due to the lack of manpower and the increasing cost of health care and testing, each increasing the cost of health care in general. Prevention is definitely the key but we have allowed our health care to become such a crisis that if we do not increase our manpower, we will not have the ability to actually take advantage of the services, whether preventive or treatment. People are already in a dilemma where, those who have access and actually can find a doctor, are placed on waiting lists that can extend from weeks to months (particularly for specialty care). I cannot stress this enough throughout my conversation on our health care crisis. We have to face our manpower shortage in health care and create incentives for health care workers to want to continue practicing so that our health care reform will not be in vain.

Change.gov : Partnership to Fight Chronic Disease | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 14:54:13 +0000

Youth in the US now consume on average more than 300 kcal per day of sugar sweetened beverages but people do not need sugar filled liquids to be physically active, this is simply a misperception based on consumerism, not healthy communities. Well we surely are in desperate need of change in environmental and social settings in order to combat obesity in this country. These changes cannot be based simply on individual choices but need to be focused on behavioral determinants of obesity, and then improve the food and activity environments of children and youth. Make it simple to make a healthy choice.

Change.gov : American Association of Port Authorities | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 14:25:37 +0000

One of the things I hope we all can do, is to inform those who comment on these pages and are not necessarily as informed as others. There is nothing wrong with that but it is our duty as citizens and leaders to help educate those who do not understand the process. I cannot tell you how often I come across organizations, led by people with really great intentions yet they have no clue about the legislative process and become very frustrated. Needless to say for those of us who do understand it the frustrations are not any less but we have ways in which our advocacy and involvement in the process can help make a change. If we stay passive and only complain during crisis, it is too late. When you vote for a representative, it is your obligation to make sure he/she is doing what they promised to do. Even if that does not happen, the representative has to get the sense that his/her constituency is watching their actions which affect a whole community and as such elected officials cannot become so comfortable about setting rules that communities are left out of the decision-making process.

Change.gov : Partnership to Fight Chronic Disease | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 12:27:41 +0000

I think we may want to reconsider the term "alternative" since the very substances we are using under the label of alternative, are those which were there before other medicines came on the corporate market. Also, a lot of alternative medicines are already used in some form in traditional medicinal substances. Consider the fact that alternative care has existed since the beginning of time amid religious beliefs and practices, mystery, superstition, fear, and misunderstanding. Alternative/Holistic medicine focuses on supporting mind body and spirit to heal itself as it is designed to do while traditional medicine perceives the human body as a battleground on which wars are waged with chemical bombs and knives against invaders, how can these divergent ideologies be merged unless doctors are retrained.Doctors are trained as mechanics who work on the physical mechanism. They are in the business of "treatment, not healing" and this has to change first.

Change.gov : American Association of Port Authorities | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 12:09:25 +0000

If you continue to encourage every other community member to do the same and truly stay on top of the legislative process, you will find that more and more questions can arise and in fact help the advocacy for or against certain types of legislation because the community will actually be involved. Policy is supposed to be created from the bottom up, not from the top down.

Change.gov : American Association of Port Authorities | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 12:07:36 +0000

On a day to day basis, while the Congress is in session, you can follow on C-SPAN as well as on line, the process of the votes on the floor that day. Every Congressional record is available and you should be able to contact your representatives and request this record, which is for public viewing. Furthermore, you can go back for many years to find out how Members have voted and who supports a particular piece of legislation, whether they are they original sponsor or co-sponsor. Also, if you think about it, during the presidential debate there was much going back and forth about who voted for what, not because there was a secret file but because it is public record. Please call your local representative anytime you are questioning a Bill and als find out what they are doing not only when we are in crisis but throughout their legislative career. I find that most constituents vote and that's where their involvement ends, when in fact they put someone in office to work on their behalf. So accountability and responsibility are of the utmost importance if you care about your own wellbeing and that of your community.

Change.gov : Partnership to Fight Chronic Disease | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 04:42:00 +0000

drug companies no longer have to rely on their own research for new drugs, and few of the large ones do. Increasingly, they rely on academia, small biotech startup companies, and the NIH for that.[7] At least a third of drugs marketed by the major drug companies are now licensed from universities or small biotech companies, and these tend to be the most innovative ones.[8] While Bayh-Dole was clearly a bonanza for big pharma and the biotech industry, whether its enactment was a net benefit to the public is arguable.

Change.gov : Partnership to Fight Chronic Disease | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 04:40:42 +0000

Continued: The most important of these laws is known as the Bayh-Dole Act, after its chief sponsors, Senator Birch Bayh (D-Ind.) and Senator Robert Dole (R-Kans.). Bayh-Dole enabled universities and small businesses to patent discoveries emanating from research sponsored by the National Institutes of Health, the major distributor of tax dollars for medical research, and then to grant exclusive licenses to drug companies. Until then, taxpayer-financed discoveries were in the public domain, available to any company that wanted to use them. But now universities, where most NIH-sponsored work is carried out, can patent and license their discoveries, and charge royalties. Similar legislation permitted the NIH itself to enter into deals with drug companies that would directly transfer NIH discoveries to industry.

Change.gov : Partnership to Fight Chronic Disease | Change.gov: The Obama-Biden Transition Team

Mon, 29 Dec 2008 04:39:39 +0000

Continued: The pharmaceutical industry and its CEOs quickly joined the ranks of the winners as a result of a number of business-friendly government actions. I won't enumerate all of them, but two are especially important. Beginning in 1980, Congress enacted a series of laws designed to speed the translation of tax-supported basic research into useful new products—a process sometimes referred to as "technology transfer." The goal was also to improve the position of American-owned high-tech businesses in world markets.