Sunday, January 18, 2009

News Clipping Archives

 

Maryland / Regional

Baltimore women become face of HIV/AIDS (Baltimore Examiner)

The forgotten dead (Baltimore Sun)

CDC reports sudden uptick in births, troubling details (Baltimore Sun)

National / International

Privacy Issue Complicates Push to Link Medical Data (New York Times)

Opinion

Forced to abort (Washington Times Editorial)

Government, stay out of the pool (Hagerstown Herald Mail Commentary)

 

 

Baltimore women become face of HIV/AIDS

 

By Sara Michael

Baltimore Examiner

Sunday, January 19, 2009

 

Nairobia Ramey didn't know much about AIDS and her risks for contracting the disease before she was diagnosed with it three years ago.

 

"It never dawned on me at 24 to ask my male partner about HIV, because I didn't know about HIV," said Ramey, 27, of Baltimore.

 

"Maybe because I wasn't brought up that way. We didn't talk about sex."

 

Now, Ramey is one of about 10 women who shared their stories recently for the new Southern AIDS Living Quilt, a Web site aimed at educating people about the growing effect of HIV and AIDS on women, particularly black and Hispanic women, in the United States.

 

Ramey sat down with filmmakers to be a piece of what they called "a virtual quilt" of videos of women living with AIDS.

 

"We have the messages and the information, and yet we are leading this disease," said Luana Clark, 58, who has been living with HIV for more than 15 years.

 

"I feel like it's my God-given duty to do all I can to make women aware."

 

Baltimore has the second-highest rate of new AIDS cases in the country, and Maryland ranks third in new cases, according to data from the Maryland AIDS Administration, which is part of the state Department of Health and Mental Hygiene.

 

In Baltimore, 86 percent of new HIV cases in 2006 were among blacks, and 37 percent of new cases were women. Blacks accounted for 75 percent of new HIV cases in Maryland.

 

Nationwide, black and Hispanic women represented 80 percent of new HIV and AIDS cases among women in 2005, according to the Centers for Disease Control and Prevention.

 

By having minority women tell their story, the Southern AIDS Living Quilt seeks to reduce the stigma and encourage others to get tested. The quilt is a joint project of the organizations Southern AIDS Coalition and www.testforlife.org Test for Life.

 

"The project's primary goal is to communicate to people, particularly women of color, that there are others out there that share their experiences. They are not alone," said John Procter, a member of the Southern AIDS Living Quilt team.

 

"We really wanted to bring this message to life."

 

Minority women may more often find themselves in high-risk environments, such as domestic abuse, or lacking access to health care, which could explain some of the rising HIV rates, said Baltimore resident Carolyn Massey, 52, who was diagnosed in 1993.

 

There should be better education and outreach to minority women, Clark said.

 

"We have to be more culturally sensitive," she said.

 

For Gail Jones-Childs, 48, filming her story for the project gave her an opportunity to urge other women to known their HIV status.

 

"Testing is very important," she said while filming her segment for the project. "Get tested, get tested, get tested."

 

Copyright 2009 Baltimore Examiner.

 

The forgotten dead

Our view: Marylanders must be shaken from complacency over alcohol-related deaths and pursue comprehensive changes in the way the state deals with impaired drivers

 

Baltimore Sun

Sunday, January 18, 2009

 

One death every 40 hours.

 

That's the reality of crashes involving alcohol or drugs on Maryland roads. Since 2004, an average of about 220 people are killed each year by drunk or impaired drivers while nearly 5,000 are injured.

 

The numbers reveal other constants: Young drivers are more likely to be involved, and so are men. Saturday and Sunday evenings and early mornings are the deadliest hours. More than 24,000 will be arrested for driving under the influence.

 

But here's one of the most troubling numbers of all: Maryland ranks a miserable 35th among states when drunken driving deaths are compared with total vehicle miles traveled.

 

That's outrageous. There is simply no excuse why so many innocent sons and daughters must be sacrificed to drunken drivers on Maryland roads. It ought to be viewed as one of the most pressing public safety issues facing the state. Yet too often it seems to require a particularly brutal crash, or series of them, to stir public interest. Occasionally, lawmakers will pass some minor change to the law and declare victory.

 

But the problem is far more persistent and requires a comprehensive approach that involves not only legal reforms but also changes in enforcement, the way information about drivers is handled by state agencies, alcohol treatment programs and the judicial system.

 

A statewide task force came up with just such a plan and published a report last October that drew little to no attention. But the report ought to be required reading for Gov. Martin O'Malley, his staff and all 188 members of the Maryland General Assembly. The group's 42 recommendations provide the clearest road map to reducing death and injury here that we've seen in some time. They range from relatively minor changes that would require no extra spending to the ambitious and likely controversial. Here are some of the best:

 

• Track offenders from the point of arrest to determine the success or failure of enforcement and treatment options.

 

• Upgrade the state's ignition interlock program to reach more first-time offenders; that should ensure violations recorded by these devices have greater consequence.

 

• Organize more high-visibility enforcement, such as sobriety checkpoints, and publicize it. Police don't need 30 officers (as is too often the current practice) at a time to do this when a half-dozen will do; the point is not to maximize arrests but to send a message to potential offenders.

 

• Tighten laws regulating underage drinking. Not only should a minor lose his driver's license for six months if caught drinking, but a 16-year-old non-driver caught drinking ought to have his driver's license eligibility delayed for six months, too.

 

Some of these reforms can be made right away while others will take time. But the most important step is for the state's elected leaders to acknowledge the failure of the status quo and rally Marylanders to this important cause. One death every 40 hours is not acceptable under any circumstances.

 

Copyright 2009 Baltimore Sun.

 

CDC reports sudden uptick in births, troubling details

 

By Frank D. Roylance

Baltimore Sun

Sunday, January 18, 2009

 

Amid the largest crop of American newborns since the baby boom, a new federal report reveals some worrisome changes in recent childbirth patterns across the nation.

 

Rates of births to teens and to unwed women have ended years of declines and headed higher, setting new records, according to the report on birth trends in 2006 from the Centers for Disease Control and Prevention. At the same time, the percentage of women receiving prenatal medical care in their first trimester, a trend that had been improving, turned lower.

 

The authors also report:

•The highest level of low birthweight babies - 8.3 percent - in four decades.

 

•A sharp increase since 1990 in pre-term babies - up 20 percent.

 

•Steep increases since 1990 in the percentage of mothers who gained too little or too much weight (less than 16 pounds or more than 40) during pregnancy - up from 24 percent to 33 percent of all births.

 

•A record-high percentage of women undergoing Caesarean deliveries in 2006, to more than 31 percent of all live births.

 

The troubling news comes as American women in 2006 were having more babies than at any time since 1961. Births totaled almost 4.3 million in all, up 3 percent from the previous year.

 

Statistics broken down by state show that Maryland women generally scored as well as or better than the national average on these issues.

 

But the state, one of the wealthiest in the nation, still shows sharp contrasts in childbirth trends between racial and ethnic groups, with black and Hispanic mothers and their babies typically disadvantaged relative to whites.

 

Copyright © 2009, The Baltimore Sun.

 

Privacy Issue Complicates Push to Link Medical Data

 

By Robert Pear

New York Times

Sunday, January 18, 2009

 

WASHINGTON — President-elect Barack Obama’s plan to link up doctors and hospitals with new information technology, as part of an ambitious job-creation program, is imperiled by a bitter, seemingly intractable dispute over how to protect the privacy of electronic medical records.

 

Lawmakers, caught in a crossfire of lobbying by the health care industry and consumer groups, have been unable to agree on privacy safeguards that would allow patients to control the use of their medical records.

 

Congressional leaders plan to provide $20 billion for such technology in an economic stimulus bill whose cost could top $825 billion.

 

In a speech outlining his economic recovery plan, Mr. Obama said, “We will make the immediate investments necessary to ensure that within five years all of America’s medical records are computerized.” Digital medical records could prevent medical errors, save lives and create hundreds of thousands of jobs, Mr. Obama has said.

 

So far, the only jobs created have been for a small army of lobbyists trying to secure money for health information technology. They say doctors, hospitals, drugstores and insurance companies would be much more efficient if they could exchange data instantaneously through electronic health information networks. Consumer groups and some members of Congress insist that the new spending must be accompanied by stronger privacy protections in an era when digital data can be sent around the world or posted on the Web with the click of a mouse.

 

Lawmakers leading the campaign for such safeguards include Representatives Edward J. Markey of Massachusetts and Pete Stark of California, both Democrats; Senator Patrick J. Leahy, Democrat of Vermont; and Senator Olympia J. Snowe, Republican of Maine.

 

Without strong safeguards, Mr. Markey said, the dream of electronic health information networks could turn into “a nightmare for consumers.”

 

In the last few years, personal health information on hundreds of thousands of people has been compromised because of security lapses at hospitals, insurance companies and government agencies. These breaches occurred despite federal privacy rules issued under a 1996 law. Congress is trying to strengthen those privacy protections and make sure they apply to computer records. Lobbyists for insurers, drug benefit managers and others in the health industry are mobilizing a campaign to persuade Congress that overly stringent privacy protections would frustrate the potential benefits of digital records.

 

One of the proposed safeguards would outlaw the sale of any personal health information in an electronic medical record, except with the patient’s permission.

 

Another would allow patients to impose additional controls on certain particularly sensitive information, like records of psychotherapy, abortions and tests for the virus that causes AIDS. Patients could demand that such information be segregated from the rest of their medical records.

 

Under other proposals being seriously considered in Congress, health care providers and insurers would have to use encryption technology to protect personal health information stored in or sent by computers. Patients would have a right to an accounting of any disclosures of their electronic data. Health care providers and insurers would have to notify patients whenever such information was lost, stolen or used for an unauthorized purpose. And patients — or state officials acting on their behalf — could recover damages from an entity that improperly used or disclosed personal health information.

 

Rahm Emanuel, who will be the White House chief of staff for Mr. Obama, advocated such safeguards when he was a House member from Illinois. “As we move forward on health information technology,” Mr. Emanuel said, “it is absolutely essential that an individual’s most personal and vulnerable information is protected.”

 

Advisers to Mr. Obama say he favors strong privacy protections but does not want the dispute to slow down the bill.

 

Mary R. Grealy, president of the Health Care Leadership Council, which represents large health care corporations, said the proposed safeguards could be an impediment to the widespread adoption of health information technology and counteract any economic stimulus effect.

 

In a letter to Congressional leaders, Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group for insurers, expressed “serious concern about privacy provisions being considered for inclusion in the economic stimulus bill.”

 

She criticized, in particular, a proposal that would require health care providers to obtain the consent of patients before disclosing personal health information for treatment, payment or “health care operations.”

 

Such a requirement, she said, could cripple efforts to manage chronic diseases like diabetes, which often require coordination of care among many specialists.

 

At the moment, senior House Democrats are determined to include privacy safeguards in the economic recovery bill. But some insurance lobbyists said they hoped Congress would punt on the issue, leaving privacy standards to be developed by the Health and Human Services Department, where they believe they can make their case more effectively. Microsoft has joined many consumer groups in supporting stronger safeguards. The software giant has developed products that allow consumers and providers to store and share medical data in a secure format.

 

“Health information technology will succeed only if privacy is protected,” said Frank C. Torres, director of consumer affairs at Microsoft. “For the president-elect to achieve his vision, he has to protect privacy.”

 

Senator Sheldon Whitehouse, Democrat of Rhode Island, and Peter R. Orszag, director-designate of the White House Office of Management and Budget, said electronic medical records could be more secure than paper records.

 

“If the files are electronic,” Mr. Whitehouse said, “computers can record every time someone has access to your medical information.” But, he said, the challenge is political as well as technical.

 

“Until people are more confident about the security of electronic medical records,” Mr. Whitehouse said, “it’s vitally important that we err on the side of privacy.”

 

The data in medical records has great potential commercial value. Several companies, for example, buy and sell huge amounts of data on the prescribing habits of doctors, and the information has proved invaluable to pharmaceutical sales representatives.

 

“Health I.T. without privacy is an excellent way for companies to establish a gold mine of information that can be used to increase profits, promote expensive drugs, cherry-pick patients who are cheaper to insure and market directly to consumers,” said Dr. Deborah C. Peel, coordinator of the Coalition for Patient Privacy, which includes the American Civil Liberties Union among its members.

 

Copyright 2009 New York Times.

 

Forced to abort

 

Washington Times Editorial

Sunday, January 18, 2009

 

Many women say they have been pressured into abortions they did not want, according to research conducted by the Elliot Institute, a nonprofit specializing in the effects of abortion on women and families.

 

For years, the pro-choice movement has circulated horrid tales of back-alley abortions performed before Roe v. Wade legalized abortion on demand in 1973. Yet the opposite phenomenon, which has occurred across the nation, is even more disturbing. In a society in which abortion is legal, many women and teens are pressured to abort their child. So how much choice do American women really have over their reproductive capacities?

 

Women are coerced to abort a fetus by either husbands or boyfriends who do not want the additional responsibility or expense of a child; by parents who are ashamed of a teen pregnancy or who seek to conceal incest or rape; or by counselors, pastors and health professionals who insist this is in a woman's best interest even when she doesn't think so. Consider the pressures women face to abort a child: 45 percent of men interviewed at abortion clinics said they urged abortion, including 37 percent of married men, according to the report "Forced Abortion in America" that compiled much of the research on this topic. Women are often threatened by male companions who take them to their abortion appointment, according to eyewitness accounts at abortion clinics. And women are also encouraged to abort their fetus by the staff at these clinics who have a vested interest in selling the procedure.

 

Pressure to abort can consist of badgering a pregnant woman until she concedes, intimidation, blackmail and even violence. An astounding 64 percent of women say they were intensely pressured to abort their fetus, according to a 2004 study published in the Medical Science Monitor. Hundreds of women have come forward to tell their tale - and some of these stories have led to convictions of coercers.

 

In Florida, Glenda Dowis brought her pregnant daughter at gunpoint to an abortion clinic, where the staff called police. To cover up her son's rape of a 12-year-old, Pennsylvania mother Joyce Farley took the pregnant girl out of state for an abortion - her parents were not notified. Nine women held in a juvenile detention center in Chalkville, Alabama accused the male guards of repeatedly raping them and then forcing the girls to have abortions when they became pregnant. Augencia Jasso of New Mexico was charged after hitting his pregnant, young, sexually abused victim in the stomach, deliberately inducing a miscarriage.

 

In other instances, coercion was less intense, but nonetheless played a vital role. A homeless woman, Shontrese Otry, was coerced to get an abortion by Emergency Shelters Inc., whose staff would not give her shelter unless she aborted the baby; she later won a $25,000 settlement. Actress Hunter Tylo was told by producers of "Melrose Place" to "just go out and get an abortion" when she became pregnant; she was fired - and later won a pregnancy discrimination suit. Assistant women's basketball coach Sharrona Alexander was told by a head coach at the University of California- Berkeley to quit or have an abortion; she gave birth and then won a $115,000 settlement.

 

Elliott Institute founder David Reardon says that Americans need to think about the many ways women feel pressured to abort, and then suffer severe emotional and psychological consequences. In one instance, a pregnant teen he interviewed said she was asked by her mother: "Where will you live?"According to Mr. Reardon, "The withdrawal of social and economic support by parents is among one of the most common forms of coercion."

 

Yet, despite the growing body of evidence on the issue of forced abortions, little headway has been made in protecting women. "I have been disappointed in the pro-life camp for not raising the level of urgency on this,"said Dr. Reardon. A simple solution is for states to pass a bill such as "The Prevention of Coerced and Unsafe Abortions Act" featured in the report.

 

This would require health professionals to screen for coercion and to counsel against an abortion in instances where there is a high risk that the woman is not freely consenting or that she will suffer severe depression - and possibly even attempt suicide - as a result of the procedure. Introducing a legal liability for psychological damage is one possible way to combat these practices. There is an ugly - and underreported - underside to the abortion industry: "Choice" is sometimes turned into coercion. The back alleys are gone, but the dangers for both mother and child are ever-present.

 

Copyright 2009 Washington Times.

 

Government, stay out of the pool

 

By Tim Rowland

Hagerstown Herald Mail Commentary

Sunday, January 18, 2009

 

Citing our poor health, government scolds us for not exercising. Then when we try to exercise, government says we can't, citing, of all things, health regulations.

 

Because of a $2 billion budget deficit, the State of Maryland says it is looking for inexpensive ways this year to improve our quality of life.

 

Here would be a good start: Wipe out a whole raft of state-imposed regulations that prevent whole communities from getting healthier under the theory that one member of that community might not, however slim that chance might be.

 

A clear example was on display this week, when a group of seniors were told they could no longer swim at the pool in the Plaza Hotel because there's no life guard on duty. Guests of the hotel can swim there without a life guard. But not the group of seniors, who had been doing so for years, apparently without incident.

 

That's because the state uses an arcane set of legal definitions for "public pools," "semi-public pools" and "recreational pools." Apparently, the state believes the water is wetter in a public pool than in the other kinds, so there is more chance for drowning.

 

So a great, healthy and mutually beneficial program among private senior citizens and private enterprise is wiped out in the name of unyielding state regulations. Of course the local health department is just following the law and probably has little choice in the matter, but it is nonsense when it insists that the state "did not close the pool." That line is spoken like a true - well, a true member of a government agency.

 

If there were no health department (i.e., state) interference, it seems clear that the seniors would still happily be swimming at the Plaza. So don't talk to us about how, technically, it is the hotel's responsibility to do this or that. It is the state's responsibility to enact rules that make some degree of sense.

 

And this isn't the only area where the health department flies squarely in the face of our health. Many people want to purchase wholesome, locally raised meat or buy raw milk from a local farm that hasn't been tainted by the nation's industrial-agricultural complex. But they can't, because these small farms don't have a government inspector analyzing every step of the production process.

 

Think back to the last few, food-related health scares. Spinach, ground beef, tomatoes, peanut butter - all were products of big, government approved agribusiness. Such episodes are rare on the conscientious, family farms that the government assures us cause certain death.

 

It all gets back to risk, and our preoccupation with wanting to reduce our risk-factor to zero. But in life, this can never be. We know now that fretful mothers who scoop their tots off of a dirty floor are doing them no favors, because children need exposure to germs in order to fight them. In our pursuit of zero-risk, we make things worse.

 

Of course legal liabilities have a strong hand in this phenomenon as well, and our propensity to sue over every unlucky turn of an ankle has contributed in no small way to the problem.

 

But the state could make a strong start in the disassembly of the zero-risk fallacy by allowing for activities that have a one in a million chance of working out badly, but otherwise contribute to the greater good and a richer, healthier life.

 

I believe the great majority of us are comfortable taking responsibility for our own decisions and do not require state protection at every turn.

 

The added benefit would be to bring respect back to our health departments. These agencies are, or should be, one of our more serious and important advocates when it comes to the big matters of keeping sewage from seeping into the public water supply or plants belching toxic chemicals into the air.

 

Yet today, say the words "health department," and you get a variety stray snickers and rolling of eyes. That's because just about everyone has some first-hand story of government cracking down on the brownies they're trying to sell at their yard sales. Elimination of these trivial and time consuming deeds would restore health departments to their proper standing as respected agencies that work for the people instead of telling them where they can and can't swim.

 

Tim Rowland is a Herald-Mail columnist.

 

Copyright 2009 Hagerstown Herald-Mail

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