Disparities & Access

"The scheduled launch of UNICEF’s Mother-Baby Pack in Kenya tomorrow marks the moment when this innovation for preventing mother-to-child HIV transmission begins to fulfil its potential to save lives in the developing world. The Mother-Baby Pack is a creative response to an unmet need. Every day, more than 1,000 infants worldwide are infected with HIV during pregnancy, labour, delivery or breastfeeding. Most are in sub-Saharan Africa.

Without medical help, at least half of these babies will die before their second birthday. But a medical and social intervention known as prevention of mother-to-child transmission, or PMTCT, can safeguard them from HIV – while protecting the health of their mothers.

The Mother-Baby Pack is a take-home box of PMTCT drugs designed for women and children who have no access to conventional, high-quality preventive care. It contains all the anti-retroviral drugs and antibiotics required to protect the health of one mother and child. The medicines are pre-measured and packaged to make it easy for adults to administer them correctly. Only pregnant women living with HIV who do not yet require treatment for their own health will receive Mother-Baby Packs."

"Minority patients have a significantly decreased survival from colon cancer compared to white patients, most often as a result of a late diagnosis. To help address this problem, a team of healthcare professionals at Memorial Sloan-Kettering Cancer Center has identified an efficient way to increase minority access to lifesaving colorectal cancer screening (CRCS) in communities where multiple barriers to preventive care exist. In the November 8 issue of the journal Cancer, the group reports how women living in Harlem were introduced to CRCS during their routine mammography screening.

'We hypothesized that mammography centers, similar to the one where this study took place, offer a unique opportunity to introduce the concept of colon cancer screening, because the women being tested are most likely already familiar with the concept of cancer screening," explained Moshe Shike, MD, an attending physician at Memorial Sloan-Kettering Cancer Center and the study's lead author. "Unfortunately, minorities in this community often have a late diagnosis and subsequent poor outcome from colon cancer because they are not able to – for one reason or another – access the routine preventive care they need. However, minority women, including many living in Harlem, are taking advantage of mammography screening as a result of ongoing outreach and education efforts.'"

"Studies have demonstrated that black and Hispanic women are less likely to receive recommended breast cancer treatments than white women. Compared with white women, black women had 0.91 times lower odds of receiving recommended local therapy, 0.90 times lower odds of receiving hormonal therapy, and 0.87 times lower odds of receiving chemotherapy. Hispanic women were also less likely than white women to receive hormonal therapy. Hormone receptor testing did not differ by race/ethnicity. These modest racial disparities persisted even after accounting for insurance and socioeconomic status.

Despite efforts to eliminate disparities in cancer care in recent years, this study suggests that modest racial differences in the receipt of recommended breast cancer care still persist even after taking patients' insurance and socioeconomic status into account."

"African American women are more likely than white women to be diagnosed at later stages of the disease and are more likely to die from breast cancer. Researchers have long wondered why this is true and have considered lack of health insurance as a likely factor.

Yet, a troubling new study says that race and-or ethnicity--rather than insurance status-- is the leading cause for these delays in breast cancer diagnosis in minority women."

"The seven women were accused of killing their newborn babies and handed long prison sentences. They insisted they had suffered miscarriages and should not be punished; one claimed she wasn't even sure she was pregnant.

The women have finally been freed, after years in jail and only after their cause was taken up by human rights organizations here and abroad and by a handful of determined legislators.  However the pregnancies ended, the cases highlighted the poor quality of reproductive healthcare and education in parts of Mexico, and the stigma still attached to unwanted pregnancies.

Free, but not exonerated. The women were released only after the state legislature reduced the penalty for the crime most were convicted of: infanticide.  Advocates for the women say they got caught up in Mexico's cultural wars over abortion. Abortion was legalized in Mexico City in 2007, but not in the rest of the country. In numerous states, Guanajuato included, there has been a backlash as local authorities seek to restrict even further the ability of women to terminate their pregnancies.

Veronica Cruz, director of Las Libres social-welfare center in Guanajuato that supported the women, said she believed authorities wanted to prosecute the women for having induced abortions. But abortion only carries a sentence of six months to three years in jail. By charging them with killing a full-term born infant, authorities could send the women to prison for up to 29 years and send a chilling message."

"Every year, anti-choice state legislators propose measures intended to restrict women's access to abortion, including mandatory delays, biased counseling provisions and other burdensome and unnecessary requirements. On average, more than six hundred bills are proposed annually and dozens are passed, making it increasingly difficult for women in many states to access abortion. This year has been one of the most challenging state legislative sessions for women's access to abortion in many years. States considered and enacted some of the most extreme restrictions on abortion in recent memory, as well as passing laws creating dozens of other significant new hurdles. At the same time, pro-choice legislators, advocates and governors continued to stand up for women's health and rights and in many cases defeated harmful legislation. As we begin to assess the impact of the 2010 session on women's access to reproductive healthcare, the Center offers this preliminary recap of some of the major trends and most onerous laws enacted this session."

"A bill supporters say is essential to women's health is awaiting a decision by Governor Arnold Schwarzenegger. It would fully restore a program that provides free cancer screenings to low-income women.

The Every Woman Counts Program offers breast and cervical cancer screenings to poor women statewide. More than 6,000 women in San Diego County use the program annually.

Late last year, the governor made some changes to save money. He raised the minimum age for eligibility for mammograms from 40 years old to 50. He also froze enrollment in the program.

The legislature has unanimously approved a bill that would reverse those changes. The governor hasn't said whether he'll sign the bill."

"More mothers die during pregnancy or soon after in New York than in almost every other state, and according to reports released on Friday by the New York Academy of Medicine and the city’s health department, social factors like poverty, obesity and lack of insurance may be responsible.

While the total number of maternal deaths are small — an average of about 40 a year across the state — city health officials said their analysis showed that maternal mortality was being driven by environmental factors like poor nutrition that could be changed through public policy. New York City’s analysis, billed as one of the most sophisticated looks at maternal mortality in the country, studied 161 women who died of pregnancy-related causes in the city from 2001 to 2005. It found that 49 percent of the women who died were obese. Black women, who were more likely to be obese, were seven times as likely to die in pregnancy as white women. Hispanic and Asian women were twice as likely to die as white women."