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National Marrow Donor Program Increasing Efforts To Attract Minority Donors
The National Marrow Donor Program, a not-for-profit group that manages a national registry for potential bone marrow donors, is using social networking sites to attract donors from minority communities, the Wall Street Journal reports. The process of finding a genetic match for a bone marrow transplant is often more difficult for minorities or people who identify themselves as multiracial because patients and donors must be genetically compatible. According to the Journal, a white patient has an 88% chance of finding a match, while the odds of most minorities finding a match can be as low as 60%. The odds of some minorities actually receiving a transplant can be as low as 20% because of other factors such as access to care in their communities, the Journal reports. About seven million U.S. residents already have signed up for the national registry -- recently renamed Be the Match -- and the program also has increased outreach to younger potential donors through social networking Web sites, such as Facebook and MySpace (Landro, Wall Street Journal, 5/27).
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Senate Fiscal Year 2010 Spending Bill Excludes Abstinence-Only Education Funding, Needle Exchange Language
The Senate Appropriations Labor, HHS, Education and Related Agencies Subcommittee on Tuesday approved by voice vote its fiscal year 2010 spending bill draft, which excludes funding for abstinence-only sex education programs and, unlike the House bill, does not include language lifting the ban on the use of federal funding for needle exchange programs, CQ Today reports. According to the article, Committee Chair Tom Harkin (D-Iowa) "confirmed that the bill will not contain funding for abstinence-only education programs when the full committee marks it up on Thursday. Instead, the draft will contain funding for more comprehensive sex education, which can include teaching abstinence." Harkin also said that the Senate bill does not contain language lifting the ban on the needle exchange funding because that is "a matter for conference" (Wolfe, 7/28).
News of the day
Segregation Decreases Access To Surgical Care For Minorities, Study Finds
New research published in the June issue of the Journal of the American College of Surgeons reveals that in counties with the highest levels of segregation, an increase in the African-American or Hispanic population was associated with a decrease in the availability and use of surgical services and an increase in the number of emergency room visits. This research supports prior studies that have shown that minority groups in the United States have comparatively poorer access to a range of health care services, often resulting in late diagnosis of illness and delayed treatment.
Oncology

Risk For Premature Birth May Be Heightened By Pre-Pregnancy Depressed Mood

Researchers trying to uncover why premature birth is a growing problem in the United States and one that disproportionately affects black women have found that pre-pregnancy depressive mood appears to be a risk factor in preterm birth among both blacks and whites. Black women, however, have nearly two times the odds of having a preterm birth compared to white women, according to Amelia Gavin, a University of Washington assistant professor of social work and lead author of a new study that appears online in the June issue of the Journal of Women"s Health. "Preterm births are one of the most significant health disparities in the United States and the overall number of these births increased from 10.6 percent in 2000 to 12.8 percent in 2005," she said. While there appears to be some sort of link between giving birth prematurely and depressed mood, the study found no cause and effect, said Gavin, who studies health disparities. She believes the higher preterm birth rate among blacks may be the result of declining health over time among black women. For this study, premature birth referred to any child born after less than 37 weeks of gestation. Normal gestation ranges from 38 to 42 weeks. Data for the study was drawn from a larger longitudinal investigation looking at the risks for cardiovascular disease among more than 5,000 young adults in four metropolitan areas. The Coronary Artery Risk Development in Young Adults Study also collected information about mental health and pregnancy outcomes. Between 1990 and 1996, 555 women in the larger study gave birth. These women were the subjects in the depression-premature birth study. "At this point we can"t say that pre-pregnancy depressive mood is a cause of preterm birth or how race effects this association," said Gavin. "But it seems to be a risk factor in giving birth prematurely and higher pre-pregnancy depressive mood among black women compared to white women may indirectly contribute to the greater odds of preterm birth found among black women." In the study 18.1 percent of the black women had a preterm birth compared to 8.5 percent of the white women. This difference may be the result of what she calls "weathering," or accelerated declines in health due to repeated socioeconomic and political factors. "What some people experience by being black takes a toll on the physiological system, and over time wear and tear that occurs across neural, neuroendocrine and immune systems as a result of chronic exposure to stressors lead to health disparities for blacks. Some of this may manifest itself in premature birth and low-birth weight," Gavin said. The study did not look at depressive mood or depression during pregnancy because the larger research project did not collect that data. She hopes to replicate and expand her findings by analyzing data from another study to look at depressive mood prior to pregnancy and childhood poverty to see if those two factors in part explain the black and white difference in preterm delivery. That study also will look at the role antidepressive medication plays in preterm birth. "My ultimate goal is to incorporate a life course health development framework to examine disparities in birth outcomes," she said. "You have to look at the context of health across the life course of a woman, not just during pregnancy." The consequences of higher preterm delivery are a growing burden on the health care system and parents. Studies have shown that preterm babies have higher morbidity rates and U.S. preterm birth rates are creeping up with no good explanation. In the U.S. the population at greatest risk for major depression is women of childbearing age and the onset and course of depression are often intertwined with reproductive events. A recent national study reported that 8.4 percent of pregnant women in the past year experienced major depression and only slightly more than 14 percent of those women sought treatment for any mood disorder. Co-authors of the study are David Chae of Emory University, Sarah Mustillo of Purdue University, and Dr. Catarina Kiefe of the University of Alabama at Birmingham and the Birmingham Veterans Affairs Medical Center. The National Center for Research Res and the Roadmap for Medical Research, both components of the National Institutes of Health, funded the research. Joel Schwarz University of Washington


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