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College Access For The Working Poor [July 31, 2007] Assessing Healthcare Quality And Safety [July 30, 2007] How Parents And The Public Look At Higher Education Today [July 27, 2007] Status Of Education In Rural America [July 26, 2007] International Directory Of Quality Assurance Bodies [July 25, 2007] Healing The Healthcare Staffing Shortage [July 24, 2007] Negative Reaction To Report That Criticizes Accreditation [July 23, 2007] Provider's Knowledge Of Genetics [July 20, 2007] Is Accreditation As Bad As Some Critics Believe? [July 19, 2007] Are Citizens Of The World Satisfied With Their Health [July 18, 2007] Health Records Alone Don't Aid Patient Care [July 17, 2007] Federal Policies Offer Mixed Signals About When to Retire [July 16, 2007] America's Children: Key National Indicators Of Well-Being 2007 [July 13, 2007] Poll Reveals Skepticism About The Value Of Tenure [July 12, 2007] Financing Medicare And Medicaid In The Long Run [July 11, 2007] Financing Medicare And Medicaid In The Long Run [July 11, 2007] Academic Health Center CEOs Say Faculty Shortages A Major Problem [July 10, 2007] AHRQ Seeks Submissions To Build Its New Health Care Innovations Exchange [July 9, 2007] Joint Commission Announces National Patient Safety Goals [July 6, 2007] Male Exodus From Primary Care Practice Of Medicine [July 5, 2007] The Effects Of Marriage On Health [July 3, 2007] Congress Passes Extension Of Higher Education Act [July 2, 2007] Predoctoral And Postdoctoral Training Awards Available [June 29, 2007] Most Populous U.S. Cities [June 28, 2007] Health Care Improves When Patients Have A Medical Home [June 27, 2007] Campus Accountability [June 26, 2007] Percentage Of Individuals Without Health Insurance [June 25, 2007] Health Care And The Budget: Issues And Challenges [June 22, 2007] Institutional Versus Academic Discipline Measures Of Student Experience [June 21, 2007] Men Avoid Prevention Measures [June 20, 2007] Update On Reauthorization Of Higher Education Act [June 19, 2007] Complementary And Alternative Medicine Predoctoral Research Fellowships Available [June 18, 2007] Quality Of Care Is Better When Patients Have More Chronic Illnesses [June 15, 2007} Mapping The Growth Of Older America [June 14, 2007] U.S. Hospital Care: Separate But Not Equal [June 13, 2007] Graduate Education's Role In U.S. Competitiveness And Innovation [June 12, 2007] State Snapshots Highlight Gains And Lags In Health Care Quality [June 11, 2007] Health Careers Website For Students Obtains Renewed Life [June 8, 2007] Training Physicians for Public Health Careers [June 7, 2007] Curbing The Cost Of College Textbooks [June 6, 2007] College And University Ranking Systems [June 5, 2007] The Limits Of Reductionism In Medicine [June 4, 2007] The Condition Of Education 2007 [June 1, 2007] College Access For The Working Poor College Access for the Working Poor: Overcoming Burdens to Succeed in Higher Education , a major report by the Institute for Higher Education Policy, examines the precarious position of working poor students in our society. At the prospect of attending postsecondary education, these students realize it requires navigating through a minefield of conflicting work and family demands. The report points out the unique barriers working poor students experience and calls attention to the need for policies and practices to raise expectations, enrollment, and completion rates of the working poor. The report can be accessed by clicking Assessing Healthcare Quality And Safety As health care quality and patient safety concerns rise, the latest Commonwealth Fund Health Care Opinion Leader Survey finds leaders united behind several key reform measures: more than half (56%) support the creation of a new public-private entity to coordinate quality efforts and form a national quality agenda; 95% believe that fundamental payment reform is needed; and three-fourths (73%) say that greater organization and integration of provider care is necessary for improved quality and efficiency. Within these broad categories, the survey found consensus for specific strategies—many that include government leadership. For additional information, click How Parents And The Public Look At Higher Education Today The Secretary of Education's Commission on the Future of Higher Education called for reforms such as greater accountability and productivity in higher education. A report from the National Center for Public Policy and Higher Education and Public Agenda explores how the American public is thinking about higher education today. Are Americans pleased with the system as it exists or are they looking for change? How is the system working from the public's point of view and from the point of view of parents whose children may soon be students? To explore this question, Public Agenda, a nonprofit, nonpartisan organization that conducts opinion research on public policy issues, designed and fielded a random sample survey of 1,001 Americans, including over-samples of African-American and Hispanic parents with children in high school. The project included five focus groups around the country and interviews with more than two dozen corporate, media, philanthropic, and legislative leaders. The study also examined a series of similar public surveys, going back to 1993, to see how the public's views have changed (or stayed the same) over time. The report can be accessed by clicking Status Of Education In Rural America A new report from the National Center for Education Statistics (NCES) provides information about the status of education in rural America. Among the findings are the following: International Directory Of Quality Assurance Bodies A directory produced by the Council for Higher Education Accreditation (CHEA) contains contact information about 467 quality assurance bodies, accreditation bodies and Ministries of Education in 175 countries. The quality assurance and accreditation bodies have been authorized to operate by their respective governments either as agencies of the government or as private (nongovernmental) organizations. The information has been obtained from the quality assurance or accreditation body or ministry of education. It has been reformatted by CHEA but otherwise not edited. The terminology used by the different organizations and governments is not standardized. This directory is provided as a public service without warranty of any kind. The directory does not constitute an endorsement by CHEA of the agencies or organizations contained here. It can be accessed by clicking http://www.chea.org/intdb/disclaimer.asp Healing The Healthcare Staffing Shortage The federal government predicts that by 2020, nurse and physician retirements will contribute to a shortage of approximately 24,000 doctors and nearly 1 million nurses. Health industry leaders are faced with the challenge of orchestrating care in an increasingly complex and converging healthcare labor market. Seeking solutions means understanding that while the challenges confronting nurse and physician shortages are very different, their roles and futures are starting to converge. A new report from the Health Research Institute at PriceWaterhouseCoopers discusses this issue. The document can be accessed by clicking http://pwchealth.com/cgi-local/hregister.cgi?link=reg/pubwhatworks.pdf . Negative Reaction To Report That Criticizes Accreditation [July 23, 2007] The July 19 entry in this section of the ASAHP homepage contains a reference to a policy report from the American Council of Trustees and Alumni (ACTA) entitled “Why Accreditation Doesn't Work and What Policymakers Can Do about It.” An opposing point of view is offered by the Council for Higher Education Accreditation (CHEA). The comments from CHEA may be accessed by clicking http://www.chea.org/ia/IA_072007.html . Provider's Knowledge Of Genetics Genetics now has established itself in the United States and in other countries not only as a specialty of medicine, but also as a thread throughout all of health care. A concerted impetus exists from government agencies and scientific groups to educate future practitioners about genetics and to incorporate more genetics into the general practice of health care. According to a study by Harvey et al in the May 2007 issue of Genetics in Medicine , more than 80% of 5915 respondents reported having between one and four affected family members, having been diagnosed within the last 5 years, and consulting an average of six different provider types (excluding genetics professionals). Despite having chronic genetic conditions that pose risks to themselves, their offspring, and other family members, 64% of the total study sample reported receiving no genetics education materials from their providers. The data highlight the importance of allied health providers and demonstrate the need for a team approach to care through communication across disciplines. Allied health providers, in fact, scored higher than primary care and specialist physicians in their ability to collaborate with patients to identify needed services and to develop management plans, and in their understanding of the medical and psychosocial impact of the condition on the family. Yet, the overall distribution of “poor” knowledge rankings among providers indicates that there is much work to be done to incorporate genetics in a clinically meaningful way across disciplines. In the absence of genetics information from providers, individuals and families turned to multiple sources (including the Internet, advocacy organizations, literature, and classes). In turn, these educated consumers expressed frustration with an apparent lack of receptivity among providers to information about the genetic condition in the family. Is Accreditation As Bad As Some Critics Believe? A newly released policy paper by the American Council of Trustees and Alumni (ACTA) is entitled, “Why Accreditation Doesn't Work and What Policymakers Can Do about It.” This paper is intended as a primer for policymakers on lessons learned from decades of experience with the federal system of higher education accreditation. It streamlines, updates, and expands ACTA's 2002 investigation, “ Can College Accreditation Live Up to Its Promise? ” which found that accreditation did not ensure quality, was not protecting the curriculum from serious degradation, and was giving students, parents, and public decision-makers almost no useful information about institutions of higher education. The new investigation purports that things have only become worse. The paper can be accessed by clicking Are Citizens Of The World Satisfied With Their Health This paper represents initial analyses of data on self-perceived health conditions and satisfaction with personal health from a representative survey of citizens in 130 countries. The analysis examines the effects of income and age on health perceptions along with the combined effect of cultural norms and income. Three important conclusions can be drawn. First, individual perceptions regarding personal health status are remarkably consistent around the world. Second, the incidence of satisfaction with personal health in the United States is comparable to that in most countries. Third, perceptions of personal health correlate strongly with respondents' income level, both globally and regionally. [ Health Affairs 26, no. 5 (2007): w545-w551 (published online 17 July 2007; 10.1377/hlthaff.26.5.w545)] The article can be accessed by clicking http://content.healthaffairs.org/cgi/reprint/hlthaff.26.5.w545v1 Health Records Alone Don't Aid Patient Care While electronic health record systems hold promise for helping improve the quality of health care and reducing medical errors, a new AHRQ-funded study has found that they do not in and of themselves improve quality. The study, by Linder et al published in the July 9 issue of the Archives of Internal Medicine , which examined how electronic health records affect quality of care in the doctor's office setting, found that EHRs were not associated with better quality care. Researchers suggest that implementation of EHR systems must be accompanied by other quality improvement undertakings in order to be successful. Federal Policies Offer Mixed Signals About When to Retire According to a new report from the government Accountability Office (GAO), federal policies offer incentives to retire both earlier and later than Social Security's full retirement age depending on a worker's circumstances. Nearly half of workers report being fully retired before turning age 63 and start drawing Social Security benefits at the earliest opportunity—age 62. Early evidence, however, suggests small changes in this pattern. Traditionally, some workers started benefits when they reached age 65. GAO's analysis indicates that retiree health insurance and pension plans are strongly associated with when workers retire. After controlling for other influences such as income, GAO found that those with retiree health insurance were substantially more likely to retire before the Medicare eligibility age of 65 than those without. GAO also found that men with defined benefit plans were more likely to retire early (before age 62) than those without, and men and women with defined contribution plans were less likely to do so. The report can be accessed by clicking http://www.gao.gov/new.items/d07753.pdf. America's Children: Key National Indicators Of Well-Being 2007 Compared to national statistics for the previous year, there has been an increase in the percentage of children living with at least one working parent and the percentage of children living in households classified as food insecure has declined. High school students were more likely to have taken advanced academic courses and the percentage of young adults who completed high school has increased. The adolescent birth rate has dropped to a record low.Increasing were: the percentage of children served by community water systems that did not meet all applicable standards for healthy drinking water and the percentage of children living in physically inadequate or crowded housing or housing that cost more than 30 percent of household income. The percentage of low birthweight infants also increased as did the percentage of births to unmarried women. The rate at which youth were perpetrators of serious violent crime increased slightly. These findings are described in detail in America's Children: Key National Indicators of Well-Being, 2007 , the U.S. government's annual report that monitors the well-being of the Nation's children and youth. The report is a compendium of the most recently released federal statistics on the nation's children, issued by the Federal Interagency Forum on Child and Family Statistics. It presents a comprehensive look at critical areas of child well-being. These encompass family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. The report can be accessed by clicking http://childstats.gov/pdf/ac2007/front.pdf . Poll Reveals Skepticism About The Value Of Tenure As legislation is introduced in more than a dozen states across the country to counter political pressure and proselytizing on students in college classrooms, a majority of Americans believe the political bias of college professors is a serious problem, according to a new Zogby Interactive poll released yesterday. The survey also showed that an overwhelming majority also believe that job security for college professors leaves them less motivated to do a good job than those professors who do not enjoy a tenured status - 65% said they believe non-tenured professors are more motivated to do a good job in the classroom. It should be noted that no definition of tenure was provided for respondents, which calls into question the degree to which they understand what tenure entails. The poll was conducted this month through an online survey of 9,464 adults, and has a margin of error of +/- 1 percent. A Zogby spokesman said that the poll was conducted by the polling company itself, and was not sponsored by any group. Financing Medicare And Medicaid In The Long Run Under current law, rising health care costs and the aging of the population will cause federal spending on Medicare, Medicaid, and Social Security to rise substantially as a share of the economy. If tax revenues as a share of gross domestic product (GDP) remain at current levels, that additional spending will eventually cause future budget deficits to become unsustainable. To prevent those deficits from growing to levels that could impose substantial costs on the economy, the choices are limited: Revenues must rise as a share of GDP, projected spending must fall, or both. The Congressional Budget Office (CBO) has prepared an analysis of the potential economic effects of using higher tax rates alone to finance the projected increases in spending over the next several decades. That analysis also examines the effect of such tax changes on various illustrative taxpayers. The Report can be accessed by clicking http://www.cbo.gov/ftpdocs/82xx/doc8295/07-09-Financing_Spending.pdf . Financing Medicare And Medicaid In The Long Run Under current law, rising health care costs and the aging of the population will cause federal spending on Medicare, Medicaid, and Social Security to rise substantially as a share of the economy. If tax revenues as a share of gross domestic product (GDP) remain at current levels, that additional spending will eventually cause future budget deficits to become unsustainable. To prevent those deficits from growing to levels that could impose substantial costs on the economy, the choices are limited: Revenues must rise as a share of GDP, projected spending must fall, or both. The Congressional Budget Office (CBO) has prepared an analysis of the potential economic effects of using higher tax rates alone to finance the projected increases in spending over the next several decades. That analysis also examines the effect of such tax changes on various illustrative taxpayers. The Report can be accessed by clicking Academic Health Center CEOs Say Faculty Shortages A Major Problem Worsening faculty shortages in academic health centers are threatening the nation's health professions educational infrastructure, according to the latest report by the Association of Academic Health Centers (AAHC). Based on a questionnaire of AAHC members – the CEOs of academic health centers nationwide – the report found that 94 percent of CEOs think faculty shortages are a problem in at least one health professions school, and 69 percent think that these shortages are a problem for the entire institution. These shortages are widespread across institutions, affecting nearly every type of health professions school. Faculty shortages in nursing were rated as most severe, with 81 percent of CEOs declaring them to be a problem, including 45 percent who rate nursing faculty shortages as “very much a problem.” Not far behind, 77 percent of CEOs declared faculty shortages to be a problem in allied health, 71 percent in pharmacy, 70 percent in medicine, 67 percent in dentistry, and 55 percent in schools of public health. Facing shortages, half of respondents reported the need to make institutional changes. Institutional responses included cutting programs, merging programs, and limiting student enrollment. Limiting student enrollment was the most common strategy cited by CEOs. Asked to assess state government awareness of health workforce issues, including faculty shortages, CEOs gave governors and state legislatures low ratings. However, CEOs expressed the need for federal and state governments to take a great deal of action on health workforce issues. The report can be accessed by clicking AHRQ Seeks Submissions To Build Its New Health Care Innovations Exchange Joint Commission Announces National Patient Safety Goals The Joint Commission recently announced the 2008 National Patient Safety Goals and Related Requirements for each of its accreditation programs and its Disease-Specific Care Certification Program. The Goals and Requirements, recently approved by the Joint Commission's Board of Commissioners, apply to the nearly 15,000 Joint Commission-accredited and certified health care organizations and programs. Major changes in this sixth annual issuance include a new Goal and Requirement that address the recognition of, and response to unexpected deterioration in a patient's condition. The new Goal and Requirement respecting the deteriorating patient will ask hospitals and critical access hospitals to select a suitable method for enabling care-givers to directly request and obtain assistance from a specially-trained individual(s) if and when a patient's condition worsens. The goals can be accessed by clicking http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/ . Male Exodus From Primary Care Practice Of Medicine An exodus of men from primary care practice is driving a marked shift in the physician workforce toward such specialties as cardiology and dermatology, reinforcing concerns about a looming shortage of primary care physicians, according to a new national study released by the Center for Studying Health System Change (HSC). Two factors have helped mask the severity of the shift from primary care—a growing proportion of female physicians, who disproportionately choose primary care, and continued reliance on international medical graduates (IMGs), who now account for nearly a quarter of all U.S. primary care physicians, according to the study. Since 1996-97, a 40 percent increase in the female primary care physician supply has helped to offset a 16 percent decline in the male primary care physician supply relative to the U.S. population, the study found. At the same time, primary care physicians' incomes have lost ground to both inflation and medical and surgical specialists' incomes. And women in primary care face a 22 percent income gap relative to men, even after accounting for differing characteristics. "If real incomes for primary care physicians continue to decline, there is a risk that the migration of male physicians will intensify and that female physicians may begin avoiding primary care—trends that could aggravate a predicted shortage of primary care physicians," said Paul B. Ginsburg, president of HSC, a nonpartisan policy research organization funded principally by the Robert Wood Johnson Foundation. The report may be accessed by clicking http://www.hschange.org/CONTENT/934/ . The Effects Of Marriage On Health Marriage has become an increasingly important topic in academic and policy research. A burgeoning literature suggests that marriage may have a wide range of benefits, including improvements in individuals' economic well-being, mental and physical health, and the well-being of their children. A new report from Mathematica Policy Research, Inc that was prepared for the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services focuses on recent research evidence concerning one of these potential benefits of marriage—its effects on health. The report provides an overview of what is currently known about the relationship between marriage and health; it also suggests directions for future research. The report may be accessed by clicking Congress Passes Extension Of Higher Education Act The Senate passed the "First Higher Education Extension Act of 2007" (S. 1704) on June 27 and the House did likewise the following day. The legislation will extend temporarily the authority of the Higher Education Act (HEA) through July 31. The authorization for the HEA reauthorization expired on September 30, 2003. Several extensions have been enacted since then as a means of achieving program continuity. Predoctoral And Postdoctoral Training Awards Available The Agency for Healthcare Research and Quality (AHRQ) will award Ruth L. Kirschstein National Research Service Award (NRSA) Institutional Research Training Grants (T32) to eligible institutions as the primary means of supporting predoctoral and postdoctoral health services research training to help ensure that a diverse and highly trained workforce is available to assume leadership roles related to the Nation's health services research agenda. The primary objective is to prepare qualified individuals for careers in health services research who will focus their careers on producing research that will be implemented to improve the health care of all Americans. Because of the nature and scope of the proposed research, training needs will vary from application to application and it is anticipated that the size of each award will also vary. The total amount awarded and the number of awards will depend upon the number, quality, and costs of the applications received. AHRQ plans to fund a mix of new training programs and competing continuation programs, assuming a sufficient number of meritorious applications. Only domestic, non-profit, private or public institutions that have strong and high-quality research programs in the area(s) proposed for research training and have requisite staff and facilities may apply for grants to support NRSA Institutional Research Training Grants (T32 mechanism). For additional information, click http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-08-001.html . Most Populous U.S. CitiesPopulation growth or decline can have an impact regarding the extent of health care services provided and the amount of tax revenue available to finance them. Phoenix has become the nation's fifth most populous city, according to U.S. Census Bureau population estimates released today. As of July 1, 2006, this desert metropolis had a population of 1.5 million. New York continued to be the nation's most populous city, with 8.2 million residents or more than twice the population of Los Angeles, which ranked second at 3.8 million. The estimates reveal that Phoenix moved into fifth place ahead of Philadelphia, the latest evidence of a decades-long population shift. Nearly a century ago, in 1910, each of the 10 most populous cities was within roughly 500 miles of the Canadian border. The 2006 estimates show that seven of the top 10 — and three of the top five — are in states that border Mexico. Only three of the top 10 from 1910 remained on the list in 2006: New York, Chicago and Philadelphia. Conversely, three of the current top 10 cities (Phoenix; San Jose, Calif.; and San Diego) were not even among the 100 most populous in 1910, while three more (Dallas, Houston and San Antonio) had populations of less than 100,000. The estimates also reveal that many of the nation's fastest-growing cities are suburbs. North Las Vegas, NV, a suburb of Las Vegas, had the nation's fastest growth rate among large cities (100,000 or more population) between July 1, 2005, and July 1, 2006. It was joined on the list of the 10 fastest-growing cities by three in the Dallas metro area: McKinney (ranking second), Grand Prairie (sixth) and Denton (ninth). New Orleans had by far the largest population loss among all cities with populations of at least 100,000 people. The city lost slightly more than half of its pre-Hurricane Katrina population. It fell from 452,170 on July 1, 2005, to 223,388 one year later — a loss of 50.6 percent. To put the size of this loss into perspective, Hialeah, Fla., which experienced the second-highest rate of loss over the period, saw its population decline by 1.6 percent. For additional information, click http://www.census.gov/Press-Release/www/2007/cb07-91factsheet.pdf . Health Care Improves When Patients Have A Medical Home Providing minority patients a “medical home” in which they have a regular doctor or health professional who oversees and coordinates their care would help eliminate racial and ethnic health disparities and promote more health care equity, says a new report from The Commonwealth Fund. The report, based on a 2006 survey of more than 2,830 adults, shows that linking minority patients with a health care setting that offers timely, well-organized care where they can routinely seek physicians and medical advice can help them better manage chronic conditions and obtain critical preventive care services. According to the report, Closing the Divide: How Medical Homes Promote Equity in Health Care , in 2006 nearly one-half of Hispanics and more than one of four African Americans were uninsured at some point during the year. In contrast, 21 percent of whites and 18 percent of Asian Americans lacked coverage. In addition to being the groups most likely to go without health insurance, African Americans and Hispanics are least likely to have a regular doctor or source of care. While health insurance coverage is an important determinant of whether individuals can obtain essential care, the authors say insurance alone cannot eliminate racial and ethnic disparities in health. The report can be accesses by clicking Two public-college groups, the American Association of State Colleges and Universities and the National Association of State Universities and Land-Grant Colleges, have unveiled a draft template for the joint “Voluntary System of Accountability” on which they have been working for more than one year. Leaders anticipate that the voluntary reporting system — which contains data on such things as graduation and retention rates, financial aid, tuition and other costs and, most controversially, students' performance on measures of learning outcomes — will be approved by the associations' boards in November and become operational afterwards. The draft template can be accessed by clicking http://www.nasulgc.org/VSATemplate-Draft-6-25-07.pdf . Percentage Of Individuals Without Health Insurance CDC's National Center for Health Statistics issued a new report today entitled "Early Release of Health Insurance Estimates Based on Data From the 2006 National Health Interview Survey." The study examines data collected from interviews in over 100,000 households nationwide. Some of the highlights include:
Additional information can be obtained by clicking http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease200706.pdf . Health Care And The Budget: Issues And Challenges Yesterday, Peter Orszag (Director of the Congressional Budget Office) testified before the Senate Committee on the Budget. He stated that rising costs represent a critical issue for employers-who sponsor most private health insurance coverage-and for the enrollees and patients who ultimately bear the costs of health insurance and health care. At the same time, substantial concerns exist about the number of individuals who lack health insurance, about the quality of care that is provided both to the uninsured and to the insured, and about trends in health such as the growing prevalence of obesity. His testimony can be accessed by clicking IInstitutional Versus Academic Discipline Measures Of Student Experience The study can be accessed by clicking Men Avoid Prevention Measures
Men in the United States may not be as healthy as they say they are. The survey showed men spend an average of 19 hours a week watching television, and more than four hours a week watching sports, but just slightly more than one-third (38%) of men exercise on a regular basis. And, the CDC estimates, almost three out of four (71%) men are overweight. Update On Reauthorization Of Higher Education Act A bill to reauthorize the Higher Education Act would replace the National Advisory Committee on Institutional Quality and Integrity (whose 15 members are all appointed by the education secretary), with a new panel that would have roughly comparable duties and powers. Of the new panel's 15 members, five each would be appointed by the Education Department, the Senate, and the House of Representatives. The bill, as currently written, would require accreditors to ensure that colleges "use empirical evidence" and "external indicators" to show how they perform in areas such as student retention, course and program completion and graduation, state licensure and job placement (for work-related programs), and enrollment of students in graduate programs. The Senate bill also would endorse the Education Department's approach to the other issue most hotly debated in the accreditation negotiating process: the way many colleges treat academic credits from students transferring from institutions that are nationally rather than regionally accredited. The 534-page bill can be accessed by clicking Complementary And Alternative Medicine Predoctoral Research Fellowships Available Quality Of Care Is Better When Patients Have More Chronic Illnesses Contrary to popular belief, patients with multiple chronic illnesses do not receive worse quality of care, according to a RAND Corporation study, which is the study is the first large scale assessment of quality of care in patients with multiple chronic conditions. It had been widely assumed that quality would get worse as the number of chronic conditions went up because there was simply too much for busy clinicians to do. The new Rand study, published in the June 14 edition of the New England Journal of Medicine , refutes this notion. Mapping The Growth Of Older America According to a new report from The Brookings Institution, aging baby boomers constitute this decade's fastest growing age group, expanding nearly 50 percent in size from 2000 to 2010. This group--more highly educated, with more professional women, and more diverse than its predecessor--will add new stresses to suburban and Sun Belt locations where they are predominantly "retiring in place" with demands for health, transportation, and other services. The report can be accessed by clicking http://www3.brookings.edu/views/articles/200705frey.pdf . U.S. Hospital Care: Separate But Not Equal A new study detailing hospital care for African-American patients was published in the June 11, 2007 issue of Archives of Internal Medicine . The study, funded by the Robert Wood Johnson Foundation (RWJF) and conducted by researchers at the Harvard School of Public Health, found that hospital care in the U.S. is highly concentrated. Just a small number of hospitals care for the vast majority of elderly African-American patients in America. The researchers also found that hospitals that disproportionately care for elderly African-Americans often provide a somewhat lower quality of care. The study showed that just 5 percent of American hospitals cared for nearly half of all elderly African-American patients and just 25 percent of hospitals cared for nearly 90 percent of elderly African-American patients. The study also clearly shows that hospitals with high concentrations of minority patients provide modestly inferior care in pneumonia for all its patients. 2004 Medicare data were used to calculate the volume and proportion of African-American patients discharged. The study examined the hospitals' structural characteristics and performances according to quality measures for patients with acute myocardial infraction, congestive heart failure, and pneumonia. The article is entitled, "Concentration and Quality of Hospitals That Care for Elderly Black Patients." Graduate Education's Role In U.S. Competitiveness And Innovation A blue-ribbon panel assembled by the Council of Graduate Schools (CGS) released a report that calls for a renewed commitment to American graduate education, recognizing its critical role in enhancing the nation's economic competitiveness and innovation. The Advisory Committee on Graduate Education and American Competitiveness, comprised of university presidents, corporate leaders, and graduate school deans, called for increased collaboration between government, higher education, and the business community to strengthen U.S. competitiveness and national security through increased support for graduate education. At a forum held at the Library of Congress in Washington, DC, Members of Congress and other interested parties discussed their perspectives on the issues raised in the report, Graduate Education: The Backbone of American Competitiveness and Innovation , which contains findings and action items for three targeted sectors: universities, business leaders, and policymakers. The report can be accessed by clicking State Snapshots Highlight Gains And Lags In Health Care Quality New State Snapshots released today by the federal Agency for Healthcare Research and Quality (AHRQ) show States have made promising gains in health care quality while identifying needed improvements in areas ranging from cancer screening to treatments of heart attack patients. AHRQ's State Snapshots Web tool was launched in 2005. It is an application that helps State health leaders, researchers, consumers, and others understand the status of health care quality in individual States, including each State's strengths and weaknesses. The 51 State Snapshots —every State plus Washington, D.C.—are based on 129 quality measures, each of which evaluates a different segment of health care performance. While the measures are the products of complex statistical formulas, they are expressed on the Web site as simple, five-color "performance meter" illustrations. The data, drawn from AHRQ's 2006 National Healthcare Quality Report , come from various data sources that cover multiple years. The statistics provide State-specific information, but also underscore the reality that some shortcomings in health care quality are widespread. The State Snapshots provide summaries that measure health care quality in three different contexts: by types of care (such as preventive, acute, or chronic care), by settings of care (such as nursing homes or hospitals), and care by clinical area (such as care for patients with cancer or respiratory diseases). After selecting a State on a national map, users may view whether that State has improved or worsened compared to other States in a particular area of health care delivery. The State Snapshots can be accessed by clicking Health Careers Website For Students Obtains Renewed Life The Robert Wood Johnson (RWJF) has awarded a $672,000 grant to the American Dental Education Association (ADEA) to administer and expand a free, interactive health careers website designed to explain the array of health professions and provide easy access to students seeking information about health careers. Explore Health Careers is a joint initiative involving national foundations, professional associations, health career advisors, educational institutions, and college students. Originally funded by the Josiah Macy, Jr. Foundation, the website was housed at the Association of Academic Health Centers until recently. Now, ADEA will continue as the purveyor of valuable information to students about careers in allied health and other health professions. The website may be accessed by clicking http://www.explorehealthcareers.org/en/index.aspx . Training Physicians for Public Health Careers Public health efforts have resulted in tremendous improvements in the health of individuals and communities through preventive health services, vaccines, improved sanitation and hygiene, safer workplaces, and enhanced food and drug safety. However, despite the achievements of public health, there is a growing shortage of public health workers, including a critical shortage of public health physicians, and many public health workers are inadequately prepared to face today's public health challenges. Concern about this shortage led the U.S. Congress to mandate an IOM study to determine: 1) what knowledge and skills are needed by public health physicians, 2) the number of programs needed to maintain an adequate supply of physicians trained for public health careers, and 3) how these programs can be funded. The resulting report, Training Physicians for Public Health Careers , makes recommendations that address this charge. The report may be accessed by clicking http://www.nap.edu/catalog/11915.html#toc . Curbing The Cost Of College Textbooks A new report from the federal Advisory Committee on Student Financial Assistance (ACSFA) details how colleges and states are working to make textbooks more affordable for students and how they can partner with the private sector to adapt these efforts to the rapidly changing textbook market. Turn the Page: Making College Textbooks More Affordable presents the results of a yearlong study by ACSFA commissioned by Congress, specifically by Reps. Howard P. “Buck” McKeon (R-CA) and David Wu (D-OR). ACSFA serves as an independent source of advice to Congress and the Department of Education on student financial aid policy. The report may be accessed at http://www.ed.gov/about/bdscomm/list/acsfa/turnthepage.pdf . College And University Ranking Systems Over the decades since higher education rankings first appeared, numerous debates have surfaced about their methodologies, objectivity, impact on colleges and universities, and role in the structure of accountability within nations that use them. The Institute for Higher Education Policy released College and University Ranking Systems: Global Perspectives and American Challenges to acknowledge that while college and university rankings are growing in their frequency and popularity, greater understanding about how these ranking systems function is needed to ensure accountability and greater transparency. The report may be accessed by clicking The Limits Of Reductionism In Medicine According to an article in the May2007 issue of PLoS Medicine, since Descartes and the Renaissance, science, including medicine, has taken a distinct path in its analytical evaluation of the natural world. This approach can be described as one of “divide and conquer,” and it is rooted in the assumption that complex problems are solvable by dividing them into smaller, simpler, and thus more tractable units. Because the processes are “reduced” into more basic units, this approach has been termed “reductionism” and has been the predominant paradigm of science over the past two centuries. Reductionism pervades the medical sciences and affects the way we diagnose, treat, and prevent diseases. While it has been responsible for tremendous successes in modern medicine, there are limits to reductionism, and an alternative explanation must be sought to complement it. The alternative explanation that has received much recent attention, due to systems biology, is the systems perspective. Rather than dividing a complex problem into its component parts, the systems perspective appreciates the holistic and composite characteristics of a problem and evaluates the problem with the use of computational and mathematical tools. The systems perspective is rooted in the assumption that the forest cannot be explained by studying the trees individually. The article may be accessed by clicking The Condition Of Education 2007 The Condition of Education 2007 is a new report from the National Center for Education Statistics (NCES) that summarizes important developments and trends in education using the latest available data and by presenting 48 indicators on the status and condition of education. Topics include: enrollment trends by age for all ages, preprimary education, elementary/secondary education, undergraduate education, graduate and professional education, and adult education. The report may be accessed by clicking http://nces.ed.gov/programs/coe/list/index.asp . |
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In 2006, there were 43.6 million Americans of all ages who did not have health insurance (at the time of the interview), or 14.8% of the population. 
Among working-age Americans (those ages 18-64), there were 19.8% who did not have health insurance in 2006, a slight increase from 18.9% in 2005. 
Approximately 9.3% of children under the age of 18 did not have health insurance in 2006, a decrease from 13.9% in 1997. 
In 2006, the percentage uninsured at the time of interview among the 20 largest states ranged from 7.7% in Michigan to 23.8% in Texas.