Breaking News
March 25, 2018 - Humanigen Completes Enrollment of Phase 1 Clinical Trial of Lenzilumab for Treatment of Chronic Myelomonocytic Leukemia
March 25, 2018 - ENDO 2018 Roundup: New Tx Options for Obesity, Low BMD, Benign Thyroid Disease
March 25, 2018 - The protein that prevents loose teeth
March 24, 2018 - Morning Break: Skip the Finger Exam? Self C-Section; Toxic Toenail Fungus
March 24, 2018 - 3-D simulations reveal synergistic mechanisms of the human heart
March 24, 2018 - Newly designed three-part molecule shows promise to treat breast cancers
March 24, 2018 - Pubertal hormones not responsible for changes in social behavior during adolescence
March 24, 2018 - Waning Vaccine Protection May Be Driving Rise in U.S. Mumps Cases
March 24, 2018 - Folic Acid in Utero Tied to Food Allergy Risk
March 24, 2018 - Trial shows safety of drugs for irregular heartbeat patients undergoing treatment
March 24, 2018 - Penn State psychologists shed light on false memories in older adults
March 24, 2018 - Patients who self-discharge should be viewed more positively, say researchers
March 24, 2018 - Wearable brain scanner enables brain imaging whilst moving
March 24, 2018 - Trump Signs $1.3 Trillion Spending Bill, Averts Shutdown
March 24, 2018 - Two drugs prevent heart problems in breast cancer patients
March 24, 2018 - Research provides better understanding of how some cancer cells resist treatment
March 24, 2018 - Certain nutrients found in food may help reduce symptoms of psychotic illness
March 24, 2018 - AbbVie Announces Positive Topline Results from Second Phase 3 Study Evaluating Investigational Elagolix in Women with Uterine Fibroids
March 24, 2018 - AHRQ Is in Trouble | Medpage Today
March 24, 2018 - Could a pap test spot more than just cervical cancer?
March 24, 2018 - Men have greater hospital readmission risk following firearm injury, study shows
March 24, 2018 - Pediatric psychologist shares 11 warning signs of childhood depression
March 24, 2018 - OncoBreak: ‘I Was Normal Once’; Ending Cervical Cancer; Mammo Controversy
March 24, 2018 - Gum Disease by the Numbers
March 24, 2018 - Studies show tool can identify individual needs, supports to help youths with autism, intellectual disabilities
March 24, 2018 - Study reveals cause of extreme nausea in pregnancy
March 24, 2018 - New findings highlight need to reconsider cervical cancer screening guidelines
March 24, 2018 - Smartwatch App Might Help Detect A-Fib
March 24, 2018 - TAVR Reasonable for Low-Flow, Low-Gradient Aortic Stenosis
March 24, 2018 - Kids with severe brain injuries may develop ADHD: study
March 24, 2018 - Researchers explore ways to help older adults taper off and stop using sedatives
March 24, 2018 - Back pain being mismanaged globally
March 24, 2018 - Fingerprint test accurately and noninvasively detects heroin, cocaine users
March 24, 2018 - Leading experts to promote cardiovascular health at EuroPrevent 2018
March 24, 2018 - A Role for Rituximab in Lupus?
March 24, 2018 - New osteoarthritis genes discovered
March 24, 2018 - Maternal intake of DHA supplement linked to higher fat-free body mass in children
March 24, 2018 - Royal College of Pathologists‘ bulletin provides summary of Tissue Handling Workshop
March 24, 2018 - Maternal alcohol use early in pregnancy may be risk factor for infant abdominal malformation
March 24, 2018 - Savara Initiates Phase 2a Clinical Study of Molgradex for the Treatment of NTM Lung Infection
March 24, 2018 - Accelerated WBI Should be the Norm for Most Breast Cancers
March 24, 2018 - Experts seek to standardize treatments for childhood rheumatic diseases
March 24, 2018 - Foil-based measuring chip rapidly detects Legionella
March 24, 2018 - Bariatric surgery linked to positive outcomes in very obese adolescents with type 2 diabetes
March 24, 2018 - Researchers identify chemical responsible for carcinogen formation in recycled wastewater
March 24, 2018 - Obesity and severe obesity continue to rise among U.S. adults
March 24, 2018 - Missed hospital appointments increase after spring clock change in the UK
March 24, 2018 - Researchers explore ways to manage and prevent falls in older adults with dementia
March 24, 2018 - Are there risks from secondhand marijuana smoke? Early science says yes.
March 24, 2018 - NUST MISIS researchers produce elastic metal rods for scoliosis treatment
March 24, 2018 - New University of Bath project seeks to make injections safer
March 24, 2018 - Higher-dose RT does not improve survival but reduces recurrence risk for prostate cancer patients
March 24, 2018 - Researchers examine link between knee pain and depression in older adults
March 24, 2018 - FDA Alert: BD Vacutainer Blood Collection Tubes by Becton, Dickinson and Company (BD): Class I Recall
March 24, 2018 - Daytime Sleepiness Linked to Amyloid Accumulation Without Dementia
March 24, 2018 - Energy storehouses in the brain may be source of Alzheimer’s, targets of new therapy
March 24, 2018 - Praising people with autism shows promise for producing more exercise
March 24, 2018 - Using harmless red or infrared light to diagnose breast cancer
March 24, 2018 - Clash over abortion hobbles a health bill. Again. Here’s how.
March 23, 2018 - Virtual nature environment could be new way to recover from stress
March 23, 2018 - New study identifies key cellular mechanisms behind vascular aging in mice
March 23, 2018 - Nightmares Common Among U.S. Troops, But Seldom Reported
March 23, 2018 - Another Record Low for Tuberculosis in U.S.
March 23, 2018 - Changes in the eye connected to a decline in memory
March 23, 2018 - Radiologist creates dramatic teaching tool using power of VR
March 23, 2018 - Grilled meat could be raising the risk of hypertension finds study
March 23, 2018 - Mutations found in bassoon gene may help explain cause of rare brain disorder
March 23, 2018 - Childhood Brain Injuries May be Linked to ADHD Years Later
March 23, 2018 - Why treating addiction with medication should be carefully considered
March 23, 2018 - Researchers make key discovery about cellular pathway linked to myriad of diseases
March 23, 2018 - Researchers uncover cause of rare childhood neurodegenerative disease
March 23, 2018 - Measles infection in early childhood could contribute to later COPD
March 23, 2018 - Opioid painkiller is top prescription in 11 states
March 23, 2018 - Sienna Biopharmaceuticals Announces First Patient Dosed In Proof-of-Concept Trial of Topical By Design™ JAK Inhibitor SNA-125 for Atopic Dermatitis
March 23, 2018 - In Teen Girls, Neural Patterns May Drive Emotional Resilience
March 23, 2018 - Gene-based test for urine detects, monitors bladder cancer
March 23, 2018 - BD to introduce new digital solution for IV chemotherapy administration process at EAHP 2018
March 23, 2018 - New computational method helps to identify tumor cell mutations with greater accuracy
March 23, 2018 - Researchers identify potential obesity treatment in freezing hunger-signaling nerve
March 23, 2018 - Wales participates in the 100,000 Genomes Project
A poor neighborhood in Chicago looks to Cuba to fight infant mortality

A poor neighborhood in Chicago looks to Cuba to fight infant mortality

image_pdfDownload PDFimage_print

Really, everything.

“In the last 12 months, have you had any problems with any bug infestations, rodents or mold?” Dr. Kathy Tossas-Milligan, an epidemiologist, asked Yolanda Flowers during a recent visit to her home, in Chicago’s Englewood neighborhood. “Have you ever had teeth removed or crowned because of a cavity?”

Though they seem to have little to do with motherhood, these questions are borrowed from the playbook of the Chicagoans’ new mentors — doctors from the Cuban Ministry of Public Health. As Tossas-Milligan administered her survey, two Cuban doctors sat nearby, observing.

Cuba, a poor country where many of the cars on the road are half a century old, may seem an unlikely role model for American health care. But its infant mortality rate, at 4.3 per 1,000, is lower than the United States’ 5.7 per 1,000, according to the World Health Organization’s 2015 data. And Cuba’s rate is much better than the infant mortality rates in some of the poorest parts of the U.S. In the Englewood neighborhood, for instance, 14.5 babies per 1,000 do not reach their 1st birthday. That’s a rate comparable to war-torn Syria.

“Cuba is not a rich country,” said Dr. Jose Armando Arronte-Villamarin, one of the Cuban doctors. “[So] we have to develop the human resources, at the primary health care level.”

Now University of Illinois at Chicago health workers are bringing Cuban-style surveys and home visits to Englewood.

“Sometimes the answers are in the most unexpected places,” Tossas-Milligan said. “Sometimes it’s hard for us to face the reality that, as much as we spend, we have somehow not been successful at keeping our babies alive.”

The home visits came out of a partnership between the Cuban Ministry of Public Health and the University of Illinois Cancer Center. Three Cuban doctors and a nurse embedded in Chicago from August to December, joining their American counterparts in visiting the homes of 50 women of reproductive age in Englewood.

In exchange for a $50 stipend, the women answer dozens of questions, on topics ranging from the state of their home to their emotional well-being.

The project is funded by a $1 million grant from the W.K. Kellogg Foundation, which has also paid for some American health care workers to visit Cuba.

In Chicago, researchers plan to use the data they gather to classify women into four risk groups. Those deemed at higher risk will be recommended for additional home visits. The idea, Tossas-Milligan said, is to address these women’s medical issues at an early stage and at home as much as possible, to avoid costly hospital bills.

“What we are hoping to discover is issues in Englewood that truly impact health, that are not being collected,” she said, “that the doctors cannot see when they come and see [a] woman, and prescribe her one pill.”

One question the team has been asking women for example, is when they last saw a dentist. Gum disease, while unlikely to come up during an expectant mother’s hospital visit, has been linked to premature birth.

In her interview, Yolanda Flowers said that she hadn’t been to a dentist “since 1999 or 2000,” which she attributed to a lack of insurance and a longtime fear of the dentist. And at 47, Flowers has had a difficult obstetric history: three miscarriages and one premature birth. Her baby did not survive.

Flowers, who said she had “bare-bones insurance” or had been on Medicaid for much of her adult life, first attempted a planned pregnancy in 2003, with her then-fiancé. She visited a doctor who, Flowers recalled, suspected an ovarian cyst. But before they went further, Flowers’ fiancé died in an accident. In 2009, she tried to get pregnant again and visited a different doctor for help. That doctor, offered under a different health insurance plan, was not aware of her history, Flowers said, “because you only get a limited amount of time with the doctors, and there is only so much that I remembered.”

Tossas-Milligan and Arronte-Villamarin said that even if Flowers does not attempt another pregnancy, simply having that information, and having it in one place, could help them head off problems facing other potential mothers in the neighborhood.

The American health care workers would like to scale up this system to address other key health problems in underserved parts of the city.

Experts who have studied the Cuban health system say that is an idea worth exploring, but it would require much more than just home visits and health surveys.

“When a doctor or team [in Cuba] finds there problems in the home … and they think it has any bearing on her pregnancy, she gets help,” said Dr. Mary Anne Mercer, a senior lecturer emeritus at the University of Washington.

Mercer noted that Cuba, despite being very poor, guarantees resources for at-risk women.

By contrast, the Chicago effort may identify women in Englewood as needing food or different housing, but they would have to find a way to fill those needs on their own.

“Thinking about a very poor, low-income, disadvantaged setting in the U.S., I don’t think we’ve got those resources,” Mercer said. “So it’s nice to say, ‘Yeah, we could do it, if we were willing to expend those resources,’ but I am not convinced we could.”

“Would,” Mercer corrected. “I’m not convinced we would.”

This story is part of partnership with WBEZ and PRI’s The World.

KHN’s coverage of these topics is supported by Heising-Simons Foundation and The David and Lucile Packard Foundation

Kaiser Health NewsThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Tagged with:

About author

Related Articles