THE LEGACY OF TUSKEGEE
Nearly half of all Americans living with HIV are Black and rates of new cases are eight times higher in Blacks than Whites. This study interviewed HIV-infected Black veterans, most of whom were receiving treatment at the Veterans Health Administration, the largest provider of HIV care in the United States. Many participants believed that HIV was a disease created by the government to control poor and minority populations and that pharmaceutical companies withheld the cure for HIV/AIDS. Others suspected that the medication they’d been prescribed sped the progress of HIV infection to AIDS; therefore, they deceived their healthcare providers regarding their medication adherence. Conspiracy theories about HIV still abound and may contribute to poor treatment outcomes among Black veterans and perhaps other veterans as well.
GETTING-BACK-TO-HOME COOKING
Social service agencies are increasingly collaborating with healthcare institutions to improve the health of communities. These researchers describe a collaboration between a hospital and an agency on aging to offer specialized meals (e.g., vegetarian, pureed) to patients after hospital discharge. The program delivered meals weekly to the doorsteps of 622 high-risk Medicare patients during their transition from hospital to home or to an alternative setting, such as long-term care. Over a 24-month evaluation period, the Simply Delivered Meals (SDM) program, added to standard supervised community care transition planning, led to a 38% decrease in hospital readmission rates, compared to the pre-SDM period. Home-delivered meals to patients that attend to dietary restrictions can help frail, low-income persons remain out of the hospital.
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RECESS IN PIECES ACROSS THE US
Obesity rates among US children have tripled in the past three decades. This places children at higher risk for poor health outcomes, such as type II diabetes and cardiovascular disease. They are also more likely to be overweight as adults. While causes can vary between individuals, common solutions include physical activity, healthier food choices, and participation in health-oriented community education events. In 2017, the Council of State Governments published a research brief summarizing physical activity legislation across the United States. School recess is one attractive option for increasing physical activity and it also benefits children’s emotional, social, and mental health. Physical exercise can increase attention span and improve academic performance.
Only five states, shown in green on the map, have legislation mandating recess in elementary schools: Connecticut, Indiana, Missouri, Rhode Island, and Virginia. Each state passed legislation aimed at elementary schools, mandating a recess period (or, in the case of Indiana, physical activity, which may “include the use of recess”). Connecticut, Missouri, and Rhode Island have a minimum recess requirement of 20 minutes, whereas Virginia and Indiana do not mention time in their policies. Eight other states have “general activity” requirements, mandating daily or weekly physical activity, expanding into physical education, field trips, exercise programs, etc. These are: Arkansas, Colorado, Iowa, Louisiana, the Carolinas, Tennessee, and Texas.
All other states supplement mandatory recess with alternative policies, primarily physical education, and vary in their degree of requirement. Massachusetts has mandatory physical education for grades K-12, but no recess requirements. That may change, as Rep. Marjorie Decker introduced a bill in 2017 to provide grades K-5 with 20 minutes of recess.
Bills emphasizing academic achievement, such as the No Child Left Behind Act, encourage increasing class time, often taking time away from recess. Multiple organizations, including the Center for Disease Control, recommend that physical activity and recess should be mandatory. —Erin Polka, PHP Fellow
Map: The Council of State Governments, State Policies on Physical Activity in Schools, Matt Shafer, CSG graduate fellow, and Elizabeth Whitehouse, CSG director of education and workforce.
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