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WASHINGTON (AP) -- Minorities are more likely than white patients to rate their health care as fair or poor, a view that is particularly true among Chinese-Americans, blacks born in Africa and Vietnamese-Americans.
Researchers have long stressed that improving patients' perception of their care is important to improving outcomes. That's because negative experiences can lead to less time spent with a physician and poor communications between doctor and patient.
To get a more detailed view of the differing perceptions that patients have, researchers at Harvard University and the Robert Wood Johnson Foundation surveyed 4,334 adults last year. The researchers asked patients such questions as how quickly they were able to get an appointment the last time they were sick and whether their doctor explained things in a way the patient could understand. The researchers found that whites routinely rated their experience higher than did the minority patients, who still had largely favorable views of their care.
For example, 91 percent of whites rated their care as excellent or good. That percentage fell for most ethnic groups, with the lowest ratings recorded among Chinese-Americans, 74 percent; African-Americans born in Africa, 73 percent; and Vietnamese-Americans, 72 percent.
When it came to getting an appointment, about 63 percent of whites were able to get an appointment on the same day or the next day after they became sick or injured. That percentage dropped to 42 percent for Cuban-Americans and 39 percent for African-Americans born in the Caribbean.
About three-quarters of whites reported that their doctor listened carefully to them. That percentage fell to 62 percent for Korean-Americans and 58 percent for those from Central America or South America.
Previous research on disparities tended to take a broad look at the major ethnic groups even though group members often came from different countries. The Harvard study used much more detailed categories. For instance, there were three categories for African-Americans based on whether they were born in the Caribbean, Africa or the United States.
The researchers said the additional detail was important because the best ways to reduce disparities will reflect the unique experiences and needs of minority groups.
Dr. Anne Beal, assistant vice president at the Commonwealth Fund, said the latest study results are consistent with previous research of how minority patients view the quality of their health care. She said perception is reality when it comes to patients being treated with respect.
"Because the findings are so consistent, it's not something where we can say it's just about the patients," Beal said. "They are reporting their experiences and the results should be taken seriously."
Beal said the Harvard study also showed that there are steps that health care providers can take to improve patients' perceptions, such as resolving language barriers. She said health care providers should incorporate translation services into their practice. Even physicians who work in small practices or on their own can make use of phone banks designed to improve doctor-patient communications.
Beal said doctors now pay for that service out of their own pocket, but that service should be reimbursable through government health programs such as Medicaid and Medicare.
The report will be published in the journal Health Affairs.
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On the Net: Health Affairs: http://www.healthaffairs.org
Mar 11 06:53
By JULIANA BARBASSA
Associated Press Writer
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SAN FRANCISCO (AP) -- Tibetan immigrants protesting Chinese control of their homeland vowed to make San Francisco, the only U.S. city to host the Olympic torch relay, the focal point of American demonstrations against the Beijing Games.
Demonstrators on Monday unfurled a Tibetan flag over the flight of white stone steps leading into San Francisco City Hall and held a portrait of the Dalai Lama, the Tibetan Buddhist spiritual leader, above the crowd next to banners saying "Olympics in China, Torture in Tibet," and "Truth is our only weapon."
The protesters, some wiping away tears while singing the Tibet national anthem, also called on Mayor Gavin Newsom to reject the April 9 torch run and urged city officials to pass a resolution calling on China to improve conditions for Tibetans in their homeland.
"San Francisco has always stood for freedom and human rights," said protester Yangchen Lhamo. "But Gavin Newsom has clearly sided with China on this."
Newsom's spokesman had no immediate comment.
Monday was the anniversary of a failed 1959 Tibetan uprising that forced the Dalai Lama into exile, and Tibetan exiles around the world used the day to protest this summer's games.
Exiles demonstrated in New Delhi, India, and Kathmandu, Nepal. In Dharmsala, India, the home of the Tibetan government in exile, hundreds of Tibetans started a planned six-month march to their homeland but were stopped a day into it by police, who were acting on an Indian government order banning the march.
In Olympia, Greece, birthplace of the ancient Olympic Games, Tibetans lit a Freedom Torch to start a relay intended to course through 50 cities and finish inside Tibet the same day Beijing will hold the opening ceremonies, Aug. 8.
In San Francisco, Tibetan activists plan to line the parade route to remind Americans of China's human rights abuses in their home country, organizers said.
Chinese Communist troops occupied Tibet in 1951, and Beijing continues to rule the region with a heavy hand. China enforces strict controls on religious institutions and routinely vilifies the Dalai Lama, who won the 1989 Nobel Peace Prize.
China says it has ruled Tibet for centuries, although many Tibetans say they were essentially an independent state for most of that time.
The International Olympic Committee has said the games are not a political tool and has declined to comment on China's human rights record.
Mar 11 17:37
By MICHAEL KUNZELMAN
Associated Press Writer
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NEW ORLEANS (AP) -- A congressional leader is asking the Labor Department to turn over information about a Mississippi company accused of exploiting and defrauding hundreds of Indian nationals who worked at its Gulf Coast shipyards after Hurricane Katrina.
In a letter sent Tuesday to Labor Secretary Elaine Chao, Rep. George Miller, D-Calif., requested copies of reports from any department investigation of Signal International, an oil rig construction and repair company based in Pascagoula.
Miller, who chairs the House Education and Labor Committee, also asked the Labor Department to provide him with documentation for any guest worker that Signal has employed in the past five years.
A federal lawsuit filed last Friday by a group of workers from India accuses Signal of subjecting the immigrant workers to forced labor and poor living conditions at its facilities in Pascagoula and Orange, Texas.
The lawsuit claims Signal's recruiters lured them to the United States with the false promise of green cards and permanent U.S. residency when their visas actually lasted less than a year.
Signal says several federal agencies, including the Labor Department, reviewed the company's employment practices and facilities and found them in compliance with the law. The company also dismissed the suit's allegations as "baseless and unfounded."
Labor Department spokesman Loren Smith said an investigation of Signal that ended in March 2007 didn't find any violations of federal labor laws.
Smith said he couldn't disclose the reason for the investigation, which included an inspection of Signal's Pascagoula facility but didn't expand to other company locations.
Tushar Sheth, an attorney for the Asian American Legal Defense and Education Fund, said the Labor Department should have conducted a more thorough review.
"We need a real investigation," said Sheth, who is part of a legal team that filed the suit on behalf of the former Signal workers. "They really need to look at the broader picture."
Signal is among many Gulf Coast companies that hired foreign workers to fill a shortage of skilled labor after hurricanes Katrina and Rita in 2005. Signal hired more than 500 guest workers from India to be welders and pipefitters and perform other jobs.
Miller said he has sponsored legislation designed to protect guest workers from "unjust treatment" by labor recruiters and employers.
"I have also made clear my position that guest worker programs generally ... are in need of both strengthened labor protections for U.S. and foreign workers and greater labor law enforcement," he wrote in his letter to Chao.
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Mar 11 21:07
By MARK NIESSE
Associated Press Writer
HONOLULU (AP) -- When Hawaii celebrates the 50th anniversary of statehood next year, organizers envision a grand Waikiki parade and other events celebrating a half-century of cultural integration and economic growth.
No events are final, but planners have been meeting since November to decide on an appropriate way to remember the golden anniversary of the nation's youngest state on Aug. 21, 2009.
Hawaii marks the 49th anniversary of Congress' approval of statehood Wednesday.
"I can see why some people would want to celebrate it, others would want to observe it and others will reject it entirely," said Arnie Saiki, an independent Web developer who created statehoodhawaii.org.
The festivities will highlight the islands' accomplishments since 1959, and there also could be educational events to discuss the overthrow of the Hawaiian monarchy that eventually led to statehood, said Kippen de Alba Chu, chairman of the 50th Anniversary of Statehood Commission.
There won't be accommodations for those who reject the United States and claim Hawaii is still an independent nation, he said.
"They will probably organize their own events, but that's outside our scope," he said. "Once we became a state, it's hard to reverse. It put us on equal footing with the rest of the United States."
In addition to the Waikiki parade, Chu foresees the potential for commemorative aloha shirts, license plates and stamps.
The anniversary could be used to hold community discussions on Hawaii's history, Native Hawaiian rights and efforts to preserve the islands for the next 50 years, he said.
SupplementWeekend People
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"I'm hoping that it's a celebration," said Rep. Ryan Yamane, D-Waipahu-Mililani, chairman of the House Tourism and Culture Committee. "However, those who were impacted by the overthrow have every right to have their say as well. ... Maybe it's a time we can reflect on how much Hawaii has changed."
One idea would be for Hawaii to host a Makahiki festival as part of the party, where islanders across the Pacific could visit to participate in activities including sports, hula dancing, singing and eating, Saiki said.
Ah Quon McElrath, a labor union activist who rallied for statehood decades ago, said she wants the anniversary to emphasize how the workers rights' movement built momentum for Hawaii's admission into the union.
"Let's make people understand the history," said McElrath, a commission member. "Many people who have grown up and come to Hawaii don't realize what the labor movement did to get us statehood."
The commission requested $500,000 from the state budget to pay for the anniversary events.
The Senate Committee on Economic Development and Taxation approved the measure Tuesday, but lawmakers haven't decided on how much money to appropriate. The full House of Representatives previously passed the bill.
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On the Net:
HB2909: http://www.capitol.hawaii.gov/
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