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As part of its observance of National Minority Health Month in April, the Office of Minority Health (OMH) at the U.S. Department of Health and Human Services (HHS) today launched the Active & Healthy Challenge. The purpose of the challenge is to encourage individuals, especially racial and ethnic minorities, to work physical activity into their daily and weekly schedules. The challenge is co-sponsored by the Louisiana Department of Health’s Bureau of Minority Health Access.

The Active & Healthy Challenge is designed to support the newly released Physical Activity Guidelines for Americans (PAGs) and the Move Your Waycampaign from the HHS Office of Disease Prevention and Health Promotion. Teams will compete in the month-long challenge by logging their physical activity (e.g. brisk walking, running, biking, dancing or swimming) and converting the activities into steps. The challenge is also open to individuals. 

The new PAGs recommend that everyone move more and sit less throughout the day. Adults need at least 150-300 minutes of moderate-to-vigorous physical activity each week with muscle-strengthening activities two or more days a week. Children and adolescents ages six to 17 should do 60 minutes or more of moderate-to-vigorous physical activity each day and muscle-strengthening at least three days a week. Preschool-aged children, ages three through five, should be physically active throughout the day to enhance growth and development.

The challenge will begin April 1, 2019 and end at midnight ET on April 30, 2019.

OMH will announce the winning team and individuals at the end of the challenge.

Get instructions to sign up your team for the challenge at the National Minority Health Month webpage, where you’ll also find tips, promotional materials and other resources available in English and Spanish.

This article was written by and from the perspective of Josephine Gurch, with the Hogg Foundation for Mental Health.

This past summer, we checked in with God’s Way Christian Baptist Church of Taylor, Texas, one of 11 faith-based organizations to receive funding from the Hogg Foundation’s African American Faith-Based Education and Awareness Initiative (Faith-Based Initiative) grant, to learn about their Wellness and Empowerment Community Ministries.

Stigma in Faith Circles

For many—especially those without access to mental health services—faith circles are places of refuge, with pastors and clergy tending to the emotional needs of their congregants as much as their spiritual ones. Long-held stigma, however, often keeps conversations about mental health conditions behind closed doors, leading to shame and misunderstanding.

That’s why it’s so important, Dr. Rowe tells us, that we equip pastors “with the information they need to serve their congregations and communities.” Faith leaders, no matter the size of their following, are influencers; and when they preach mental health lessons from the pulpit, people listen.

Inclusion through Dialogue

The appeal of mental health education, Dr. Rowe finds, grows when dialogues use inclusive language. “Being aware of how you title programs,” she says, “how inclusive you are, as opposed to pointing to a specific population, helps you draw people to the information you’re trying to provide for them.”

By honoring individual experience and testimony, inclusive mental health dialogues make room for difference—giving participants the words and space they need to express their vulnerabilities without shame. “Our congregation has actually gotten closer,” Dr. Young says, speaking about the impact of the grant on his church. “We’ve been offering several sessions, and each session the attendance grows.”

Read more and listen to the podcast on Hogg.UTexas.edu.

Long deployments in Iraq and Afghanistan have contributed to an increase in mental health issues in the U.S. military, with many soldiers struggling to cope with post-traumatic stress, depression, and other mental health conditions. In a military culture, coping with these issues isn’t easy: seeking help is stigmatized, and soldiers are often expected to simply “get over” their troubles.

Military leaders have sought to improve mental health services, but balancing the need for mental health care with the need for soldiers to perform on the job is challenging. And that effort has floundered—in part because different teams working toward that common goal failed to cooperate effectively, according to research by Julia DiBenigno, an assistant professor of organizational behavior at Yale SOM. DiBenigno found that commanders and mental health providers often clash over care recommendations that required soldiers to refrain from field exercises or other duties; commanders feel these directives detract from their units’ readiness for deployments, while providers consider them essential to their patients’ wellbeing and recoveries. 

In a study published in Administrative Science Quarterly, DiBenigno found that these conflicts can be successfully addressed by assigning members from one group to serve as points of contact for the other group, while maintaining close ties with their home group. This organizational structure promoted forming long-term relationships between providers and military units while mitigating concerns about providers becoming coopted by the interests of the more powerful commanders. According to DiBenigno, this organizational design choice worked because it allowed commanders and care providers to connect and see one another as individuals rather than faceless, oppositional entities. Breaking stereotypes by forming these connections helps resolve conflict, DiBenigno says. At the same time, because these point of contact providers still worked surrounded by their own professional colleagues, they were protected from cooptation from their closer relationships with commanders. 

Typically, organizations try to solve conflicts through superordinate goals, inter-team meetings, co-location, and strategic planning, among other strategies. But these strategies frequently fail, because they don’t account for the differences in professional identities that often lie at the heart of the conflict. “When different professional groups work together, things often fall apart because each group is focused on the part of the overall goal that aligns with their professional identity,” DiBenigno says. “Even though the army adopted this overarching goal to care about not only mission readiness but mental health, different professional groups that had to deliver on that goal were each focused only on their part.” 

Conflicts emerged in many areas. For example, commanders typically needed to have at least 90% of their sub-units ready for deployment, a goal they were assessed on regularly. Reaching that goal required an ethos that put the team’s needs above those of any individual soldier. When providers limited a soldier’s ability to work because of their mental health, “it degrades our troops’ ability to accomplish a mission,” a commander said. 

Providers, on the other hand, were focused on individual soldiers’ wellbeing. “Even if I can’t get him back to duty, it’s also about helping someone become a good human being when they go back to society,’’ one provider said. Care providers’ need to guard patients’ health information often conflicted with a commander’s need to know whether a soldier was mentally prepared for battle. And while providers aimed to reduce the stigma associated with seeking mental health care, many commanders thought soldiers should simply toughen up and cope. These differences led to an intractable conflict, where both commanders and providers stereotyped the other group (“bullies” vs. “Berkeley hippies”), and viewed their goals as opposing ones.

Read more at Yale Insights.

Implicit biases in doctor’s offices and elsewhere in health care are likely drivers behind stark racial and class divides in drug addiction and overdose deaths in California, a new study suggests.

While affecting people across race and ethnicity, the opioid crisis gripping the nation has been concentrated largely among low-income whites, and has been labeled a problem primarily of public health, not of criminal justice. The epidemic is thought to have been touched off by a combination of social factors – including trauma, poverty and a lack of economic opportunity – and the widespread availability of prescription opioids beginning in the 1990s.

The new study, published in JAMA Internal Medicine, indicates the health care field has had a hand in driving the epidemic that goes beyond merely dispensing prescription drugs, suggesting that differing access to and within the system has resulted in rampant addiction among low-income whites as well as a sea of untreated pain in minority communities.

“The prescription drug crisis should really be thought of as a double-sided epidemic,” says Joseph Friedman, the study’s lead author and a medical student at the David Geffen School of Medicine at UCLA. “Essentially, the systematic racism within the health care system has led to increased addiction and overdoses in low-income white areas, but also, (to) insufficient treatment among communities of color.”

For example, in the poorest and whitest ZIP code areas in California analyzed by researchers, 44.2 percent of adults – defined as those 15 and older – received at least one opioid prescription per year on average, compared with 16.1 percent of adults in the richest, most racially diverse areas and 23.6 percent of adults across the state. In the state’s lowest-income, most racially diverse areas, meanwhile, 20.3 percent of adults were prescribed at least one opioid.

Stimulant prescriptions, meanwhile, were concentrated in mostly white, high-income areas, while benzodiazepines – medications that can be prescribed for anxiety such as Xanax, Valium and Diastat – were more prevalent in whiter areas, but did not significantly differ by income level.

The findings suggest race and class can outweigh a patient’s medical needs in determining who has access to prescription drugs, with consequences both “protective” and harmful, Schriger says. While the study notes that only a small fraction of prescriptions in a community represent an addiction or dependence, opioid overdose death rates in California have tended to be highest among low-income white communities that also have higher prescription rates.

Read more on U.S. News. 

There has been a great deal of discussion in the media about farmers and mental health in the past few years, not least because of some misinterpreted statistics from the Centers for Disease Control and Prevention (CDC) that suggested suicide rates among farmers were five times those of the general population. Farmworkers, on the other hand, have largely flown under the radar.

When you’re buying vegetables from the grocery store, you’re probably not thinking about the people who picked them. Worker health is not on the label.

The vast majority of farmworkers ― 78 percent according to reported estimates ― are migrants. These are the men, women and children in some cases bringing us the food on our plates, completing the bulk of the grueling, thankless tasks on farms across the country. 

But due to a variety of factors — from inadequate housing to wage theft and on-the-job harassment — this population is experiencing a mental health crisis, with high rates of anxiety and depression.

A study of 248 women in Latino farmworker families in North Carolina found that 31 percent of participants had significant symptoms of depression, three times the rate of depression among U.S. women generally. Another analysis of nearly 400 agricultural workers, also in North Carolina, found that 50 percent were at risk of alcohol misuse, 17 percent had substantial depressive symptoms and 9 percent had substantial anxiety.

And yet, social stigma prevents many farmworkers from openly discussing mental health. In these communities, “you don’t talk about family problems or personal problems outside the family,” said Brandon Foster, a psychologist with the Family HealthCare Network in Visalia, California ― a nonprofit that started out helping farmworkers but now provides a wide range of services to anyone within the local community.

“Most rural, agricultural-based economic areas have a lot of poverty and for farmworkers it may go back generations,” Foster said. Tulare County, where he works, is one of the biggest farming counties in California and has a 24 percent poverty rate. “That really wears on your sense of hope for the future,” he added.

Suicide rates may represent the most dreaded outcome, the National Farmers Union said in response to the latest CDC data, “but fall well short of painting a complete picture of behavioral health among farmers and farmworkers.”

When suicide does occur in farmworker communities, it takes a significant toll on the families of the victims. “It’s universally devastating within this community,” said Foster. “I don’t know that I’ve ever talked to somebody who said: ‘Yes this happened 15 years ago, we did everything we could to help, and now we’re getting on with our lives.’ Instead, I see a lot of people who say, ‘We still can’t get past it, even years later.’”

Read more on HuffPost.com.

For years, Alaska Native people sought to manage their own Tribal health care system. When the Alaska Native Tribal Health Consortium formed, that goal had been reached, and the work was just beginning. With Tribal health care in Alaska no longer directed by Indian Health Service administrators in Maryland, ANTHC had the flexibility to manage services that would enable Alaska Native people to chart their own course to good health.

“We knew if we had that authority, we could move in a more agile way,” said Roald Helgesen, a Tribal health care leader from Sitka who was named CEO of ANTHC in 2011.

From the beginning, ANTHC’s leaders prioritized a proactive approach to health and health care, in ways designed specifically for Alaska Native people and the communities where they live.

The telehealth initiative grew out of a 1997 partnership between the University of Alaska Anchorage and the Alaska Native Health Board. Called the Village Telemedicine Project, this early tech venture deployed telemedicine equipment to four regional hospitals and 20 village clinics, providing for the first time a regular connection between rural patients and medical specialists.

Tribal health organizations asked for connections in more communities.

“A lot of our village clinics didn’t have computers,” said Chief Information Officer Stewart Ferguson, who continues to lead ANTHC’s telemedicine program today. “We didn’t have connectivity. It was very, very nascent. But clearly people saw the value.”

Buoyed by this initial success, the Alaska Federal Health Care Partnership sought and received Congressional funding to build a telehealth system that would be used throughout the Tribal health care network and at remote locations. ANTHC eventually took on management of the collaborative, inter-agency project.

When the telemedicine program went live in 2001, dial-up internet was the best that could be hoped for in many rural communities. Live videoconferencing simply wasn’t an option. So Ferguson and his team pioneered an asynchronous approach called “store and forward.” Images and information were digitally packaged and sent like an email to providers who could then remotely review and prescribe treatment for each case. The project also included custom workstations designed to take up no more than 4 square feet of clinic space, with touch screens (ubiquitous today, but rare at the time) and a user interface designed to be easy for community health aides to operate even with limited computer literacy.

“The adoption was quite fast,” Ferguson said. “By 2003, we had the equipment out to 248 sites.”

As connectivity improved, the system expanded to include real-time videoconferencing along with store and forward. Initially used primarily for otology and cardiology, today the telemedicine system is used across multiple specialties. Double-blind studies have established its accuracy and efficacy. Now that more villages are getting broadband, Ferguson said he expects telehealth to reach even further into both clinics and homes, with expanded options for behavioral health, palliative care, post-discharge support for NICU babies and their families, and even trauma care.

While Alaska’s Tribal health care system addresses today’s health matters, it’s actively trying to prepare for what may be on the horizon. ANTHC’s Clinical and Research Services program studies issues, trends, and questions that impact the health of Alaska Native people. Recently, Helgesen said, the Consortium has been looking closely at adverse childhood experiences. Alaska Native people are more likely to experience the social factors that are increasingly linked to negative health outcomes in adulthood. More and more, research indicates that community and culture can have a meaningful impact on physical and behavioral health.

Read more on AnchorageDailyNews.com