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JHPIEGO's Dr. Harshad Sanghvi Receives International Health Award - Global Health Council Present Award For Best Practices In Global Health On May 28
Jhpiego, an international non-profit health organization affiliated with Johns Hopkins University, is pleased to announce that Dr. Harshad Sanghvi, Vice President and Medical Director of Jhpiego, has been awarded the 2009 Award for Best Practices in Global Health from the Global Health Council.
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Texas Lawmakers Divert Millions From Family Planning Clinics To Community Health Centers
Specialty clinics that provide family planning services in Texas have seen a significant decrease in state funding over the past four years because lawmakers have redirected millions of dollars to expand family planning at community health centers, the Dallas Morning News reports. The funding changes began in 2005, when lawmakers said they were shifting funding to community health centers because they offered more comprehensive health care to low-income patients. Advocates for the family planning clinics argue that the policy is an attempt by antiabortion-rights advocates to shut the clinics down. Although clinics that receive state funding are prohibited from offering abortion services, some conservative lawmakers believe that limiting the funding will hurt groups like Planned Parenthood, which offers abortion services at other locations, according to some family planning advocates. The Morning News reports that state lawmakers might return some of the funding to the specialty clinics during the current legislative session; however, the funding only would equal any money left unused by the community health centers.The most significant funding change occurred in 2005, when almost 25% of the state"s $45 million annual family planning budget was set aside for "federally qualified health centers" -- community health centers that offer services to uninsured and underserved people. Advocates for family planning clinics say that the number of patients receiving state-funded reproductive services declined by nearly 22%, from 326,000 patients in 2005 to 255,000 in the last fiscal year. They also note that the community health centers have an unused surplus of more than $11.5 million since 2005, which they say the family planning clinics could have used.According to the Morning News, many public health experts believe that specialty clinics that have family planning services offer more efficient and effective reproductive care than community health centers. David Warner, a health care finance and policy expert at the University of Texas Lyndon B. Johnson School of Public Affairs, said the specialty clinics are "very targeted" and "don"t have a lot of overhead," whereas the community clinics have "limited enrollment and can be a lot less accessible." He added, "Continuing to starve those clinics means that you"re not going to be reaching the number of people you could be reaching with family planning services." Family planning clinics in Texas offer more than a dozen services ranging from birth control prescriptions to breast and cervical cancer screening and sexually transmitted infection testing. However, reproductive health advocates say many people often associate the clinics with abortion services, which gives antiabortion-rights lawmakers an incentive to shut down the clinics by withholding funding. Fran Hagerty, CEO of the Women"s Health and Family Planning Association of Texas, said, "Some lawmakers believe if they can prevent Planned Parenthood from participating in the state"s family planning program, then they"ve accomplished their goal."Supporters of community health centers say that billing issues and other administrative problems have distorted their data on how many reproductive health patients they are treating. Many women receive care at the community centers for family planning services along with treatment of other health problems, so they often are not recorded as reproductive health patients, according to the centers (Ramshaw, Dallas Morning News, 5/22).
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In New U-M Lab-On-A-Chip Device, Music Is The Engine
Music, rather than electromechanical valves, can drive experimental samples through a lab-on-a-chip in a new system developed at the University of Michigan. This development could significantly simplify the process of conducting experiments in microfluidic devices.
Oncology

Risk For Premature Birth May Be Heightened By Pre-Pregnancy Depressed Mood

Researchers trying to uncover why premature birth is a growing problem in the United States and one that disproportionately affects black women have found that pre-pregnancy depressive mood appears to be a risk factor in preterm birth among both blacks and whites. Black women, however, have nearly two times the odds of having a preterm birth compared to white women, according to Amelia Gavin, a University of Washington assistant professor of social work and lead author of a new study that appears online in the June issue of the Journal of Women"s Health. "Preterm births are one of the most significant health disparities in the United States and the overall number of these births increased from 10.6 percent in 2000 to 12.8 percent in 2005," she said. While there appears to be some sort of link between giving birth prematurely and depressed mood, the study found no cause and effect, said Gavin, who studies health disparities. She believes the higher preterm birth rate among blacks may be the result of declining health over time among black women. For this study, premature birth referred to any child born after less than 37 weeks of gestation. Normal gestation ranges from 38 to 42 weeks. Data for the study was drawn from a larger longitudinal investigation looking at the risks for cardiovascular disease among more than 5,000 young adults in four metropolitan areas. The Coronary Artery Risk Development in Young Adults Study also collected information about mental health and pregnancy outcomes. Between 1990 and 1996, 555 women in the larger study gave birth. These women were the subjects in the depression-premature birth study. "At this point we can"t say that pre-pregnancy depressive mood is a cause of preterm birth or how race effects this association," said Gavin. "But it seems to be a risk factor in giving birth prematurely and higher pre-pregnancy depressive mood among black women compared to white women may indirectly contribute to the greater odds of preterm birth found among black women." In the study 18.1 percent of the black women had a preterm birth compared to 8.5 percent of the white women. This difference may be the result of what she calls "weathering," or accelerated declines in health due to repeated socioeconomic and political factors. "What some people experience by being black takes a toll on the physiological system, and over time wear and tear that occurs across neural, neuroendocrine and immune systems as a result of chronic exposure to stressors lead to health disparities for blacks. Some of this may manifest itself in premature birth and low-birth weight," Gavin said. The study did not look at depressive mood or depression during pregnancy because the larger research project did not collect that data. She hopes to replicate and expand her findings by analyzing data from another study to look at depressive mood prior to pregnancy and childhood poverty to see if those two factors in part explain the black and white difference in preterm delivery. That study also will look at the role antidepressive medication plays in preterm birth. "My ultimate goal is to incorporate a life course health development framework to examine disparities in birth outcomes," she said. "You have to look at the context of health across the life course of a woman, not just during pregnancy." The consequences of higher preterm delivery are a growing burden on the health care system and parents. Studies have shown that preterm babies have higher morbidity rates and U.S. preterm birth rates are creeping up with no good explanation. In the U.S. the population at greatest risk for major depression is women of childbearing age and the onset and course of depression are often intertwined with reproductive events. A recent national study reported that 8.4 percent of pregnant women in the past year experienced major depression and only slightly more than 14 percent of those women sought treatment for any mood disorder. Co-authors of the study are David Chae of Emory University, Sarah Mustillo of Purdue University, and Dr. Catarina Kiefe of the University of Alabama at Birmingham and the Birmingham Veterans Affairs Medical Center. The National Center for Research Res and the Roadmap for Medical Research, both components of the National Institutes of Health, funded the research. Joel Schwarz University of Washington


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