“As far as our beliefs about unequal access to health care, whether we are conservative or liberal seems to be much more important than whether we are Republican or Democrat,” said Harry Perlstadt, professor of sociology.

Michigan State University sociologist, contends party ideology is more important than party affiliation when it comes to public perception of health disparities.

The issue is back in the headlines after Republicans captured the U.S. House Nov. 2 and vowed to repeal the new health care law that expands coverage to all Americans. Perlstadt said that while government officials and health workers are familiar with the social factors that create health disparities for minorities and low-income people, the perceptions of the general public have not been fully explored, particularly in terms of political values and identity.

Understanding the nuances of how the public perceives health disparities is important for lawmakers on both sides of the aisle as they shape their strategies on health care reform, Perlstadt said.

He commissioned a telephone survey with MSU’s Institute for Public Policy and Social Research that gathered information on the respondents and asked a series of questions regarding their beliefs about health disparities. The questions included, “How often do you think the health care system treats people unfairly based on whether they have health insurance?” and “How often does a person’s race or ethnic background affect whether they can get routine medical care when they need it?”

Perlstadt analyzed the survey data and found that race, age, sex, income and whether a respondent lived in an urban or rural community all influenced their beliefs on health disparities. Political party and ideology also affected their beliefs – only not quite as Perlstadt had predicted.

“When I started this, I thought party affiliation would be more important than ideology,” Perlstadt said. “And while party is still important, it takes a backseat to ideology.”

“There is no question that the U.S. Preventive Services Task Force Recommendations have caused a great deal of confusion and worry among women and their families across this country. I want to address that confusion head on. The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don’t determine what services are covered by the federal government.

“There has been debate in this country for years about the age at which routine screening mammograms should begin, and how often they should be given. The Task Force has presented some new evidence for consideration but our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.

“What is clear is that there is a great need for more evidence, more research and more scientific innovation to help women prevent, detect, and fight breast cancer, the second leading cause of cancer deaths among women.

“My message to women is simple. Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for years — talk to your doctor about your individual history, ask questions, and make the decision that is right for you.”

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• Creating or expanding state and local efforts to implement recommendations in the U.S. Department of Health and Human Services HAI Action Plan
• Increasing health care facilities’ and health departments’ use of  CDC’s National Healthcare Safety Network, a surveillance system that allows HAI data to be tracked, analyzed and compared for prevention efforts
• Hiring and training public health staff to promote and lead HAI prevention initiatives
• Complementing HAI investments from other HHS agencies

“Americans expect to get better when they go to the hospital, not worse” said HHS Secretary Kathleen Sebelius. “Unfortunately, every year, thousands of Americans die from illness they contract after they enter the hospital. Thanks to Chairman David Obey’s leadership, the Recovery Act includes critical resources that will help fight these infections and keep patients safe.”

Efforts will focus on HHS priority targets such as bloodstream infections, surgical site infections and catheter-associated urinary tract infections, and will address pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. diff). The investment represents the first time Congress has appropriated HAI prevention funds specifically to states.

“We expect these programs to strengthen tracking and prevention of healthcare-associated infections, enhance facility accountability, provide data for informed policy, and ultimately save lives,” said CDC Director Thomas R. Frieden, M.D., M.P.H.  “Funding critical prevention efforts at state and local levels represents a significant investment toward elimination of HAIs and improved patient safety.”

CDC estimates that every year, Americans contract 1.7 million infections while being treated in hospitals. These infections are associated with approximately 99,000 deaths annually. In addition to the significant toll on patients’ lives, HAIs represent an estimated $30 billion in added healthcare costs.

HHS has addressed HAIs by coordinating efforts across the Department and creating the HHS action plan which includes five-year national prevention targets to reduce and prevent much of the significant burden to our nation. One of the goals of the HHS Action Plan is to collaborate effectively with public and private sector partners to accomplish the large-scale prevention of HAIs. For instance, CDC is collaborating with several states that have demonstrated that implementing CDC’s HAI prevention guidelines and using NHSN to monitor progress can achieve major decreases in HAIs. Prevention success can be characterized in a number of ways. Some states have shown quick reductions after implementing prevention efforts, and others have sustained low infection rates over an extended period of time. For example, in the first six months of 2009, compared to 2008, hospitals in Tennessee achieved a 30 percent reduction of bloodstream infections associated with central lines (a catheter, or tube, that is inserted into a major vein or artery, and that ends up close to or in the heart). In another instance, intensive care units in a New York state hospital group achieved a 70 percent reduction of central line-associated bloodstream infections and sustained these rates for a three-year period.

“Many states and localities have lacked the resources and personnel needed to appropriately address the HAI burden,” said Marion Kainer, M.D., M.P.H., director of the Tennessee Department of Health Hospital Infection and Antimicrobial Resistance Program, and HAI prevention lead for the Council of State and Territorial Epidemiologists.  “This investment will provide a unique opportunity to make prevention of HAIs a national accomplishment.”

Background on HAI Investments in the Recovery Act

The American Recovery and Reinvestment Act of 2009, Public Law 111-5 (ARRA) was signed into law on February 17, 2009. Within the Recovery Act, $50 million was appropriated to support states in the prevention and reduction of healthcare associated infections (HAI).  The Centers for Medicare & Medicaid Services (CMS) will use $10 million to improve the process and frequency of inspections for ambulatory surgical centers, while CDC will allocate $40 million to states to create or expand state-based HAI prevention collaboration efforts, enhance state abilities to monitor and track HAIs, and build within health departments a workforce trained in HAI prevention.  For more information on the Recovery Act: www.recovery.gov.   For more information about CDC’s HAI Recovery Act funding: www.cdc.gov/hai/recoveryact.

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