Why Black Premies Are In Danger

A mother's hand touching her baby's headThe National Medical Association (NMA) is the nation’s oldest and largest association of African American (AA) physicians and is a longstanding advocate of patient health, increased healthcare coverage and access and remains the leading voice against health disparities. The NMA previously issued a “Call to Action” regarding the Respiratory Synctial Virus (RSV) based on its commitment to all of the nation’s children but particularly minority premature infants. “The NMA has a long history of advocating for those who do not have a “voice” in healthcare; certainly our advocacy for premature infants who are at increased risk from RSV is unwavering,” said Dr. Rahn Kennedy Bailey, President of the NMA.

RSV is an infection which is the major cause of respiratory illness in infants and young children. According to the CDC, 18% of African American women give birth to a premature baby, thus, 100,000 African- American babies are born early every year in the United States, compared to 12% for Hispanic women and 11.6% for Caucasian women. Premature birth is one of the leading causes of RSV which has caused an estimated 90,000 hospitalizations and 4,500 deaths per year in children five years of age and younger. With the current flu outbreak at its peak, RSV is often mistaken for a cold; however, it must be noted that RSV is 10 times more lethal than the flu.

The NMA’s position on RSV is a result of a stringent review process which was embarked upon in 2010 when the NMA convened experts and a variety of organizational leaders to review RSV in the minority community. As a result of this meeting, the NMA’s Consensus Panel publication was produced a comprehensive approach to RSV based on the most current and reliable medical evidence. The Consensus Panel paper provides a roadmap for increased awareness, education, treatment and public health policy. “The NMA’s recommendations are not that of just one segment of our physicians or even ours solely as an organization. Our process involves several organizations and experts from the entire spectrum of healthcare,” said Dr. Bailey. The NMA’s paper is the most extensive and comprehensive document focused on RSV in African Americans ever produced.

The NMA is particularly concerned about access to care and other barriers that would place all children at risk and disproportionately affect African Americans. The NMA has repeatedly expressed serious concerns about clinical guidelines published by the American Academy of Pediatrics’ Committee of Infectious Disease (AAP/COID), which decreases the length of time that infants receive the antibody that protects them from RSV. The NMA has recommended that additional research be conducted to ensure that

physicians provide the maximum protection to infants and children at risk of RSV. Further, the NMA is alarmed that the guideline changes have limited scientific backing to support the restriction in access to treatment and strongly encourages more clinical trials with a representative number of African American infants. “We cannot continue to experiment with our infants or support “off-label” treatment via decreasing the length of treatment and dosing. The NMA will continue to advocate for increased research and demands the recommended duration of treatment be based on substantial clinical trials and thus scientific evidence. As the nation’s association of African American physicians with a vibrant pediatric section that treats hundreds of thousands of children each year, we truly believe that our input is invaluable and should be heard,” continued Dr. Bailey.

The NMA has contacted the American Academy of Pediatrics (AAP) repeatedly over the last two years focusing on its strong support of African American children and the need to protect them from RSV based on scientific evidence. The current and past President of the NMA have specifically written letters to the President of the AAP and sent numerous communications including a copy of the landmark Consensus Panel paper. The NMA’s requests have sought AAP’s input, partnership and collaboration in protecting these vulnerable infants. The AAP has failed to acknowledge the NMA’s requests, expertise and concerns repeatedly despite written communications, dozens of phone calls, and numerous emails over a two year period. “As an association of physicians, it is mind boggling that our peers will not respond to our requests for meetings, discussions or review of the current literature and recommendations on this topic. Further, as the nation’s oldest association of African American physicians, it is even more disheartening and speaks to a larger question of inclusion and respect for our expertise,” said Dr. Bailey. “We don’t expect any organization to simply adopt our stance on health issues or even health disparities. However, we do expect that our history, reputation, expertise and skill in treating and advocating for patients be respected enough to have a conversation between professional physician organizations, without being ignored.” The NMA will continue to advocate for the lives of all children and be the clear and resounding voice to address this health disparity in African American babies; it challenges other organizations to stand with them in this effort.

Is Gun Violence A Health Disparity?

Revolver and bulltes on a dark surfaceThe National Medical Association (NMA) is the nation’s oldest and largest medical association representing the interest of over 50,000 African American physicians and the patients they serve. The NMA is committed to addressing health disparities and cites gun violence as a disparity.

“The President of the United States was on target in his call for the American people to demonstrate an unwavering commitment to reducing gun violence in our country. The Congress must now follow his lead, and pass meaningful legislation to reduce the bloodshed,” said Rahn Kennedy Bailey, MD, FAPA, President of the NMA Chairman of the Department of Psychiatry, Meharry Medical College and one of the nation’s leading psychiatrists.

“As a forensic psychiatrist, I have witnessed both ends of the spectrum, the victim and the criminal. Gun violence has been an issue in this country for decades.”

The NMA stands ready to be a resource and assist the President and specifically Health and Human Services Secretary, Kathleen Sebelius, as well as U. S. Secretary of Education, Arne Duncan.

“The NMA has always been at the forefront of patient advocacy since its existence, we have steadfastly supported mental health equity. I have personally dedicated my life to ensuring that we increase awareness, diagnosis and treatment of mental illness while combating stigma and barriers to care,” said Dr. Bailey.

“The NMA houses experts from various aspects of medicine and stands ready to participate in the dialogue on mental health, patient privacy and other health related issues.”

The NMA is encouraged by the Obama Administration’s Gun Violence Prevention Task Force recommendations which directly affect healthcare professionals and their patients:

Directing the Centers for Disease Control and Prevention (CDC) to resume public health research on gun violence
Clarifying mental health benefits under the Affordable Care Act (ACA)
Reminding doctors that the ACA does not prohibit asking their patients about guns in their homes;

Releasing a letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover
Finalizing regulations clarifying essential health benefits and parity requirements within ACA exchanges

Committing to finalizing mental health parity regulations and launching a national dialogue on mental health.

In an op-ed response following the Sandy Hook tragedy, Dr. Bailey proposed a three step approach to address violence:

Prevention: Physicians are trained to detect subtle signs of fragile and potentially violent thinking. States must support mental health programs with words, actions and resources.

Risk Management: Our country needs more restricted limits on gun ownership and a ban on the sale of assault weapons as a first step.

Education: We are educating our society with more violence by providing easy access to violent video games and other readily accessible violent entertainment…not less.
Dr. Bailey alerts the nation that people with severe mental illness are at greater risk of being victims of violent crimes versus the perpetrators. We must not categorize all patients with mental health needs as violent and capable of these horrendous acts.

The NMA is concerned about the potential risks to patient confidentiality, increased stigma and barriers to persons needing mental health evaluation. The organization is committed to working with the federal, state and local agencies in developing the protocols for implementation. Healthcare professionals must be at the table from the beginning and seen as invaluable partners in addressing gun violence.
“The NMA is uniquely prepared to partner and lead aspects of this national gun control initiative,” stated Dr. Bailey. “As the nation’s leading African American psychiatrists, trauma surgeons, emergency room, and primary care physicians; we are on the front lines every day trying our best to repair the damage done by an unconscionable amount of violence to the victims and their families; both physically and mentally. The nation must reduce the carnage today, because tomorrow is too long to wait.”