India asks its states not to partner with Philip Morris-funded foundation

NEW DELHI (Reuters) – India’s health ministry has asked all state governments in the country not to partner with the Foundation for a Smoke-Free World (FSFW) because of its links to tobacco giant Philip Morris International Inc, a letter seen by Reuters showed.

FILE PHOTO: A man smokes a cigarette along a road in Mumbai, India, October 26, 2016. REUTERS/Danish Siddiqui/File Photo

Established in 2017, the FSFW focuses on eliminating usage of cigarettes and works toward smoking cessation using new technologies and alternative products. It says it works independently, but the World Health Organization (WHO) has said there are “clear conflicts” due to the $80 million in annual funding the foundation receives from Philip Morris.

At least three Indian anti-tobacco groups earlier this year wrote to the federal health ministry in New Delhi calling for the rejection of any possible partnerships with FSFW, according to copies of their representations seen by Reuters.

India’s federal health ministry has sent a letter, dated June 24, to chief secretaries of all states, saying they should not partner with FSFW and also advise other departments and institutions in their region accordingly.

The ministry said Philip Morris was funding FSFW as well as manufacturing and promoting harm-reduction smoking devices. Reuters has previously reported Philip Morris has plans to launch its iQOS smoking device in India which it says is less harmful than conventional cigarettes.

“Any collaboration with the Foundation for a Smoke Free World should be avoided in the larger interest of Public Health,” senior health ministry official, Sanjeeva Kumar, wrote in the letter, which was reviewed by Reuters.

The Foundation for a Smoke-Free World, which is led by former WHO official Dr. Derek Yach, said it “operates with complete independence from Philip Morris” and was committed to full transparency about who its funders were. 

Philip Morris, which has a stated longer-term vision to replace cigarette sales with products such as its iQOS device, in a statement said FSFW was “an independent body governed by its own independent Board of Directors”.


In recent years, the Indian government has intensified its tobacco-control efforts, raising cigarette taxes and ordering companies to print bigger health warnings on cigarette packs.

India has 106 million adult smokers, second only to China, and more than 900,000 people die each year in India due to tobacco-related illnesses.

A federal health ministry official said on Sunday the letter on FSFW had been sent as a preventive measure to dissuade states from any collaboration with the foundation, and similar instructions were likely to be sent to other federal ministries.

The FSFW said there were no projects with any state government institutions in India. “We seek partnerships with all who share our goal to end smoking in the world,” a spokesperson said in a statement to Reuters.

In May, FSFW said its team was committed to working with others “to accelerate an end to smoking in this generation” in India. It also invited people to study its strategic plan.

That same month, Philip Morris in a press statement said it had urged the Indian government to create a regulatory environment for devices such as its iQOS.

When the FSFW was launched in 2017, the WHO had said it will not partner with the foundation and asked governments around the world and public health communities to follow the agency’s lead.

(Story refiled to fix grammar in paragraph 4)

Reporting by Aditya Kalra; Editing by Martin Howell and David Evans

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U.S. federal court delays adoption of healthcare rule on abortion

FILE PHOTO – A imaging table inside the Reproductive Health Services of Planned Parenthood St. Louis Region, Missouri’s sole abortion clinic, in St. Louis, Missouri, U.S. May 28, 2019. REUTERS/Lawrence Bryant

WASHINGTON (Reuters) – The U.S. Department of Health and Human Services (HHS) and its opponents in a California lawsuit agreed on Friday to delay implementing a rule that would allow medical workers to decline performing abortions or other treatments on moral or religious grounds, according to a federal court filing.

The rule, which was due to take effect on July 22, will now be delayed for final consideration until Nov. 22, the filing said.

The move comes after President Donald Trump’s administration announced the rule earlier in May. It has also championed several policies to restrict abortion both in the United States and abroad.

Known as the “Protecting Statutory Conscience Rights in Health Care; Delegations of Authority,” the measure aims to protect conscience and religious rights surrounding abortion, sterilization and assisted suicide, HHS officials have said.

Planned Parenthood and other nonprofits offering family-planning services argue that the rule, if implemented, would impose heavy costs on healthcare providers dependent on federal funding, which they could lose by refusing to comply.

Reporting by Katanga Johnson; editing by Jonathan Oatis

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New study finds increase in erectile function after consumption of nuts

A recent study, partially supported by the INC and published in the journal Nutrients, observed a significant increase in erectile function after the consumption of 60 g/day of nuts.

Lifestyle risk factors such as smoking or stress may influence erectile dysfunction through the vascular and nervous system. This study explored the effects of nut supplementation on erectile function.

Forty-three healthy males, aged 18-35, were assigned to a “nut group” and consumed the usual Western-style diet supplemented with 60 g/day of raw mixed nuts (30 g of walnuts, 15 g of almonds, and 15 g of hazelnuts); and forty participants were assigned to a “control group” and they followed the usual Western-style diet but avoided nut consumption during the 14-week follow-up. Levels of nitric oxide and E-selectin (two biomarkers of erectile endothelial function) were measured. Participants also completed the International Index of Erectile Function (IIEF) questionnaire, which evaluated the influence of nuts on erectile function through 15 questions.

The results of the questionnaire observed a significant increase in some of the erectile function parameters in the nut-supplemented group. The study, conducted by Dr. Albert Salas-Huetos and led by Dr. Mònica Bulló from Rovira i Virgili University in Spain, concluded that a Western-style diet supplemented with mixed nuts may help to improve erectile function.

This is the largest randomized clinical trial to date analyzing the effect of nut supplementation on erectile and sexual function in subjects without erectile dysfunction.”

Dr. Mònica Bulló


INC International Nut and Dried Fruit Council

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China tightens vaccine management after scandals

FILE PHOTO – A nurse prepares a vaccine to be given to a child in a hospital in Beijing, China, April 13, 2016. REUTERS/Damir Sagolj

BEIJING (Reuters) – China passed a law on Saturday tightening the supervision and management of how vaccines enter the market, requiring stricter management of their production, research and distribution, after a series of safety scandals.

China has pledged to reform and improve vaccine production and management after the scandals, including one last year in which a firm fabricated production and inspection records and sold ineffective vaccines, shaking public confidence in drugs made domestically.

The new law mandates severe punishment for those who participate in illegal practices, such as the fabrication of data, or who impede investigations, the Xinhua state news agency reported.

Reporting by Ben Blanchard; Editing by Robert Birsel

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Theranos founder Elizabeth Holmes, top deputy ordered to stand trial in 2020

LOS ANGELES (Reuters) – Theranos founder Elizabeth Holmes and her former second-in-command at the Silicon Valley blood-testing startup were ordered on Friday to stand trial next year on fraud charges stemming from their claims about the company’s technology, court documents show.

FILE PHOTO: Elizabeth Holmes, CEO of Theranos, attends a panel discussion during the Clinton Global Initiative’s annual meeting in New York, U.S., September 29, 2015. REUTERS/Brendan McDermid/File Photo

During a hearing in federal court in San Jose, California, U.S. District Judge Edward Davila set jury selection to begin in the trial of Holmes, 35, and former Theranos President Ramesh “Sunny” Balwani, on July 28, 2020, according to minutes of the proceedings.

Davila ordered the trial to begin in August 2020. It was expected to last three months.

Holmes and Balwani, 54, were indicted in June 2018 on 11 counts of conspiracy and wire fraud. They have pleaded not guilty.

Prosecutors say Holmes and Balwani engaged in a pair of schemes to defraud investors, doctors and patients with claims that Theranos had developed a revolutionary new blood testing system.

Holmes and Balwani are accused of using advertising and solicitations to encourage doctors and patients to use the company’s testing laboratory services even though they knew it could not produce accurate and reliable results consistently.

Holmes, a Stanford University dropout who started Theranos at age 19, was celebrated as a rising star of Silicon Valley. In 2015, Forbes magazine anointed her America’s youngest self-made female billionaire.

Balwani joined Theranos in 2009 and ran day-to-day operations until 2016.

Questions were first raised about the accuracy and reliability of her signature blood-testing device in a series of articles in the Wall Street Journal in 2015. This touched off a string of state and federal investigations into the company.

In March of 2018 Holmes settled civil fraud charges brought by the U.S. Securities and Exchange Commission under which she was barred from serving as an officer or director of a public company for 10 years.

Reporting by Dan Whitcomb in Los Angeles; Editing by Tom Brown

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Missouri’s only abortion clinic to stay open until at least August 1

(Reuters) – Missouri’s only abortion clinic will remain open for now after a state arbiter on Friday ordered a stay in response to Planned Parenthood’s challenge of the state health department’s refusal to renew the clinic’s license.

A banner stating “STILL HERE” hangs on the side of the Planned Parenthood Building after a judge granted a temporary restraining order on the closing of Missouri’s sole remaining Planned Parenthood clinic in St. Louis, Missouri, U.S. May 31, 2019. REUTERS/Lawrence Bryant

Planned Parenthood, the women’s healthcare and abortion provider that operates the clinic, filed a petition with Missouri’s Administrative Hearing Commission on Tuesday after the group challenged the health department’s denial in state court and a judge referred the matter to the commission.

The clinic would have had to stop providing abortion services on Friday if the commission did not grant the stay, which allows it to stay open until its initial Aug. 1 hearing date.

In its ruling, the commission noted that the issue of abortion entails great public interests for opponents and proponents, but that the only question it was considering was a motion to stay the expiration of a statutory license.

“Consequently, the public interest of our concern is the procedural due process of licensees to appeal the decisions of regulatory bodies. We find that granting this stay sufficiently protects that interest,” the commission said.

Dr. Colleen McNicholas of the Reproductive Health Services of Planned Parenthood of the St. Louis Region said in a statement that they were relieved by the last-minute reprieve.

“This has been a week-to-week fight for our patients and every Missourian who needs access to abortion care,” McNicholas said. “There are two things that remain unchanged in Missouri: the uncertainty our patients face, and our will to continue fighting for their right to access safe, legal abortion.”

Missouri health officials declined to renew the St. Louis clinic’s license last week on the grounds it failed to meet their standards. If Missouri officials succeed in closing the clinic, it would become the only U.S. state without a legal abortion facility.

Abortion is one of the most divisive issues in the United States. Missouri is one of 12 states to pass laws restricting abortion access this year, some aimed at provoking a U.S. Supreme Court review of the landmark 1973 Roe v. Wade decision that recognized a woman’s constitutional right to terminate her pregnancy.

“The terrifying reality is that access is hanging on by a thread with a narrowing timeline,” McNicholas, who is a physician at the clinic, said in a statement ahead of the ruling.

Judge Michael Stelzer had issued a temporary injunction on Monday letting the clinic stay open until Friday at 5 p.m. CT (2200 GMT), ahead of the decision of the commission, which serves as an independent arbiter in disputes between state agencies and individuals or groups.

On Friday, a group of civil rights groups, doctors and clinics sued Georgia seeking to overturn a law passed in March that bans abortions if an embryonic or fetal heartbeat can be detected.

And the U.S. Supreme Court sidestepped a major new challenge to abortion rights by declining to hear Alabama’s bid to revive a Republican-backed state law that would have effectively banned the procedure after 15 weeks of pregnancy.

Separately in New York City, Mayor Bill de Blasio said the city’s public health system will stop participating in the federal Title X program for as long as a “gag rule” is in effect that prevents medical providers from sharing information and counseling about abortion with their patients.

Missouri state officials have said one of their conditions for renewing the clinic’s license was to be allowed to interview several physicians who were involved in what they said were multiple life-threatening abortions at the clinic.

Planned Parenthood officials have said they do not directly employ all the clinic’s staff and cannot force certain health workers to give interviews.

Reporting by Gabriella Borter in New York; Additional reporting by Daniel Wallis; Editing by Cynthia Osterman and James Dalgleish

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Sarepta surges after Pfizer gene therapy data raises safety concerns

(Reuters) – Shares of Sarepta Therapeutics Inc (SRPT.O) surged 15% on Friday after some safety concerns were raised in a small, early-stage study of a competing gene therapy for a rare muscle-wasting disorder from Pfizer Inc (PFE.N).

FILE PHOTO: The logo of U.S. pharmaceutical corporation Pfizer Inc. is seen at a branch in Zurich, Switzerland October 2, 2018. REUTERS/Arnd Wiegmann/File Photo

Sarepta reported promising data from its study last year and is in a race with Pfizer and Solid Biosciences Inc (SLDB.O) to first market a gene therapy for the genetic degenerative disorder that affects one in 3,500 to 5,000 males.

Shares of Pfizer were marginally up in midday trading, while Sarepta shares were up 15% and Solid Biosciences was up about 10%.

Baird analyst Brian Skorney said Pfizer fell way short on both safety and efficacy, making Sarepta’ position in the space even stronger.

Sarepta already has a treatment, Exondys 51, in the market for some form of the disease.

People with the condition lack the protein dystrophin needed to keep muscle cells intact. That can lead to life-threatening damage to the heart, and over time, death, often at a young age.

Pfizer’s six-patient study tested two different dosages of the gene therapy in boys in the age group of 6 to 12. Two months after receiving the one-time therapy, mini-dystrophin expression levels ranged from 10% to 60% of normal.

Skorney said all measures of expression looked worse. “More importantly, it just did not look safe.”

Two Duchenne muscular dystrophy (DMD) patients in the trial experienced side effects that landed them in the hospital, the company said.

The higher tested dose appeared to be more effective, according to data presented by Pfizer at the Parent Project Muscular Dystrophy conference in Orlando, Florida.

Pfizer said it had paused enrollment in the study and then modified the study protocol in order to mitigate future risks of similar safety events.

The company said future trials will use the higher dose, which had triple the concentration of virus with genetic material. The U.S. drugmaker said it also may test an intermediate dose.

Both of the boys who required hospital treatment had received the higher dose.

One had developed a kidney injury. He was hospitalized for 11 days and received two doses of Alexion’s (ALXN.O) Soliris, but left the hospital with normal kidney function.

The other suffered nausea and vomiting after the treatment and spent two days in a hospital.

Reporting by Michael Erman in New York and Manas Mishra in Bengaluru; Editing by Bill Berkrot and Maju Samuel

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Alzheimer’s Genes Might Show Effects in Your 20s

News Picture: Alzheimer's Genes Might Show Effects in Your 20sBy Alan Mozes
HealthDay Reporter

Latest Alzheimer’s News

THURSDAY, June 27, 2019 (HealthDay News) — Every college student misplaces keys or forgets an appointment from time to time. Usually it’s no big deal. But a new study warns that when young people with a family history of Alzheimer’s disease have memory lapses, it could be an early sign of something serious.

That’s the concern raised by a new memory test taken by nearly 60,000 men and women between the ages of 18 and 85.

The results revealed that participants between 18 and 65 who had family members with Alzheimer’s scored lower than those who did not. That included even young adults in their 20s.

But, “no one should feel doomed to experience Alzheimer’s, certainly not simply because your parents or grandparents were diagnosed with the disease,” stressed study author Matt Huentelman. He is a professor of neurogenomics with TGen, a genetics research institute based in Phoenix.

Lots of non-inherited factors play a role in Alzheimer’s risk, he explained. And, “there are many cases of people with family history and/or high genetic risk for Alzheimer’s who live long lives without memory problems.”

But there’s no getting around the fact that roughly 75% of Alzheimer’s risk is thought to be driven by genetics, said Huentelman. And the test does suggest that a young person’s memory may be impacted by genetic risk “as many as four decades before the typical onset of Alzheimer’s disease,” he added.

The test results and analysis were published online recently in the journal eLife.

Huentelman and his colleagues pointed out that more than 5 million Americans now live with Alzheimer’s. By 2050, that number is expected to nearly triple, approaching 14 million. The disorder is the leading cause of dementia, and has no known treatment or cure.

To get a better handle on how a family history of Alzheimer’s might affect future risk, the team launched an online word memory test in 2013.

Called “MindCrowd,” the launch got a big publicity boost from celebrities such as Lynda Carter, Valerie Bertinelli and Ashton Kutcher, who spread the word via social media.

By August 2018, nearly 60,000 people had signed up in all 50 states and across 150 countries. Most (92%) were white.

The analysis is based on that figure, although the ongoing project has now tested 116,000 recruits.

Test takers were shown 12 sets of two linked words. Afterwards just one word was randomly displayed, and everyone was asked to recall the missing word. The process was repeated three times.

In addition, participants provided information on their health and their family’s health.

Nearly 5,000 participants who reported a family history of Alzheimer’s also provided a blood or saliva sample. Samples were measured for levels of a particular protein (apolipoprotein E, or APOE) long associated with Alzheimer’s risk.

In the end, the team found a clear link between having a family history of Alzheimer’s and lower memory test scores.

However, “it is important to note that our test isn’t a clinical diagnostic test for dementia,” said Huentelman. “It isn’t designed to diagnose Alzheimer’s. It is also important to note that the differences we see are significant, yet subtle. So, they are unlikely to affect the daily living activities of any of these young individuals.”

Still, the link is real, he said, and “we need to conduct research like ours to start trying new things to make headway towards treatments and cures.”

Huentelman emphasized “that there are a few things we know that are good for the brain and can help reduce the risk of dementia.”

He said those include exercising, getting good sleep, eating a nutritious diet, being socially active, and avoiding smoking and lifestyle choices that could lead to diabetes or heart disease.

Such prevention efforts were endorsed by Keith Fargo, director of scientific programs and outreach with the Alzheimer’s Association.

But Fargo also advised against reading too much into the findings.

“While genetics certainly play a role in risk for Alzheimer’s disease, there is not a single number that clinicians or researchers agree upon yet to describe the size of that role,” he said. “The fact is that it is almost impossible to predict whether any particular individual will develop Alzheimer’s or not.”

Copyright © 2019 HealthDay. All rights reserved.

SOURCES: Matt Huentelman, Ph.D., professor, neurogenomics division, and head, neurobehavioral research unit, TGen, Phoenix; Keith Fargo, Ph.D., director, scientific programs & outreach, Alzheimer’s Association, New York City; June 18, 2019, eLife, online


Dementia, Alzheimer’s Disease, and Aging Brains
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KHN’s ‘What The Health’: Dems Debate Health Care

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Health care played a feature role in the first debate among Democratic presidential candidates Wednesday, with would-be nominees spreading across the spectrum on the question of how quickly to move to universal coverage and what, if any, role should remain for private insurance.

Meanwhile, President Donald Trump earlier this week signed an executive order calling for hospital prices to be made more available to the public. But some analysts wonder if publicizing prices could cause them to rise rather than fall.

This week’s panelists are Julie Rovner from Kaiser Health News, Stephanie Armour of The Wall Street Journal, Rebecca Adams of CQ Roll Call and Anna Edney of Bloomberg News.

Among the takeaways from this week’s podcast:

  • Sen. Elizabeth Warren’s strong endorsement during the debate for eliminating private health insurance could come back to haunt her with moderate voters. The more nuanced stance of moving more gradually to universal care championed by other candidates, such as Sen. Amy Klobuchar, seems geared to a general election campaign.
  • President Donald Trump’s order this week for federal agencies to come up with a rule mandating more transparency in health care touches on a pain point for patients: They want to be able to know their costs upfront.
  • It has been an article of faith among conservatives that if consumers had access to transparent pricing in health care, it would help bring down costs because people would migrate to cheaper care options. But some recent studies raise questions about that.
  • The Supreme Court’s decision to take a case brought by insurers who did not get money originally promised them under the Affordable Care Act could lead to some difficult remedies. Several of the insurers have gone out of business and it’s not clear how they or their enrollees would be compensated if they prevail in court.
  • Senate Majority Leader Mitch McConnell said the health costs bill sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) will be a priority to get on the floor for a vote this summer. But the sponsors are still in negotiations with Sen. Bill Cassidy (R-La.) about how to resolve “surprise” medical bills.

Also this week, Rovner interviews NPR’s Jon Hamilton, who wrote the latest KHN-NPR “Bill of the Month” feature about expensive monitoring during spine surgery. If you have an outrageous medical bill you would like to share with us, you can do that here.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: The Washington Post’s “When Abortion Was Illegal: A 1966 Post Series Revealed How Women Got Them Anyway,” by Elisabeth Stevens

Stephanie Armour: STAT News’“Ghost Networks of Psychiatrists Make Money for Insurance Companies but Hinder Patients’ Access to Care,” by Jack Turban

Rebecca Adams: NPR’s “San Francisco Bans Sales of E-Cigarettes,” by Laura Klivans

Anna Edney: The New York Times’ “Vaccine Injury Claims Are Few and Far Between,” by Pam Belluck and Reed Abelson

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts.

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How Black Pharmacists Are Closing The Cultural Gap In Health Care

SHILOH, Ill. — After a health insurance change forced Bernard Macon to cut ties with his black doctor, he struggled to find another African American physician online. Then, he realized two health advocates were hiding in plain sight.

At a nearby drugstore here in the suburbs outside of St. Louis, a pair of pharmacists became the unexpected allies of Macon and his wife, Brandy. Much like the Macons, the pharmacists were energetic young parents who were married — and unapologetically black.

Vincent and Lekeisha Williams, owners of LV Health and Wellness Pharmacy, didn’t hesitate to help when Brandy had a hard time getting the medicine she needed before and after sinus surgery last year. The Williamses made calls when Brandy, a physician assistant who has worked in the medical field for 15 years, didn’t feel heard by her doctor’s office.

“They completely went above and beyond,” said Bernard Macon, 36, a computer programmer and father of two. “They turned what could have been a bad experience into a good experience.”

Now more than ever, the Macons are betting on black medical professionals to give their family better care. The Macon children see a black pediatrician. A black dentist takes care of their teeth. Brandy Macon relies on a black gynecologist. And now the two black pharmacists fill the gap for Bernard Macon while he searches for a primary care doctor in his network, giving him trusted confidants that chain pharmacies likely wouldn’t.

Black Americans continue to face persistent health care disparities. Compared with their white counterparts, black men and women are more likely to die of heart disease, stroke, cancer, asthma, influenza, pneumonia, diabetes and AIDS, according to the Office of Minority Health.

But medical providers who give patients culturally competent care — the act of acknowledging a patient’s heritage, beliefs and values during treatment — often see improved patient outcomes, according to multiple studies. Part of it is trust and understanding, and part of it can be more nuanced knowledge of the medical conditions that may be more prevalent in those populations.

For patients, finding a way to identify with their pharmacist can pay off big time. Cutting pills in half, skipping doses or not taking medication altogether can be damaging to one’s health — even deadly. And many patients see their pharmacists monthly, far more often than annual visits to their medical doctors, creating more opportunities for supportive care.

That’s why some black pharmacists are finding ways to connect with customers in and outside of their stores. Inspirational music, counseling, accessibility and transparency have turned some minority-owned pharmacies into hubs for culturally competent care.

“We understand the community because we are a part of the community,” Lekeisha Williams said. “We are visible in our area doing outreach, attending events and promoting health and wellness.”

To be sure, such care is not just relevant to African Americans. But mistrust of the medical profession is especially a hurdle to overcome when treating black Americans.

Many are still shaken by the history of Henrietta Lacks, whose cells were used in research worldwide without her family’s knowledge; the Tuskegee Project, which failed to treat black men with syphilis; and other projects that used African Americans unethically for research.

“They completely went above and beyond,” says Macon (center) of Vincent and Lekeisha Williams, owners of LV Health and Wellness Pharmacy.(Michael B. Thomas for KHN)

Filling More Than Prescriptions

At black-owned Premier Pharmacy and Wellness Center near Grier Heights, a historically black neighborhood in Charlotte, N.C., the playlist is almost as important as the acute care clinic attached to the drugstore. Owner Martez Prince watches his customers shimmy down the aisles as they make their way through the store listening to Jay-Z, Beyoncé, Kirk Franklin, Whitney Houston and other black artists.
Prince said the music helps him in his goal of making health care more accessible and providing medical advice patients can trust.

In rural Georgia, Teresa Mitchell, a black woman with 25 years of pharmacy experience, connects her customers with home health aides, shows them how to access insurance services online and even makes house calls. Her Total Care Pharmacy is the only health care provider in Baconton, where roughly half the town’s 900 residents are black.

“We do more than just dispense,” Mitchell said.

Iradean Bradley, 72, became a customer soon after Total Care Pharmacy opened in 2016. She struggled to pick up prescriptions before Mitchell came to town.

“It was so hectic because I didn’t have transportation of my own,” Bradley said. “It’s so convenient for us older people, who have to pay someone to go out of town and get our medicine.”

Lakesha M. Butler, president of the National Pharmaceutical Association, advocates for such culturally competent care through the professional organization representing minorities in the pharmacy industry and studies it in her academic work at the Edwardsville campus of Southern Illinois University. She also feels its impact directly, she said, when she sees patients at clinics two days a week in St. Charles, Mo., and East St. Louis, Ill.

“It’s just amazing to me when I’m practicing in a clinic setting and an African American patient sees me,” Butler said. “It’s a pure joy that comes over their face, a sigh of relief. It’s like ‘OK, I’m glad that you’re here because I can be honest with you and I know you will be honest with me.’”

She often finds herself educating her black patients about diabetes, high blood pressure, high cholesterol and other common conditions.

“Unfortunately, there’s still a lack of knowledge in those areas,” Butler said. “That’s why those conditions can be so prevalent.”

Independent black-owned pharmacies fill a void for African American patients looking for care that’s sensitive to their heritage, beliefs and values. For Macon, LV Health and Wellness Pharmacy provides some of that vital support.(Michael B. Thomas for KHN)

Avoiding Medical Microaggressions

For Macon, his experiences with medical professionals of backgrounds different from his own left him repeatedly disappointed and hesitant to open up.

After his wife had a miscarriage, Macon said, the couple didn’t receive the compassion they longed for while grieving the loss. A few years later, a bad experience with their children’s pediatrician when their oldest child had a painful ear infection sparked a move to a different provider.

“My daughter needed attention right away, but we couldn’t get through to anybody,” Macon recalled. “That’s when my wife said, ‘We aren’t doing this anymore!’”

Today, Macon’s idea of good health care isn’t colorblind. If a doctor can’t provide empathetic and expert treatment, he’s ready to move, even if a replacement is hard to find.

Kimberly Wilson, 31, will soon launch an app for consumers like Macon who are seeking culturally competent care. Therapists, doulas, dentists, specialists and even pharmacists of color will be invited to list their services on HUED. Beta testing is expected to start this summer in New York City and Washington, D.C., and the app will be free for consumers.

“Black Americans are more conscious of their health from a lot of different perspectives,” Wilson said. “We’ve begun to put ourselves forward.”

But even after the introduction of HUED, such health care could be hard to find. While about 13% of the U.S. population is black, only about 6% of the country’s doctors and surgeons are black, according to Data USA. Black pharmacists make up about 7% of the professionals in their field, and, though the demand is high, black students accounted for about 9% of all students enrolled in pharmacy school in 2018.

For Macon, though, the Williamses’ LV Health and Wellness Pharmacy in Shiloh provides some of the support he has been seeking.

“I still remember the very first day I went there. It was almost like a barbershop feel,” Macon said, likening it to the community hubs where customers can chitchat about sports, family and faith while getting their hair cut. “I could relate to who was behind the counter.”

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