Examining breast cancer disparities in African Americans with suggestions for policy.

Breast cancer is a commonly diagnosed malignancy and the second leading cause of cancer-related death among American women today. The literature suggests that African American Women (AAW) are more likely to die from the disease each year compared to their White counterparts. A biological basis for this disparity exists-early age of onset, more advanced stage of the disease, more aggressive histological changes, and worse survival. Even though mechanisms underlying these disparities are poorly understood, recent studies suggest that the poorer breast cancer outcome observed in AAW may, in part, result from underlying molecular factors. The present review was undertaken to investigate if AAW do, in fact, develop a more aggressive form of breast cancer compared to other racial groups based on molecular level differences and social determinants. This review also addresses health policy changes that may be implemented to aid in eliminating this disparity.

An Analysis of Nashville's Safety-Net Hospital.

Currently, over 100,000 individuals in the Metro Nashville, TN area are either uninsured or underinsured, a statistic that is of grave concern in an increasingly prosperous and growing city. It is, however, unsurprising in a state that has not expanded Medicaid. In the absence of Medicaid expansion, public safety-net hospitals prove ever more vital in addressing the health needs of the community. Nashville's only public safety-net hospital-Nashville General Hospital (NGH)-faces challenges associated with financial growth as well as changes in the demographic profile of the patient population and in-service utilization. To combat the decline, NGH, like many similar hospitals around the country, may consider possible organizational and financial restructuring to achieve sustainability.

The underserved aged and the role of the African American church.

Historically, the church has been a central institution in the life of the African American community, and caring for bodies, as well as souls, has been a critical aspect of its ministry. The significance of this role will increase in importance in the foreseeable future given the escalating costs of health care services. There is an increasing realization that churches must be involved in the provision of health services if society is to improve the health status of this population. This paper examines the role of the African American church in providing formal and informal health care services to the underserved aged.