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Battling Contagions of Superstition and Ignorance; A Ukrainian-Born Physician Coaxes Nervous Immigrants to Accept Western Medicine
By LISA BELKIN
Published: August 11, 1992, NEW YORK TIMES
Three-year-old Leonid Rozental had seen the vaccination needle and was screaming as Dr. Anatoly Belilovsky approached. "This will be like the bite of a big mosquito," said the doctor in Russian to the boy. Then, he gave Leonid the shot and a lollipop in quick succession.
"He should have had this when he was 2 months old," the doctor said, referring to a standard vaccination intended to prevent a type of meningitis.
But Leonid and his parents moved to the United States from Russia four months ago, where, Dr. Belilovsky said, doctors are trained to be sparing with vaccines for fear that they will hurt, not help, the child. Bridge Between Two Worlds
As a pediatrician in Brighton Beach, Brooklyn, Dr. Belilovsky is a bridge between two medical worlds. Brighton Beach is a haven for immigrants from the former Soviet Union, and each day Dr. Belilovsky confronts the medical care in that part of the world.
He has seen children with undiagnosed heart problems that are now harder if not impossible to correct; children with severe anemia because their mothers had poor prenatal care; a handicapped child who died of measles because her doctors were trained not to give vaccinations to handicapped children.
"I have cabinets filled with charts of kids who didn't get their vaccinations on time," Dr. Belilovsky said.
Dr. Belilovksky is typical of doctors throughout New York City who work in neighborhoods steeped in other cultures. Doctors who treat Mexican immigrants, for instance, see high rates of immunity to certain antibiotics, which are as available as aspirin in Mexico. Those whose patients are natives of the Caribbean grow accustomed to eggs placed in the windowsills of sickrooms to ward off the spirits of illness and fear.
Dr. Belilovsky is particularly well prepared to treat immigrants of the former Soviet republics, where medications have long been scarce and where folk medicine has been entrenched for even longer. He was born in the city of Lvov in what is once again Ukraine, where his mother, Kira Belilovsky, worked as a pediatrician. A Practice in Brighton Beach
He and his family moved to the United States in 1976, when he was 15 years old. Dr. Kira Belilovsky took the tests required to practice medicine and her son graduated from Brooklyn Technical High School, Princeton University and the University of Connecticut School of Medicine. After completing pediatrics training three years ago he joined his mother's practice in Brighton Beach. Of the 5,000 patients in their office files, 80 percent are immigrants from the former Soviet Union.
Dr. Belilovsky remembers his mother's complaining that she might as well forget everything she learned in Soviet medical schools and begin again in the United States. Recently he read some of her Russian textbooks and has come to understand what she meant. "Genetics," he said of the books his mother used as a medical student, "was described as a bourgeois pseudoscience developed to perpetuate the class system. The whole of psychiatry was covered in one paragraph."
Once he joined his mother, however, Dr. Belilovsky had to do a lot of relearning too. His first surprise was that his Russian was not adequate for the job. Though he had spoken the language since he was born, his vocabulary stopped growing at age 15 and he was lost when trying to explain medical problems to patients. Antibiotics? Oh No!
Even when he knew the words he had a difficult time communicating. "I remember the first time I told a family their child was O.K. and would only need some antibiotics," he said. "Their faces fell. I thought I was giving good news, that we can cure this, no problem. Their faces said, oh no, it's so serious it needs antibiotics."
Back home, he learned, his patients had been told that antibiotics would damage a child's liver and should only be given in cases of extreme illness. At least twice a week, he estimates, he has to persuade a mother to give such medication to her child.
"I go out in the waiting room," he said of how he approaches those conversations. "I pick out a patient who had a good result with the same drug and I say, 'Tell this lady what happened.' "
It requires similar coaxing for some parents to sign vaccination consent forms. "The fear of vaccines is unbelievable," he said. "Over there doctors believe that any tiny problem is a reason not to give the shot. He sneezed twice last week. He's sensitive to ragweed. Anything."
Leonid, for instance, was born slightly prematurely and doctors delayed his diphtheria vaccination for a year and did not give him several other vaccines at all. Vaccinations Are Easier
It is easier to win the arguments over vaccinations, he said, than those over antibiotics.
"They can't go to school without them and I'm not going to give them a note saying otherwise," he said.
Dr. Belilovsky spends time talking patients out of as many things as he talks them into. Transplanted medicines, for instance. Nearly every family brought the contents of the medicine cabinet with them and Dr. Belilovsky's first advice is "throw out all the medications from the old country."
"Those that I know what they are, I don't know how they're made," he said.
For years, he said, patients have been asking him about a fever-reducing medicine widely used back home but unknown in the United States. Earlier this year, he said, he saw a listing of ingredients for the medicine and was appalled. The drug contained aspirin, which has been linked with Reye's syndrome in children, and amidopyrin, which, Dr. Belilovsky said, was taken off the American market decades ago because it was potentially fatal.
"It works, sure," he said. "It will drop the fever of anything. Problem is it will sometimes drop it to room temperature."
Less dangerous, he said, are the variety of folk medicines on which his patients sometimes rely. Cupping, in which suction is created by applying a warm glass to the chest wall, is harmless, he said, unless it prevents a patient from getting to the doctor for more effective treatment. Gridding, in which a tic-tac-toe pattern is drawn on the skin in iodine, to relieve inflammation, is just as ineffective, he said, but potentially more dangerous. He recently saw a child with a second-degree burn from the iodine.
Amid the frustration, however, there are victories. Leonid is one. After the boy calmed down, Dr. Belilovsky noted the vaccination in the chart. With it, the child's immunization record is up to date.
"It won't hurt him?" his mother asked, hugging her son.
"It will help him," Dr. Belilovsky said.
Photo: The consequences of the former Soviet Union's remoteness are seen daily by Dr. Anatoly Belilovsky. As a pediatrician in the Brighton Beach section of Brooklyn, he deals with patients who have fled lands where medications were scarce and folk medicine entrenched. Two-year-old Michella Gugliev was treated for a virus last week. (Michelle V. Agins/The New York Times)
A version of this article appeared in print on August 11, 1992, on page B1 of the New York edition.
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Black male children are four times more likely to have food allergies: study
BY Rosemary Black
DAILY NEWS STAFF WRITER
Wednesday, March 18th 2009, 11:37 AM
Black male children are more prone to food allergies than the rest of the population, according to one study.
Black male children are at an especially high risk for developing food allergies, according to a new study presented Tuesday in Washington, DC, at the annual meeting of the American Academy of Allergy, Asthma and Immunology.
They’re about four times as likely to be food allergic as the rest of the population, says Dr. Andrew Liu, a co-author of the study, which he says was sponsored by the National Institutes of Health.
“We know that children are more likely to have a food allergy,” says Liu, an associate professor at the National Jewish Medical Research Center in Denver. “And we know that people of black ethnicity tend to have a higher rate of food allergy.”
The survey was the first one in the U.S. in which researchers actually took blood samples and tested them for signs of potential food allergy, says Dr. Scott Sicherer, co-author of the study and professor of pediatrics at Mt. Sinai Medical Center. The study involved 8,203 participants who ranged in age from 1 to 85 and had a food sensitivity to egg, milk, peanut and shrimp. Blacks, males and children, especially black male children, were found to have higher levels of the immune responses associated with clinical food allergy, Liu explained.
“Further studies have to be done,” Sicherer says. “This group now has to be thought about a little bit extra by doctors.”
Researchers didn’t theorize about why black male children may have a higher rate of food allergy. Some experts feel that introducing a food too early in life sets up a child for food allergy. “But our understanding of early introduction is unclear,” Liu says. “There are other signs that early introduction could be protective. Clinical trials are underway now to try to determine whether introducing a food early can cause a food allergy.”
Liu says that the next step is exploring why black male children are so high-risk for food allergies. “We hope that this study raises awareness on some key issues, helps us identify the groups at risk, and then target groups for research and policy making.”
What causes food allergies in general isn’t clear, says Dr. Anatoly Belilovsky, a Brooklyn-based pediatrician and allergy expert.
“Some studies have shown that being on a farm has a protective effect against allergies,” he says. “We know that obese children tend to be more allergic.”
“There are many different theories,” says Dr. David Resnick, director of the Allergy Division at New York-Presbyterian Morgan Stanley Children’s Hospital. “It could be environmental, or genetic, or a combination. We know that African Americans have higher asthma rates. More research is needed before you can make any conclusions.”
About 2.5 percent of the population has a food allergy, and peanut and shrimp are the most common allergens, Liu says.
Food allergies aren’t necessarily a lifelong sentence. Many kids outgrow their allergies to wheat, soy and milk, Resnick says. A young child with a peanut allergy has a 20 percent chance that he will outgrow the allergy, but there’s only a 10 percent chance that he will outgrow a tree nut allergy, Resnick says.
Read more:
http://www.nydailynews.com/lifestyle/health/2009/03/18/2009-03-18_black_male_children_are_four_times_more_.html#ixzz0fW5mwkbV --------------------------------------------------------------------------------------------------
http://pregnancy.coverleaf.com/pregnancy/200912?pg=84#pg84 ---------------------------------------------------------------------------------------------------
From:
http://www.nydailynews.com/ny_local/2009/10/07/2009-10-07_unspoken_minority_toll_swine_flus_bigger_impact_on_blacks_and_hispanics_is_not_b.html Swine flu's bigger impact on blacks and Hispanics is not being addressed
Juan Gonzalez - News Wednesday, October 7th 2009, 4:00 AM
During all their swine flu briefings the past few months, city and federal health officials have been virtually silent about the outsize impact the pandemic appears to be having on blacks and Hispanics.
The
Centers for Disease Control alluded to the problem in a small Sept. 4 report, but only in a passing mention.
That report, an analysis of the first H1N1-related deaths among
U.S. children, revealed that 33% (12 of 36) were among Hispanics. All told, half of the H1N1 children's deaths between April and August were among African-Americans and Hispanics. That's considerably more than the percentage of both groups in the population.
Since then, the total number of pediatric fatalities has reached 60, but the CDC has not issued any further ethnic and racial breakdowns on the impact of the disease. Asked about that yesterday, an agency spokesman said a new report will be ready before the end of the week.
By themselves, the childhood deaths might not seem sufficient in number to raise alarm bells.
But several recent studies from local health departments around the country suggest a broader trend is already underway in minority communities:
- Boston's Public Health Commission found that 37% of all swine flu cases in that city occurred among blacks, though the black population is only 25%. Likewise, Hispanics comprise 14% of Boston residents but one-third of all confirmed H1N1 cases. Even more disturbing, three of every four people hospitalized for the virus in Boston have been black or Hispanic.
- Chicago's Department of Public Health studied 1,500 lab-confirmed swine flu cases between late April and late July and found blacks and Hispanics were four times more likely to be hospitalized than whites.
- Oklahoma's Department of Public Health reported last week that African-American children in the state were being hospitalized for swine flu at three times the rate of white children and twice the rate of Native American children. The higher hospitalization most likely reflects disparities in health conditions among population groups, experts say.
Asthma and obesity, for instance, are more prevalent among African-Americans and Latinos, precisely the kinds of conditions that can lead to more severe reactions to the H1N1 virus.
Low-income families also are less likely to have health insurance and more likely to delay seeking treatment until a child has to go to the emergency room.
Half the 12 Hispanic children with swine flu in the CDC study, for example, suffered a cardiac or respiratory attack before they even reached an ER.
Veteran Brooklyn pediatrician Dr.Anatoly Belilovsky suggested another possibility. More than 25% of his patients in Brooklyn's Brighton Beach area are Mexican immigrants, Belilovsky says, and many suffer from Vitamin D deficiency, which can affect the strength of a person's immune system.
Unfortunately, here in New York City, the epicenter of the nation's swine flu wave this spring, health officials have not even begun the kind of study that Boston and Chicago completed.
"We haven't had a reliable way to gather the data," Assistant Health Commissioner Geoffrey Cowley said yesterday.
Cowley's boss, Health Commissioner Tom Farley, and Deputy Mayor Linda Gibbs did show up at Montefiore Medical Center's Children's Hospital on Tuesday to kick off the city's swine flu vaccination program.
As that vaccine becomes more plentiful during the next few weeks, parents should not hesitate to have their children inoculated.
Read more:
http://www.nydailynews.com/ny_local/2009/10/07/2009-10-07_unspoken_minority_toll_swine_flus_bigger_impact_on_blacks_and_hispanics_is_not_b.html#ixzz0fW7k5KfX - Boston's Public Health Commission found that 37% of all swine flu cases in that city occurred among blacks, though the black population is only 25%. Likewise, Hispanics comprise 14% of Boston residents but one-third of all confirmed H1N1 cases. Even more disturbing, three of every four people hospitalized for the virus in Boston have been black or Hispanic.
- Chicago's Department of Public Health studied 1,500 lab-confirmed swine flu cases between late April and late July and found blacks and Hispanics were four times more likely to be hospitalized than whites.
- Oklahoma's Department of Public Health reported last week that African-American children in the state were being hospitalized for swine flu at three times the rate of white children and twice the rate of Native American children. The higher hospitalization most likely reflects disparities in health conditions among population groups, experts say.
Asthma and obesity, for instance, are more prevalent among African-Americans and Latinos, precisely the kinds of conditions that can lead to more severe reactions to the H1N1 virus.
Low-income families also are less likely to have health insurance and more likely to delay seeking treatment until a child has to go to the emergency room.
Half the 12 Hispanic children with swine flu in the CDC study, for example, suffered a cardiac or respiratory attack before they even reached an ER.
Veteran Brooklyn pediatrician Dr.Anatoly Belilovsky suggested another possibility. More than 25% of his patients in Brooklyn's Brighton Beach area are Mexican immigrants, Belilovsky says, and many suffer from Vitamin D deficiency, which can affect the strength of a person's immune system.
Unfortunately, here in New York City, the epicenter of the nation's swine flu wave this spring, health officials have not even begun the kind of study that Boston and Chicago completed.
"We haven't had a reliable way to gather the data," Assistant Health Commissioner Geoffrey Cowley said yesterday.
Cowley's boss, Health Commissioner Tom Farley, and Deputy Mayor Linda Gibbs did show up at Montefiore Medical Center's Children's Hospital on Tuesday to kick off the city's swine flu vaccination program.
As that vaccine becomes more plentiful during the next few weeks, parents should not hesitate to have their children inoculated.
Read more:
http://www.nydailynews.com/ny_local/2009/10/07/2009-10-07_unspoken_minority_toll_swine_flus_bigger_impact_on_blacks_and_hispanics_is_not_b.html#ixzz0fW7k5KfXThe higher hospitalization most likely reflects disparities in health conditions among population groups, experts say.
Asthma and obesity, for instance, are more prevalent among African-Americans and Latinos, precisely the kinds of conditions that can lead to more severe reactions to the H1N1 virus.
Low-income families also are less likely to have health insurance and more likely to delay seeking treatment until a child has to go to the emergency room.
Half the 12 Hispanic children with swine flu in the CDC study, for example, suffered a cardiac or respiratory attack before they even reached an ER.
Veteran
Brooklyn pediatrician Dr.Anatoly Belilovsky suggested another possibility. More than 25% of his patients in
Brooklyn's Brighton Beach area are Mexican immigrants, Belilovsky says, and many suffer from Vitamin D deficiency, which can affect the strength of a person's immune system.
Unfortunately, here in
New York City, the epicenter of the nation's swine flu wave this spring, health officials have not even begun the kind of study that Boston and
Chicago completed.
"We haven't had a reliable way to gather the data,"
Assistant Health Commissioner Geoffrey Cowley said yesterday.
Cowley's boss,
Health Commissioner Tom Farley, and
Deputy Mayor Linda Gibbs did show up at
Montefiore Medical Center's Children's Hospital on Tuesday to kick off the city's swine flu vaccination program.
As that vaccine becomes more plentiful during the next few weeks, parents should not hesitate to have their children inoculated.
Read more:
http://www.nydailynews.com/ny_local/2009/10/07/2009-10-07_unspoken_minority_toll_swine_flus_bigger_impact_on_blacks_and_hispanics_is_not_b.html#ixzz0fW7rLPEU ---------------------------------------------------------------------------------------------------------------------------------------------------
http://news.google.com/newspapers?nid=1499&dat=19920715&id=EOYdAAAAIBAJ&sjid=hywEAAAAIBAJ&pg=5060,5231055 - Boston's Public Health Commission found that 37% of all swine flu cases in that city occurred among blacks, though the black population is only 25%. Likewise, Hispanics comprise 14% of Boston residents but one-third of all confirmed H1N1 cases. Even more disturbing, three of every four people hospitalized for the virus in Boston have been black or Hispanic.
- Chicago's Department of Public Health studied 1,500 lab-confirmed swine flu cases between late April and late July and found blacks and Hispanics were four times more likely to be hospitalized than whites.
- Oklahoma's Department of Public Health reported last week that African-American children in the state were being hospitalized for swine flu at three times the rate of white children and twice the rate of Native American children. The higher hospitalization most likely reflects disparities in health conditions among population groups, experts say.
Asthma and obesity, for instance, are more prevalent among African-Americans and Latinos, precisely the kinds of conditions that can lead to more severe reactions to the H1N1 virus.
Low-income families also are less likely to have health insurance and more likely to delay seeking treatment until a child has to go to the emergency room.
Half the 12 Hispanic children with swine flu in the CDC study, for example, suffered a cardiac or respiratory attack before they even reached an ER.
Veteran Brooklyn pediatrician Dr.Anatoly Belilovsky suggested another possibility. More than 25% of his patients in Brooklyn's Brighton Beach area are Mexican immigrants, Belilovsky says, and many suffer from Vitamin D deficiency, which can affect the strength of a person's immune system.
Unfortunately, here in New York City, the epicenter of the nation's swine flu wave this spring, health officials have not even begun the kind of study that Boston and Chicago completed.
"We haven't had a reliable way to gather the data," Assistant Health Commissioner Geoffrey Cowley said yesterday.
Cowley's boss, Health Commissioner Tom Farley, and Deputy Mayor Linda Gibbs did show up at Montefiore Medical Center's Children's Hospital on Tuesday to kick off the city's swine flu vaccination program.
As that vaccine becomes more plentiful during the next few weeks, parents should not hesitate to have their children inoculated.
Read more:
http://www.nydailynews.com/ny_local/2009/10/07/2009-10-07_unspoken_minority_toll_swine_flus_bigger_impact_on_blacks_and_hispanics_is_not_b.html#ixzz0fW7MrUT2