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Share on Pinterest Fly View Productions/Getty ImagesAround 60 million women in the US have cardiovascular disease (CVD).Women from racial and ethnic minority groups are at greater risk of CVD death.A new American Heart Association (AHA) statement emphasizes that doctors must also consider social determinants of health when screening for CVD.These include factors such as discrimination, environment, and language barriers.

An estimated 60 million women in the US (equal to 44% of the population) live with some form of cardiovascular disease (CVD).

Additionally, 1 in 5 deaths among women stems from CVD with those from racial and ethnic minorities at greater risk.

Traditional contributing factors, such as obesity, smoking, diabetes, and high cholesterol, are frequently considered by doctors when assessing a patients CVD risk.

However, a new scientific statement from the American Heart Association (AHA), published in its journal Circulation, highlighted that medical professionals must look beyond these when monitoring and treating CVD in women, especially those from underrepresented groups.

In comparison to other women, Black women in the US (including African American and Afro Caribbean) have the highest rate of heart disease, stated Dr. Heather M. Johnson,a preventive cardiologist at Boca Raton Regional Hospital, part of Baptist Health South Florida, who was not involved with the report.

The AHA researchers stated that nontraditionalsocio-economic factors such as discrimination and environment must be considered if the gap in CVD treatment and survival between whites and racial and ethnic groups is to be reduced.

Many of these are often overlooked but can significantly affect health risks, care, and outcomes.

Understanding both traditional and nontraditional risk factors are important to prevent heart disease, but also to support the early diagnosis and treatment of heart disease in women, Johnson told Healthline. How bias, discrimination, and racism can affect your health

In the statement, the researchers said: Behavioral and environmental factors and social determinants of health disproportionately affect women of underrepresented races and ethnicities.

These factors result in a higher prevalence of CVD and significant challenges in the diagnosis and treatment of cardiovascular conditions, they added.

Five social determinants of health were emphasized in the AHAs statement. But what are they and how do they influence CVD?Discrimination

The AHA noted that discriminatory barriers faced by ethnic communities lead to high levels of stress. This, in turn, contributes to CVD issues such as inflammation and hypertension.

Research also highlights that minority groups can encounter racial bias and stereotyping from white healthcare providers which may lead to patients having their concerns dismissed or receiving poorer care.

Studies show this is often due to the activation of stereotypes that influence clinical judgment, said Heather Orom, PhD, associate professor of community health and health behavior at the University at Buffalo.

Furthermore, when actions are perceived as racially motivated or discriminatory, this can put a wedge between provider and patient and create an environment of mistrust, said Dr. Deborah L. Crabbe, a professor of medicine at the Temple Heart and Vascular Institute at Lewis Katz School of Medicine.

As a result, she told Healthline, patients may not follow through with care recommendations and may even seek other providers, perhaps delaying care for their medical condition.Language barriers

Understanding medical terms and phrasing can be tricky enough for patients at the best of times. However, things are complicated further when the doctor and patient dont share the same first language.

Language barriers can reduce patients satisfaction with their care, care quality, and safety, explained Orom.

Furthermore, she told Healthline, such barriers can hinder the doctor-patient relationship, prevent patients from advocating for themselves, and inhibit the doctor from understanding the full complexity of a patients condition and their life circumstances. Environment

The AHA statement revealed that environmental factors, such as air pollution, high long-term arsenic exposure, and cadmium and lead exposure, have been linked to CVD.

Studies show minority groups are more likely to live in areas with more air pollution and closer proximity to toxic waste and other hazards.

For decades, polluting industries, waste facilities, and other sources of exposure, such as highways systems, have been more likely to be placed in neighborhoods of color, Orom revealed. This stems from the fact these communities have had less political and economic clout. Assimilation to a different culture

The AHA statement didnt expressly state how acculturation or assimilation to a different culture can impact CVD.

However, this is an important factor for CVD that often is missed, stated Dr. Yu-Ming Ni, a cardiologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center.

For instance, he shared with Healthline that older studies of Japanese individuals showed those who traveled to Hawaii and then to the continental U.S. had higher CVD rates than their peers who stayed in Japan.Healthcare access

It was noted in the AHA statement that there is evidence that SDOH factors experienced in youth, such as inability to access healthcare or inability to afford care, may affect heart health into adulthood and contribute to CVD risk factors and outcomes in adulthood.

Research shows that Black, Hispanic, Asian-American, and Native individuals are less likely to have health insurance.

But healthcare access isnt only about insurance, said Crabbe. For example, [it also] includes geographic access to a particular health care service.

Orom concurred, stating there is a typically lack of high-quality healthcare facilities in neighborhoods where people of color have historically lived.

Other social burdens can limit access, too. For example, United States Census Bureau data shows that ethnic minority groups are generally poorer compared to white populations. Poverty can prevent individuals from purchasing necessary medications, for example.

Finally, Michele Horan, a registered nurse and COO of Healthy Alliance, shared that other daily stressors such as care responsibilities and the potential of eviction can reduce the capacity of underserved communities to access healthcare.

In most cases, these urgent situations are prioritized over ones health and well-being, Horan told Healthline. Addressing life challenges, in my experience, will almost always surpass healthcare, accessible or not. What to discuss with your doctor

If you think youre at higher risk of CVD, its crucial to ensure your doctor is aware of your concerns and potential risk profile.

Ni said discussing with your doctor means they can be more aggressive with screening.

For example, doctors might choose to test for disease states with no symptoms earlier than usual if the fear is that someone has a higher risk due to the environment they live in, he explained.

Tests and screenings generally vary depending on the patient and their history.

Its recommended that everyone understands their individual risk for heart disease and has a preventive heart health evaluation, Johnson said.

This assessment, she explained, includes a detailed discussion of their traditional and nontraditional risk factors for heart disease.

According to Johnson, further preventative screening tests are also possible and include:Electrocardiogram (EKG or ECG)Coronary artery calcium scan (also known as a calcium score)Special cholesterol tests What can healthcare professionals do to help?

According to the AHA researchers, culturally sensitive, peer-led community and healthcare professional education is a necessary step in CVD prevention.

Language barriers can be overcome by providing translators or simply using language apps, such as Google Translate. Studies show that using such app in healthcare settings can significantly improve both doctor and patient satisfaction.

Horan said healthcare providers need to screen patients from minority groups in a culturally competent and sensitive way.

Identifying barriers and the root cause behind them with a proactive lens is often the only way to effectively coordinate care in a manner that addresses their patients full spectrum of needs, she asserted.

Education is vital for both medical professionals and patients, said Crabbe.

Healthcare organizations can provide training and education to staff regarding the challenges that minorities and women face in receiving healthcare, she noted.

Meanwhile, Crabbe continued, opportunities to provide education to improve the health literacy of minorities and women could help improve patient acceptance of healthcare recommendations, and thus compliance.

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BBC and Channel 4 should ‘merge’ to survive, Sir Phil Redmond says

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BBC and Channel 4 should 'merge' to survive, Sir Phil Redmond says

One of Britain’s most legendary TV dramatists, Sir Phil Redmond, is no stranger to tackling difficult issues on screen.

Courting controversy famously with his hard-hitting storylines on his children’s show Grange Hill for the BBC in 1978, before he switched over to Channel 4 to give it its two most prominent soaps, Brookside (1982) and later Hollyoaks (1995).

He’s been a pivotal figure at Channel 4 from its inception, widely considered to be a father to the channel.

Sir Phil Redmond says the BBC and Channel 4 should team up to survive
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Sir Phil Redmond says the BBC and Channel 4 should team up to survive

While he’s been responsible for putting some of TV’s most impactful storylines to air for them – from the first lesbian kiss, to bodies buried under patios – off-screen nowadays, he’s equally radical about what should happen.

“Channel 4’s job in 1980 was to provide a platform for the voices, ideas, and people that weren’t able to break through into television. They did a fantastic job. I was part of that, and now it’s done.”

It’s not that he wants to kill off Channel 4 but – as broadcasting bosses gather for Edinburgh’s annual TV Festival – he believes they urgently should be talking about mergers.

A suggestion which goes down about as well as you might imagine, he says, when he brings it up with those at the top.

He laughs: “The people with the brains think it’s a good idea, the people who’ve got the expense accounts think it’s horrendous.”

Some of the original Grange Hill cast collecting a BAFTA special award in 2001. Pic: Shutterstock
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Some of the original Grange Hill cast collecting a BAFTA special award in 2001. Pic: Shutterstock

A ‘struggling’ BBC trying to ‘survive’

With charter renewal talks under way to determine the BBC’s future funding, Sir Phil says “there’s only one question, and that is what’s going to happen to the BBC?”

“We’ve got two public sector broadcasters – the BBC and Channel 4 – both owned by the government, by us as the taxpayers, and what they’re trying to do now is survive, right?

“No bureaucracy ever deconstructs itself… the BBC is struggling… Channel 4 has got about a billion quid coming in a year. If you mix that, all the transmissions, all the back office stuff, all the technical stuff, all that cash… you can keep that kind of coterie of expertise on youth programming and then say ‘don’t worry about the money, just go out and do what you used to do, upset people!’.”

Brookside's lesbian kiss between Margaret and Beth (L-R Nicola Stapleton and Anna Friel) was groundbreaking TV. Pic: Shutterstock
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Brookside’s lesbian kiss between Margaret and Beth (L-R Nicola Stapleton and Anna Friel) was groundbreaking TV. Pic: Shutterstock

How feasible would that be?

Redmond claims, practically, you could pull it off in a week – “we could do it now, it’s very simple, it’s all about keyboards and switches”.

But the screenwriter admits that winning people over mentally to his way of thinking would take a few years of persuading.

As for his thoughts on what could replace the BBC licence fee, he says charging people to download BBC apps on their phones seems like an obvious source of income.

“There are 25 million licences and roughly 90 million mobile phones. If you put a small levy on each mobile phone, you could reduce the actual cost of the licence fee right down, and then it could just be tagged on to VAT.

“Those parts are just moving the tax system around a bit. [then] you wouldn’t have to worry about all the criminality and single mothers being thrown in jail, all this kind of nonsense.”

Original Brookside stars at BAFTA - L:R: Michael Starke, Dean Sullivan, Claire Sweeney and Sue Jenkins. Pic: PA
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Original Brookside stars at BAFTA – L:R: Michael Starke, Dean Sullivan, Claire Sweeney and Sue Jenkins. Pic: PA

‘Subsidising through streaming is not the answer’

Earlier this year, Peter Kosminsky, the director of historical drama Wolf Hall, suggested a levy on UK streaming revenues could fund more high-end British TV on the BBC.

Sir Phil describes that as “a sign of desperation”.

“If you can’t actually survive within your own economic basis, you shouldn’t be doing it.

“I don’t think top slicing or subsidising one aspect of the business is the answer, you have to just look at the whole thing as a totality.”

Mark Rylance (L) and Damian Lewis in Wolf Hall: The Mirror And The Light. Pic: BBC
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Mark Rylance (L) and Damian Lewis in Wolf Hall: The Mirror And The Light. Pic: BBC

Since selling his production company, Mersey Television, two decades ago, much of his current work has focused on acting as an ambassador for the culture and creative industries.

Although he’s taken a step away from television, he admits he’s disappointed by how risk-averse programme makers appear to have become.

“Dare I say it? There needs to be an intellectual foundation to it all.”

The Hollyoaks cast in 1995. Pic: Shutterstock
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The Hollyoaks cast in 1995. Pic: Shutterstock

TV’s ‘missing a trick’

He believes TV bosses are too scared of being fined by Ofcom, and that’s meant soaps are not going as far as they should.

“The benefits [system], you know, immigration, all these things are really relevant subjects for drama to bring out all the arguments, the conflicts.

“The majority of the people know the benefits system is broken, that it needs to be fixed because they see themselves living on their estate with a 10 or 12-year-old car and then there’s someone else down the road who knows how to fill a form in, and he’s driving around in a £65k BMW, right? Those debates would be really great to bring out on TV, they’re missing a trick.”

While some of TV’s biggest executives are slated to speak at the Edinburgh Television Festival, Redmond is not convinced they will be open to listening.

“They will go where the perceived wisdom is as to where the industry is going. The fact that the industry is taking a wrong turn, we really need somebody else to come along and go ‘Oi!'”

When I ask if that could be him, he laughs. Cue dramatic music and closing credits. As plot twists go, the idea of one of TV’s most radical voices making a boardroom comeback to stir the pot, realistic or not, is at the very least food for thought for the industry.

Edinburgh TV Festival runs from 19 – 22 August.

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Noel Gallagher praises ‘amazing’ Liam for Oasis reunion tour

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Noel Gallagher praises 'amazing' Liam for Oasis reunion tour

Noel Gallagher has said he is “proud” of his brother Liam after the pair reunited for this summer’s Oasis Live ’25 tour.

The highly anticipated reunion was announced in August last year, after the brothers seemingly put the feud which led to their split in 2009 behind them.

At the time, Noel said he “simply could not go on working with Liam”, but having just completed the UK-leg of their comeback tour, he has nothing but praise for his younger sibling.

“Liam’s smashing it. I’m proud of him,” Noel told talkSport in his first interview since the tour began.

“I couldn’t do the stadium thing like he does it, it’s not in my nature. But I’ve got to say, I kind of look and I think ‘good for you, mate’. He’s been amazing.

“It’s great just to be back with Bonehead [Paul Arthurs] and Liam and just be doing it again.”

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‘We need each other’: Oasis back on stage

When asked if he has felt emotional during the tour, Noel added: “I guess when it’s all said and done we will sit and reflect on it, but it’s great being back in the band with Liam, I forgot how funny he was.”

He went on to say he was “completely blown away” after the band’s opening night in Cardiff, and “grossly underestimated” what he was getting himself into when first signing up for the shows.

Fans in Manchester don Oasis merch. Pic: Reuters
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Fans in Manchester don Oasis merch. Pic: Reuters

The brothers at Wembley, London. Pic: Lewis Evans
Image:
The brothers at Wembley, London. Pic: Lewis Evans

He said: “It was kind of after about five minutes, I was like, ‘all right, can I just go back to the dressing room and start this again?’

“I’ve done stadiums before and all that, but I don’t mind telling you, my legs had turned to jelly after about halfway through the second song.”

Pic: Big Brother Recordings
Image:
Pic: Big Brother Recordings

“Every night is the crowd’s first night, you know what I mean?” he continued. “So every night’s got that kind of same energy to it, but it’s been truly amazing. I’m not usually short for words, but I can’t really articulate it.”

Having played to packed crowds in Cardiff, London, Manchester, Dublin and Edinburgh, Oasis have scheduled dates around the world including in major cities across the US, Canada, Mexico, Australia, and Japan.

Read more:
Oasis photographers remember the early days
Wembley investigating smuggling claims at Oasis gig

It’s rumoured the band will continue their run of shows next year, when it marks 30 years since they played two sell-out nights at Knebworth Park to an estimated 250,000 people.

When quizzed on the rumours on talkSport, Noel quickly changed the subject, saying: “Right, let’s talk about football.”

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Labour smell dirty tricks over asylum hotel court ruling – but the risks are clear

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Labour smell dirty tricks over asylum hotel court ruling - but the risks are clear

“It’s an interesting moment,” was how one government source described the High Court ruling that will force an Essex hotel to be emptied of asylum seekers within weeks.

That may prove to be the understatement of the summer.

For clues as to why, just take a glance at what the Home Office’s own lawyer told the court on Tuesday.

Granting the injunction “runs the risk of acting as an impetus for further violent protests”, the barrister said – pointing out that similar legal claims by other councils would “aggravate pressures on the asylum estate”.

Right on cue and just hours after the ruling came in, Broxbourne Council – over the border in Hertfordshire – posted online that it was urgently seeking legal advice with a view to taking similar court action.

The risks here are clear.

Police officers ahead of a demonstration outside The Bell Hotel. Pic: PA
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Police officers ahead of a demonstration outside The Bell Hotel. Pic: PA

Recent figures show just over 30,000 asylum seekers being housed in hotels across the country.

If they start to empty out following a string of court claims, the Home Office will struggle to find alternative options.

After all, they are only in hotels because of a lack of other types of accommodation.

There are several caveats though.

This is just an interim injunction that will be heard in full in the autumn.

So the court could swing back in favour of the hotel chain – and by extension the Home Office.

Read more:
Who says what on asylum hotels?

Protesters in Epping on 8 August. Pic: Reuters
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Protesters in Epping on 8 August. Pic: Reuters

We have been here before

Remember, this isn’t the first legal claim of this kind.

Other councils have tried to leverage the power of the courts to shut down asylum hotels, with varying degrees of success.

In 2022, Ipswich Borough Council failed to get an extension to an interim injunction to prevent migrants being sent to a Novotel in the town.

As in Epping, lawyers argued there had been a change in use under planning rules.

The hotel has been the scene of regular protests. Pic: PA
Image:
The hotel has been the scene of regular protests. Pic: PA

But the judge eventually decided that the legal duty the Home Office has to provide accommodation for asylum seekers was more important.

So there may not be a direct read across from this case to other councils.

Home Office officials are emphasising this injunction was won on the grounds of planning laws rather than national issues such as public order, and as such, each case will be different.

Failing Labour approach or Tory tricks?

But government sources also smell dirty tricks from Epping Council and are suggesting that the Tory-led local authority made the legal claim for political reasons.

Pointing to the presence of several prominent Tory MPs in the Essex area – as well as the threat posed by Reform in the county – the question being posed is why this legal challenge was not brought when asylum seekers first started being sent to the hotel in 2020 during the Conservatives‘ time in government.

Epping Council would no doubt reject that and say recent disorder prompted them to act.

But that won’t stop the Tories and Reform of seizing on this as evidence of a failing approach from Labour.

So there are political risks for the government, yes, but it’s the practicalities that could flow from this ruling that pose the bigger danger.

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