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THE MICHIGAN CHRONICLE

Change or die! How to change

when change is hard:

Michigan needs to ‘Switch’

By Tom Watkins

In their newly released

book, “Switch,” two broth- ers team up to help provide a pathway to change.

Chip Heath and his brother,

Dan, the best-selling authors of “Made to Stick,” have writ- ten a prescription for affecting change, both big and small.

The authors, who write a

monthly column for the equal- ly compelling Fast Company magazine (www.fastcompany. com) bring together decades of counterculture research in psychology, sociology and other fields to shed new light on how we can effect transfor- mational change.”

As the second decade of the

new millennium gets under way, Michigan, among all the states, is the candidate most in need of “transformational change.”

I am advocating that Michi-

gan foundations step up to pur- chase this book for all elected leaders across the state and the Heath brothers be fea- tured speakers at the Detroit Regional Chambers Mackinaw Island policy confab.

This is a message that

needs to be heard and provides the ingredients for action.

Clearly, change is the most

talked about and least acted- upon concept in our state cap- itol today.

We need someone to model

a change strategy that is suc- cessful and effective in getting Michigan unleashed from the last century and propelled into the 21st century global knowl- edge economy.

“Switch: How to Change

Things When Change Is Really Hard” “shows that success- ful changes follow a pattern that can be used to make the changes that matter, whether it’s changing the world or changing your waistline.”

The Heath brothers discuss

how change agents help align the heart and mind to better harvest change.

One standout example in

the book is the idea of “taking a bright spot and cloning it.”

invest in education, retraining and 21st century infrastruc- ture?

Seeking “bright spots”

provides a clear road map to change.

To be sure, Michigan has

begun thinking about suc- cess.

Gov. Granholm proposed

the idea of two-year budgeting that L. Brooks Patterson, Oak- land County Executive, and his team have perfected at the local level.

The Michigan Business

Tom Watkins

“We need to search

not for the dark holes but the bright spots. What are cities, states or nations doing to get their financial houses in order to invest in education, retraining and 21st century infrastructure? Seeking ‘bright spots’ pro- vides a clear road map to change.”

The concept is simple

— stop focusing on how-and- why things don’t work, and in- stead discover what does work and follow that path. Or as the authors put it, “We need to ask ourselves a question that sounds simple but is, in fact, deeply unnatural: What’s working and how can we do more of it?” They say, “Don’t solve problems — copy suc- cess.”

Bringing the idea home,

take a look around Michigan, the U.S. and the world and stop plugging the holes. In- stead seek to emulate others’ success.

We need to search not for

the dark holes but the bright spots. What are cities, states or nations doing to get their financial houses in order to

Leaders (formerly Renaissance Detroit, www.businessleader- sforMichigan.org) have con- ducted a benchmarking study to develop the Five-step Michi- gan Turn Around Plan to pro- vide a template for Michigan’s recovery that many across the state ascribe to.

Defining Moment (www.the- centerformichigan.net),

The Center for Michigan’s a

multi-year campaign, seeks to engage more than 10,000 citizens in nearly 200 commu- nity conversations between the two peninsulas to develop a shared vision and common agenda that propels our state forward.

Change is often avoided

until it can be avoided no longer. If there was ever a time for Michigan to make the dif- ficult decision to change-- this is it.

We know what the prob-

lems are in this state, but need more people willing to seek unconventional solutions.

So, Michigan, read “Switch:

How to Change Things When Change Is Really Hard” and learn how to change things when change is hard.

To get the change process

going in your organization, visit www.switchbook.com/ resources.

Tom Watkins served the

watkins@aol.com.

March 24-30, 2010

Page A-5

Cancer publishes HealthCore breast cancer treatment disparity study

Cancer, the peer-reviewed

international journal of the American Cancer Society, has published a study conducted by HealthCore, Inc. in its Jan. 1 edition, demonstrating dis- parities in breast cancer treat- ment between commercially insured African American and White women.

The HealthCore study re-

iterates the findings of previ- ous studies — conducted in populations using government health programs — that Afri- can-American women are di- agnosed in later stages of the disease.

“This study demonstrates

that disparities in breast cancer care exist even when patients have access to em- ployer-provided healthcare,” said Dr. Joe Singer, Health- Core vice president for clini- cal affairs. “A key takeaway from our study is that Afri- can-American women were diagnosed with breast cancer at younger ages, but in later stages of breast cancer, when chances of survival diminish greatly.”

The study, funded by

Amgen, was conducted in col- laboration with Blue Cross

and Blue Shield of Georgia and the American Cancer Society.

The HealthCore study also

found that not all women who tested positive for hormone receptor cancer received anti- estrogen therapy, which is a standard of care set by guide- lines established by the Na- tional Comprehensive Cancer Network and the American Cancer Society. Of those women who did test positive, white women were more likely than African-American women to receive anti-estrogen thera- py.

Specifically, found:

• White women (55.2 per- cent) were more likely than Af- rican-American women (38.4 percent) to be diagnosed with stage 0 or stage 1 disease.

• Twice as many African- American women (6.1 percent) compared with White women (3.6 percent) were diagnosed with stage IV disease.

• Among women who tested positive for hormone recep- tor cancer, African-American women were less likely to re- ceive treatment, such as aro- matase inhibitors or tamoxi-

the study fen.

• White women were twice as likely to receive anti-estrogen therapy compared with Afri- can-American women, after adjusting for age, cancer stage, and social economic status.

"While treatment for de-

pression and anxiety oc- curred in both groups, less than half of those women had notes in their medical charts to follow-up with their pri- mary care physician and only one women was referred to a mental health professional," said Dr. Otis Brawley, chief medical officer for the Ameri- can Cancer Society and study co-author. "Clearly, this is a health intervention needed for both African American and White women."

The study pool of 3,017

women was identified from a medical claims database with information extracted from medical chart data on 766 women. Of those patients who had race data, 79.8 percent were White and 16.6 percent were African American.

For more information, go to

www.healthcore.com.

Study finds kidney disease risk higher for low-income minorities

Chronic kidney disease

(CKD) afflicts a large number of younger minority adults receiving medical care in set- tings that serve the uninsured and underinsured (settings collectively known as the healthcare safety net). Poor, minority adults with moder- ate to severe CKD are also two to four times more likely to progress to kidney failure than non-Hispanic whites. These are the findings from a study published online in the Clinical Journal of the Ameri- can Society of Nephrology (CJASN).

The study indicates that

targeted efforts to assess the burden and progression of CKD within the healthcare safety net are vital to improv- ing the quality of care for this vulnerable population, and ul- timately saving lives.

Researchers at the Univer-

sity of Washington, the Uni- versity of California, San Fran-

cisco, and Stanford University examined data from 15,353 adults with non-dialysis depen- dent CKD stages 3-5. All were receiving regular ambulatory care in the Community Health Network of San Francisco and were followed for a period of 12 months to 9.4 years. The study authors measured the time it took for patients to progress from moderate to severe CKD to end-stage renal disease (ESRD) or death.

The vast majority of study

participants were indigent; 40 percent were either uninsured or enrolled in Medicaid; and one-third spoke a primary lan- guage other than English – all vulnerable populations which have been underrepresented in prior studies of CKD.

In contrast to the general

population and prior CKD studies in the United States, the study authors found CKD afflicted a large fraction of young adults (20-39 years

old), most of whom were racial or ethnic minorities. Overall, African Americans, Hispanics, Asians and Pacific Islanders with CKD were at higher risk of developing ESRD, compared with non-Hispanic whites.

Because so little is known

about CKD in the healthcare safety net, the authors call for additional research to assess what is needed to curb the progression of the disease, particularly among vulnerable populations.

The study is being pub-

lished in conjunction with World Kidney Day, an inter- national effort to raise aware- ness about the growing inci- dence of kidney disease and the need for increased funding for kidney disease research and education.

For more information about

kidney disease and World Kidney Day, visit www.asn-

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