This Week in Research: Archaeology in Annapolis; Hospitals at Home

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In this series, we look at the newest findings coming out of our area’s top research universities. We’ve got some great minds in Baltimore — let’s learn what they’re learning!

Not all archaeologists get their work done in Egyptian tombs; some of them look at the secrets of the more recent past. Take the research being conducted by University of Maryland archaeology professor Mark Leone, who’s leading students in an excavation of a twentieth-century home. But it’s not just any home — the Annapolis house belonged to an African-American woman who was married to a Filipino man, and Leone is using his findings to explore early twentieth-century immigration conflicts between blacks and Filipinos.

But the story begins much earlier than that, with James Holliday, a freed slave who was one of the first African Americans employed by the U.S. Naval Academy. He bought a house on East Street in Annapolis,  and his granddaughter lived in the same home decades later when she married a Filipino cook in 1919. But racial tensions were running high in the early decades of the twentieth century, and blacks and Filipinos were two disadvantaged groups that were often pitted against one another. The Naval Academy’s Commandant at the time claimed to prefer working with Filipinos because they were “clean, honest, military, studious, amenable to discipline,” and “cost less to feed.”

Unsurprisingly, tensions resulted. “The Academy hired Filipinos to work in the kitchen as messmen, officer stewards or laborers,” says Leone’s graduate student, Kathrina Aben. “In practice, this meant replacing African Americans in their jobs.” But intermarriage was one way that the two groups adapted to one another. “We’re discovering family stories carved in irony,” Leone says. “[This couple was] brought together by its racial stereotyping, and yet overcoming cultural and racial barriers quite successfully in their own lives.”

So far, the excavation has revealed very little evidence of Filipino culture. “This could reflect a high degree of Filipino cultural adaptation or families in which these immigrant men left the running of the household to their American wives,” posits Kathryn Deely, another of Leone’s graduate students. “Alternately, we might have missed something or not known what to look for. We hope this year to find more evidence to answer the question.”

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As we reported earlier, crowded hospitals mean that patient care suffers. But short of building a bunch of new buildings — a long and costly process — what’s a medical center to do? New research out of Johns Hopkins offers a possible solution:  bringing the hospital into patients’ homes.

Hopkins professor Bruce Leff developed a model where certain kinds of patients get daily in-home visits from doctors and nurses, who provide them with hospital-level care. When the program was put into practice by a New Mexico health system, the results were more than encouraging:  costs were reduced by 19 percent, and patients were both healthier and happier. (Most of the patients were elderly women with multiple diagnoses, including recurring congestive heart failure, deep vein thrombosis, and pulmonary embolism.) Their hospital readmission and mortality rates were lower than their in-patient peers, and they reported higher rates of satisfaction.

According to Leff, the program is a practical example of “what health care reform is attempting to achieve. It’s a high-quality clinical program that provides patient-centric individualized care while making the most effective and efficient use of the health-care dollar.” Of course, there are still plenty of barriers to increased in-home care. Many people are still convinced that getting taken care of in a hospital is safer, and many current health insurance programs (including Medicare) aren’t set up to handle these sorts of programs.



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