SB 277 protects kids + gets us useful public health data

While I was busy reading everything written about the King v Burwell decision and celebrating a massive human rights win, California governor Jerry Brown eliminated “personal belief” vaccine exemptions. California now joins Mississippi and West Virginia as the only states that require vaccines for all children unless contraindicated due to medical necessity.

The most important result of the passage of SB 277 is that it says, boldly and definitively, that vaccines are not only safe and necessary for protecting an individual child, but that the safety of the population will not be threatened by pseudoscience and conspiracy theories.

Even if the law doesn’t significantly change vaccination rates, its passage elevates the status of vaccines. It says to California parents you can believe whatever outrageous ideas you want, but your anti-science views cannot endanger other people, especially other children.

SB 277 implementation also gives officials an opportunity to research the ways that vaccine legislation impacts public health. Wired puts it nicely:

Whether or not the law has a significant effect on the health of California’s kids, this is a prime opportunity to carefully study the effects of legislation like this on both vaccination and disease rates. Health officials would love to know for sure that SB277 will have a meaningful impact on public health. But they can’t. It’s notoriously hard to draw connections between statewide vaccine laws and disease numbers.

This is awesome! Ending the personal exemption means that all kids enrolled in public school must receive all vaccinations. And we’ll be able to get good data on potential connections between legislation, vaccination rates, and disease outbreaks. End of story. Right?

Not necessarily.

There seems to be a loophole that will allow doctors who have inexplicably been converted over the anti-vaccine cause and who believe that a vaccine may harm a child to give medical exemptions. 

Presumably, this exists because some kids are just flat out allergic to some vaccines (on a personal note, I’m allergic to the pertussis vaccine so I depend on herd immunity, myself).  I haven’t found much analysis of this caveat aside from general statements about not giving a vaccine to kids who are allergic to it. I wouldn’t be surprised if we see families seeking exemptions through a doctor who believes vaccines are harmful for all children and who are then being kept from enrolling their children in public schools.

I’m eager to see how this unfolds, both among pro- and anti-vaxxers and as a new way of understanding how policy decisions impact public health. California, thank you for giving this a shot for the rest of us, and thank you for taking a stand against the nonsense bubbling up across the country.

If you live in the US and are worried about getting Ebola, you’re self-absorbed.

My dear friend Lisa shared this with me on Facebook: More Americans have been married to Kim Kardashian than have died from Ebola.

 

I love a good Kim K jab, especially if it’s intended to calm down some of this Ebolanoia*. But I quickly realized that while it’s important to properly communicate how unlikely it is for someone in the US to be infected with Ebola, it is equally important not to downplay the seriousness of what’s happening in West Africa.

 

At this point, we’ve all talked with a person who’s terrified of contracting Ebola. Or maybe we’re that person ourselves. But honestly, the likelihood of someone in the US coming down with it is miniscule. There have been three confirmed cases and a total of 172 people are under surveillance due to their contact with the three cases. Sixty of those people have completed surveillance and are healthy. Ebola’s R0, the number of people one person with a disease is likely to infect unless precautions are taken, is between 1.5 and 2.

 

And precautions are being taken. We have been quarantining anyone who’s come into contact with the Ebola patients in the US. Ebola is only contagious once a person starts showing symptoms, so if someone in quarantine—the only people who had direct contact with the confirmed cases—shows symptoms, the newly-sick person will not be able to infect anyone else. This means that Ebola will almost certainly not be a problem in the US.

 

However, Ebola is a huge problem in West Africa. In the countries of Guinea, Liberia, and Sierra Leone, more than 9000 people have contracted the disease, and half of them have died. People living in these countries are the ones who are at risk, not those of us sitting comfortably on our couches reading (and/or writing) blog posts about Ebola.

 

So, those of us in the US shouldn’t be worried about catching Ebola. But that doesn’t mean we shouldn’t be worried. We just need to be worried about the right thing.

 

Although it’s killing West Africans almost exclusively, Ebola is a world-wide health concern. Not just in a don’t-want-to-spread-the-disease kind of way, but because every life matters. Each person infected with Ebola has a basic human right—the right to health—taken from them. This is an avoidable travesty. We know how to stop the epidemic, and yet we are not. The lives of the people of Guinea, Liberia, Sierra Leone, and other West African nations are meaningful.

 

If you’re one of the people who are convinced they’ll get Ebola sitting in a movie theater in New Jersey or on a plane to Kansas City, I urge you to channel that anxiety into something more constructive. Donations to organizations doing good work will likely be the best way to help. CNN has a good list. If financial support isn’t an option for you, become an educated megaphone for sane Ebola information. Learn what’s really going on and post about it on Facebook, talk to your coworkers, email your mom.

 

And if you make any more Kardashian+Ebola memes, send them my way.

 

 

*a portmanteau of Ebola and paranoia. I discovered and fell in love with this term via Maryn McKenna.

Action Phase Podcast Episode 18

health insurance marketplaceOn this episode, I sit down with Nancy O’Connor, Regional Administrator for CMS Region 3. We talk about why people without health insurance really need to get some ASAP, why Medicaid expansion is really important, and that if you already have health insurance, you can sit back and relax. Remember: the health insurance Marketplace closes March 31! If you’re visiting for the first time via The Public’s Health, welcome! I hope you enjoy the show.

Action Phase is on iTunes. Subscribe so you never miss an episode. Please rate the show in order to help other people find it.

As always, you can stream it here, too.

https://ia601202.us.archive.org/13/items/18-NancyOconnor-ActionPhasePodcast/18-NancyOconnor-ActionPhasePodcast.mp3

Friday Five: Manning, Uganda, beer, Spanish screenings, wellness programs

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Chelsea Manning comes out

After being sentenced to 35 years in military prison for handing classified documents to be published on the infamous WikiLeaks, Bradley Manning came out as a transwoman (someone assigned “male” at birth but who identifies as “female”), asked to be called Chelsea and referred to as a woman. She will still be imprisoned at the all-male Ft. Leavenworth and the facility does not offer hormone treatment or sex reassignment surgery. Her incredibly high profile is sparking conversations about pronouns, Gender Dysphoria, and health care within the military. Furthermore, Manning’s announcement highlighted the fact that transgender people are not allowed to serve in the US military, despite the fact that transwomen join the military at twice the rate of the general population. Politics aside, Manning is about to embark on a difficult journey, and I hope the Army treats her with the human dignity to which she is entitled.

Confused about trans terminology? GLAAD has a great glossary here.

 

Hemorrhagic fever outbreak in Uganda

Late last week, Ugandan health officials announced an outbreak of Crimean Congo Hemorrhagic Fever (CCHF), which has killed at least one person. CCHF has no known cure or vaccine and an up to 40% case fatality rate, meaning that up to 40% of people who contract it will die. CCHF is zoonotic, which means that the virus lives in animals or insects and is somehow transferred to humans; CCHF is spread through tick bites or exposure to the blood or tissue of animals infected by tick bites. CCHF and other viral hemorrhagic fevers are characterized by bleeding under the skin, sudden high fevers, and kidney or liver damage, among other symptoms. Thankfully, hospitals have leftover protective equipment and disinfectants from 2010’s yellow fever outbreak, and Ugandan officials are watching the outbreak carefully.

 

Stay away from the Bud Ice (not just because it’s gross)

A few months after turning 21, I was headed to a friend’s house and didn’t want to arrive empty handed. Being new to the beer-purchasing demographic, I was overwhelmed and reached for the cheapest option, Steel Reserve…and it was one of the most repulsive beverages I’ve ever tried to consume. Little did I know that six years later, Steel Reserve would be tagged as a beverage highly likely to land drinkers in the ER, along with other gems like Bud, Bud Light, Bud Ice, and Colt 45. These five brands accounted for the majority of alcohol consumed among Baltimore ER patients. They’re cheap, potent, and highly popular: a dangerous mix that can quickly lead to unhealthy drinking behaviors. (PS: I’m no booze snob, but Steel Reserve is forever on my no-buy list.)

 

Autism screenings are rarely conducted in Spanish

The American Academy of Pediatrics recommends screening children for autism spectrum disorders (ASD) at 9, 18, and 24 or 30 months of age. However, a study released this week showed that only 29% of California primary care doctors surveyed provided these screenings in Spanish. Considering that as of 2010, 14 million Californians identified as Hispanic, this finding may illuminate another reason why Spanish-speaking children are diagnosed with ASD at lower rates and later ages than their white non-Hispanic peers. While it’s premature to assume the low rates of Spanish-language screening exist across the country, and to assume that all Hispanic people would require a screening in Spanish, the study does tell us about the cultural competence of these particular doctors. Systemic exclusion of these children from the recommended process puts them at a disadvantage—this is a health equity issue that needs to be quickly addressed.

 

Employers provide lots of wellness options for employees

Kaiser Family Foundation released a report this week about employer based health benefits, and the headlines strewn across news sites noted a 4% increase in family health insurance premiums, which is modest but higher than inflation and wage increases. When I read the report, I found something even more interesting: employers are providing an astonishing number of wellness programs. Nearly all large employers (200+ employees) provide at least one wellness program such as gym memberships, flu shots and vaccines, and smoking cessation counseling. Smaller employers are less likely to have these programs in place, but even so, 76% of them do. This is a win-win for employers and employees: keeping workers healthy cuts costs for employers not only on health insurance, but on lost work days and presenteeism.

 

 

Friday Five: withdrawal, Amanda Bynes, gluten-free labels, vaccine rates, urgentrx

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Pulling out is surprisingly popular

A study that will be published in the September issue of Obstetrics & Gynecology shows that 31% of women aged 15-24 used withdrawal as the primary form of contraceptive at least once. The study also found that 21% of those women became pregnant, compared to 13% of women who used other methods. I was pretty outraged to learn that so many young women rely on their partners to pull out, so I consulted the Kinsey Institute site Kinsey Confidential to compare different forms of contraceptives:

Method Typical Effectiveness Theoretical Effectiveness
Withdrawal 81% 94%
Male condoms 85% 98%
Oral contraceptives 92% 99.9%
Intrauterine Device (IUD) 99% 99%
Implant 99.01% 99.01%

Whelp, turns out the much-touted condoms don’t fare much better in preventing pregnancy than withdrawal, but IUDs and implants are far better. Advocating for more extensive use of IUDs and implants would help more women learn about their effectiveness and safety, and could play a major role in reducing the number of unplanned pregnancies. (FYI: condoms protect against some STIs, so keep using them, okay?)

Now we know what’s ailing Amanda Bynes

After publicly unraveling, actress Amanda Bynes has been placed on psychiatric hold and reportedly diagnosed with schizophrenia. Schizophrenia is a debilitating yet treatable disease that can lead to delusions, hallucinations (including hearing voices and smelling odors that don’t exist), and cognitive issues, among other symptoms. I sincerely hope that her family and doctors help her find the right treatment so she can find relief from her suffering. This story is playing out all over the gossip mills, and we can learn from this: erratic behavior requires intervention. In an open letter, her former co-star Nick Cannon also taught us an important lesson about how provide compassion:

So I say to my sister Amanda Bynes you’re not alone. I’m here for you. I understand. I care and I appreciate you, because that’s what family does and that’s what family is for. I also extend this to anyone else in my life, past or present that may find themselves in hard times. I’m here! Call me! Because I truly believe, the hand you’re helping up today may be the one you’re reaching for tomorrow.

Side note: take a look at this fantastic Atlantic article with Dr. Christine Montross titled “How well do we really understand mental illness?” for more insight into the hows and whys of treating severe mental illness.

Gluten-free labels, now with accuracy!

People with celiac disease, those with gluten sensitivity/intolerance, and dieters can all rejoice because this week, the FDA standardized the label “gluten-free.” The limit is 20 ppm, the lowest amount of gluten detectable in a food product. Foods such as fresh fruit and eggs can carry the label “gluten free” because they naturally contain no gluten. Regulations like this help consumers make informed choices. Considering more than two million Americans cannot digest gluten, having consistent, effective labels is the right thing to do for their health.

State-by-state vaccine rates tell us about exemptions

Each year, the CDC analyzes vaccine rates among the 50 states, Washington DC, five cities, and eight other US jurisdictions that receive federal funding for immunizations. This year, Mississippi topped the list, with 99.9% of kindergarteners receiving full doses of MMR, DTaP, and varicella (chicken pox). Overall, median exemption rate for the country was 1.8%; Oregon had the highest, with 6.5% of kindergarteners not meeting the vaccine standards. Interestingly, Mississippi does not allow religious or philosophical exemptions for immunizations. Removing religious and philosophical exemptions altogether wouldn’t be appropriate, but perhaps the success Mississippi has with getting children vaccinated will spark a conversation about strengthening the requirements for getting an exemption.

UrgentRx: alleviating upset stomachs, potentially saving lives

Forbes just published its list of what it deems the 25 most innovative consumer and retail brands of the year. An over-the-counter medication company, UrgentRx, made the cut. The company produces powders of common treatments for headaches, allergies, and digestive issues, along with plain aspirin intended for use during a heart attack. UrgentRx powders can be taken without water, meaning that you can give yourself a hit of heartburn medicines whenever you need it. The implication for potentially life-saving doses of aspirin are immense: a study in the American Journal of Cardiology, as reported by Harvard Medical School, showed that chewed aspirin worked faster against heart attacks than swallowing it whole or taking a liquid version. For a person with heart disease, carrying around a powdered dose eliminates the need to chew and provides the benefits of aspirin as quickly as possible.

Friday Five: heat, Bloomberg, Texas, heroin, ACA

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Let’s all do the heat wave! Just in case you’ve ignored the Facebook status updates, tweets, and complaints from co-workers, I want to inform you that it is Very Hot Outside. Growing up in Florida gives a person a skewed sense of the appropriate level of summertime heat and humidity, but this week has been tough even for me. In all seriousness, the heat is severe and dangerous, especially because so many people in the affected areas (map) don’t have air conditioning. So follow the heat advisory instructions: stay inside, run that AC (if you have it), drink water, and check in on seniors—they’re especially susceptible to high temperatures. And remember, we’ll all look back fondly this week while we wait for snow plows in January.

Bloomberg’s at it again But this time, he just wants New Yorkers to bypass the elevator and take the stairs instead. Mayor Bloomberg signed an executive order on Wednesday that requires all government building to be laid out using “Active Design” principles in order to promote physical activity like taking the stairs. We often talk in public health about making the healthy choice the easy choice and changing the built environment to encourage physical fitness. Bloomberg’s latest move may spark an interest in healthier buildings. Could Active Design be the new LEED certification?

You haven’t heard the whole story about Texas This was a big week for abortion controversy in Texas, and there’s already extensive coverage of what happened, so here’s some news you may have missed:

  •  You can now purchase Rick Perry voodoo dolls (cultural appropriation isn’t just for Miley Cyrus)
  • Texas Democrat Rep. Harold Dutton introduced a bill that would ban all abortion legislation until the state abolishes the death penalty.
  • The pink running shoes Wendy Davis wore during her filibuster have over 280 positive reviews on Amazon, and not all of them extol the arch support.

What did I miss?

Heroin’s popularity is growing in Northern New England In New Hampshire, the number of fatal heroin overdoses jumped from just seven in 2003 to a surprising 40 in 2012. The increase has also been observed in Vermont, with a 40% increase in heroin addiction treatment, and Maine, which had three times the heroin overdoses in 2012 as in 2011. There are a few factors that may contribute to this growing problem: increased control over prescription painkillers, the relative cheapness of heroin compared to painkillers, and because heroin can be sold at a higher price in rural areas than in urban centers, distributors are incentivized to sell more. Heroin is now taking up most of drug enforcement agents’ time in the area. Controlling infectious diseases like HIV and Hepatitis C will be the next challenge for the area’s public health community.

Curious about what’s happening next with the ACA? Kaiser Family Foundation released a new ACA video starring its charming YouToons. This one, a follow up to 2010’s “Health Reform Meets Main Street,” explains how to “Get Ready for Obamacare.” (Interesting, the change in terminology over three years!) This easy to understand breakdown of the complicated law is accessible to all audiences. Anyone talking to the public should be emulating this kind of clear communication. http://www.youtube.com/watch?v=JZkk6ueZt-U

Friday Five: sterilization, pain robot, brains, surgeons, Sharknado

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Rural women are more likely to be sterilized

Tubal ligation, also known as sterilization or “getting your tubes tied,” is far more common among rural women as compared to urban women. Of rural women, 23% said they had been sterilized; urban women, 13%. There is only speculation about why this difference exists. Some of the theories floating around are: less access to other forms of birth control; piggybacking tubal ligation onto post-partum Medicaid coverage; lower educational level. Importantly, 39% of those rural women regret their decision. We should be asking why they didn’t choose a long-term, reversible birth control such as an IUD or an implant (like Implanon) instead.

Somewhat cute robot helps reduce kids’ pain and suffering during injections

As a needle phobic myself, I was very excited to learn that there’s an innovation in helping kids’ distress during shots. The robot not only talks to the child in order to distract him or her from the scary needle, but encourages exhalation during the injection to help with muscle relaxation (video here). There are two reasons why reducing pain and anxiety for children receiving immunizations is important: excessive worry can make other parts of the exam difficult, and in the future, an adult who had a bad medical experience as a child may be more likely to avoid care. These both have significant health implications. If this robot can help, I say let’s get one in every pediatrician’s office—and maybe in internist’s offices too, for ‘fraidy cats like me.

Brain pathways involved with learning and changing behavior charted

This week the NIH published a study identifying neural pathways associated with learning and changing behavior in mice. The nerves associated with the switch from moderate to compulsive drinking were found to also have a role in learning and decision making. Researchers hope that their insights will be helpful in understanding alcoholism and addiction. Learning more about why some people can use substances in moderation while others become addicted is crucial to improving mental and physical health. Hopefully, these findings will also apply for humans.

Surgery residents operate less often under new rules

Medical residents (doctors who are done with medical school and are completing their practical training) work notoriously long shifts and even longer workweeks. Restrictions created in 2011 limited shifts to 16 hours for first-year residents and 28 hours for the more advanced doctors and everyone’s week is limited to 80 hours. Surgical residents have in turn participated in fewer hours of surgery because of the limits on working hours. Many doctors are concerned that this will put the budding surgeons at risk for not gaining enough experience. There has to be a balance between allowing doctors to get enough rest while also learning enough to practice on one’s own—the question is, how

Kathleen Sebelius may in fact have a sense of humor

Twitter blew up last night with references to Sharknado, a horribly wonderful movie about a tornado that blew sharks into a city. (I don’t know how that works, I didn’t watch it!) Buzzfeed immediately wrote an article claiming “There is no Obamacare coverage for pre-existing Sharknado injuries.” Kathleen Sebelius replied: https://twitter.com/Sebelius/status/355766513334108160 Hey, an ACA joke!

I leave you this weekend with an excellent infographic explaining pretty much everything you need to know about gender, sexual orientation, and the like…The Genderbread Person!

Genderbread-Person

Friday Five: Chicago, ACA, firefighters, prescription drugs, vaccine recall

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week.  

Fourth of July shootings in Chicago

This Fourth of July weekend is proving to be deadly for Chicago. Yesterday, eight people were killed and more than 30 were hurt in shootings across the city. The youngest victim is just five years old, and was shot while attending a party in a park with his family. These shootings are a disgrace, as is the lack of national coverage of the violence permeating Chicago. Victims’ stories should be plastered across every news station and website, and the nation should be reviving the post-Sandy Hook gun conversation in light of this inexcusable violence.

 

Another ACA delay

The Obama administration added to the confusion surrounding the Affordable Care Act by pushing the employer mandate deadline back one year to January 1, 2015. Another instance of caving to private sector demands means increased misunderstanding for the public. The law was incredibly complicated as written, and the administrative tweaks, House repeals, and flat-out lies disseminated by the media ensure that nobody has any idea what’s going on. The ACA is the single most important change to health care the US has seen since 1965, and its frustrating to watch it falter. Hopefully, the exchanges will still open as scheduled on October 1.

 

Firefighters killed in Arizona fires

Nineteen elite firefighters were killed on Sunday battling a blaze that is still only 45% contained. Their deaths have reminded us that the people suffering from these fires are not only those who lose their homes, but the people who are willing run into the flames to try to protect those homes. We’re learning about the hotshot teams specially trained to fight wildfires, an aspect of firefighting that was unknown to many people. I’ve been trying to imagine what it’s like to do what these teams do: go out to the fire, live near it for days, battling it while awake and smelling it while you sleep. I am in awe and very grateful.

 

More ‘scripts, more problems

This was a big week for news about prescription drugs. A brief rundown:

  • 70% of Americans take at least one prescription a day, mostly antibiotics, antidepressants, or painkillers
  • The number of fatal overdoses in women quadrupled between 1999 and 2010, and approximately 42 women die daily from overdoses
  • The FDA busted 1600 illegal online pharmacies

 

Hepatitis B Vaccine recall

Merck issued a recall this week for one lot of the Hepatitis B vaccine Recombivax. The issue is not with the vaccine itself, but with the glass vials that may easily crack. Merck is concerned about the sterility of the vaccine, and the FDA assures consumers there’s no need to be revaccinated if a doctor administered one of the recalled lot. The anti-vaccine websites I visited seem to have not picked this up yet, so maybe this vaccine news won’t be misconstrued. We can only hope.

In honor of yesterday's Fourth of July holiday, here's a little Katy Perry to get you dancing:

http://www.youtube.com/watch?v=QGJuMBdaqIw

Friday Five: violence, HPV, obesity, smog, Obamacare

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Global rates of violence against women are alarmingly high

This week, the WHO released a study showing that more than 30% of women around the world have been victims of physical or sexual violence, particularly from their spouse or partner. The report also outlines the health issues associated with violence against women: death, depression, alcohol use, STIs, unwanted pregnancies and abortions, low birth weight babies. The WHO recommends that health care providers take violence more seriously. These findings remind us that violence is not a far away issue that impacts other people—all of the WHO regions have violence rates hovering between 23-38% (map). Whether we realize it or not, we all know women who have experienced violence against them, and we are all responsible for ensuring women have the education and mobility they need to keep themselves safe.

 

HPV rates are lower in teen girls thanks to vaccine

And now for some good news: the prevalence (number of cases currently in the population) of vaccine preventable HPV in teen girls has dropped 56% since the introduction of the vaccine. The ultimate goal is to have 80% of American children vaccinated in order to create herd immunity, meaning that enough people are vaccinated so the virus has nowhere to go. However, only about half of teen girls have gotten the necessary three doses of Gardasil or Cervarix. It’s time to stop stalling. Vaccinate kids and help prevent them from developing cervical, anal, or—as Michael Douglas reminded us—throat cancer.

 

AMA declares obesity a disease

The American Medical Association (AMA) voted this week to define obesity as a disease, identifying it as a complex issue that requires therapeutic medical treatment. They hope to reduce stigma and understand obesity to be a disease because it impairs some body functions. Critics denounced the decision, saying that because obesity is defined using BMI, it is not a precise diagnosis and that obesity has no specific symptoms of its own, only that it a contributing factor to other diseases. Although obesity is often characterized as a willpower and laziness issue, the resolution, as quoted in the New York Times, says:

The suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes.

Hopefully, the AMA’s decision will lead to increased insurance reimbursement for obesity treatments, including nutritionists and gym memberships, as well as medical interventions and therapy.

 

Singapore is covered with smog

Fires in Indonesia are causing dangerous smog in the country and Singapore. Though no one has fessed up to starting the fires, they are likely due to illegal land clearing practices in Sumatra, which is west of Singapore. Today, Singapore’s Pollution Standards Index (PSI) hit 401, far higher than the “dangerous” level defined by a PSI of 300, and is considered “life-threatening” to the ill and elderly. Smog is a mixture of accumulated greenhouse gases and smoke, and is made worse by the combination of pollutants, sunlight, and heat that creates ozone. Smog causes serious respiratory, eye, and skin problems, and this smog is so thick visibility is seriously impaired.

 

Dems love the term “Obamacare,” Republicans don’t

The Kaiser Family Foundation June tracking poll shows that when referred to as “Obamacare,” 73% of Democrats responded favorably to the Affordable Care Act (ACA), as compared to 58% when the ACA was called “health reform law.” Republicans, however, saw an increase in unfavorable responses when the ACA was called “Obamacare,” from 76% to 86%. Apparently, the pejorative likely coined by none other than Mitt Romney has been successfully appropriated and turned into a rallying point for Democrats in support of the ACA. Obama is a linguistic master, and this shows he can turn even the most negative epithet into a compliment. Take that, Sarah Palin!

It's the first day of summer! This lion knows how to celebrate:

http://www.youtube.com/watch?v=mV1CVTPVAJg

Friday Five: Sarah Murnaghan, Plan B, Arizona, wildfires, mindfulness

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. The triumph of Sarah Murnaghan

Follow up from two weeks ago: Sarah Murnaghan got new lungs! After a judge ruled that she must be added to the top of the adult transplant list, Sarah was matched with organs within days. The Murnaghan family will now step out of the public eye and, as Sarah’s mother says, they will be “focusing all of [their] attention on Sarah” as she recovers from surgery. Sarah is not the only one to benefit from her family’s perseverance—11 year old Javier Acosta was also added to the list. This judicial intervention will certainly inspire ethical debate about who can get which organs, and hopefully children’s lives will be valued as much as adults’.

 

Judge Korman: New hero of reproductive rights?

After the Obama administration finally dropped its appeal of Judge Edward Korman’s ruling that all products containing levonorgestrel be made available over the counter, the administration decided to make available only Plan B One Step (containing just one pill rather than two). Korman is not happy about this. Plan B One Step is manufactured by Teva, and if it is the only emergency contraceptive authorized to be sold over the counter, Teva will be able to set its price and have no competition. Korman argues this unduly burdens low-income women and that “it is the plaintiffs, rather than Teva, who are responsible for the outcome of this case, and it is they, and the women who benefited from their efforts, who deserve to be rewarded.” Korman also makes it clear that if the FDA or Teva drag their feet on getting Plan B One Step to the drugstore shelves, they should expect to be sued again.

 

Arizona finally decides to expand Medicaid

Despite her deep opposition to the Affordable Care Act, Governor Jan Brewer now accepts that the ACA is here to stay and that Arizona should get in on the billions of dollars available to the state. Her website even touts the Medicaid expansion as “the conservative choice for Arizona.” Imagine that: after realizing that “uninsured Arizonans get sick just like the rest of us” (because uninsured people are markedly different from the insured, of course) providing them with Medicaid would help reduce the rates paid by the insured! Brewer even denies the state is participating in “ObamaCare” by crediting former (Republican) Governor Fife Symington with coming up with the idea of the expansion in the 1990s. I’m pleased that 57,000 additional Arizonans will have access to Medicaid, but Brewer can obviously see the advantages of the expansion and yet spent months rabidly fighting the ACA…what a hypocrite.

 

Wildfires? Denver Post has us covered

Multiple wildfires in Colorado are causing serious problems for the state, and the Denver Post is taking care of business when it comes to covering the fires. It’s providing maps of the perimeters of each fire, the properties damaged, and a map of all fires across the country. There are chilling before-and-after photos of neighborhoods turned to ashes. The Denver Post is doing an excellent job of keeping people informed, spotlighting the firefighters, and reminding residents of preparedness procedures without being alarmist. With two people killed and hundreds of homes burned down, the fires are a significant natural disaster, and the Denver Post will keep us all informed.

 

Mindfulness classes in high school

Central Bucks High School East will add a new subject to its curriculum: mindfulness. Using techniques from Learning to BREATHE, the school hopes to teach students to regulate their emotions, manage stress, and strengthen their ability to focus. Central Bucks East hopes the mindfulness training will help high-achieving students feel less stressed about AP classes, applying for college, and taking the SAT while the training will also be taught in a program designed for students to learn how to live independently. Acknowledging that stress hurts students (whether they are in classes about healthy interpersonal relationships or European History) shows that Central Bucks East is trying to see its students as whole people. I’m eager to see this program evaluated—will mindfulness change test scores or graduation rates?

 

Start the weekend off right with the evolution of Daft Punk and Pharrell's new song Get Lucky as it would have sounded if it was made in the past.

http://www.youtube.com/watch?v=3r3BOZ6QQtU