Raw milk, cholera, and Appalachia: Cool stuff I read this week

I came across a bunch of interesting articles and bits of news this week, and I thought I’d share them with you. Spend your lazy Sunday catching up on current events. The Dietary Guidelines Advisory Committee released its recommendations this week. They encourage us to eat less sugar and saturated fat, but say we don’t really need to worry about our cholesterol intake.

There’s a new rapid test for Ebola.

Speaking of Ebola, Al Jazeera America ran a fascinating and discouraging two-part series on the social implications of the epidemic.

Although Haiti has improved its infrastructure in response to the epidemic, cholera is still a major problem in the country.

This interview with the Baltimore City health commissioner Dr. Leana Wen reminds us that public health isn’t just about Ebola and cholera and measles--it’s also about rat control and the social determinants of health. [Audio and abridged transcript.]

Flu season is starting to wind down.

The first broad study of two kinds of muscular dystrophy was published, revealing important epidemiological information about the disorders.

Despite some progress, Appalachia is still teeming with health disparities and poverty.

There’s a new tickborne virus in town.

For goodness’ sake, stop drinking raw milk. Pasteurization exists for a reason!

More than 25% of Americans with diabetes are undiagnosed. That’s 8.1 million diabetics who are not receiving treatment or making lifestyle changes.

Thank you, Alan Cumming, for using humor to highlight just how ridiculous the FDA’s new ruling restricting gay and bisexual men from donating blood unless they have been celibate for a year.

Alan Cumming Celibacy Challenge

 

Come back tomorrow for another Awesome Infographic!

Friday Five: Non-fatal illness, Medicare, gay blood donors, e-cigarettes, infographic

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Q: What’s the most prevalent form of non-fatal illness in the world? A: Mental illness and substance abuse disorders. That’s right—mental and emotional issues such as depression, anxiety, drug abuse, and schizophrenia account for 22.8% of all non-fatal illnesses. This isn’t just in the US, but across 187 countries and 30 years. It’s time to stop pretending these disorders don’t exist. The authors of the study presenting these findings say it best: In view of the magnitude of their contribution, improvement in population health is only possible if countries make the prevention and treatment of mental and substance use disorders a public health priority.

Doctors still take Medicare beneficiaries Rumor has it that in light of the Affordable Care Act’s changes to Medicare reimbursement, doctors are fleeing the system and leaving seniors without medical care. But a report from the Department of Health and Human Services showed that in 2012, 90.7% of doctors accepted new Medicare patients, compared to 87.9% in 2005. Furthermore, more doctors are accepting new Medicare patients than are accepting those with private insurance. If you have Medicare, nearly all doctors will accept you. ACA myth debunked.  

Banned4Life wants the FDA to allow gay blood donors Men who have sex with men cannot donate blood. The FDA reasons that because gay men comprise 2% of the US population but in 2010 accounted for 66% of all new HIV infections, and because HIV goes through an “undetectable” period just after initial infection, keeping gay men out of the donor pool maintains the safety of the blood supply. The newly formed Banned4Life group seeks to change this policy. Banned4Life is urging the FDA to consider sexual behaviors, rather than sexual preference or orientation, when deciding who cannot donate blood. Life-threatening illnesses, gay rights, and government regulations can rile up lots of people, and I hope the FDA looks carefully at its policy and is transparent about the decision it makes.  

E-Cigarettes are getting popular among teens Combining two of their favorite things, rebellion and new technology, teens are adopting the newest form of nicotine on the market, electronic cigarettes (or e-cigarettes). Nearly 10% of high schoolers have tried them, doubling the rate from 2011 and far exceeding the 6% of adult smokers who have given e-cigarettes a puff or two. This finding from the CDC raises some interesting questions: are e-cigarettes safer than regular ones? Are the anti-smoking campaigns aimed at teens intended to be anti-cigarette or anti-addiction? Hypothetically, if e-cigarettes carry no risk of disease, would it be okay for teens to use them? Will indoor smoking bans apply to e-cigarettes? These will be crucial questions to address as e-cigarettes gain popularity.

Just how imperfect is US health care, anyway? This colorful, informative, and slightly dizzying infographic from the MPH program at George Washington University shows us how not-so-well our health care stacks up to the rest of the world. Interesting points to consider:

  • 79% of Americans use some kind of contraceptive, one of the only times we’re mostly ahead of the pack, trailing only Russia, the UK, and Canada.
  • Ghana, Algeria, Mexico, and many more countries have higher measles vaccination rates among one year olds.
  • There is 1/3 of a general practitioner for every 1000 Americans, while there is just over two specialists for every 1000 people (87.5% of practicing doctors are specialists).

US vs World Infographic

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: 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