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.

 

 

Why we can't let Jenny McCarthy join The View

Jenny McCarthy’s dangerous vaccines-cause-autism message has been well catalogued and critiqued by writers across the Internet (you can start here, here, and here). But I hadn’t ventured far into her world until hearing the news that she was “in serious talks” to join the popular daytime talk show The View. Vaguely knowing that she advocates for some batty autism cures, I stuck my toe into the world that literally made her its president, Generation Rescue. My conclusion? If ABC makes the mistake of hiring her, and she brings her anti-doctor, anti-science rhetoric to The View, all of us concerned with spreading evidence-based information better be ready every day to combat her misinformation. McCarthy's book chronicling how she "cured" her son of autism.

A note about sources: finding balanced sources on vaccine safety is a tough task, and I found myself questioning both the Generation Rescue folks and the people criticizing them. Many of the sources I found are very biased and a link to them does not mean I endorse their message. As you find yourself going down the rabbit hole, remember to read everything skeptically. However, the best resource I found for anyone interested in the actual science regarding this issue is the Children’s Hospital of Philadelphia’s Vaccine Education Center.

I learned about the “Biomedical” approach to “curing” autism through a video McCarthy made a few years ago. Generation Rescue no longer has on its site, but YouTube squirreled it away for our viewing pleasure—Part 1 Part 2.  She goes into detail about how and why “Biomedical” is the only thing that makes sense for healing children with autism. I suggest you carve out fifteen minutes to watch it so you know what’s coming if she makes it onto The View.  Warning: the video may cause bouts of rage.

The two most important parts of the video are direct quotations from McCarthy that summarize the danger she poses to public health:

  1. After listing brand name supplements and referring viewers to Kirkman Laboratories to purchase them, McCarthy encourages parents to give supplements to children in order to “detox” them from yeast and toxins, and says, “If you’re unsure about dosage, ask your pediatrician.” Then she rolls her eyes. “Or, most of the time, they don’t know anything. So I would say, um, ask someone at Kirkman Laboratories.”

So here we have McCarthy herself telling us not to trust pediatricians. Rather, we should call up a company that sells allergen free supplements and ask them how much to give to children. She encourages us to trust salespeople over trained professionals, simply because she believes in what they’re selling. In her view, doctors are useless and possibly malicious.

2. Attesting to the power of positive thoughts, she invokes the book “The Secret” and says, “Whatever you think becomes your reality.”

This is some serious magical thinking. McCarthy believes that her wishes will come true. She imagined her own son being healed of autism, and lo and behold, he was! When all a person has to do is believe something is true, she has no need for scientific facts. Give that person a microphone, and she may be able to convince others that whatever they believe is the truth, too.

By lending her face and considerable charisma to the cause, McCarthy has already done serious damage to immunization levels across the country by raising the profile of misguided vaccine fears. Many states are below the necessary vaccination level to maintain herd immunity for pertussis, measles, and diphtheria. Herd immunity means that there is a certain percentage of the population that needs to be vaccinated against a disease in order to keep the unvaccinated safe. Vaccination keeps infectious diseases from spreading by containing the possibility of an outbreak. For example, in order to protect those who cannot be vaccinated—infants, pregnant women, etc. from measles, 92-94% of the population needs to be vaccinated against it. When immunization levels drop below 92%, the population is at risk for an outbreak and the same people who could not get the vaccine are now at risk for the disease.

The View is a daily show. If she’s hired, I’m sure McCarthy will talk about anything from insomnia to hair color to shoe insoles, if her Twitter feed is any indication. But it will only be a matter of time until the issue for which she is best known becomes part of the conversation. When it does, we must be ready to talk openly about the results of research and the reliability of doctors to give sound, proven advice. Though talking about it over and over may seem redundant or boring, the truth is that vaccine levels are declining and we must speak on behalf of public health.

In the meantime, tell ABC what you think about McCarthy joining The View. Phil Plait at Slate has an excellent example of the polite note he wrote and inspired me to write to them and make my note public. Here is what I wrote to them. Feel free to use some version of my letter if you’d like:

I strongly urge you not to hire Jenny McCarthy as a new co-host. She is the president of the group Operation Rescue, which advocates for practices that harm the public's health, especially avoiding vaccines. If she is hired by The View, she will have a daily opportunity to influence the health decisions of viewers. Please do not add to the ease with which bad and potentially dangerous health information is spread.

For more information, please see http://bit.ly/12pTOyW  

Sincerely,

Teagan Keating

Please take the time to write to ABC before they hire her. Because if she does make it onto the show, we’ll have to do a lot more than that.