Friday Five: Veterans, birth, ACA, Politifact, #HealthPolicyValentines

It's back by popular demand! (Okay, maybe only Carmen asked if I was ever going to write another Friday Five, but she's so awesome that she counts as at least ten people.) Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Obama signs vet suicide prevention act Yesterday, President Obama signed the Clay Hunt Suicide Prevention for American Veterans Act, legislation aimed at improving the VA’s mental health care and removing barriers that prevent veterans from seeking treatment for mental health conditions. Death by suicide is particularly high among veterans over age 50. While their wish to end their lives may not be directly related to their service, the VA has a responsibility to care for veterans who qualify for VA care and are in need of it. The VA is notoriously problematic, and I hope that the newly-required external audits built into this Act will keep it accountable. After asking them to do what nearly every other American refuses to do, we continually fail our veterans--this Act is just a fraction of what they deserve.

Birth: Home versus hospital A short literature review by Dr. Rikki Lewis reveals interesting findings about the complexities and controversies surrounding home birth.

  • In the US, home births increased by 29% between 2004 and 2009.
  • Among studies investigating the risks and outcomes of home birth, there is little consistency in patient selection and the necessity of reporting infant deaths after transport to the hospital means that those deaths are reported as hospital deaths rather than deaths at home.
  • Policies for deciding to take a woman laboring at home are much clearer in the United Kingdom than in the US.
  • Home births are far less expensive than hospital births, which average about $20,000.

As the hospital versus home birth debate continues, it will be important to use correctly interpreted research as the basis for argument.

ACA open enrollment ends on Sunday The last day to sign up for insurance through the Marketplace is Sunday, February 15. According to the awesome website ACAsignups.net 10.5 million people have already signed up. Originally, the Department of Health and Human Services estimated that 13 million people would receive coverage during the open enrollment period, but later readjusted the estimate to between nine and ten million. If you need insurance and haven’t signed up, do it now...don’t procrastinate! (Also, can we take a moment to wonder why the “marketplace.gov” doesn’t redirect to healthcare.gov? Missed opportunity!)

 

Politifact takes on measles and vaccines One of the best, most useful sites ever, Politifact, evaluated the truthfulness of public statements about measles and vaccines. While their website could use a redesign to make articles like this one easier to read, the information they’ve provided is really valuable. They’re successful in debunking the “vaccines have mercury” claim and Rush Limbaugh’s accusation that Obama’s immigration policy allowed measles to enter the United States through Mexico. Politifact also highlights some of the true statements made by Megyn Kelly and other cable news pundits. While you’re reading their website, take a look at their ratings of statements about health care in general.

Health policy nerds love bad jokes Valentine’s Day isn’t only about romantic love. It can also be a time for you to express your deep, abiding passion for one of the nerdiest arms of public health: policy. Back in 2011, Emma Sandoe started the hashtag #HealthPolicyValentines so we could enjoy gems such as:

and

Groan worthy? Maybe, but totally great anyway.

Have an awesome Friday. I'll be back here tomorrow with a Valentine's Day-themed post!

Friday Five: Merck for Mothers, Gates Foundation, mental health, antibiotics, housing

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

The US’s high infant mortality rate is often cited as an indicator of our nation’s poor health. However, the maternal mortality rate is often ignored while the number of pregnancy-related deaths has doubled since 1990. Pharmaceutical giant Merck established its Merck for Mothers overseas to help reduce maternal mortality and has just announced it will import those programs to work with expectant mothers in the US. It will provide $6 million in funding for initiatives in ten states and three cities, including Baltimore and Philadelphia. The project will also work to standardize procedures for pregnancy-related emergencies.

Maternal mortality by GDP per capita. I've highlighted a few countries for comparison. While the US does have a comparatively low maternal mortality rate, it is far above other countries with similar GDPs. The size of the circles represent the size of the population, and the color indicates the geographic region. Source: Gapminder

 

The Gates Foundation funds all kinds of new public health ideas

The Bill and Melinda Gates Foundation is dedicated to improving public health around the world, and its Grand Challenges Explorations is a way to promote innovation. This week, the Foundation announced the 81 winners of this year’s $100,000 grants. All of the grants awarded fall into these categories:

  • Increasing the interoperability of good data (ex: improving humanitarian information management in crises)
  • Develop the next generation of condom (ex: condom applicator that can minimize interruption)
  • Labor saving innovations for women smallholder farmers (ex: participatory reality TV show encouraging the use of draught animals)
  • New approaches for the detection and treatment of selected neglected tropical diseases (ex: artificial snail decoy to confuse a parasite)
  • The ‘One Health’ concept: bringing together human and animal health for new solutions (ex: new canine rabies vaccine)

Non-specialist health care workers in developing nations are successful at mental health care

A report published this week shows good news for mental health in low- and mid-income countries. Examining 38 studies, researchers found that non-specialists (such as doctors and nurses rather than psychologists and psychiatrists), who have some mental health training, have been successful in alleviating mental, neurological, and substance abuse issues. Compared to untrained health care workers, patients of trained workers had a positive affect on depression, youth PTSD, and problem drinkers. The researchers caution against making assumptions about what kinds of interventions might work. But the bright side is that training primary care workers to consider mental health needs could help get much-needed care to people who may otherwise go without. You can read the report—and a plain language summary—here.

Tonight’s nightmare is…bacteria that no antibiotic can kill

New Zealander Brian Pool died in July, but the specifics of his death were just reported this week. While in teaching in Vietnam, he underwent surgery and contracted KPC-Oxa 48, a strain of bacteria that is resistant to all antibiotics. That’s right, all of them. New Zealand authorities were strict about quarantine, so there’s little worry that the bug will spread from this particular incident. If you’d like to learn about all the things at risk if we lose the ability to kill bacteria, Maryn McKenna has a terrifying run down.

Why we need public housing

I’ve recently become interested in the importance of safe, stable, and affordable housing as a prerequisite for good health. Ensuring everyone has their basic needs met is perhaps the most important public health issue. How can anyone expect to have a successful smoking cessation intervention if participants don’t know where they’ll sleep tonight? Now that I’m paying attention to the issue, I’m seeing it everywhere. This infographic explains how public housing can be a part of the solution.

public_housing_info

Friday Five: Cigarettes, taxes, cancelled insurance, krokodil, pre-term births

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. This time, it's Bloomberg-heavy!  

New Yorkers have to be 21 to buy cigarettes

In what may be his last public health move before leaving office, New York City mayor Michael Bloomberg is set to sign a bill that will raise the purchasing age of nicotine products to 21. The bill covers cigarettes, e-cigarettes, cigars, and cigarillos. About 90% of adult smokers become smokers before age 20, so I understand the public health rationale. However, I question whether it is ethical to make a product illegal for some adults to purchase based simply on the person’s age. The fallout from this soon-to-be law will help frame tobacco laws around the country, and I’m eager to see what happens next.

 

Mexico creates a junk food tax

Mexico has one of the highest rates of overweight and obese citizens—higher than even the United States. This week, the Mexican Congress approved a bill adding an 8% tax to all “high-calorie” foods like potato chips and sweets and a one peso/liter (about $0.08) tax to all soft drinks. The tax initiative was funded in part by Michael Bloomberg’s foundation. It is resolutely opposed by Femsa, the Mexican manufacturer and distributor of Coca-Cola, and Bimbo, which owns Sara Lee, Entenmann’s, and other processed food companies. Hopefully, when the costs inevitably are passed along to consumers, consumption of these items will fall and the population move toward a healthier weight.

 

Some health insurance plans have been cancelled due to the ACA

Before the implementation of the ACA, about 5% of Americans purchased health insurance individually. Many of these plans are now being cancelled because they do not fit the requirements all plans must meet under the new law. There’s lots of outrage, particularly at President Obama, because people feel misled. It’s pretty clear what’s happening: there’s a combination of insurance companies ended “grandfathered” plans early (which is their decision, not mandated by the ACA) and plans being cancelled because they were purchased after the “grandfathering” date and therefore are not legal. For an excellent flowchart showing how and why this is happening, Jon Lovett made an intricate one.

 

Pre-term birth rates fall again

The US pre-term birth rate fell to a 15 year low of 11.5%, or 1 in 9, in 2012. Although we still have the worst pre-term birth rate of all the industrialized nations, this is a positive development. This is the sixth year in which the rates declined, but the reasons why are not clear. Pre-term, low birth weight, and very low birth weight babies can have developmental delays, need more care, and cost more—on average, about $51,600. For more detailed information, see the March of Dimes 2013 Premature Birth Report Card.

 

Appearance of krokodil may be a false alarm in the US

(Warning: DO NOT Google image search for krokodil. Trust me.)

A month or two ago, the internet was abuzz with reports of people losing body parts to a new drug, krokodil. This homemade heroin substitute popular in rural Russia causes horrible sores that lead to severe disfigurement. A few cases popped up in a number of states earlier this year, but now the DEA suggests these were heroin use-related problems, like staph or MRSA infections at the users’ injection sites. Compounding the skepticism is the fact that in some places, a dose of heroin costs only $5 (!!!), virtually eliminating the need for even the most desperate user to knowingly inject his or herself with krokodil. Here’s to hoping that it really hasn’t shown up here, and that this interest we now have leads to getting actual krokodil users help.

Friday Five: Hajj, pinkwashing, listeria, IVF, President Taft

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

Hajj ends with no significant health scares

The Muslim pilgrimage to Mecca, called hajj, concludes today. Public health officials worried about the spread of MERS as well as the annual concerns of fires, stampedes, and the transmission of pathogens through the ritual of head shaving. Thankfully, there have been no injuries or deaths so far (though we’ll have to keep watch for MERS and the infectious diseases associated with the head shaving). The number of pilgrims was down significantly from 3.2 million last year to just under two million this year. Hopefully, this success can be emulated in future years—keeping people safe during religious rituals should be a priority for Saudi Arabia.

 

Just say no to pinkwashing

I don’t understand how someone thinks that purchasing pink M&Ms or water bottles or scarves does any more good than donating directly to a breast cancer research charity—and in fact, it doesn’t. Luckily, Breast Cancer Action runs a campaign every October called Think Before You Pink, encouraging consumers not to purchase these products. This year they’re targeting the known carcinogens that are in various “awareness” items. They’re pushing for legislation that would require chemicals in consumer products to be tested for safety before they come to market, something that is not required now. Take a look at what they’re proposing, and even if you don’t want to sign the petition, please consider sending a couple bucks to the American Cancer Society or another reputable charity rather than buying a pink iPhone case

 

Food recall: listeria edition

There is yet another food recall this week, this time with ready to eat chicken and ham products from Garden Fresh Foods tainted with listeria (the irony of company names involved in recalls always makes me giggle). Garden Fresh had a previous recall in September involving foods sold at Target, Weis, and other outlets. If you bought chicken or ham salad from Weis, and the package has "EST. 17256" or "Est. P-17256" printed on it, throw it away! Listeria usually causes trouble in the usual vulnerable groups: elderly adults, pregnant women, small children, and people with compromised immune systems. For the list of recalled foods, see the USDA.

 

IVF has been a huge success

Preliminary research shows that there have been at least five million births as a result of in vitro fertilization (IVF). IVF is the process of stimulating ovulation, retrieving eggs, fertilizing those eggs in a controlled environment, and transferring the resulting embryo into the woman’s uterus. People choose to use IVF for many reasons: maternal age, fallopian tube issues, male infertility, or to allow LGBT couples to have a child biologically related to a partner. Infertility is losing its stigma in no small part due to the surge in IVF babies. Having options about when and how to start a family is crucial, and being able to talk about those options and decisions helps normalize the ideas for others.

 

Former presidents…they’re just like us!

William Howard Taft, our portliest president, seems to have used the late 1800s version of Weight Watchers to slim down. New research shows that he had a years-long correspondence with a weight loss doctor who suggested a low-fat, low-calorie diet combined with exercise, portion control, and daily weigh-ins. Taft lost weight, but complained of constant hunger—no surprise because he was limited to small portions of meat, vegetables without butter, plain salad, and cooked fruit. He was not able to stick to the diet long term, so he eventually regained the weight he lost, much like modern dieters. Permanent weight loss is incredibly difficult, and Taft shows us that even the powerful can struggle with their weight.

 

Oh, and I’d love if you’d check out the first episode of my new podcast, Action Phase!

Friday Five: Salmonella, abortion, bubonic plague, rabies, Tom Hanks

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

Government shutdown, Foster Farms, and drug-resistant Salmonella

Foster Farms—a chicken processor who was the source of a Salmonella outbreak earlier this year—has been implicated in selling meat that has sickened at least 278 people in 17 states. Although the processor insists the problem is due to consumers insufficiently cooking their chicken, they have decided to revamp their procedures rather than be shut down by the USDA. This particular outbreak consists of seven strains of Salmonella, four of which are drug resistant—and due to the government shutdown, the CDC cannot properly investigate the problem and may be missing information that could reduce illness or save lives. This is a perfect example of a useful government program that should be funded regardless of politics…salmonella doesn’t care if you vote red or blue.

 

Abortion news

There’s lots going on this week regarding abortion. A woman who will have to leave the country to terminate her pregnancy since she is carrying twins who have anencephaly is highlighting Northern Ireland’s total ban on abortion. Ohio passed a budget that included three abortion restrictions, and the ACLU is suing the state, claiming the rules have nothing to do with the budget and are unconstitutional. The Nebraska Supreme Court upheld a ruling stating a pregnant foster child was not mature enough to elect to have an abortion, so she must deliver the baby and place it for adoption. Arsonists have tried to attach the Planned Parenthood in Joplin, Missouri twice in one week. Finally, some good news: California expanded access for abortions by allowing nurse practitioners, physician’s assistants, and certified nurse-midwives to perform abortions.

 

Bubonic plague may be an issue for Madagascar

Unless Madagascar gets its rat population under control, it’s likely to face a bubonic plague epidemic starting this month. That’s right, the Black Death is endemic in the island nation. Rats abound in the main prison, and the concern is that if the bacteria is introduced to those rats, the fleas they carry will be able to spread bubonic plague to inmates, employees, and visitors. And you can’t just kill rats—you have to kill the fleas, too. No word on what’s being done to avert this potential disaster.

 

Rabies vaccines are way too pricey

Fewer than 10 people have been documented as surviving full-blown rabies, but if a person who has been bitten receives the rabies vaccine before serious symptoms develop, they are likely to survive. Rabies kills about 24,000 people, mostly children, annually across Africa (approximately 26,000 die in Asia). Rabies experts at a conference this week in Dakar, Senegal suggested the best preventive measure is to tie up dogs since the post-bite treatment is cost prohibitive to most people who are bitten in Africa. The treatment requires four or five injections that cost about $13 each. Seems to me that rabies vaccine manufacturers Sanofi Pasteur and Novartis should be striking a deal with someone to lower these costs and save a huge number of lives.

 

Tom Hanks has Type 2 diabetes

During an interview with Dave Letterman, America’s favorite actor Tom Hanks announced he has Type 2 diabetes due to years of uncontrolled high blood sugar. Hanks doesn’t blame his weight fluctuations for movie roles, but says, “I think it goes back to the lifestyle I’ve been leading since I was probably seven, not 36.”  He joins the ranks of Paula Deen, Randy Jackson, Billie Jean King, Patti LaBelle, Larry King, and 25.8 million Americans. Can you imagine if Paula Deen, Larry King, and Tom Hanks did a diabetes prevention campaign? That’d be TV ratings gold.

http://www.youtube.com/watch?v=wBhZoTN2bvM

 

Friday Five: Marketplace, Olympians’ teeth, Wikipedia, sprinklers, McDonalds

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

The Health Insurance Marketplace is open for business

The day is finally here: the Health Insurance Marketplace is open! I’d hoped to poke around a little and report on what I saw, but the site is so busy I haven’t yet been able to get past this page:

alot_of_visitors

The fact that the site has been overloaded with visitors for the past four days shows us that we are ready to buy insurance and are on board with the Affordable Care Act. We’ll still have to work through some bugs, I’m sure, but I’m glad to see so many Americans are excited about this new option. Once I get past the waiting page, I’ll be sure to let you know how things work in the Marketplace.

Brush and floss twice a day…even you, Olympians!

According to a study just published in the British Journal of Sports Medicine, athletes competing at the 2012 London Olympics who visited the athlete’s village dental clinic had surprisingly bad teeth. Of those people examined, 55% had cavities, 45% had lost some tooth enamel, 76% had gingivitis, and 15% had periodontitis. A full 40% of athletes were “bothered” by their oral health, and 18% admitted their dental problems caused issues with training and athletic performance. While we hold up these Olympians as paragons of health and fitness, their teeth tell us another story. Oral health is an indicator of overall health, and perhaps focusing intently on training is leading them to disregard other important aspects of their health.

Earn credit for editing Wikipedia at UCSF medical school

The medical school at University of California, San Fransisco (UCSF) is offering a unique course to its fourth year students: editing medical Wikipedia articles. They are working with Wikiproject Medicine to add citations and increase the accuracy of the 100 most popular medical articles on Wikipedia. Health care providers use Wikipedia often, and medical students have an abundance of information—so it makes sense for the students to contribute their knowledge for the good of site they’ll use frequently in their practice. UCSF is the first medical school to link Wikipedia’s education goals with course credit. Hopefully, the combined knowledge of the nation’s medical students can be used to help all of us understand the details of razor burn (the #1 most-viewed medical page).

Nursing homes need sprinklers

Medicare and Medicaid require all new nursing homes or additions to a nursing homes to have automatic sprinkler systems. Older nursing homes did not have any regulation regarding fire suppression or sprinklers until August 2008, and they were given five years to comply with the rule. Now that those five years have passed, approximately 1000 facilities have “partial” systems, and about 125 have no sprinklers at all. Considering nursing home residents often have mobility issues, an uncontrolled fire in one of the facilities would be devastating. If you know of a nursing home that does not have a proper sprinkler system, I suggest calling CARIE (I did my summer internship at CARIE; they’re wonderful) and talk with the ombudsmen there to help ensure the safety of the residents.

Happy Meals just got a little happier

This week, McDonalds announced major changes to its menus—value meals can now be accompanied by salad, fruit, or vegetable in lieu of fries, Happy Meals will no longer be promoted with soda but instead with milk, juice, or water, and advertising and packaging for children will encourage wellness and good nutrition. The changes will be made in McDonalds’ 20 major markets across the world, which comprise 85% of global sales. The most important part of these changes is the addition of choice. Adults and children alike will be able to choose salad instead of fries, water rather than soda. Having these choices available—and encouraged—will help fulfill the public health goal of making the healthy choice the easy choice.

Friday Five: Lea-Ann Ellison, antibiotic resistance, apps, medical marijuana, adorableness

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

Surprise! Lifting weights while pregnant is controversial

Americans do a great job of finding reasons to criticize women, especially when it comes to reproduction and motherhood. This week, we were subjected to a wave of judgment about Lea-Ann Ellison, who has the audacity to lift weights while 33 weeks pregnant. She says her doctor is fine with her exercise. Pregnant women are told to continue being active, and that’s exactly what she’s doing. If her doctor—not the ones quoted by media outlets—deem her exercise intensity level safe, then we should butt out.

 

Antibiotic resistance is going to be a big problem

A first-of-its-kind report from the CDC on the status of antibiotic resistance classifies 18 microorganisms as “urgent,” “serious,” or “concerning” in their ability to fight antibiotics. The list includes everyone’s favorite infections: gonorrhea, typhoid, and tuberculosis. Antibiotics are one of the most important reasons our life expectancy has grown, and losing the ability to kill bacteria will certainly mean more severe illness. This is a great opportunity for primary prevention (preventing illness before it starts); strategies such as advocating for condom use, safe food handling practices, and vaccines will be necessary. Meanwhile, doctors should be discerning about prescribing antibiotics, and we must invest more money and effort into developing new drugs.

 

Now some apps will come with an “FDA approved” message

The FDA has made its final decision about which mobile health apps it will regulate. It is focusing on apps that could cause significant risk to users if the app does not function correctly. Apps that allow the user to check blood glucose levels or turn the phone into an ultrasound machine could be game changers for providers and patients. However, when I looked for these apps on the iTunes store, I couldn’t find any. Is this because they won’t be released until after the FDA approves them?

 

Egg Harbor dispensary is set to open

The long-awaited South Jersey medical marijuana dispensary run by the Compassionate Care Foundation is set to open in just a few weeks in Egg Harbor. Sales will be by appointment only and the building cannot have any illuminated signs, ostensibly to reduce the inevitable interest of recreational users. Interestingly, the non-profit Compassionate Care Foundation will have to pay federal income taxes because the federal government does not recognize its non-profit, leading to a projected cost to consumers of $400 per ounce, with a limit of two ounces per month. Could the rules and restrictions placed on the Egg Harbor dispensary be a model for regulating dangerous yet legal painkillers? We have a lot to learn from the state-by-state legalization of marijuana, and I’m interested to see how this evolves.

 

Adorable Care Act. That’s right. Adorable.

The Adorable Care Act has stolen my heart. These animals are just too damn cute. And they’re advocating for the Affordable Care Act on Tumblr and Twitter? Oh man, sign me up for insurance right now. Observe these baby animals that I poached right from the Tumblr:

This kitten is so excited she can stay on her parents' insurance for a few more years.

adorable_care_piglet

Friday Five: 9/11, tobacco in India, painkiller labels, Chobani recall, child abuse & neglect

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

9/11 responders are suffering from cancer

While we remember the 12th anniversary of the attacks on the World Trade Center, another attack is being waged upon the responders: cancer. So far, 1,140 people have been certified by NIOSH to have 9/11-related cancer. The types of cancer are varied—from non-melanoma skin cancer to non-Hodgkins lymphoma to colon cancer—and thankfully, the September 11th Victim Compensation Fund will cover all related medical and mental health expenses. However, an important deadline approaches: if a person knew of their related medical condition before October 2011, he or she must sign up with the Fund before October 3, 2013 in order to have their treatment covered. If you know anyone who may be eligible for this benefit, please (1) thank them for their selflessness and (2) tell them to sign up ASAP.

 

Tobacco + India = Bad News

Approximately 275 million people out of India’s 1.2 billion population use smokeless tobacco or cigarettes. According to a report from the International Tobacco Control Project, the country could see 1.5 million deaths annually if the number of tobacco users is not reduced by 2020. What’s even more alarming is that 94% of tobacco users surveyed said they had no plans to quit, despite government efforts to curb consumption and self-reported regret for beginning the habit. Citizens groups also advocate for tobacco-free living. This ad from Cancer Patients Aid Association is an example of the kinds of messaging Indians receive.

 

Source

 

New labels for some, but not all, narcotic painkillers

The FDA has announced updates to the labels for extended release narcotic painkillers to remove the idea that the painkillers should be prescribed for “moderate-to-severe pain.” Instead, opiates like OxyContin (oxycodone) and MS Contin (morphine sulfate) should be prescribed only when a patient’s pain cannot be controlled by other methods. These changes do not apply to fast-acting painkillers like Percocet (acetaminophen and oxycodone) or Vicodin (acetaminophen and hydrocodone) because the FDA sees that class of opioids to be less susceptible to abuse and overdose. Hopefully the new label will encourage doctors to think carefully about which painkillers they prescribe. The misuse of these drugs is out of control, and as doctors are the gatekeepers of prescriptions, their cooperation is essential to reducing addiction and unintentional deaths.

 

Chobani yogurt is moldy

Beloved and wildly popular Chobani brand Greek yogurt has been recalled. The problem of bloated, exploding containers is said to be due to contamination by the mold Mucor circinelloides. Although this kind of mold is not known to cause gastrointestinal problems, 89 people have reported nausea and vomiting after eating the recalled yogurt. That said, if your breakfast is fizzing through the lid, please don’t eat it. Let’s have some common sense, okay?

 

New child abuse and neglect report demands changes to the system

A report released this week from the Institute of Medicine described the fractured, underfunded, and unevaluated way the US researches and addresses child abuse and neglect. There are more than three million reports of abuse each year, involving at least six million children. The most common form of mistreatment is neglect, or when a caregiver fails to provide food, supervision, protection, medical care, education, or nurturing and affection. The full report gives a sense of how poorly the US manages child abuse and neglect, and this infographic also gives the basics. Children who are victims of abuse or neglect are far more likely to have serious health problems, including mental health issues, so eliminating violence against children should be at the forefront of public health efforts.

 

This week’s Friday Five is extra-depressing, so I’m going to leave you with a bonus uplifting story:

Wearing a sandwich board may help you find a kidney donor

Larry Swilling of South Carolina has been walking around wearing a sandwich board asking for a kidney donor for his wife Jimmie Sue. A complete stranger, a woman named Kelly Weaverling from Virginia Beach, decided to get tested and was found to be a match. The transplant happened on Wednesday and both Jimmie Sue and Kelly are doing well. Bonus: Larry’s efforts have led to 125 new registered kidney donors in South Carolina.

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.