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: 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: 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: National Immunization Awareness Month

national immun awareness monthThis week’s Friday Five focuses on five important or interesting facts about vaccines in honor of National Immunization Awareness Month. Most of the sections are adapted just slightly from other sources. You can find the original source material by clicking the link next to each subheading.  

How do vaccines work? (History of Vaccines)

Vaccines work to prime your immune system against future “attacks” by a particular disease. When a pathogen enters your body, your immune system generates antibodies to try to fight it off…Vaccines work because of this function of the immune system. They’re made from a killed, weakened, or partial version of a pathogen. When you get a vaccine, whatever version of the pathogen it contains isn’t strong or plentiful enough to make you sick, but it’s enough for your immune system to generate antibodies against it. As a result, you gain future immunity against the disease without having gotten sick: if you’re exposed to the pathogen again, your immune system will recognize it and be able to fight it off.

 

What is herd immunity? (Vaccines Today)

Herd immunity is a form of immunity that occurs when the vaccination of a significant portion of a population (or herd) provides a measure of protection for individuals who have not developed immunity. It arises when a high percentage of the population is protected through vaccination against a virus or bacteria, making it difficult for a disease to spread because there are so few susceptible people left to infect…These include children who are too young to be vaccinated, people with immune system problems, and those who are too ill to receive vaccines (such as some cancer patients)…The proportion of the population which must be immunized in order to achieve herd immunity varies for each disease but the underlying idea is simple: once enough people are protected, they help to protect vulnerable members of their communities by reducing the spread of the disease. However, when immunization rates fall, herd immunity can break down leading to an increase in the number of new cases.

 

Do children get too many shots? (from CHOP Vaccine Education Center)

Newborns commonly manage many challenges to their immune systems at the same time. Because some children could receive as many as 25 shots by the time they are 2 years old and as many as five shots in a single visit to the doctor, many parents wonder whether it is safe to give children so many vaccines…From the moment of birth, thousands of different bacteria start to live on the surface of the skin and intestines. By quickly making immune responses to these bacteria, babies keep them from invading the bloodstream and causing serious diseases. In fact, babies are capable of responding to millions of different viruses and bacteria because they have billions of immunologic cells circulating in the bodies. Therefore, vaccines given in the first two years of life are a raindrop in the ocean of what an infant’s immune system successfully encounters and manages every day.

 

What do vaccine preventable illnesses look like? (Immunization Action Coalition)

Most people in the US have never seen a case of polio or diphtheria. This photo gallery may help remind us why immunizing against these diseases is so important.

 

How can we lessen the pain of getting shots? (CHOP Vaccine Education Center)

(This is important for scaredy-cats like me.)

For most children, getting vaccines simply means the pain of getting a shot. Although pain is to some extent unavoidable, there are a few things worth trying in older children.

Blowing away the pain

One technique is called "blowing away the pain." Just before the shot, take out a feather, tell the child to take a deep breath, closing his eyes if he wants, and then to blow out...blow, and blow on the feather until you or the nurse tells them to stop. The distraction of blowing on the feather has been shown in one study to lessen the amount of pain perceived by the child.

Cold versus pain

Another idea is to swab a small amount of alcohol on the forearm of the opposite arm that will receive the vaccine. The child then blows on the alcohol before and during the shot. Our bodies don't feel cold and pain in the same place at the same time. Rather, when confronted with the choice of cold or pain, the body picks cold. So the feeling of pain from the shot will be reduced.

EMLA cream

For older children with severe phobias to needles, you might consider the use of an EMLA patch applied to the skin. The limitation of this technique is that the patch (which helps to numb the area) must be applied at least one hour before the injection. Also, EMLA cream works to decrease pain caused by injections under the skin (called subcutaneous injections), but doesn't lessen the pain of vaccines given in the muscles.

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: 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

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.

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