STEM research & Obama's budget proposal

STEM research and Obama 2016 budget proposalYesterday, I wrote about new data showing that medical research funding has not increased significantly since 2004. Because of the ever-rising cost of research, flat funding levels are worrisome--because of this funding plateau, we may not have the advanced treatments that could save or improve lives available to us as our population ages. Moreover, the United States is on its way to being surpassed in innovation by other countries funding research more vigorously. The Pew Research Center for Internet, Science, and Techonology released a report late last week examining the beliefs the public and scientists hold about STEM (science, technology, engineering, and medicine) research. Using representative samples of the public and of members of the American Association for the Advancement of Science, Pew delved into the nitty-gritty of individuals’ attitudes about science and its role in society. Especially for public funding, these views are important to consider because government funding options are influenced by voters and the political environment. (The report is rich and full of fascinating statistics, most of which I won’t be able to address here, so I recommend reading it in full at your leisure.)

Public perception of research funding

Just over 70% of Americans believe that government investment in engineering, technology, and basic science research will pay off eventually. About one-quarter say that the outcomes are not worth the investment. However, only 61% of the public supports government investment in STEM research. Over one-third have faith that private investment alone will be enough to progress STEM.

There seems to be little difference between Republicans (and right-leaning independents) and Democrats (and left-leaning independents) in beliefs about the importance of STEM research. Younger people tend to value investing in research more than Americans over age 65.

Scientists’ perception of research funding

About half of scientists surveyed believe that this is a good time for STEM, a notable decrease from 76% in 2009. Scientists are slightly more positive about their own fields, however, with 62% saying that now is a good time for their specialty.

The negative perceptions may be influenced by attitudes surrounding the funding process. More than eight out of ten scientists assert that obtaining federal research dollars is more difficult today than it was in 2009. Nearly half report that getting funding from industry and foundations is also more difficult. And scientists are in nearly total agreement (88%) that lack of funding is a serious problem for the ability to conduct high quality research.

Obama’s budget proposal for 2016

If most Americans believe that funneling money into STEM research is an important investment, why do most scientists feel that federal funding is difficult to obtain? President Obama released his budget proposal--let’s see what it has to say about funding research.

This table highlights just a few key areas relevant to STEM research funding and compares their proposed funding to the funding of other, unrelated program areas in the budget. Rows with red text represent STEM research funding.

Funding Area Proposed budget allocation
Special education $12.5 billion
Science and research laboratories $12.8 billion
NASA $18.1 billion
Health research and food safety $37.5 billion
Veterans health care $66.7 billion
Medicare $589.7 billion
National defense (including personnel, operations, equipment, and supplies) $615.5 billion
Social Security $944.3 billion

STEM research is funded at a much lower rate than the budget behemoths Medicare, Defense, and Social Security. One could argue that if we didn’t need or want to spend so much money on these areas, we would be able to fund more research. However, in the case of Social Security and Medicare, the United States has made a commitment to its citizens to provide health care for selected populations and financial support to those who have earned it. These costs are somewhat non-negotiable.

Political cartoon Obama budget

Whether these funding levels are sufficient for STEM research is not something on which I can meaningfully comment. But if researchers feel like they aren’t being funded well enough, and the American public values STEM investment, I have to wonder whether the United States is providing funding on the levels that the American public would prefer.

Without developing new technologies and advancing our understanding of medical science, we will soon be less innovative than other countries and will not produce the health breakthroughs we so desperately need. If we aren’t properly funding this research, we are the ones who will suffer.


Note: My views do not represent the views of any person or any entity associated with the National Cancer Institute, the National Institutes of Health, the United States government, or anything else. These ramblings are mine and mine alone.

Action Phase Podcast Episode 18

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

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

As always, you can stream it here, too.

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

Action Phase Podcast Episode 5

carie_contact_imageKaren Chenoweth runs CARIE Line, a call-in advocacy hotline at the Center for Advocacy for the Rights and Interests of the Elderly (CARIE). We discuss the vulnerability of asking for help, empowering seniors to advocate for themselves, and navigating Medicare. To download the episode, go here and save this page as an mp3. Then you can listen to it in the music player of your choice. Or, simplify your life and listen to it here!

https://ia601006.us.archive.org/21/items/5-KarenChenoweth-ActionPhasePodcast/5-KarenChenoweth-ActionPhasePodcast.mp3

 

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: 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: Transplant ethics, Planned Parenthood, Hepatitis C, immigrants, Google

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Child in dire need of lung transplants starts a debate on ethics

Ten year old Sarah Murnaghan has been waiting for lung transplants for 18 months due to her cystic fibrosis and related lung failure. Doctors say she is not likely to live past the weekend without a transplant, so the severity of her illness placed her at the top of the pediatric list. However, Sarah is on very bottom of the adult list, meaning that any adults in need of lungs will be offered the organs before her, regardless of whether or not their need is as pressing as hers. Since 2005, organs are supposed to be distributed based on need, but that rule applies only to patients over age 12. Sarah’s parents have petitioned Kathleen Sebelius to change the rules to allow pediatric transplants of adult organs based not on age but on medical necessity. Hopefully, Sarah’s dire situation will ignite a conversation on organ donation and the ethics of treating children as if they are adults. (Okay, so this is six sentences but I think it’s worth it.)

Planned Parenthood case will not be heard by the Supreme Court

Indiana tried—and failed—to refuse Medicaid funding to Planned Parenthood. The Supreme Court refused to consider an appeal on behalf of the state to allow Indiana to withhold money from Planned Parenthood because it offers abortion services, even though federal law prohibits Medicaid dollars from being spent on abortion. Hopefully, this development will stall other attacks on low-income women’s right to choose their health care providers. However, the wily anti-choice movement is probably cooking up other ways to deny services to women—Indiana already has a law in place requiring facilities that offer non-surgical abortions to meet the same standards as facilities that perform surgical abortions. The Supreme Court’s choice not to hear the appeal is important, but as usual, fighting against restrictions on this legal medical procedure is a constant battle.

Is the “war on drugs” to blame for millions of Hepatitis C cases?

The Global Commission on Drug Policy called for an end on “the war on drugs,” in part because criminalization of injection drugs has lead to a quiet epidemic of Hepatitis C. The Commission estimates that of the 16 million injecting drug users (IDUs), 10 million are living with Hepatitis C; China, the Russian Federation, and the USA have the highest rates of Hepatitis C among IDUs. Arguing that harsh drug laws dissuade IDUs away from public health efforts such as needle exchanges, the Commission recommends reforming existing drug laws and focusing on health rather than incarceration and forced treatment. While I doubt many countries will decriminalize heroin and other injectable drugs, I’m pleased the Commission is drawing attention to the broader health concerns of IDUs. Regardless of drug use or dependence, a person has a right to access public health initiatives without fearing arrest and imprisonment.

Immigrants subsidize Medicare

A study published in June’s Health Affairs showed that in 2009 naturalized and non-citizen immigrants contributed $33 billion to the Medicare trust fund and received $19 billion in expenditures, creating a surplus of $14 billion. American-born citizens, on the other hand, contributed $192 billion and used $223 billion, creating a deficit of $31 billion. There are a few reasons why immigrants’ contributions lead to surplus: there are 6.5 working immigrants for every one retired immigrant and the cost of care for immigrants is less than the cost of care for the American-born. In a time when immigration and a path to citizenship are pressing issues, focusing on the positive contributions of new residents and citizens can only help decision makers to make choices to encourage new immigration. This study reminds us that immigration is crucial to the success and longevity of the United States, and treating all immigrants with respect and dignity is non-negotiable.

Google nutrition facts and get a clear answer

This coming week, Google is launching a new search feature: type a question about nutrition facts, and it provide you with a precise answer. The screen shots look much like the results when Googling conversions from cups to liters or the definition of a word. The feature is rolling out in the United States over the next ten days, but it shown up yet in Philadelphia so I haven’t been able to give it a try myself. Having the ability to ask direct questions about the nutrient content of food helps demystify some of the complicated information about healthy eating. This is health communication done right!

If you're looking to change up your workout routine this weekend, may I suggest Prancercise?

http://www.youtube.com/watch?v=o-50GjySwew