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: Building collapse, Oklahoma tornadoes redux, Hepatitis A, cavities, vacation

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

The storefront of the Salvation Army thrift store crushed by the falling building. I took this photo on Thursday after the collapse and before the storefront was taken down.

Mid-morning on Wednesday, a building being demolished at 22nd and Market Streets in Philadelphia collapsed onto a Salvation Army thrift store, killing 6 and injuring 13 people. One resident was worried about unsafe demolition practices and lodged a formal complaint with the city, but the inspection deemed the conditions safe. One lawsuit has already been filed, and the city has put in place new demolition standards. There is some question about whether or not the contractor, Griffin Campbell, violated federal safety standards and was otherwise negligent. This story will continue to unfold, educating all Philadelphians about the importance of hiring knowledgeable and safe construction companies.

 

Oklahoma slammed by more tornadoes

At least 10 tornadoes touched down in Oklahoma last Friday, one of which was nearly 2 miles wide and is reported to have had winds near 300 miles per hour. Most upsetting is that because of a combination of rush hour traffic and people leaving their homes to avoid the tornadoes, many people were in their cars at the time; at least 8 people killed during the storm were in their vehicles. Despite the standard instruction to stay indoors (and get underground if possible) during a tornado warning, perhaps residual fear from the Moore tornado caused panic. Interestingly, one of the major activities of relief workers has been administering tetanus vaccines. Because tetanus bacteria live in soil and enter the body through puncture wounds, cleaning up after a disaster is a likely way to become exposed.

 

Berry mix causes a Hepatitis A outbreak

A frozen organic berry-pomegranate mix is the latest food borne illness culprit, sickening 61 people in seven states as of June 5. Hepatitis A is spread by contaminated food, which in the US generally occurs due to improper hand hygiene. The virus is genetically linked to other Hepatitis A viruses found in the Middle East, and the berry mix included pomegranate sees from Turkey. A unintended consequence of a global food market may be sharing food borne illnesses internationally.  The CDC has detailed information about which lots are being recalled—if you have a bag of Townsend Farms frozen berries in your freezer, please make sure it’s safe to eat.

 

Chances are, you need a cavity filled

Approximately 66% of people worldwide have serious untreated dental problems. Globally, the major oral health problems are shifting from tooth loss to severe gum disease and unfilled cavities. This means that people are keeping their teeth longer, but the teeth they’re keeping aren’t too healthy. Considering anti-fluoride rhetoric abounds, I’m not surprised. As most of Europe refuses to fluoridate and 780 million people worldwide lack access to safe water, basic oral health principles are often ignored.

 

Going on vacation is good for you...if you turn off your phone!

This infographic from Expedia UK explains how technology changes your thought patterns and causes stress, while touts the restorative power of vacations free from smartphones, laptops, and tablets. Of course, Expedia wants you to travel for their own reasons, but this might be the push we all need to put down the phone, pick up the sunscreen, and enjoy the summer!

Holidays_Unplugged_Expedia_Infographic

Why Won't Portland Fluoridate?

Portland, Oregon votes tomorrow on whether or not to fluoridate its water supply. I’m fascinated by the ways people adopt non-mainstream beliefs, so I jumped right into the anti-fluoridation activism vortex and found a culture motivated by fear and a desire for purity. I started with the Fluoride Action Network (FAN). My first thought: these people have money. The site is nicely designed and full of videos so the information is accessible to all. FAN focuses on the idea of “mass medication,” arguing that adding fluoride to the public water supply constitutes forcing drugs on unwilling people. According to FAN, people with kidney disease are at particular risk for fluoride toxicity.   They say, “it is unethical to compromise the health of some members in a population to obtain a purported benefit for another—particularly in the absence of these vulnerable members’ knowing consent.” FAN interprets fluoridation as an attack on personal liberty, a medical harm, and an informed consent issue. They allude to a government conspiracy to medicate and dull the intelligence of the public through fluoride.

Then I found Clean Water Portland, a group dedicated to keeping fluoride out of the city’s water supply. The first reason Clean Water Portland gives for voting no tomorrow is that “Industrial byproducts don’t belong in our water.” The chemical in question is fluorosilicic acid (FSA), a waste product from fertilizer manufacturing. Associating water and fertilizer is a great way to increase skepticism. Just the phrase “industrial byproducts” seems sinister and contaminated.

Clean Water Portland also invokes parents’ anxiety about harming their children by citing the conclusions of a Harvard meta-analysis of Chinese studies on the relationship between fluoride and IQ. The studies found an approximately 7 point drop in IQ when children lived in communities with fluoridated water. The researchers in the Harvard study note that this is a preliminary analysis and that there may be other issues contributing to the IQ drop.

Clean Water Portland frames the link between fluoridated water and IQ by asserting that “in a large population such as Portland, a shift of 5 IQ points would cut the number of geniuses in half and double the number of mentally handicapped.” Whoa! A vote for fluoridation is a vote for robbing your child of genius status. How could you? This shows Clean Water Portland’s inclination toward using parents’ natural desire to protect their children as a means to maintain the “purity” of Portland’s water.

Finally, I arrived at the Facebook page of Fluoride Free Portland. It has 415 likes, and appears to be a somewhat active community of Portlanders sharing links and encouraging people to promote the anti-fluoridation message. “Clean” and “natural” are their most important buzzwords. The posts show the true fear and disgust some Portlanders have for fluoride. The page is littered with photos of FSA tanks labeled “corrosive” and “caution.” Political cartoons, quotations placed over images of pristine lakes, and photos of kids holding anti-fluoride signs adorn the page. Supporters call for their perspective to be included on the Portland Water Board website but get their information about the dangers of fluoride from unreliable sources.

Like other fringe health activist groups—I’m looking at you, anti-vaxxers—the anti-fluoride coalition exists in a world where there is a pure, clean version of life that is endangered by deceptive medicine and industry. While I believe we must have a healthy amount of skepticism, particularly regarding the motivations of corporations, the anti-fluoride groups seem to have abandoned reason. They subvert their own cause by their radical opposition. I think there are plenty of people who would be willing to have a conversation about informed consent and the potential health effects fluoride can have on vulnerable populations. The alarmism and guilt used by these groups makes the rest of us tune out their potentially valuable contributions to the conversation.

Whether Portland starts fluoridating its water is up to the voters. But we should keep an eye on the anti-fluoride movement. Anti-vaccine groups were not taken seriously at first, and now we have outbreaks of pertussis and measles. With the easy communication afforded by the Internet, anti-fluoride could become the next big health movement, and our teeth will suffer.