[Gallup Poll] Two in Three Uninsured Americans Plan to Buy Insurance

From the 30 September 2013 Gallup Poll 

 

Less than half say they will use the state or federal exchanges

by Frank Newport and Kyley McGeeney

PRINCETON, NJ — Nearly two in three uninsured Americans say they will get insurance by Jan. 1, 2014, rather than pay a fine as mandated by the Affordable Care Act (ACA), while one in four say they will pay the fine. Less than half of the uninsured say they plan on getting health insurance specifically through a federal or state health insurance exchange.

Gallup asked a nationally representative sample of 5,099 Americans between Sept. 17-26 about their awareness of several pending ACA provisions and their anticipated healthcare choices in the months ahead. The ACA requires that most Americans get insurance by Jan. 1, 2014, or pay a fine, and advocates of the ACA are urging the uninsured to take advantage of new federal and state health exchanges to obtain health insurance.

Overall, 83% of Americans are aware that most Americans will be required to have health insurance or pay a fine beginning January 2014. This awareness drops to 68% among those who are uninsured, and is at 69% among the vital group of 18- to 29-year-olds who are the most likely of any age group to be uninsured.

 

Although the uninsured’s awareness of the individual mandate component of the ACA remains below the national average, it is up by 12 percentage points from a June 20-24 survey, when 56% of uninsured Americans said they were aware of it.

Familiarity With Exchanges Is Low

One of the primary components of the ACA is the creation of government-run health insurance exchanges. These exchanges are essentially websites in each state that provide a central clearinghouse where individuals can review and then purchase health insurance. Consumers can also find out if they qualify, based on their income, for government subsidies of their health insurance premiums. These exchanges are a major part of the ACA and have been heavily featured in ACA promotion.

At this juncture, relatively few Americans — 37% — are familiar with the health exchanges, even though these insurance marketplaces officially open for business on Oct. 1. Familiarity with the exchanges is even lower among the crucial group of Americans who do not have health insurance. In fact, half of the uninsured say they are “not at all familiar” with the exchanges.

And young adults aged 18 to 29 are also less familiar with the exchanges than those who are older.

This low level of familiarity with the exchanges may help explain the finding that less than half of the uninsured say they will get health insurance for 2014 specifically through a state or federal health insurance exchange.

Overall, 66% of the uninsured who plan on getting health insurance rather than pay a fine say they will get insurance through an exchange, leaving the rest who apparently are unsure about how they will get their insurance, or who will seek insurance perhaps through their employer, through Medicare or Medicaid, or buy a plan on their own outside of an exchange.

Implications

Although less than half of the uninsured say they plan on buying health insurance for 2014 through a federal or state exchange, this percentage may well rise in the months ahead for two reasons. First, almost-two thirds of the uninsured say they are more likely to get health insurance rather than pay a fine if they don’t, indicating a demand for insurance that will need to be fulfilled in some fashion over the next three months. Second, current familiarity with the health exchanges among the uninsured is low, and as awareness increases, willingness to use the exchanges may rise as well.

Survey Methods
Results for this Gallup poll are based on telephone interviews conducted Sept. 17-26, 2013, on the Gallup Daily tracking survey, with a random sample of 5,099 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia.

For results based on the total sample of national adults, one can say with 95% confidence that the margin of sampling error is ±2 percentage points.

For results based on the total sample of 4,427 adults with health insurance, one can say with 95% confidence that the margin of sampling error is ±2 percentage points.]

For results based on the total sample of 651 adults without health insurance, one can say with 95% confidence that the margin of sampling error is ±5 percentage points.]

Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample of national adults includes a minimum quota of 50% cell phone respondents and 50% landline respondents, with additional minimum quotas by region. Landline telephone numbers are chosen at random among listed telephone numbers. Cell phones numbers are selected using random digit dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.

Samples are weighted to correct for unequal selection probability, nonresponse, and double coverage of landline and cell users in the two sampling frames. They are also weighted to match the national demographics of gender, age, race, Hispanic ethnicity, education, region, population density, and phone status (cellphone only/landline only/both, cellphone mostly, and having an unlisted landline number). Demographic weighting targets are based on the March 2012 Current Population Survey figures for the aged 18 and older U.S. population. Phone status targets are based on the July-December 2011 National Health Interview Survey. Population density targets are based on the 2010 census. All reported margins of sampling error include the computed design effects for weighting.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

For more details on Gallup’s polling methodology, visit www.gallup.com.

English: President Barack Obama’s signature on the health insurance reform bill at the White House, March 23, 2010. The President signed the bill with 22 different pens. (Photo credit: Wikipedia)

 

Related articles

• Poll: 71 Percent of Uninsured ‘Unfamiliar’ with Federal Health Insurance Exchange (rinf.com)
• New Gallup Poll Reveals Americans Would Rather Pay Fine Than Enroll In ObamaCare (downtrend.com)
• Gallup: At Least 25% of Uninsured Americans Say They Will Stay That Way (joemiller.us)
• Confused about Obamacare > Americans still not familiar with health-insurance exchanges. (newsreview.com)
• Most Americans, Including those Without Health Insurance, are Unprepared to use the New Health Insurance Exchanges (sacbee.com)
• 25% plan to not buy insurance, pay fine… (breitbart.com)
• The People Who Need Obamacare Most Don’t Know How To Get It (huffingtonpost.com)
• Gallup: Number of Americans Who Will Refuse To Join Obamacare And Instead Pay Individual Mandate Fine Jumps To 34%, Up 9 Points Since Last Month… (libertycrier.com)

 

[Press Release] Prescription Drug Abuse: Strategies to Stop the Epidemic

From the 7 October 2013 press release at Trust for America’s Health – Preventing Epidemics. Protecting People.

Prescription Drug Abuse: More than Half of States Score 6 or Less out of 10 on New Policy Report Card, While Drug Overdose Deaths Doubled in 29 States in the Last Decade

Washington, D.C. October 7, 2013 – A new report, Prescription Drug Abuse: Strategies to Stop the Epidemic, finds that 28 states and Washington, D.C. scored six or less out of 10 possible indicators of promising strategies to help curb prescription drug abuse. Two states, New Mexico and Vermont, received the highest score receiving all 10 possible indicators, while South Dakota scored the lowest with two out of 10.

According to the report by the Trust for America’s Health (TFAH), prescription drug abuse has quickly become a top public health concern, as the number of drug overdose deaths – a majority of which are from prescription drugs – doubled in 29 states since 1999. The rates quadrupled in four of these states and tripled in 10 more of these states.

Prescription drug related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C. Misuse and abuse of prescription painkillers alone costs the country an estimated $53.4 billion each year in lost productivity, medical costs and criminal justice costs. Currently only one in 10 Americans with a substance abuse disorder receives treatment.

“Prescription drugs can be a miracle for many, but misuse can have dire consequences. The rapid rise of abuse requires nothing short of a full-scale response – starting with prevention and education all the way through to expanding and modernizing treatment,” said Jeffrey Levi, PhD, executive director of TFAH. “There are many promising signs that we can turn this around – but it requires urgent action.”

In the Prescription Drug Abuse report, TFAH – in consultation with a number of public health, clinical, injury prevention, law enforcement and community organization experts – reviewed a range of national recommendations and examined a set of 10 indicators of strategies being used in states to help curb the epidemic. There are indications that some of these efforts and strategies may be having a positive impact — the number of Americans abusing prescription drugs decreased from 7 million in 2010 to 6.1 in 2011, according to the National Survey on Drug Use and Health.

Some key findings from the report include:

• Appalachia and Southwest Have the Highest Overdose Death Rates: West Virginia had the highest number of drug overdose deaths, at 28.9 per every 100,000 people – a 605 percent increase from 1999, when the rate was only 4.1 per every 100,000. North Dakota had the lowest rate at 3.4 per every 100,000 people. Rates are lowest in the Midwestern states.
• Rescue Drug Laws: Just over one-third of states (17 and Washington, D.C.) have a law in place to expand access to, and use of naloxone – a prescription drug that can be effective in counteracting an overdose – by lay administrators.
• Good Samaritan Laws: Just over one-third of states (17 and Washington, D.C.) have laws in place to provide a degree of immunity from criminal charges or mitigation of sentencing for individuals seeking to help themselves or others experiencing an overdose.
• Medical Provider Education Laws: Fewer than half of states (22) have laws that require or recommend education for doctors and other healthcare providers who prescribe prescription pain medication.
• Support for Substance Abuse Treatment: Nearly half of states (24 and Washington, D.C.) are participating in Medicaid Expansion – which helps expand coverage of substance abuse services and treatment.
• ID Requirement: 32 states have a law requiring or permitting a pharmacist to require an ID prior to dispensing a controlled substance.
• Prescription Drug Monitoring Programs: While nearly every state (49) has a Prescription Drug Monitoring Program (PDMP) to help identify “doctor shoppers,” problem prescribers and individuals in need of treatment, these programs vary dramatically in funding, use and capabilities. For instance, only 16 states require medical providers to use PMDPs.

“Fifty Americans die a day from prescription drug overdoses, and more than 6 million suffer from prescription drug abuse disorders. This is a very real epidemic – and warrants a strong public health response,” said Andrea Gielen, ScD, Director of the Johns Hopkins Center for Injury Research and Policy. “We must use the best lessons we know from other public health and injury prevention success stories to work in partnership with clinical care, law enforcement, the business community, community-based organizations, and other partners to work together to curb this crisis.”

Key recommendations from the report include:

• Educate the public to understand the risks of prescription drug use to avoid misuse in the first place;
• Ensure responsible prescribing practices, including increasing education of healthcare providers and prescribers to better understand how medications can be misused and to identify patients in need of treatment;
• Increase understanding about safe storage of medication and proper disposal of unused medications, such as through “take back” programs;
• Make sure patients do receive the pain and other medications they need, and that patients have access to safe and effective drugs;
• Improve, modernize and fully-fund Prescription Drug Monitoring Programs, so they are real-time, interstate and incorporated into Electronic Health Records, to quickly identify patients in need of treatment and connect them with appropriate care and identify doctor shoppers and problem prescribers;
• Make rescue medications more widely available by increasing access for at-risk individuals to naloxone and provide immunity for individuals and others seeking help; and
• Expand access to and availability of effective treatment options as a key component of any strategy to combat prescription drug abuse.

According to the National Center for Injury Prevention and Control (NCIPC), nationally, sales of prescription painkillers per capita have quadrupled since 1999 – and the number of fatal poisonings due to prescription painkillers has also quadrupled. Enough prescription painkillers were prescribed in 2010 to medicate every American adult continually for a month.

“The release of the prescription drug abuse report by the Trust for America’s Health represents a significant step forward in elevating public awareness of the state of prescription drug abuse in the US”, according to Ginny Ehrlich, CEO of Clinton Health Matters Initiative (CHMI). “We are proud that the Trust has completed this important research as part of its CHMI Commitment to Action and congratulate the Trust on continuing to advocate for innovation and action towards addressing this public epidemic.”

The report was supported by a grant from the Robert Wood Johnson Foundation.

Score Summary: A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org and RWJF’s web site athttp://www.rwjf.org/RxReport. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. Data for the indicators were drawn from a number of sources, including the National Alliance for Model State Drug Laws, NCIPC, Centers for Disease Control and Prevention, the Alliance of States with Prescription Drug Monitoring Programs, the National Conference of State Legislators, the Network for Public Health Law, the Kaiser Family Foundation and a review of current state legislation and regulations by TFAH. In August 2013, state health departments were provided with opportunity to review and revise their information.

10 out of 10: New Mexico and Vermont

9 out of 10: Kentucky, Massachusetts, New York and Washington

8 out of 10: California, Colorado, Connecticut, Delaware, Illinois, Minnesota, North Carolina, Oklahoma, Oregon, Rhode Island and West Virginia

7 out of 10: Florida, Nevada, New Jersey, Tennessee and Virginia

6 out of 10: Arkansas, District of Columbia, Georgia, Hawaii, Iowa, Louisiana, Maryland, Michigan, North Dakota, Ohio, Texas and Utah

5 out of 10: Alaska, Idaho, Indiana, Maine, Mississippi, Montana, New Hampshire and South Carolina

4 out of 10: Alabama, Arizona, Kansas, Pennsylvania, Wisconsin and Wyoming

3 out of 10: Missouri and Nebraska

2 out of 10: South Dakota

STATE-BY-STATE DRUG OVERDOSE MORTALITY RANKINGS

Note: Rates include total drug overdose mortality rates, the majority of which are from prescription drugs. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. Rankings are based on data from CDC’s National Center for Health Statistics, WONDER Online Database, 2010. The numbers are based on the number of people per 100,000.

1. West Virginia**** (28.9); 2. New Mexico (23.8); 3. Kentucky**** (23.6); 4. Nevada (20.7); 5. Oklahoma*** (19.4); 6. Arizona (17.5); 7. Missouri*** (17); 8. (tie) Tennessee** and Utah (16.9); 10. Delaware** (16.6); 11. Florida** (16.4); 12. Ohio*** (16.1); 13. Rhode Island** (15.5); 14. Pennsylvania (15.3); 15. Wyoming*** (15); 16. South Carolina*** (14.6); 17. Indiana**** (14.4); 18. Michigan*** (13.9); 19. Louisiana*** (13.2); 20. Washington (13.1); 21. (tie) District of Columbia and Montana** and Oregon** (12.9); 24. Colorado (12.7); 25. Arkansas** (12.5); 26. (tie) Alabama*** and Idaho** and New Hampshire** (11.8); 29. Alaska (11.6); 30. (tie) Mississippi***and North Carolina** (11.4); 32. (tie) Maryland and Massachusetts (11); 34. (tie) Hawaii and Wisconsin** (10.9); 36. Georgia*** (10.7); 37. California (10.6); 38. Maine (10.4); 39. Connecticut (10.1); 40. Illinois (10); 41. New Jersey (9.8); 42. Vermont** (9.7); 43. (tie) Kansas** and Texas (9.6); 45. Iowa**** (8.6); 46. New York (7.8); 47. Minnesota** (7.3); 48. Virginia (6.8); 49. Nebraska** (6.7); 50. South Dakota (6.3); 51. North Dakota (3.4).

** Drug Overdose Mortality Rates doubled from 1999 to 2010

*** Drug Overdose Mortality Rates tripled from 1999 to 2010

**** Drug Overdose Mortality Rates quadrupled from 1999 to 2010

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make diseaseprevention a national priority. For more information, visit www.healthyamericans.org.

 

Related articles

• Five more laws to help stop Maine’s prescription drug epidemic (bangordailynews.com)
• Report says states are failing to curb prescription drug abuse (wqad.com)
• Oklahoma ranks 5th in drug overdose, expert explains how to lower that rank (kfor.com)
• Prescription drug abuse in Pennsylvania (fox43.com)
• NSC report: only three states adequately addressing prescription drug abuse (sacbee.com)

 

More than 900 Champions for Coverage Help Americans understand the Health Insurance Marketplace

Logo of the United States Department of Health and Human Services. The symbol represents the American People sheltered in the wing of the American Eagle, suggesting the Department’s concern and responsibility for the welfare of the people. The logo is the department’s main visual identifier; the seal is now used for mainly legal purposes. The color can be either black or reflex blue. More information here and here. (Photo credit: Wikipedia)

 

From the 30 September US Health and Human Services press release

 

Health and Human Services (HHS) Secretary Kathleen Sebelius today recognized more than 900 Champions for Coverage nationwide. These organizations and businesses have volunteered to help Americans without affordable insurance learn more and get coverage through the Health Insurance Marketplace, which opens for business tomorrow and will give consumers a whole new way to shop and purchase affordable, high quality health coverage.

“A network of volunteers on the ground in every state – health care providers, business leaders, faith leaders, community groups, advocates, and local elected officials – can help spread the word and encourage their neighbors to get enrolled,” said Secretary Sebelius.

Champions for Coverage include national and local businesses and organizations – bloggers, community health centers, hospitals, communities of faith, and civic organizations. They will use publicly available materials from the Centers for Medicare & Medicaid Services (CMS) – both digital and in print – to help members of their communities understand their new options through the Marketplace. There are many ways these organizations are helping, including providing information about the law in their office, hosting education events, or posting information on their website.

“We are both excited and thankful to have such a wide variety of businesses and organizations that want to get involved and help us spread the message about these new opportunities for people to access quality, affordable health insurance with open enrollment beginning tomorrow,” said CMS Administrator Marilyn Tavenner. “Coverage for those who enroll by December 15 will begin on January 1, 2014.”

The growing list of organizations includes:

• American Academy of Family Physicians
• American Nurses Association
• Bon Secours Health System
• Huntington’s Disease Society of America
• Men’s Health Network
• National Women’s Law Center
• Lutheran Services in America
• Thrifty White Pharmacy
• YWCA USA

In all states, there will be people trained and certified to help you understand your health coverage options and enroll in a plan. They will be known by different names, depending on who provides the service and where they are located.  Using the “Find Local Help” tool, you can find information about assisters like Navigators, application assisters, certified application counselors, and government agencies.

Consumers can also find help at local community health centers and libraries. The Marketplace consumer call center is open 24 hours a day, 7 days a week at 1-800-318-2596 (hearing impaired callers using TTY/TDD can dial 1-855-889-4325), with translation services available in 150 languages. Visit HealthCare.gov or CuidadodeSalud.gov to learn more or participate in a live chat with a trained customer service representative.

Enrollment in the Health Insurance Marketplace continues for six months. Consumers can apply and choose a plan until the end of March, with coverage beginning as early as Jan. 1, 2014.

To see the list of Champions for Coverage visit: http://marketplace.cms.gov/help-us/champion.html.

To join the growing list of Champions for Coverage, visit: http://marketplace.cms.gov/help-us/champion-apply.html.

 

 

Related articles

• Updates re: Arizona Health Insurance Marketplace (blogforarizona.com)
• Iowa insurance enrollments begin trickling in (miamiherald.com)
• 4 steps to getting covered in the Health Insurance Marketplace (healthcare.gov)
• Announcing My Online Health Insurance Marketplace Resource Center (huffingtonpost.com)

 

NLM Director’s Comments Transcript Caregiver Assistance & Better Communication: 09/30/2013

From the 30 September 2013 transcript by Robert Logan, Director of the US National Library of Medicine

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I’m Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what’s new this week in MedlinePlus.

The extent of caregivers’ assistance to patients — and suggested strategies for physicians to assist caregivers — are detailed in an interesting commentary recently published in the Journal of the American Medical Association.

The commentary’s author (who is a professor at Harvard Medical School) explains about 42 million Americans are caregivers and they assist patients for an average of 20 hours a week. Muriel Gillick M.D. reports the majority of caregivers are middle-aged women caring for aging parents.

Dr. Gillick notes caregivers often assist patients with daily living activities, such as shopping, cooking, bathing, and dressing. However, Dr. Gillick writes (and we quote) “Nearly half of all caregivers report responsibility for complex medical tasks that often are the province of a professional nurse or trained technician’ (end of quote).

Dr. Gillick finds caregivers report they are responsible for clinical activities including: diet adherence, wound care, treating pressure ulcers, providing medications and intravenous fluids, as well as operating medical equipment.

Dr. Gillick notes the recipients of caregiving are likely to be seniors in the last stages of their life. In the year before death, Dr. Gillick explains only 17 percent of Americans are without a disability while about 22 percent have a persistent severe disability. She reports the largest groups of caregiver-dependent adults include seniors who are frail or have advanced dementia. Dr. Gillick notes about 28 percent of Americans are frail and 14 percent have advanced dementia in their last year of life.

Dr. Gillick adds patients who are frail or have dementia often cannot participate in the management of their care, which necessitates a caregiver’s involvement. Dr. Gillick writes (and we quote): ‘If (end of life) medical care is to be patient centered, reflecting the values (patients) no longer have the cognitive capacity to articulate, clinicians must rely on surrogates to guide them. Yet, few programs caring for patients with dementia (or frailty) regularly incorporate caregivers in every phase of care’ (end of quote).

To improve assistance to caregivers, Dr. Gillick suggests physicians need to better explain a patient’s underlying health condition as well as work with caregivers to prioritize a patient’s health care goals.

Dr. Gillick adds caregivers should be encouraged to provide input about a patient’s surroundings as well as more fully participate in health care planning in a partnership with attending physicians.

Dr. Gillick notes caregivers are especially helpful in creating a continuity of patient care within different settings. She writes (and we quote): ‘In the complex US health care system, in which patients are cared for in the home, the physician’s office, the hospital, and the skilled nursing facility, the most carefully thought-out plan of care will prove useless unless its details can be transmitted across sites’ (end of quote).

Dr. Gillick concludes physicians as well as health care organizations need to provide more educational support to help caregivers.

Meanwhile, MedlinePlus.gov’s caregivers health topic page provides comprehensive information about caregiving’s medical and emotional challenges. For example, a helpful website from the American Academy of Family Physicians (available in the ‘start here’ section) helps caregivers maintain their health and wellness.

A similar website that addresses overcoming caregiver burnout (from the American Heart Association) can be found in the ‘coping’ section of MedlinePlus.gov’s caregivers health topic page.

In addition, there are special sections loaded with tips to provide caregiving to seniors as well as women and children within MedlinePlus.gov’s caregivers health topic page.

MedlinePlus.gov’s caregivers health topic page also provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about caregiving as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s caregivers health topic page, type ‘caregiver’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘caregivers (National Library of Medicine).’ MedlinePlus.gov additionally features health topic pages on Alzheimer’s caregivers, child care, and home care services.

It is helpful to see JAMA address some caregiving issues. Let’s hope other medical journals will help educate caregivers and encourage more physician-caregiver communication.

Before I go, this reminder… MedlinePlus.gov is authoritative. It’s free. We do not accept advertising …and is written to help you.

To find MedlinePlus.gov, just type in ‘MedlinePlus.gov’ in any web browser, such as Firefox, Safari, Netscape, Chrome or Explorer. To find Mobile MedlinePlus.gov, just type ‘Mobile MedlinePlus’ in the same web browsers.

We encourage you to use MedlinePlus and please recommend it to your friends. MedlinePlus is available in English and Spanish. Some medical information is available in 43 other languages.

Your comments about this or any of our podcasts are always welcome. We welcome suggestions about future topics too!

Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

That’s NLMDirector (one word) @nlm.nih.gov

A written transcript of recent podcasts is available by typing ‘Director’s comments’ in the search box on MedlinePlus.gov’s home page.

The National Library of Medicine is one of 27 institutes and centers within the National Institutes of Health. The National Institutes of Health is part of the U.S. Department of Health and Human Services.

A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.

 

 

Read entire transcript here

 

[Reblog] If Gun Violence is a Health Epidemic, Can We Quarantine It Like a Virus?

By MIKE R. WEISSER at the 20 October 2013 post at The HealthCare Blog

At least two-thirds of the perpetrators and victims of gun violence are males under the age of 30. What else do they have in common? They live in neighborhoods with high crime rates and low family incomes, they knew each other before the violence broke out, they usually aren’t employed.

But there’s another commonality these young people share which isn’t often mentioned in discussions about gun violence and crime.

It turns out that the part of the brain that controls processing of information about impulse, desire, goals, self-interest, rules and risk develops latest and probably isn’t fully formed until the mid-20s or later. And while adolescents and young men understand the concepts of ‘good’ versus ‘bad’ as well as older adults, they tend to let peer pressures rather than expected outcomes guide their behavior when choosing between risks and rewards.

Take this neurological-behavioral profile of males between ages 15 to 30 and stick a gun in their hands. The brain research clearly demonstrates that kids and young adults walking around with guns understand the risks involved. Whether it’s the NSSF’s new Project ChildSafe, the NRA’s Eddie Eagle or the grassroots gun safety programs that have expanded since Sandy Hook, nobody’s telling the kids something they don’t already know.

So what can we do to mitigate what President Obama calls this ‘epidemic’ of gun violence when the population most at risk consciously chooses to ignore the risk? I suggest that we look at what communities have done to protect themselves from other kinds of epidemics that threatened public health in the past.

And the most effective method has been to quarantine, or isolate, the area or population where the threat is most extreme. It worked in 14th-century Italy, according to Boccaccio in The Decameron. Why wouldn’t it work now?

Last month the city of Springfield, Mass., recorded its 12th gun homicide. If the killing rate continues, the city might hit 15 shooting fatalities this year, a number it actually surpassed in 2010. This gives the city a homicide rate of 10.2 per 100,000 residents, nearly three times the national rate. Virtually all the violence takes place in two specific neighborhoods bounded by Interstate 291 and State Route 83, and all the victims are between 15 and 30 years old.

This area of less than four square miles contains roughly 30,000 residents which means the homicide rate here is 45 per 100,000, more than 10 times the national rate. And the numbers haven’t really changed in the last four or five years. This isn’t an epidemic?

Don’t get me wrong. The word ‘quarantine’ evokes images of the Warsaw Ghetto and I’m not proposing anything like that. But think of police in this neighborhood behaving like public health workers; going door to door, asking people what they know about the existence of guns. There are no constitutional issues here; someone doesn’t want to answer, you go on to the next door.

Wouldn’t the city send people out to make contact with residents if, for example, the water supply suddenly couldn’t be used?

There are grassroots efforts all over the country to make neighborhoods safer from guns. But they usually consist of meetings in churches and other public places where people come together to voice and share their concerns. It’s not the folks who come out to the meeting that you need to reach; it’s the ones who remain at home.

I’m suggesting that we go block by block, again and again, to make sure that people know about the epidemic called gun violence. It’s spread by a virus called guns, and as long as young men between 15 and 30 believe they are immune to the risk of this virus, the epidemic will continue to spread.

This post originally appeared in The Huffington Post.

Related Posts

• After the Navy Yard Shooting: A Call to Action On Mental Illness
• Stop the Presses: A Disease Management Program Worked
• 7 Burning Questions on Marijuana Legalization
• Now Is Not the Time to Talk About Gun Control

 

Related Resources

• American Journal of Public Health Provides Open Access to Articles on Gun Violence, Veterans Health, and Suicide
  http://ajph.aphapublications.org/topic/gunviolence
  The American Journal of Public Health has compiled a collection of papers and other resources to help promote awareness and policy change surrounding gun violence, veterans health, and suicide.
• Household Safety: Preventing Injuries from Firearms (For Parents)(Nemours Foundation)
• Someone at School Has a Weapon. What Should I Do?(Nemours Foundation) Also available in Spanish
• Teen Suicide and Guns(American Academy of Pediatrics)
• Injury Free Coalition for Kids
• Safe Kids Worldwide
• Article: States take a public health approach to curb gun violence….
• Article: Gun violence: a public health problem.
• Article: No easy answers: emergency physicians engage in gun control debate.

Related articles

• If Gun Violence Is a Health Epidemic, Can We Quarantine It Like a Virus? (huffingtonpost.com)
• What Do We Do About Gun Violence? (mikethegunguy.com)
• Chicago Homicide + Gun Violence Epidemic (infodesign12.com)
• Obama: ‘Epidemic of gun violence’ tearing US apart (itv.com)
• Gary Slutkin: Let’s treat violence like a contagious disease (myteducation.wordpress.com)
• Largest Gun Study Ever: More Guns, More Murder (thinkprogress.org)

[Press Release} UCLA scientist uncovers biological clock able to measure age of most human tissues

From the 20 October press release via EurkAlert

Study finds women’s breast tissue ages faster than rest of body

		IMAGE: A newly discovered biological clock measures aging throughout the body. Click here for more information.

Everyone grows older, but scientists don’t really understand why. Now a UCLA study has uncovered a biological clock embedded in our genomes that may shed light on why our bodies age and how we can slow the process. Published in the Oct. 21 edition of Genome Biology, the findings could offer valuable insights into cancer and stem cell research.

While earlier clocks have been linked to saliva, hormones and telomeres, the new research is the first to identify an internal timepiece able to accurately gauge the age of diverse human organs, tissues and cell types. Unexpectedly, the clock also found that some parts of the anatomy, like a woman’s breast tissue, age faster than the rest of the body.

“To fight aging, we first need an objective way of measuring it. Pinpointing a set of biomarkers that keeps time throughout the body has been a four-year challenge,” explained Steve Horvath, a professor of human genetics at the David Geffen School of Medicine at UCLA and of biostatistics at the UCLA Fielding School of Public Health. “My goal in inventing this clock is to help scientists improve their understanding of what speeds up and slows down the human aging process.”

To create the clock, Horvath focused on methylation, a naturally occurring process that chemically alters DNA. Horvath sifted through 121 sets of data collected previously by researchers who had studied methylation in both healthy and cancerous human tissue.

Gleaning information from nearly 8,000 samples of 51 types of tissue and cells taken from throughout the body, Horvath charted how age affects DNA methylation levels from pre-birth through 101 years. To create the clock, he zeroed in on 353 markers that change with age and are present throughout the body.

Horvath tested the clock’s effectiveness by comparing a tissue’s biological age to its chronological age. When the clock repeatedly proved accurate, he was thrilled—and a little stunned.

		IMAGE: This is Steven Horvath, Ph.D., UCLA geneticist and biostatistician. Click here for more information.

“It’s surprising that one could develop a clock that reliably keeps time across the human anatomy,” he admitted. “My approach really compared apples and oranges, or in this case, very different parts of the body: the brain, heart, lungs, liver, kidney and cartilage.”

While most samples’ biological ages matched their chronological ages, others diverged significantly. For example, Horvath discovered that a woman’s breast tissue ages faster than the rest of her body.

“Healthy breast tissue is about two to three years older than the rest of a woman’s body,” said Horvath. “If a woman has breast cancer, the healthy tissue next to the tumor is an average of 12 years older than the rest of her body.”

The results may explain why breast cancer is the most common cancer in women. Given that the clock ranked tumor tissue an average of 36 years older than healthy tissue, it could also explain why age is a major risk factor for many cancers in both genders.

Horvath next looked at pluripotent stem cells, adult cells that have been reprogrammed to an embryonic stem cell–like state, enabling them to form any type of cell in the body and continue dividing indefinitely.

“My research shows that all stem cells are newborns,” he said. “More importantly, the process of transforming a person’s cells into pluripotent stem cells resets the cells’ clock to zero.”

In principle, the discovery proves that scientists can rewind the body’s biological clock and restore it to zero.

“The big question is whether the biological clock controls a process that leads to aging,” Horvath said. “If so, the clock will become an important biomarker for studying new therapeutic approaches to keeping us young.”

Finally, Horvath discovered that the clock’s rate speeds up or slows down depending on a person’s age.

“The clock’s ticking rate isn’t constant,” he explained. “It ticks much faster when we’re born and growing from children into teenagers, then slows to a constant rate when we reach 20.”

In an unexpected finding, the cells of children with progeria, a genetic disorder that causes premature aging, appeared normal and reflected their true chronological age.

UCLA has filed a provisional patent on Horvath’s clock. His next studies will examine whether stopping the body’s aging clock halts the aging process–or increases cancer risk. He’ll also explore whether a similar clock exists in mice.

 

 

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Flu Virus Wipes out Immune System’s First Responders to Establish Infection

From the 20 October 2013 article at Science Daily

Revealing influenza’s truly insidious nature, Whitehead Institute scientists have discovered that the virus is able to infect its host by first killing off the cells of the immune system that are actually best equipped to neutralize the virus.

Confronted with a harmful virus, the immune system works to generate cells capable of producing antibodies perfectly suited to bind and disarm the hostile invader. These virus-specific B cells proliferate, secreting the antibodies that slow and eventually eradicate the virus. A population of these cells retains the information needed to neutralize the virus and takes up residence in the lung to ward off secondary infection from re-exposure to the virus via inhalation.

…

Read the entire article here

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[Reblog] Study Reveals Shocking Amount of Mercury in Many Foods we Eat

High-fructose corn syrup for sale (Photo credit: Steven Vance)

 

From the 20 October 2013 post at someone somewhere – from beyond the rainbow somewhere

 

According to The Illinois Environmental Protection Agency: Mercury poses a health risk to everybody but especially to young children and fetuses because they’re still developing.  Prolonged low level exposure may cause learning disabilities by hurting the ability of children to think and read.  Adults who have been exposed to high levels of mercury may experience trembling hands and numbness or tingling in their lips, tongues, fingers, and toes.  Acute mercury poisoning especially through ingestion, can damage the brain, liver, kidneys, and even cause death.

Research published in Environmental Health and conducted in part by a scientist at the Institute for Agriculture and Trade Policy has revealed that high-fructose corn syrup (HFCS) is contaminated with the toxic heavy metal mercuryHigh-fructose corn syrup is used in almost everything, it seems. A second study conducted by David Wallinga, M.D., entitled “Not So Sweet: Missing Mercury andHigh Fructose Corn Syrup” reveals that nearly one-third of all grocery items sweetened with HFCS  were contaminated with mercury

WHERE DOES ALL THE MERCURY COME FROM?

Most people don’t know how high-fructose corn syrup is really made. One of those processes is a bizarre chemical brew involving the creation of caustic soda by exposing raw materials to pools of electrified mercury in a large vat. Through this process, the caustic soda gets contaminated with mercury, and when corn kernels are exposed to this caustic soda to break them down, that contamination is passed through to the HFCS.

Another toxic chemical, glutaraldehyde, is also used in the production of HFCS. It’s so toxic that consuming even a small amount of it can burn a hole in your stomach.

…………

 

Read the entire article here

 

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Going all the way should mean more than completing high school

From the article by  GREG SMITH, MD | PHYSICIAN |  at the SEPTEMBER 26, 2013 post of KevinMD.com

So what is the one thing that I see over and over and over again in the management of emergency room psychiatric patients that makes me fear for our survival as a country and even as a species?

Is it the severity of psychotic illness? The rampant drug and alcohol use that starts now when kids are pre-adolescent? Is it the broken families that are producing another generation of children who have one parent or no parents and are raised by distant relatives? Is it financial poverty? Is it reliance on government assistance?

Well, I could write about any of these and make a case for all of them, but that’s not what keeps hitting me right between the eyes most days that I sit in my chair and talk to people via the Polycom screen.

The problem?

Lack of education.

 

One of my standard questions when taking a medical history is, “How far did you go in school?” I ask everyone this question because it is so very important in understanding someone’s frame of reference and their ability to assess a problem and deal with it realistically, be it a kidney stone or an episode of depression. I get answers to this question that are all over the map. I have seen teens who have graduated college already. I see old women who never graduated high school but raised entire families on their own. I see proud aging men who ply their trades, hard workers with calloused hands who had formal schooling up to the third grade and no further. I have seen professionals with decades of formal training and multiple degrees who are as psychotic as they can be, completely out of touch with reality due to drug use or mental illness.

 

Read the entire article here

 

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