[Podcast] Early Stress Gets Under the Skin: Promising Initiatives to Help Children Facing Chronic Adversity

From the 7 May 2014 item at the Brookings Institute

Disadvantaged children who often experience deep poverty, violence, and neglect simultaneously are particularly vulnerable to the pernicious effects of chronic stress. New research reveals that chronic stress alters childrens’ rapidly developing biological systems in ways that undermine their ability to succeed in school and in life. But there is good evidence that specialized programs can help caretakers learn to be more supportive and responsive. High-quality childcare can offer a safe, warm, and predictable environment amid otherwise chaotic lives, and home visiting programs can help both parents and foster parents learn to provide an environment of greatly reduced stress for their children.

On May 7, Princeton University and the Brookings Institution released the Spring 2014 volume and accompanying policy brief of the Future of Children. The release event featured researchers and policy experts who explained how chronic stress “gets under the skin” to disrupt normal development and how programs can provide the support so urgently needed by children who face chronic stress.

 

[Reblog from the Brookings Institute] CHART: Winners and Losers from Obamacare

From the 1 November 2013 item at The Brookings Institution

From Senior Fellow Justin Wolfers, co-editor of the Brookings Papers on Economic Policy:

See commentary on this chart by Dave Weigel on Slate.com.

Get more Brookings expert analysis and commentary on the Affordable Care Act.

• Fred Dews

  Managing Editor of the Brookings Website

[Brookings Institute report] Isabel V. Sawhill and Quentin Karpilow – Three Facts about Birth Control and Social Mobility

From the 1 November 2013 report

The ability to control our fertility, to have children when—and with whom—we want, is a precious gift of modern science. For women in particular, birth control has also been a boost for social mobility. But there is still progress to be made.

1. The Pill Transformed Women’s Life Chances

The Pill gave American women something genuinely new: a convenient and highly effective means of controlling their own fertility. Although the Pill was licensed by the by the FDA (as Enovid) in 1960, state and federal laws limited the access of young single women to oral contraception. But as those laws changed in the late 60s and early 70s, oral contraceptive use jumped among young single women. And look what happened to the gender mix of professional college courses:

Of course this could be coincidence. But the best researchers in the field don’t think so. Using sophisticated research designs, that isolate the causal effects of the Pill, scholars have shown that the diffusion of the Pill raised women’s college attendance and graduation rates (Hock, 2007), increased the representation of women in professional occupations (Goldin and Katz, 2002), and boosted female earnings (Bailey et al., 2012).

2. Unintended Pregnancies Still Too Common

But unintended pregnancy rates – 3 million or more a year – remain stubbornly high in the U.S. The benefits of birth control are being only partially realized. Half of all pregnancies are mistimed or unwanted – and 95 percent of all unintended pregnancies occur among women who either aren’t using contraception at all or aren’t using their contraceptive method consistently:

It is time for a new revolution in family planning, with even better contraception than the pill. Long-acting reversible contraceptives (LARCs) such as intra-uterine devices (IUDs) have a big role to play in solving America’s contraception deficit. Because these highly effective methods don’t require the daily maintenance that the Pill does, LARCs could potentially eliminate the problems of inconsistent use, as a study conducted in St Louis suggests.

3. Most Disadvantaged Need More To Lose

Early, unwed pregnancy rates are highest in the most disadvantaged communities. Recent research suggests that for those with starkly limited opportunities, better family planning may do little to improve their life trajectories. The impact of better contraception for this cohort is small for the depressing reason that they have so little to lose in the first place. These women need better family planning, but they also need better educational and work opportunities. In short, they need more to lose.

Earlier this week, I talked about these issues at an event sponsored by AEI and the Institute of Family Studies. In tomorrow’s blog post, I’ll set out the gains we could realize from getting better at birth control.

• 

  Isabel V. Sawhill

  Co-Director, Center on Children and Families, Budgeting for National Priorities

  Senior Fellow, Economic Studies

  @isawhill

  A nationally known budget expert, Isabel Sawhill focuses on domestic poverty and federal fiscal policy. She is also co-director of the Center on Children and Families and the Budgeting for National Priorities Project at Brookings.

  More Posts from Isabel > | View Expert Page >

• Quentin Karpilow

  Senior Research Assistant, Center on Children and Families

Related articles

• Family structure’s impact on children’s education and social mobility (aei-ideas.org)
• An Anti-Birth Control Employer Just Beat Obamacare in Federal Court (theatlanticwire.com)
• Obamacare Birth Control Mandate Struck Down By Appeals Court Over Religious Freedom Concerns (huffingtonpost.com)
• Birth Control Options: Think Outside the Pill (spreadthehealthbu.com)

Ten Facts about Mobile Broadband

Great summary by Darrell M. West, Vice President and Director, Governance Studies at the Brookings Institution.

Here’s just one of the facts… (others topics  include  their outnumbering of personal computers next year, increase in overall use by Americans, job creation, reshaping of education, political engagement, public safety, and disparity reduction)

 

7. Mobile Helps Patients and Health Care Providers

Health care today is dominated by physicians, hospitals, the pharmaceutical industry, insurance companies, and government agencies. Patients seek to navigate their health care by moving across a variety of providers, ordering prescription drugs from pharmacies, and seeking reimbursement from either public or private insurance plans. They spend hours connecting the dots and working out the best health care for themselves and their families.

Imagine a different system where, with the aid of the Internet, electronic medical records, and smartphones, the patient is in charge.[xviii] People monitor their own weight, blood pressure, pulse, and sugar levels, and send test results via remote devices to health care providers. Patients store their medical records online and have access regardless of where they are in the United States or around the world. They get personalized feedback via e-mail and reminders when they gain weight, have an uptick on their cholesterol levels, don’t take their medicine, or have high blood pressure. Social networking sites provide discussion forums and the benefit of collective experience from other people suffering similar problems. Patients take responsibility for their routine health care and rely on physicians and hospitals for more serious medical conditions.

This system is not a futuristic vision, but is within our grasp. It would cut costs by reducing professional responsibility for routine tasks and record-keeping, while also making it possible for patients to receive higher quality care and be more satisfied with the end-result. The technologies for this kind of system transformation currently are available through cell phones, mobile broadband, remote monitoring devices, video conferencing, and the Internet.

Smartphones offer advanced features such as mobile e-mail, web browsing, and wireless communications. The sophistication of these devices has spawned a variety of new medical applications that help doctors and patients stay in touch and monitor health care needs.

For example, there is a mobile application that allows physicians to get test results on their mobile device. They can look at blood pressure records over time, see an electro-cardiogram, or monitor a fetal heart rate. AirStrip Technologies markets an application that makes it possible for obstetricians remotely to monitor the heart rates of fetuses and expecting mothers. This allows them to detect conditions that are placing either at risk.

Work by Prgomet and colleagues has found that mobile handhelds have positive impacts on hospital physician work practices and patient care.  When equipped with such devices, researchers discovered benefits in terms of “rapid response, error prevention, and data management and accessibility”.[xix]  These benefits were especially profound in emergency room settings where time is of the essence in treating patients.

Mobile devices offer help for developing nations.  A majority of sub-Saharan Africa residents are served by cellphones with texting capabilities.  A non-profit organization called Medic Mobile seeks to use text messaging in that part of the world to track epidemics and help disaster relief personnel find those in need.[xx]

These applications make doctors more efficient because they don’t have to be in the physical presence of a patient to judge his or her condition. Digital technology allows people to overcome the limitations of geography in health care and access information at a distance. This makes it possible for patients to get a second opinion by sending that person relevant medical tests. If a personal conference is required, doctors can use video conferencing to speak to patients located in another locale.

Related Resources

• Get Mobilized! An introduction to mobile resources and tools in health sciences libraries (Medical Library Association)

  Archived 2011 online class including “lecture notes”, resources, class discussions, and related slides/videos

• Health Apps (in Health and Medical News and Resources selected by Janice Flahiff)
  a short list of information and tracking apps derived from the above Get Mobilized class

Related articles

• From DIY Diagnostic Tests to Mobile Health Competitions (scienceroll.com)
• mHealth: Seemingly Stuck in Neutral (chilmarkresearch.com)
• mHealth Moving Fast, Raising Hope, And Questions (jflahiff.wordpress.com)
• Mobile health: Hallelujah or bah humbug? (finance.fortune.cnn.com)
• mHealth Summit 2011 – Videos Available (imianews.wordpress.com)
• mHealth Moving Fast, Raising Hope, And Questions (egmnblog.wordpress.com)
• Sensei, Inc. Presenting at mHealth Summit (prweb.com)
• Zeo Sleep Monitor CEO at the 2011 mHealth Summit (medgadget.com)