[Yoga’s] Downward Dog to Decrease Inflammation

From the 20 March 2013 post at Mind the Science Gap

Doing yoga is way more than just an excuse to buy expensive leggings. Aside from improving fitness and flexibility, yoga has been used to treat many ailments including depression, arthritis, anxiety, asthma, type II diabetes, fatigue, chronic pain, IBS, and sleep disruptions. Recent research suggests that hatha yoga can also play a role in reducing risk for diabetes and cardiovascular disease. So how might twisting yourself into a pretzel lower your risk for two prominent chronic diseases?

Systemic Inflammation: the silent risk factor

You are probably familiar with acute inflammation if you have ever had an infection or sprained ankle. Swelling and pain are an effective way for our bodies to let us know that something is wrong. Chronic systemic inflammation, however, is not so apparent. It can persist undetected at a low level for years as it slowly damages body tissue while elevating risk for type II diabetes, atherosclerosis, cardiovascular disease, and age-related diseases.

Systemic inflammation is mediated by numerous chemicals inside the body. Two such chemicals are Leptin and adiponectin. These hormones are made in the adipose tissue and have recently been recognized to have a ….

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Yoga’s Effect on Inflammation

In 2012, Kiecolt-Glaser et. al. present in their paper Adiponectin, leptin, and yoga practice that “expert” hatha yoga practitioners have significantly different levels of leptin and adiponectin when compared to “novice” practitioners.  Specifically, experts are shown to have 28% higher blood level adiponectin and a leptin concentration 26% lower than that of novices. Furthermore, the experts’ average adiponectin to leptin ratios were nearly twice that of the novices. Given that leptin and adiponectin are correlated with C-reactive protein, a potent marker of inflammation, this means that those who do more yoga seem to have lower systemic inflammation….

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A 2008 study by the Yoga Journal found that 6.9% of U.S. adults, or 15.8 million people, practice yoga and that 4.1% of non-practitioners, or about 9.4 million people, say they are hoping to try yoga within the next year. On this scale, if regular yoga practice can reduce systemic inflammation in healthy adult women, this is definitely an area worth further research!

References:

Kiecolt-Glaser J, Christian L, Andridge R, Seulk Hwang B, Malarkey W, Belury M, Emery C, and R Glaser. Adiponectin, leptin, and yoga practice. Physiology & Behavior 107 (2012) 809–813. 

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New Report Provides High-Impact Recommendations to Improve Prevention Policies in America

From the 29 January 2013 Trust for America’s Health news release 

Trust for America’s Health (TFAH) has released A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years – which provides high-impact recommendations to prioritize prevention and improve the health of Americans.

The Healthier America report outlines top policy approaches to respond to studies that show 1) more than half of Americans are living with one or more serious, chronic diseases, a majority of which could have been prevented, and 2) that today’s children could be on track to be the first in U.S. history to live shorter, less healthy lives than their parents.

“America’s health faces two possible futures,” said Gail Christopher, DN, President of the Board of TFAH and Vice President – Program Strategy of the W.K. Kellogg Foundation.  “We can continue on the current path, resigning millions of Americans to health problems that could have been avoided or we invest in giving all Americans the opportunity to be healthier while saving billions in health care costs.  We owe it to our children to take the smarter way.”

The Healthier America report stresses the importance of taking innovative approaches and building partnerships with a wide range of sectors in order to be effective.  Some recommendations include:

• Advance the nation’s public health system by adopting a set of foundational capabilities, restructuring federal public health programs and ensuring sufficient, sustained funding to meet these defined foundational capabilities;
• Ensure insurance providers reimburse for effective prevention approaches both inside and outside the doctor’s office;
• Integrate community-based strategies into new health care models, such as by expanding Accountable Care Organizations into Accountable Care Communities;
• Work with nonprofit hospitals to identify the most effective ways they can expand support for prevention through community benefit programs;
• Maintain the Prevention and Public Health Fund and expand the Community Transformation Grant program so all Americans can benefit;
• Implement all of the recommendations for each of the 17 federal agency partners in the National Prevention Strategy; and
• Encourage all employers, including federal, state and local governments, to provide effective, evidence-based workplace wellness programs…..

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Analysis Of Interventions In 5 Diseases Offers Guidelines To Help Close The Gap

 

Racial/Ethnic Disparities in Self-Rated Health Status among Adults with and Without Disabilities — United States, 2004–2006. MMWR 2008:57(39);1069-1073.

 

From the 19th July 2012 article at Medical News Today

Major disparities exist along racial and ethnic lines in the United States for various medical conditions, but guidance is scarce about how to reduce these gaps. Now, a new “roadmap” has been unveiled to give organizations expert guidance on how to improve health equity in their own patient populations.

Finding Answers, a national program based at the University of Chicago and funded by the Robert Wood Johnson Foundation, seeks evidence-based solutions to reduce racial and ethnic health disparities. Its new roadmap, outlined as part of a symposium of six papers published in the Journal of General Internal Medicine (JGIM), builds upon seven years of administering grants, reviewing literature, and providing technical assistance to reduce health disparities.

The roadmap’s architects hope it can provide direction on creating effective and sustainable interventions as the health disparities field shifts from measuring the problem to taking action. ..

…The paper highlights the initial need for recognizing disparities and commitment to their reduction, and suggests that programs to reduce disparities should be integrated into broader quality improvement efforts at clinics, hospitals and other health systems.

“In the past, people did disparities work or quality work, but the two wouldn’t touch one another,” Chin said. “We’re merging the quality improvement field and the disparities field.”

The roadmap also contains advice on designing interventions to address disparities, drawing upon systemic reviews of disparities research in various diseases. Five such reviews – on HIV,colorectal cancer, cervical cancer, prostate cancer and asthma – accompany the roadmap article in the JGIM symposium.

Researchers identified characteristics of successful interventions across the five new articles and previously published reviews of cardiovascular disease, diabetes, depression and breast cancer. Effective projects were found to utilize team approaches to care, patient navigation, cultural tailoring, collaboration with non-health care partners such as families or community members, and interactive skill-based training.

The reviews also identified potential targets for reducing health disparities that have yet to be examined..

..While offering general guidelines for best practices, the authors point out that the specifics of any organization’s effort to reduce disparities must be custom-fit to the patient population and community. …

References for this article

The paper, “A Roadmap and Best Practices for Organizations to Reduce Racial and Ethnic Disparities in Health Care,” was published on July 13 by the Journal of General Internal Medicine. Five systematic reviews of disparities interventions in HIV, colorectal cancer, cervical cancer, prostate cancer and asthma accompany the main article. The articles are open access, and can be read here:http://www.springerlink.com/content/0884-8734/27/8/
The publications were funded by Finding Answers: Disparities Research for Change, a Robert Wood Johnson Foundation program, with direction and technical assistance from the University of Chicago. More information about Finding Answers and the Roadmap to Reduce Disparities can be found athttp://www.solvingdisparities.org.
University of Chicago Medical Center

 

 

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AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Car

AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Care

From a recent email update rec’d from AHRQ (US Agency for Healthcare Research and Quality)

The July 3 issue of AHRQ’s Health Care Innovations Exchange features two profiles of partnerships between clinical practices and community organizations that leverage health provider teams and lay health advisors to improve the management of chronic diseases. One profile describes a public-private initiative that worked with community health teams to improve the delivery of preventive, health maintenance, and chronic care services in Vermont. The pilot program included incentive payments to providers who met National Committee for Quality Assurance-determined care standards, access to an insurer-funded team of community-based health providers, health information incorporated into a Web-based clinical tracking system, and interfaces with other State care coordination initiatives. Over a 4-year period, the pilot program experienced a 6 percent decrease in inpatient admissions and a 10 percent decrease in emergency department visits among participating practices. Select to read more profiles related to clinical-community linkages, including innovations and tools, on the Health Care Innovations Exchange Web site, which contains more than 700 searchable innovations and 1,500 QualityTools.

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Majority Of Homeless People Have Chronic Health Conditions

From the 26 August 2011 Medical News Today article

More than eight out of 10 homeless people surveyed by researchers at St. Michael’s Hospital and elsewhere have at least one chronic health condition and more than half have a mental health problem. People who are “vulnerably housed” – meaning they live in unsafe, unstable or unaffordable housing – had equally poor, and in some cases worse, health, the survey found. The underlying cause for these health issues is poverty, said Dr. Stephen Hwang, the principal investigator of the study and a physician-researcher at the hospital’s Centre for Research on Inner City Health

“Poor housing conditions and poor health are closely linked,” said Dr. Hwang. “We need to treat both problems.” …

Read the article

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