Health and Medical News and Resources

General interest items edited by Janice Flahiff

Poor breakfast in youth linked to metabolic syndrome in adulthood — ScienceDaily

English: american breakfast

English: american breakfast (Photo credit: Wikipedia)

 

Poor breakfast in youth linked to metabolic syndrome in adulthood — ScienceDaily.

 

From the 29 January 2014 article

 

Summary — It is often said that breakfast is important for our health, and a new study supports this claim. The study revealed that adolescents who ate poor breakfasts displayed a higher incidence of metabolic syndrome 27 years later, compared with those who ate more substantial breakfasts.

The study revealed that adolescents who ate poor breakfasts displayed a higher incidence of metabolic syndrome 27 years later, compared with those who ate more substantial breakfasts.

Metabolic syndrome is a collective term for factors that are linked to an increased risk of suffering from cardiovascular disorders. Metabolic syndrome encompasses abdominal obesity, high levels of harmful triglycerides, low levels of protective HDL (High Density Lipoprotein), high blood pressure and high fasting blood glucose levels.

The study asked all students completing year 9 of their schooling in Luleå in 1981 (Northern Swedish Cohort) to answer questions about what they ate for breakfast. 27 years later, the respondents underwent a health check where the presence of metabolic syndrome and its various subcomponents was investigated.

The study shows that the young people who neglected to eat breakfast or ate a poor breakfast had a 68 per cent higher incidence of metabolic syndrome as adults…

 

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February 2, 2014 Posted by | Nutrition | , , , , | Leave a comment

[Reblog] Saying No to “Know Your Numbers” campaigns – Health News Watchdog blog

Saying No to “Know Your Numbers” campaigns – Health News Watchdog blog.

Saying No to “Know Your Numbers” campaigns

Posted by Gary Schwitzer in Health care journalismRisk communication

4 COMMENTS

“Know Your Numbers” campaigns can serve a useful purpose.

But they can also be guilty of non-evidence-based fear-mongering.  They can fuel obsessions with numbers that fully-informed people might just as soon not know anything about. There can be harm living our lives worrying about numbers, test results – making ourselves sick when we are, in fact, healthy.

Here’s a screenshot of just a tiny part of a Google search result of “Know Your Numbers” campaigns.  The list goes on and on and on.

The most recent that I saw was in the January 2014 edition of Prevention magazine.  It’s entitled, “Know Your Numbers: The 5 Health Stats You Should Know.”

While we acknowledge the prestige of the Cleveland Clinic and its chief wellness officer, we point out that there is a lot of debate in medical science circles about what is laid out in this Preventionmagazine piece. For example:

“There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion”

So if 140/90 is where this group starts thinking about treatment, and if even the American Heart Association says normal is “less than 120/80,” what we have with an announcement that 115/75 is “ideal” is mission creep, medicalizing normal blood pressure, or disease-mongering. Where does this “ideal” come from?  It may only be a few points of difference, but with a few points, thousands of Americans suddenly become “less than ideal”…or, as we often call them, patients. One minute they’re healthy.  And then – voila – with a prestigious organization’s spokesman proclaiming a new “ideal” – they’re sick, abnormal, patients.

  • Cholesterol.  Hmmm.  Let’s see what the Cleveland Clinic website says about LDL and HDL. The Clinic’s own website says the LDL goal value should be less than 130 for people who don’t have heart or blood vessel disease or high risk.  And since a Prevention magazine article reaches a broad audience, that’s the crowd we’re talking about. And the Clinic website says HDL goal value should be greater than 45.  So the Prevention magazine targets of LDL under 100 and HDL over 50 are again mission creep, medicalizing normal blood tests, or disease-mongering.  Please note:  we could (but won’t herein) write volumes about much broader questions about being obsessed over LDL or HDL numbers, which are surrogate markers that don’t tell people everything they need to know.
  • This is the one that bugs me the most.  The article lists C-reactive protein as one of the “5 health stats you should know.”  What you should know is that the US Preventive Services Task Force does not share in that endorsement.  The USPSTF states that “the current evidence is insufficient to assess the balance of benefits and harms of using the (the test) to screen asymptomatic men and women with no history of coronary heart disease (CHD) to prevent CHD events.” Even a brief look at other guidelines by other groups shows that the promotion of this test as a “stat you should know” is not as simple and uncomplicated as the Prevention magazine article makes it out to be.

Please note that almost exactly 2 years ago we wrote, “Cleveland Clinic’s Top 5 Tests for 2012 clash with many guidelines.” C-reactive protein was on that list as well.

And you may be interested in some of my past articles about “Know Your Numbers” campaigns:

Comments

Laurence Alter posted on January 13, 2014 at 10:00 am

Dear Gary & Staff:

1. “Live by the numbers; die by the numbers”
2. “The facts speak for themselves”

Live by the first expression or idiom; die by the second one.

Fine physicians give subtlety and nuance behind “the numbers.”

Laurence Alter

Reply

Gary Schwitzer posted on January 13, 2014 at 12:06 pm

Laurence,

Thanks for your note, but for the umpteenth time, there is no staff.

There wasn’t even any staff when we had funding. So there certainly isn’t any staff in the unfunded era.

Whereas I once had help from as many as almost 40 different part-time contributors, they were not staff, just very limited part-time contributors.

It’s just me, flying solo these days.

Reply

Gwyneth Olwyn posted on January 14, 2014 at 10:50 pm

Dear Gary By Himself:

1. Live by the numbers, die anyway.
2. Unequivocally one death per person.

There is no subtlety or nuance to be had for fine physicians in an era of standard of care and fear of litigation from failing to screen aggressively for potential disease.

Therefore a person needs to know ahead of getting his or her numbers checked whether he or she is ready to inadvertently become a patient based on numbers and that the treatments to change those numbers may have little to no evidence to support them.

Reply

shaun nerbas posted on January 20, 2014 at 3:01 pm

It seems that the patient must look out for themselves, ask questions, and not just accept the standard script of medical people. I had an MI 4 years ago (stent placed in the LAD which was nearly 100% blocked ) , but in the 2.5 months before that I saw 4 different doctors who told me nothing was wrong. I had normal LDL and total cholesterol,but I did have low HDL, which I had recently raised up to a ” nearly normal ” value using niacin. I walked for 1.5 hours a day, but in that 2.5 month period before the MI, while walking, I started to get increasing shortness of breath, indigestion, and a pain in my upper back, between the shoulder blades. My doctor gave me Nexium . My doctor didn’t think it was my heart. He based that on having two relatives of his with heart disease, my normal ECG, and my normal cholesterol numbers. I saw other doctors, as my shortness of breath got worse, but again, they didn’t think it was my heart. Then one day I got the symptoms while eating lunch. I went to the local hospital,who after being in communication with a larger specialized hospital, sent me to that larger center, which put the stent in. I eventually learned that over 62% of MIs happen to people with ” normal cholesterol ” . How is it possible that the cholesterol numbers used by lay doctors are so useless for diagnosis ? Does heart disease have multiple causes or do we just not have a good understanding of how do diagnose and track it ? I almost never see this inadequacy discussed by the experts ! Subsequent to my MI I became a vegan to improve my diet to remove saturated fat, which along with a grandmother who had a heart problem, were, in my mind, the reasons for my heart disease. My cardiologist acted as if I was misguided with the vegan approach, which he felt was a path almost nobody could follow.. ….. just take the statins. Maybe Cardiology is a very lucrative occupation that keeps us coming back…..see you next time ! Sorry for being so cynical, but that’s how I feel.

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January 24, 2014 Posted by | health care, Health News Items | , , , , , | Leave a comment

Preventing disease is a problem for the health industry

By  | PHYSICIAN | OCTOBER 3, 2013, at KevinMD.com

……

People come to me for answers, and my profession pitches doctors as the ones with answers.  We fix problems.

This, of course, is not true — a fact that I have come to see as a core problem in the practice of medicine in America, and a reality that (as everything seems to do) comes largely from the way we pay for medicine.  We are paid to fix problems.  How do we fix problems?  With procedures.

The best evidence for this are the things at the heart of health care: codes.   There are three types of codes that dominate the financial and clinical lives of anyone in health care:

  • ICD codes: codes for medical problems
  • CPT codes: codes for medical procedures
  • E/M codes: codes used by doctors who don’t do procedures so they can get paid for office visits

What this encourages from the medical profession is predictable: lots of problems treated by lots of procedures.  This is good for doctors who do procedures, especially ones that are cutting-edge (like robotic surgery) or ones that seem particularly dramatic and/or heroic (open heart surgery, heart stents).  These are the things the headline consuming public is most hungry for.  Just like it grabs more headlines to catch a terrorist plot just before it has its horrible effect than to prevent it early in the process, it’s a lot sexier to do a procedure to treat heart disease than to simply prevent the disease in the first place.  Which is the better outcome?  Preventing heart disease.  Which is paid more?  Not even close.

The problem with problems

A more subtle (and perhaps more significant) effect of this mindset is the way in which everything is labeled as “problems” or “diseases.”  A recent ruling of the AMA that obesity is a “disease” stirred up quite a bit of controversy. The AMA ruling does nothing to change the nature of obesity, and clearly is more a discussion of semantics, politics, and funding, than it is a true medical question.  In reality, I used to not be able to bill the ICD-9 code for obesity and get paid, but now I guess I could (if I did that kind of thing any more).  I suspect this opens the door for more procedures to be paid for by insurers, as the response to any problem is always a procedure in our system.

There is pressure now to respond to each “problem” with a procedure, or at least a thing to eliminate it as a problem.  Examples:

  • Sinus infections are routinely treated with antibiotics despite no evidence that it actually helps.  Having marketed our profession as problem-fixers, we are met with patients expecting a fix to their problem.  They are disappointed (and even angry) when we don’t “do something” for a “problem” that will resolve on its own, even if the intervention probably causes more harm than benefit.  Problem: sinusitis.  Procedure: antibiotic.  Check.
  • Cholesterol treatment is another example of this.  High cholesterol, be it LDL, total, or triglyceride is seen as a “problem,” even in people who are not at risk for heart disease.  I’ve seen many low-risk patients come to my practice on cholesterol medication that does little more than improve their numbers.  The evidence shows that certain high-risk people benefit from being on certain medications which lower the cholesterol.  For folks outside of those high-risk groups, the medications simply make numbers look better (at best) and potentially harm them (at worst).  Problem: High cholesterol.  Procedure: cholesterol drug.  Check.
  • Depression and anxiety are normal emotions.  Life is painful and unsure.  There only are two ways to avoid these emotions: die or get stoned.  My personal experience (some fairly recent) is that the times of life most marked by anxiety and depression are accompanied by significant personal growth.  Before everyone gets mad at me for saying these aren’t diseases, I must add that there are cases of both of these emotions that are terribly destructive and potentially fatal if not treated.  But we physicians have lowered the price of admission to treatment, including people going through hard times as those who have clinical depression.  Responding to TV ads about “that pill that will make me happy,” we are met with patients expecting us to “fix their problem” — a problem that is not really a problem; it’s life.  Problem: anxious and depressed people.  Procedure: medication.  Check.

A better way

I think there’s a better way to look at things.  I’ve said this before, but I am coming to grasp just how radical this approach is and just how much it undermines our health care system.  There is something far more important than problems:

Risk.

When someone comes to my office with chest pain, my thoughts do not go to the question: “what is going on?”  A more important problem comes first: “is this a dangerous situation?”  I want to know if the person is ready to die from a heart attack or other serious problem.  This is true in nearly every decision I make as a doctor when faced with a condition.  Could that cough be latent lung cancer?  Could that headache be a brain tumor?  Could the depressed man kill himself?

Risk reduction also rules how I approach disease.  I treat cholesterol and hypertension, not because they themselves are problems, but because they can lead to heart disease, stroke, and other problems.  High cholesterol is not, in my opinion, a “disease” for most people; it is a risk factor.  I treat diabetes mainly to prevent the complications.  Do I care if a 90-year-old has an A1c of 8?  No way.  It doesn’t increase their risk enough to matter.

This does not mean we approach “prevention” like the system presently does: throwing procedures at it.  The health care system doesn’t reward having healthy patients, it rewards doing procedures reported to prevent problems.  Yet the system is not addressing the true goal of prevention: risk reduction. We are “rewarded” by ordering tests, whether or not they reduce risk.  PSA testing is a perfect example of this, as are many other misguided attempts to treat prevention as another problem to  fix with a procedure.

The problem with this, of course, is that it far more to the financial benefit of doctors (and drug companies) for us to address every problem and show we are giving “good care” by checking off the box next to each problem.  In the bigger picture, risk reduction makes the jobs of future cardiovascular surgeons (and drug companies) much less secure.  It attacks the revenue stream of most doctors and hospitals (and drug companies) right where it counts: you can’t make nearly as much money off of healthy people as you can people with “problems.”

This is why, I believe, any system that profits more from people with “problems” than those without is destined to collapse.  Our system is opposed to the goal of every person I see: to stay healthy and stay on as few drugs, have as few procedures, and avoid as many doctors (and drug companies) as possible.

What would happen if we prevented disease?  What would happen if people didn’t have medical problems?  For society it would be great.  For the health care industry it would be a huge problem.

Rob Lamberts is an internal medicine-pediatrics physician who blogs at More Musings (of a Distractible Kind).

Read the entire article here

 

October 16, 2013 Posted by | health care | , , , , , | Leave a comment

August is National Immunization Awareness Month

Medication Health News

Are you up-to-date on your immunizations? August is National Immunization Awareness month, a public health campaign sponsored by the CDC to recognized the importance of vaccination and to bring awareness to vaccinations that are not meeting national goals. Vaccines are the best prevention for some serious often life-threatening illnesses. This campaign is targeting a different group each week during the month of August: students starting college, students k-12, adults 26+, and pregnant women and newborns. The CDC is providing educational materials to healthcare providers so that they can encourage their patients to get immunized. Accessibility to vaccines has improved now that many pharmacists can deliver adult vaccinations. Howis your pharmacy taking advantage of this campaign toimprove vaccination rates in adults?

For more information click here CDC

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August 2, 2013 Posted by | Consumer Health, health care | , , , , , , | Leave a comment

‘The View’, Jenny McCarthy, and a public health nightmare

You Think You Know

There’s been a lot in the news recently about the decision to hire Jenny McCarthy to replace Elizabeth Hasselback on “The View”.  I cant say that I’m particularly sad to see Hasselback go, as I was never a fan of her conservative “values” but the hiring of Jenny McCarthy – as has been pointed out by many – amounts to a public health nightmare.

For those of you who don’t know, McCarthy is a staunch believer that vaccines caused her son to have autism.  Furthermore, she is an outspoken advocate for not vaccinating children and both encourages and supports parents who choose not to do so.  McCarthy is a strong supporter of UK physician Andrew Wakefield, who published a study in 1998 showing that the measles, mumps, and rubella vaccine causes autism.  That very study has been discredited as a fraud, and follow up studies have disproved Wakefield’s claim.  Despite…

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July 22, 2013 Posted by | Consumer Health, health care | , , , , , , , , , , | 2 Comments

HIGHLIGHTED STORIES:Los Angeles ‘Health Atlas’ Show Alarming Disparities Between Neighborhoods

“More than 100 health indicators — such as obesity, coronary disease and asthma — were studied within neighborhoods across Los Angeles and compiled into a health atlas, which includes a series of 115 maps. Results show that while economic disparities do affect health, so does land use. The atlas was released by former Mayor Antonio Villaraigosa on his last day in office.

“Too often a person’s neighborhood determines their health destiny,” Villaraigosa said. The goal of compiling the atlas, he noted, was to ensure that city officials would consider how future development impacts neighborhoods where bike lanes, walking paths and parks could be integrated with new housing developments and transportation hubs.”

 

saaphi

map_of_los-angelesIn addition to socioeconomic disparities, the proximity of parks, walking paths and bike lanes affects the health of residents of Los Angeles. This correlation was discovered when 100 health indicators (including obesity, coronary heart disease, and asthma) were studied in neighborhoods across Los Angeles and compiled into a “health atlas.” Former mayor Antonio Villaraigosa is passing this information to the new mayor, Eric Garcetti, in the hopes that city departments will consider the importance of reducing environmental disparities in future development.

Read More at: http://www.huffingtonpost.com/2013/07/08/los-angeles-health-atlas_n_3557778.html

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July 17, 2013 Posted by | environmental health | , , , , , | Leave a comment

High school years hard on adolescent health, with spikes in drinking, smoking and drug use: Canada study

July 14, 2013 Posted by | Health News Items | , , , , , , , | Leave a comment

[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 ….

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….

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. 

 

March 22, 2013 Posted by | Consumer Health | , , , , , , , | Leave a comment

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

logo-1

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…..

February 6, 2013 Posted by | Consumer Health, Educational Resources (Health Professionals), Educational Resources (High School/Early College(, health care | , , , , , | Leave a comment

Door to Door in the Heartland, Preaching Healthy Living

From the 10 September 2012 article at the New York Times

By 
Published: September 10, 2012OKLAHOMA CITY — Like a missionary, Michael Bailey, a county health worker, spends his days driving his beat-up Nissan around this city’s poorest neighborhood, spreading the word in barber shops and convenience stores about the benefits of healthy diet and exercise. “Look at the kids,” he said. “Overweight, huffing andwheezing. Their lives will be miserable if this doesn’t change.”
 Mike Bailey visited James Harris at his barbershop in Oklahoma City. Mr. Bailey has persuaded  residents to enroll in a heart disease prevention program.
Mr. Bailey believes that food is slowly killing his community here, and signing people up for a program to prevent heart disease is his way of saving souls.Local governments across the country are creating dozens of such experiments with money from the Obama administration’s Affordable Care Act. It is part of a broad national effort set in motion by the law to nudge a health care system geared toward responding to illness to one that tries to stop people from getting sick in the first place. To that end, the law created the $10 billion Prevention and Public Health Fund, the largest-ever federal investment in community prevention.Supporters say the effort is long overdue in an age where preventable disease is the single largest cause of death. Indeed, unhealthy behaviors, like smoking and poor diet, account for 40 percent of premature deaths in the United States, while poor health care and limited access to the health care system accounted for a tenth of such deaths, according to an analysis of federal data and mortality studies by J. Michael McGinnis, a senior scholar at theInstitute of Medicine

But critics say efforts to influence behavior will have only a modest effect without policy measures like taxes on soda and restrictions on marketing to children to change the food environment.

Oklahoma City, run by a Republican mayor, Mick Cornett, has with little notice won federal prevention money through the new law, a surprising source of financing in this deeply conservative Republican state. The governor, Mary Fallin, turned away $54 million in federal money to help prepare for the new law last year.

Republicans in Congress derided the prevention program as “a slush fund to build sidewalks, jungle gyms and swing sets,” but Mr. Cornett has embraced its approach, turning this city — labeled one of the fattest in America in 2007 by Men’s Fitness magazine — into a laboratory for healthy living. In recent years, he has transformed it with bike lanes, walking paths and an Olympic rowing complex. He started a drive called “This City Is Going on a Diet.” He even accepted an invitation from Michelle Obama, who has made childhood obesity her signature cause, to attend the 2010 State of the Union address.

“We don’t believe in individual freedom to the extent of letting people make poor health decisions and just wither away without help,” Mr. Cornett said in an interview.

Many scientists doubt such programs actually work. Only a handful of the dozens of published studies on obesity interventions have produced results, and only when participants were intensively engaged, said Tom Baranowski, a professor of pediatrics at Baylor College of Medicine. “Sending newsletters and calling is not enough,” he said.

But some public health experts say that the kinds of things being tried under the law could help bring a cultural shift. The single biggest behavioral success of the last century — the dramatic reduction in the share of Americans who smoke — took 50 years of education, regulation and medical intervention. Likewise, only a mixture of approaches has a chance of eventually reducing rates of obesity, these experts say.

“Over time all of this effort builds up so people come to think about the problem and their own behavior in a different way,” said Bruce Link, a professor of epidemiology and sociology at the Mailman School of Public Health at Columbia University.

In Oklahoma City, county officials have focused on the least healthy ZIP code — 73111 — a sun-seared stretch of one-story bungalows, fast food restaurants and minimarts. Heart disease mortality rates are 10 times as high as in the healthiest neighborhood, which is next to one of the biggest medical complexes in the state, including a teaching hospital with a large share of charity care.

In addition to the heart program, which offers free medicine and checkups in exchange for taking a health class, the area is getting a new health complex with sports fields and walking trails, and a physical education coordinator for city schools. Public messages against sugary drinks are plastered on buses and benches. Health workers will identify the area’s highest-risk patients, connect them with doctors, and follow up with them after checkups, a measure Gary Cox, director of the county health department, said was designed to reduce emergency room visits.

Thousands of fliers for the heart program were mailed out last year, but there were few takers until Mr. Bailey, the health department worker, began persuading people to sign up in the spring….

September 12, 2012 Posted by | Public Health | , , , | Leave a comment

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.

 

Chart: General Health Status among US Adults*, by Race or Ethnicity

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 cancerprostate 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, diabetesdepression 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

 

 

July 19, 2012 Posted by | Public Health | , , , , , , , | Leave a comment

Doctors Overlook Chemical Illnesses, Study Finds

While I know folks who are prone to conditions triggered by chemical intolerances….am blessed that environmental chemicals don’t seem to affect me for whatever reason..

Am posting this especially for folks with chronic conditions of any kind. Please ask your health care provider if screening, testing,prevention of,  and treating for chemical intolerances is right for you.

 

From the 10 July 2012 article at Science News Daily

Chemical intolerance contributes to the illnesses of 1 in 5 patients but the condition seldom figures in their diagnosis, according to clinical research directed by a UT Medicine San Antonio physician.

Clinical tools are available to identify chemical intolerance but health care practitioners may not be using them, lead author David Katerndahl, M.D., M.A., said. The study is in the July 9 issue of Annals of Family Medicine.UT Medicine is the clinical practice of the School of Medicine at The University of Texas Health Science Center San Antonio.

Avoidance of triggers

The study’s authors said physicians need to know how chemical intolerance affects certain people and understand that conventional therapies can be ineffective. Some patients would improve by avoiding certain chemicals, foods and even medical prescriptions, the authors said.

Patients with chemical intolerance go to the doctor more than others, are prone to having multi-system symptoms and are more apt to have to quit their job due to physical impairment, the authors said….

…Chemically intolerant individuals often have symptoms that affect multiple organ systems simultaneously, especially the nervous system. Symptoms commonly include fatigue, changes in mood, difficulty thinking and digestive problems.

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July 11, 2012 Posted by | environmental health | , , , , , , , , | Leave a comment

Highest-Value Preventive Services Save Billions if Applied to 90 Percent of U.S. Population

From the 12 June 2012 article at the Robert Woods Foundation Web site

Identifying the highest-value clinical and community preventive services

Published: Jun 12, 2012

Dates of Project: 2006–2012

Field of Work: Identifying high-value evidence-based clinical and community preventive services.

Problem Synopsis: The health impact and cost-effectiveness of clinical preventive services such as smoking cessation or breast cancer screening needs to be examined and re-examined as more and better data becomes available, and as analytical tools improve. Disparities in the use of services also need to be examined and documented.

Similarly, preventive interventions to improve health at the community level such as seat belt laws, need to be examined for their health and economic impact.

Synopsis of the Work: A research team at the Partnership for Prevention:

  • Updated rankings of clinical preventive services recommended by the U.S. Preventive Services Task Force
  • Estimated the health and economic benefits for the U.S. population and selected subpopulations of increasing their use
  • Quantified disparities in their provision
  • Developed and tested methods for estimating the health and economic impact of interventions to improve health at the community level that were recommended by the Centers for Disease Control and Prevention

Key Results and Findings:

  • The research team updated the rankings of clinical preventive services recommended by the CDC. When published in 2012, the analysis will show that highly rated services—including childhood immunizations, tobacco cessation counseling, and discussing daily aspirin use to prevent heart disease—continue to be a good value because of their health impact and cost-effectiveness.
  • The team found that providing 90 percent of the U.S. population with three clinical preventive services—tobacco cessation screening and assistance; discussing daily aspirin use; and alcohol screening with brief counseling—would generate an estimated net savings of more than $1 billion each, per year. In addition, these three services plus colorectal cancer screening each would prevent the loss of more than 100,000 years of life, a year.
  • The team found troubling disparities, and specific opportunities for improvement, in the use of clinical preventive services among racial and ethnic populations.
  • The team created analytic tools to assess the health and economic benefits of interventions to improve health and prevent disease at the community level, and used them to assess interventions to reduce tobacco use and increase physical activity.

June 22, 2012 Posted by | Public Health | , , , , | Leave a comment

Optimism May Help Protect the Heart

myocardial infarction - Myokardinfarkt - scheme

myocardial infarction - Myokardinfarkt - scheme (Photo credit: Wikipedia)

From the 18th April 2012 article at Medical News Today

Harvard researchers suggest optimism, happiness and other positive emotions may help protect heart health and lower the risk of heart attacks, strokes and other cardiovascular events. It also appears that these psychological well-being factors slow the progress of cardiovascular disease.

The findings are the result of the first and largest systematic review of its kind, and are reported in the 16 April online issue of Psychological Bulletin, by lead author Julia Boehm, a research fellow, and senior author Laura Kubzansky, an associate professor, in the department of society, human development, and health, at the Harvard School of Public Health (HSPH) in Boston, Massachusetts….

April 21, 2012 Posted by | Consumer Health, Psychology | , , , , , , | Leave a comment

The Guide to Community Preventive Services: What Works to Promote Health

The Guide to Community Preventive Services  is a great resource for what methods and interventions work well to improve public health. It is geared towards public health officials, researchers, and policy makers. However, it is also a good aid for anyone looking for the best way(s) to address issues touching family members and friends. The information can be used to promote or advocate for changes in policies and laws at local or national levels. They can be used to positively influence changes for the better in schools, workplaces, public health departments, and more.

A good way to start is through the Topics link at the top of the page. It includes links to issues as asthma, cancer, diabetes, nutrition, obesity, vaccines, and violence. Each topic includes links to more information on the topic and related topics.
Many topics have summaries of recommendations and findings. For example the topic Diabetes includes recommendations for certain disease management programs but insufficient evidence for self management programs in school settings or worksites.

All information on the interventions for a specific topic (as violence, diabetes, alcoholism) is carefully reviewed through a standardized step by step process.  systematic reviews. Each reviews includes summarized results of all related evidence.  These unbiased evidence-based reviews are also called systematic reviews.
[Click here for a good explanation of the systematic review process]

Each topic in this community guide answer questions  such as: c

  • What interventions have and have not worked?
  • In which populations and settings has the intervention worked or not worked?
  • What might the intervention cost? What should I expect for my investment?
  • Does the intervention lead to any other benefits or harms?
  • What interventions need more research before we know if they work or not?

Click on these tabs at the top of the  home page for additional information

April 14, 2012 Posted by | Public Health | , , , , , , , , | Leave a comment

Disarming Disease-Causing Bacteria

From the 5 April 2012 Science Daily article

New treatments that combat the growing problem of antibiotic resistance by disarming rather than killing bacteria may be on the horizon, according to a new study.

Published in Nature Structure and Molecular Biology, research led by Monash Universityshowed a protein complex called the Translocation and Assembly Module (TAM), formed a type of molecular pump in bacteria. The TAM allows bacteria to shuttle key disease-causing molecules from inside the bacterial cell where they are made, to the outside surface, priming the bacteria for infection.
Lead author and PhD student Joel Selkrig of the Department of Biochemistry and Molecular Biology at Monash said the work paves the way for future studies to design new drugs that inhibit this process.
“The TAM was discovered in many disease-causing bacteria, from micro-organisms that cause whooping cough and meningitis, to hospital-acquired bacteria that are developing resistance to current antibiotics,” Mr Selkrig said.
“It is a good antibacterial target because a drug designed to inhibit TAM function would unlikely kill bacteria, but simply deprive them of their molecular weaponry, and in doing so, disable the disease process.”
“By allowing bacteria to stay alive after antibiotic treatment, we believe we can also prevent the emergence of antibiotic resistance, which is fast becoming a major problem worldwide.”…

April 6, 2012 Posted by | Medical and Health Research News | , , , | Leave a comment

New community health approach aims to combats chronic disease, empower patients, reduces costs

From the 8 February 2012 Eureka News Alert

New community health approach aims to combats chronic disease, empower patients, reduces costs

Value of Accountable Care Community approach to public health promotion and disease prevention outlined in new paper released today

AKRON, Ohio, February 8, 2012 – A new community-wide collaboration to reduce the impact of chronic disease and empower patients is generating impressive early results, leaders of the Accountable Care Community (ACC) initiative said today. The Akron-based Austen BioInnovation Institute in Akron (ABIA) is leading the initiative with its founding institutional members and more than 60 public and private community partners.

The groundbreaking effort supported by the Centers for Disease Control and Prevention unites medical, public health and social science professions, nonprofits and faith-based and community organizations for an “all-hands-on-deck” approach to public health. Eventually, communities across the country will be able to apply this new model toward public health, reducing the tremendous negative impact chronic disease has on their economies, said Dr. Janine Janosky, head of ABIA’s Center for Community Health Improvement, who is leading the effort described in a white paper released today.

The news comes just weeks after an Institute of Medicine report called for a new public health approach based on “enhanced collaboration among the public health, health care and community non-healthcare sectors” to address the challenges of chronic disease. The World Health Organization refers to the growing impact of chronic disease as “a global epidemic” reaching crisis levels. The Robert Wood Johnson Foundation estimates that by 2030, half the U.S. population will have at least one chronic condition.

The ABIA, along with national experts and more than 60 Akron organizations, have been collaborating for more than a year on a new, integrated, and measurable strategy to community health that could be replicated in other U.S. communities. The ACC approach detailed in the report “Healthier by Design: Accountable Care Community” utilizes a unique “impact equation” that measures the benefits of a seamless approach to community health, including metrics for a patient empowerment and market value of health, said Dr. Frank L. Douglas, ABIA president and chief executive officer.

“The amount spent on healthcare and health initiatives in the United States should translate into good health for the community and its residents. Unfortunately, America’s public health continues to lag behind other nations. Further, we are now in an era of debate about how to reverse the unsustainable cost trends and improve the health outcomes and quality of life for our fellow man,” Dr. Douglas said. “The development of this inventive Accountable Care Community model, which not only speaks of the need for collaboration but actually enables all parties to be on the same page with an integrated, measurable strategy, promises to improve the health of millions of patients.”

In Akron, the ACC approach uniquely aligns public, private and philanthropic resources in a coordinated fight to improve community health by identifying and closing gaps in health education, access and delivery. The group’s initial pilot project focused on diabetes self-management. Ultimately, participants changed their behaviors and took increased control over their disease. Significant results included decreases in blood sugar and bad cholesterol levels, weight loss, decreased body mass, and a decline in emergency room visits. An additional program demonstrated nearly a total of $225,000 of cost savings or cost avoidance for local healthcare institutions through the use of volunteers and community services to monitor and serve low-income, medically underserved patients with diabetes….

February 9, 2012 Posted by | Public Health | , , , , , , | Leave a comment

   

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