Monday, November 29, 2010

Seven Ways To Fight Health Inequities

In a series of opinion pieces and two-minute videos, seven Harvard School of Public Health (HSPH) faculty offer %26quot;Advice to the Next President: 7 Ways to Fight Health Inequities.%26quot; The series is published in the newly released Spring/Summer issue of the Harvard Public Health Review. The articles and videos are freely available for linking to websites.
This package may help journalists prepare stories during this presidential election season to answer the question: How might the U.S. narrow the gap between health %26quot;haves%26quot; and %26quot;have nots%26quot; — and raise average life expectancy to that of other industrialized countries?
Currently, the U.S. is ranked 47th in the world. Life expectancy averages 78.1 years, but a large segment of the U.S. population is experiencing a decline in life expectancy. [See life expectancy figures by country.]
Much of the current political debate focuses on health care for the uninsured. Yet, according to the Centers for Disease Control and Prevention, only about 10 percent of premature mortality in Americans can be traced to inadequate health care coverage. Social and environmental factors beyond insurance coverage create conditions that make poor people three times more likely to die prematurely than wealthier Americans. And even middle-income Americans are more than twice as likely to die earlier than top earners.
In the Harvard Public Health Review, seven HSPH faculty experts suggest concrete ways the next U.S. President can level the playing field for all Americans by promoting policies focused on:
* high quality schools
* safe neighborhoods and workplaces
* a cleaner environment
* reducing poverty
* desegregating our health care system
* protecting and nurturing the physical, mental and social development of children under the age of 5
* empowering communities to solve problems
* imposing stricter tobacco control standards
* providing health care for legal immigrants who are ineligible for Medicaid the first five years they are in the U.S.

Thursday, November 25, 2010

Poor US Health Care System behind Life Expectancy Lag

Is the life expectancy of Americans falling behind other nations because of a high rate of obesity, smoking, traffic accidents, and homicides? No, according to a Commonwealth Fund supported study: the blame lies with the poor US health care system.

Poor health care in the United States affects life expectancy

Spending on health care in the United States has increased at least twice the rate as 12 other countries, including Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, and the United Kingdom. Yet fifteen-year survival rates for men and women ages 45 and 65 in the United States have declined when compared with these other countries over the past three decades.
The group that fared the worst in America is white women: by 2005 their fifteen-year-survival rates were lower than those in all 12 other countries. American men did not do much better: the fifteen-year life expectancy for 45-year-old men also fell, dropping from third in 1975 to 12th in 2005.
Peter Muennig and Sherry Glied at Columbia University, who authored the study, “What Changes in Survival Rates Tell Us about U.S. Health Care,” came to their conclusions after examining behavioral risk factors and health care spending for all 13 countries. Their report notes that “the findings undercut critics who might argue that the US health care system is not in need of major changes.”
They found very little difference in the smoking habits among Americans when compared with the other countries, although Americans were more likely to be obese than their counterparts in other countries. However, the percentage of obese adults rose faster in most other countries between 1975 and 2005 than in the United States. In terms of traffic fatalities and homicides, these could not explain the significant change in life expectancy found in the study.
Muennig, who is an assistant professor at Columbia University’s Mailman School of Public Health, noted that given the United States does not fare worse in smoking, obesity, traffic fatalities, and homicides, they were lead to “believe that failings in the US health care system, such as costly specialized and fragmented care, are likely playing a large role in this relatively poor performance in improvements in life expectancy.”
Commonwealth Fund President Karen Davis said that the study’s findings are “stark evidence that the U.S. health care system has been failing Americans for years,” and has resulted in this lag in life expectancy. Although she pointed out that the “Affordable Care Act will take significant steps to improve our health care system,” any potential benefits from this act will likely not be evident for many years.

Saturday, November 20, 2010

Residue from cigarette smoke may pose health hazard, study says

The scent of cigarette smoke is stubborn, clinging to clothes, walls and hair. Now scientists are beginning to explore the health threats of “third-hand smoke,” or the residue left behind after the smoke clears.
In a study published Monday, Lawrence Berkeley National Laboratory scientists showed how tobacco smoke lingering on surfaces chemically reacts with air, releasing potentially harmful substances.
Much has been made of the perils of secondhand smoke. The U.S. Surgeon General estimated in 2006 that it causes 50,000 deaths a year. But the idea of third-hand smoke is relatively new. The phrase was coined last year in the journal Pediatrics.
“Many people think that after the smoke is gone things are clean, but that is probably not the case,” said Hugo Destaillats, the study’s co- author.
Destaillats and his colleagues exposed cellulose, a material present in many household objects, to cigarette smoke and then nitrous acid, a molecule found in the air.
After several hours of exposure, they found the cellulose had 10 times the amount of tobacco-specific carcinogens than it did originally. The scientists also found high levels of a particle that is not present in freshly emitted tobacco smoke.
Destaillats said toxicologists will have to look into whether this new particle is harmful to humans.
Kent Pinkerton, an inhalation toxicologist at UC Davis Medical School, said it is, noting that cigarette smoke has 4,000 components, with toxic particles that end up on surfaces that can release them through simple touch.
Third-hand smoke is most harmful for children, he said.
“It’s not only because of what children breathe in, but because the smoke deposits itself,” he said. “Children are very oral and they put things in their mouths, so they would expose themselves to toxic particles by ingestion as well.”
California’s smoking rates are below the national average: 13.3 percent of adults smoke, compared to the national average of 21 percent.
California also has been at the forefront of secondhand smoke policies, outlawing, for example, smoking in a car with a child passenger. Monday, Gov. Arnold Schwarzenegger announced $4.7 million in American Recovery and Reinvestment Act funds for health and fitness initiatives, including expanding programs to decrease tobacco use and second-hand smoke exposure.
Much needs to be done in other areas of tobacco control, said Paul Knepprath from the American Lung Association. He would like to see smoking banned in all apartment buildings, which could have third-hand smoke implications.
The Berkeley study was published in the Proceedings of the National Academy of Sciences, and was funded by the University of California Tobacco-Related Diseases Research Program.

Monday, November 15, 2010

Is Genetics Responsible for Liberals?

Are you a liberal and proud of it, or do liberals and their views get under your skin? In either case, genetics may be responsible for this particular political outlook, according to researchers.

Being liberal may be in your genes

In the first study to name a specific gene that predisposes people to adhere to certain political views, researchers from the University of California, San Diego, and Harvard University have named a dopamine receptor gene called DRD4 as a responsible party. The research appears in the latest edition of the Journal of Politics.
To arrive at their conclusion, the investigators evaluated 2,000 participants in The National Longitudinal Study of Adolescent Health. When they compared genetic information with the subjects’ social networks, they discovered that individuals who had a certain variant of the DRD4 gene were more likely to be liberals once they reached adulthood. This was true, however, only among those who were active socially during adolescence.
Although this is the first time a specific gene has been matched with being liberal, previous research has suggested a relationship between a variant of the gene and people who are novelty seekers, a behavior associated with personality characteristics related to political liberalism.
According to James H. Fowler, professor of political science and medical genetics at UC San Diego and the study’s lead researcher, “These findings suggest that political affiliation is not based solely on the kind of social environment people experience.”
Fowler and his team suggest that individuals with the gene variant tend to be more interested in learning about others’ points of view, which leads them to seek out more people and friends and have broader exposure to different lifestyles. This may make them more liberal than average. They noted that “it is the crucial interaction of two factors—the genetic predisposition and the environmental condition of having many friends in adolescence—that is associated with being more liberal.”
In today’s volatile political environment, the suggestion that genetics may be behind one’s liberal views may become interesting fodder for the media and politicians alike.