Suggested Citation: Jung, B.C. (2011 - 2023). Betty C. Jung's 2011 Public Health Blog (January - June).
Web document: https://www.bettycjung.net/Blog2011b.htm
Eating right has gotten so much easier now with the introduction of the MyPlate icon. Basically, half of what you eat should be fruits and vegetables.
If you want to make it even easier, I recommend "Cut out white foods" or "Do colors." Make your plate as colorful as possible. The only thing white would be the glass of milk (preferably skim or low-fat), and everything else should be non-white. This means cutting out white rice, white potatoes, white bread, etc. You can eat as much fruits and vegetables as you like as they are nutrition dense. Grains and protein should make up less than half your plate. Happy eating!
According to a June 23rd New England Journal of Medicine's report, based on data from the Nurses' Health Study I and II and the Health Professionals Follow-up Study:
Roughly half of the average 3.35 pounds a healthy, nonobese American gains over four years could be chalked up to eating more potato chips over time (1.69 lb per additional serving per day);
Other food strongly associated with weight gain...included:
Potatoes at 1.28 lb
Sugar-sweetened beverages at 1.00 lb
Unprocessed red meats at 0.95 lb
Processed meats at 0.93 lb
Four-year weight loss was most associated with intake of:
Yogurt at -0.82 lb
Nuts at -0.57 lb
Fruits at -0.49 lb
Whole grains at -0.37 lb
Vegetables at -0.22 lb
Eating more or less of any single food generally had a modest effect on weight, but together the changes in diet and exercise accounted for large differences in weight gain over time.
These tended to be creeping gains of only 0.8 lb on average per year, which makes it tough to perceive specific causes, "But accumulated over time, even modest increases in weight have implications for long-term adiposity-related metabolic dysfunction, diabetes, cardiovascular disease, and cancer,"
The foods associated with weight loss fit with the emphasis on fruit, vegetables, and grains on the U.S. Department of Agriculture's plate graphic that recently replaced the food pyramid to guide food choices,
Weight gain averaged 3.35 lb across the cohorts during each four-year period, representing 2.4% of body weight, and added up to an average 16.8 lb over 20 years.
Weight gain was linked to alcohol use (0.41 lb per drink per day), smoking cessation (new quitters gained 5.17 lb, former smokers gained 0.14 lb), and television watching (0.31 lb per hour per day).
Not surprisingly, physical activity was associated with 1.76 lb of weight loss over four years....
Citation source:Mozaffarian D, et al "Changes in diet and lifestyle and long- term weight gain in women and men" N Engl J Med 2011; 364: 2392-2404, as reported at http://www.medpagetoday.com/PrimaryCare/DietNutrition/27223
June 28, 2011 - CDC: Sugar Drink Consumption among U.S. High School Students Should Be Reduced
Graphic source: Google search
According to the June 23rd CDC Healthy People, Healthy Places Newsletter , high school students are drinking too much sugary beverages.
Sugar drinks, also called sugar-sweetened beverages, are the largest source of added sugars in the diets of U.S. youth. Consuming sugar drinks increases calories a factor potentially contributing to obesity among youth nationwide.
America's youths are drinking more sugar drinks than youths of previous generations.
Sugar drinks are those to which sweeteners with calories have been added. High fructose corn syrup, sucrose (table sugar) and other sweeteners add calories without adding any nutrients.
Some common sugar drinks are:
Soft drinks, soda or pop
Fruit drinks, punches
Sports drinks and energy drinks
Sweetened tea and coffee drinks
Sweetened, or flavored, milk
To support youth in choosing healthier beverages, families, schools, and other youth-serving organizations should
Reduce youths access to sugar drinks to decrease consumption.
Make adolescents aware that water and low-fat or fat-free milk are the most healthful beverages.
In limited amounts, 100% fruit juice also has health benefits.
Citation source: Berkey CS, Rockett HRH, Field AE, Gillman MW, Colditz GA. Sugar-added beverages and adolescent weight change. Obesity Research 2004;12:778-788; CDC listserv
And,"The BBC reports that drinking excessive amounts of cola can lead to muscle weakness and possibly even muscle paralysis...the ingredients within soda can cause blood potassium levels to plummet.
The study finds that when the three main ingredients commonly found in soda -- glucose, fructose, and caffeine -- are consumed in large quantities, it can lead to "caffeine intoxication" and "dangerously low" blood potassium levels. Even caffeine-free cola can be dangerous...because it still contains fructose." (Graphic and Citation Source: http://news.bbc.co.uk/2/hi/8056028.stm?lsm; as reported at http://shine.yahoo.com/channel/health/another-reason-not-to-drink-soda-muscle-weakness-and-possibly-even-paralysis-464316)
May 23, 2011 was the 30th anniversary of the first case of AIDS. That is over 30 years ago! These days, we know a lot more about this viral disease and how to treat it, and those with an HIV infection can live for many years. While there is still no cure for AIDS, it is absolutely essential that those who are infected get treated early on. It is therefore essential that those who are at risk for the infection be screened regularly.
According to the CDC, annual HIV testing is recommended for:
Sexually active men or women, who are not in a long term, mutually monogamous relationship;
Sexually active men who have sex with men (MSM), who are not in a long term, mutually monogamous relationship;
For more information about testing, see HIVTEST.org . For additional information about AIDS/HIV, see AIDS/HIV
June 24, 2011 - Man Up!
The CDC has great E-Cards, but this has to be my favorite one! Click on the graphic and find out what it is to Man Up!
June 23, 2011 - FDA's Graphic Cigarette Health Warnings
Graphic source: FDA Listserv
Graphic cigarette health warnings are coming to all cigarette packages, as stipulated by the FDA, within 15 months. Images will be paired with one of nine warnings:
WARNING: Cigarettes are addictive with an image of a man smoking through a hole in his throat
WARNING: Tobacco smoke can harm your children with an image of a parent holding a baby as smoke drifts towards them
WARNING: Cigarettes cause fatal lung disease with an image of a disease-riddled lung and a healthy lung
WARNING: Cigarettes cause cancer with an image of an open sore and stained teeth on the lips and mouth of a smoker with mouth cancer
WARNING: Cigarettes cause strokes and heart disease with an image of a man who needs an oxygen mask to breathe
WARNING: Smoking during pregnancy can harm your baby with an illustration of a crying newborn in an incubator and hooked-up to a monitor
WARNING: Smoking can kill you with the image of a dead man with a surgery-scarred chest
WARNING: Tobacco smoke causes fatal lung disease in nonsmokers with an image of a grieving family member
WARNING: Quitting smoking now greatly reduces serious risks to your health with an image of a man wearing an I Quit T-shirt
This American Cancer Society line graph shows that per capita cigarette consumption has decreased in recent years, along with a gradual decrease in the male lung cancer death rate. Unfortunately, the female lung cancer death is not showing a similar decline. In fact, cancer of the lung and bronchus is the leading cause of cancer deaths in women (May 12th entry). Regardless of gender, tobacco is the main reason why men and women are dying from lung cancer.
June 21, 2011 - Happy Summer - New FDA sunscreen labeling is coming
Now that daylight will be around longer, everyone will be spending more time in the sun. However, excessive exposure to the sun's rays increases the risk for skin cancer for those who are fair-skinned and accelerates skin wrinkling and aging for everyone.
The FDA is issuing new rules for how sunscreen products will be labeled. Watch these FDA videos for information about how sunscreens work, and what the new rules will be.
Here is a line graph from American Cancer Society's "Cancer Facts & Figures 2010" showing the cancer death rates for men.
According the 3/31 NIH news release, "Report to nation finds continued declines in many cancer rates"
"In men, incidence rates have declined for cancers of the lung, colon and rectum, oral cavity and pharynx, stomach, and brain (malignant only) while rates have risen for kidney, pancreas and liver cancers, as well as melanoma of the skin.
Keep in mind that tobacco use contributes to 90% of lung cancer deaths, among other forms of cancer. It's best to never start smoking, or if you do, to quit. For more information, see Tobacco Resources and Cancer Resources
June 19, 2011 - Happy Father's Day!
Men who are fathers are very special to those around them - their parents, their children and their wives and partners. Continue to play a vital role in their lives by being there for them. Smoking cuts into the time you can spend with those you love, so if you smoke, make the effort to stop. Not only will you improve the environment, but your lungs as well. You will breathe better, reduce the chances of developing cancer and heart disease, and generally improve your quality life. It is a win-win situation.
Womenshealth.gov reports, "The ranking is for all races and ages combined. Different races have different rankings. For example, homicide is the fourth highest cause of death for black men and HIV/AIDS is the seventh, neither of which is in the top ten for all races. For Hispanic men, homicide is sixth, followed by chronic liver disease." Source: http://www.womenshealth.gov/mens/health/index.cfm
Womenshealth.gov also reports on the health concerns for men of different racial and ethnic groups:
African-American and Hispanic-American/Latino men are less likely than white men to see a doctor.
Minority men are less likely to get timely preventive care, such as flu shots and colonoscopies.
African-American men are 30 percent more likely to die from heart disease compared to non-Hispanic white men.
Even though blacks account for about 13 percent of the U.S. population, they account for about half of the people who get HIV/AIDS.
American Indians and Alaska Natives have especially high rates of depression, suicide, and substance abuse.
African-Americans who get skin cancer are more likely to die from it than whites.
Type 2 diabetes is more common among African-Americans, Hispanic-Americans/Latinos, and American Indians than among whites.
Asians and Pacific Islanders make up 4.5 percent of the U.S. population but have more than half of the chronic cases of hepatitis B.
The reasons for these health disparities are not directly related to race and ethnicity. Instead, low income, lack of access to care, language and cultural differences, and other barriers often make good health hard to achieve for many minority groups.
...many health problems can be prevented or lessened with healthy habits like eating a healthy diet, exercising, and not smoking. Make sure to visit your doctor regularly and get the vaccines that are right for you. Also ask about screenings for conditions like high blood pressure and diabetes.
Yesterday HealthDay reported in "High School Kids Get Too Many Sugary Drinks, Too Little Exercise: CDC" (6/17 MMWR) on what CDC researchers are finding:
"Not only are high school kids guzzling far too many high-calorie sodas, they're also getting very little exercise"
In fact, just one in 10 high school boys and girls are meeting the minimum goals for physical activity outlined by in the CDC's recently released "Healthy People 2020" report,"
just over 15 percent of poll participants met the aerobic objectives, while only about half met the strength-building goal. Only 12.2 percent met both guidelines.
...consumption of sodas, sports drinks and other sugar-sweetened beverages is all too common.
...boys downed more sugar-sweetened beverages than girls. Black teens were also more likely than their white and/or Hispanic peers to drink at least one such beverage per day.
Teens should be encouraged to consume greater amounts of water and low and/or fat-free milk, alongside 100 percent fruit juice,
...the CDC team called on schools, communities and health-care facilities to band together to promote physical activity while providing more places to exercise."
"The problem is that physical activity is not required on a daily basis in most schools. And when that's the case kids are probably not exercising at all, unless they're involved in a sport."
"The goal [for schools] should be to create more opportunities for teens to be physically active,"... "And frankly, that might mean bringing back gym class."
...parents need to try to encourage healthy habits way before kids reach their teens. "Because you have to get to them when they're between 5 and 10, before they become more influenced by what their peers are doing than what their parents say."
Citation source:Dorothy Teegarden, Ph.D., professor, department of nutrition science, Purdue University, West Lafayette, Ind.; Lona Sandon, R.D., assistant professor, clinical nutrition, University of Texas Southwestern Dallas; June 17, 2011, Morbidity and Mortality Weekly Report as reported by http://freshhealthyvending.com/healthy-vending/obese-tweens-and-just-how-tough-their-battle-is/
The American Academy of Pediatrics (AAP) published online (May 29) and in June's issue of Pediatrics its report,"Clinical Report Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate?" AAP recommendations reported by Medscape on June 1st:
Pediatricians should educate patients and their parents regarding the potential health risks of energy drinks and sports drinks and explain the significant differences between these types of drinks. The terms should not be used interchangeably.
Energy drinks should never be consumed by children or adolescents, because the stimulants they contain pose potential health risks.
Children and adolescents should avoid and restrict routine consumption of carbohydrate-containing sports drinks, which can increase the risk for overweight, obesity, and dental erosion.
For pediatric athletes, sports drinks should be consumed in combination with water during prolonged, vigorous physical activity, when rapid replenishment of carbohydrates and/or electrolytes is needed.
For children and adolescents, water, not sports drinks, should be the principal source of hydration.
Oh no - more data to show global warming is definitely affecting current weather. Although many Americans had experienced probably one of the worst winters in recent memory, snowing like there's no tomorrow, followed by horrific spring flooding and EF-5 tornadoes (and, let's not forget Japan's March 11th earthquake and tsunami), trending by atmospheric experts tell a similar story about global weather patterns.
According to NASA's "Despite Subtle Differences, Global Temperature Records in Close Agreement", "four widely referenced records [NASA's Goddard Institute for Space Studies (GISS), NOAA's National Climatic Data Center (NCDC), the Japanese Meteorological Agency and the Met Office Hadley Centre in the United Kingdom] show remarkable agreement. In 2010, global temperatures continued to rise...2010 tied with 2005 as the warmest year on record, and was part of the warmest decade on record." Citation source: http://www.nasa.gov/topics/earth/features/2010-climate-records.html
June 14, 2011 - Canadian Arctic Archipelago is Melting
Map #1 depicts the Canadian Arctic Archipelago as the dark red region on the left side of the map, just above Greenland, which is colored green.
NASA reported on June 7 that
"Though much attention has been focused in recent years on the melting of ice from Greenland and Antarctica, nearly half of the ice volume currently being lost to the ocean is actually coming from other mountain glaciers and ice caps. Ice loss from a group of islands in northern Canada accounts for much of that volume....land ice in both the northern and southern Canadian Arctic Archipelago has declined sharply.
Map #2 shows ice loss from surface melting for the northern portion of the archipelago from 2004-2006 (left) and 2007-2009 (right). Blue indicates ice gain, and red indicates ice loss.(Nature, April 2011)
...the Canadian Arctic Archipelago lost an average of approximately 61 gigatons of ice per year. (A gigaton is a billion tons of ice.) The research team also found the rate of ice loss was accelerating. From 2004 to 2006, the average mass loss was roughly 31 gigatons per year; from 2007 to 2009, the loss increased to 92 gigatons per year.
...from 2001 to 2004, the sum of melting from all mountain glaciers and ice caps around the world (but not the Greenland and Antarctic ice sheets) contributed an estimated 1 millimeter per year to global sea level rise. Recent estimates suggest the Greenland and Antarctic ice sheets add another 1.3 millimeters per year to sea level.
This means 1 percent of the land ice volume mountain glaciers and ice caps account for about half of all ice loss to the world's oceans, ...Most of the ice loss is coming from the Canadian Arctic Archipelago, Alaska, Patagonia, the Himalayas, and the smaller ice masses surrounding the main Greenland and Antarctic ice sheets."
The YouTube video shows researchers trying to measure the speed of water as Greenland's glaciers are melting.
According the NASA, there was record melting in Greenland during 2010.
By the end of the season, much of southern Greenland had set a new record, with melting that lasted 50 days longer than average.
This image shows 2010 compared to the average number of melt days per year between 1979 and 2009.
Melting ice in Greenland freshens the seas near the Arctic and contributes to rising sea levels around the world. It is unclear just how much melting ice from Greenland will push sea levels up, largely because the melting is occurring much more quickly than scientists predicted. Current estimates call for an increase of up to 0.6 meters by 2100.
Here is a scary map of all the areas you can encounter a natural disaster. Aside from avoiding known geographic locations for such disasters, the one thing we can do is to prepare as best as we can for the possibility, or even eventuality of natural disasters. I like CDC's social media approach to making emergency preparedness relevant to young people today, which was released May 18th. If faced with a zombie invasion, what would we do? For more information, explore this widget:
In recent weeks, the midsection of the U.S. has been devastated by natural disasters. First, there were the historic floods from the Mississippi River, and then the killer tornadoes during the last week of May, with a few devastating several towns in Massachusetts on June 1st. Lives lost are in the hundreds, and property damage and loss in the millions. It will be years before survivors can regain a semblance of the their lives before these disasters.
According to Livescience.com: "Nearly 1,200 tornadoes have swarmed the United States this year, according to preliminary numbers from the National Oceanic and Atmospheric Administration (NOAA). Four of these storms have been rated at the highest tornado strength, an EF-5. The death toll from these tornadoes has likely topped 500, a number not seen since 1953."
"The tornado that devastated Joplin, Mo., killing at least 125 people, is not only the deadliest single tornado to strike the United States since 1947, but the storm has now been upgraded to an EF-5, the most intensely damaging tornado on the Enhanced Fujita Scale, with winds in excess of 200 mph (322 kph).
It is the fourth EF-5 tornado this year. In contrast, a single EF-5 hit the United States in 2008, one hit in 2007; before that, the last EF-5 hit in 1999." (Citation source: http://news.yahoo.com/s/livescience/20110525/sc_livescience/thesciencebehindthisterribletornadoseason)
For all you scholarly types, this is your lucky day!
As of June 2, 2011, the National Academies Press is making its treasure trove of publications, some 4000+, plus any future reports to come, available for free downloads!
This is a wonderful contribution to the global knowledge base of scientific knowledge. This comes at a good time, given that many people are hardpressed during these economic times to spend only on bare necessities. Well, now you can keep your mind active and thriving with what you can find here!
These 2 maps say it all about the current economy. Being unemployed has become a more common experience for a larger portion of the population between 2007 and 2010.
According to the May 4th yahoo Finance article,"America's Middle Class Crisis: The Sobering Facts":
"There are 8.5 million people receiving unemployment insurance and over 40 million receiving food stamps.
At the current pace of job creation, the economy won't return to full employment until 2018.
Middle-income jobs are disappearing from the economy. The share of middle-income jobs in the United States has fallen from 52% in 1980 to 42% in 2010.
Middle-income jobs have been replaced by low-income jobs, which now make up 41% of total employment.
17 million Americans with college degrees are doing jobs that require less than the skill levels associated with a bachelor's degree.
Over the past year, nominal wages grew only 1.7% while all consumer prices, including food and energy, increased by 2.7%.
Wages and salaries have fallen from 60% of personal income in 1980 to 51% in 2010.
The middle class is shrinking, which threatens the social composition and stability of the world's biggest economy."
June 6, 2011 - AHRQ and Public Health Emergency Preparedness
Today the AHRQ listserv reports that it is changing its priorities regarding Public Health Emergency Preparedness:
"AHRQ Public Health Emergency Preparedness Program Announcement
As of June 30, 2011, the Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) is discontinuing its Public Health Emergency Preparedness Research Program (PHEP)."
Since AHRQ began its work in public health emergency preparedness in 2000, the federal government has increased its efforts to prepare for and respond to public health emergencies.
As preparedness programs have expanded and diversified at the federal level, coordination among them has become more complex and a realignment of federal resources is needed. Activities pursued under AHRQ's program will continue to be supported by other federal agencies.
AHRQ is currently working with its federal partners to ensure that emergency preparedness materials developed by the agency remain publicly available to emergency planners and responders in the field....
AHRQ is proud of the contributions it has made to the emergency preparedness field and is confident that our federal partners will continue to provide valuable leadership and support. We appreciate the dedication of those in the emergency preparedness community who continue working to keep our nation safe and ready to respond in times of crisis."
In recent years there have been continuous reports about a possible connection between cell phone use and cancer. On May 31st, The World Health Organization thinks there is enough of a connection to warrant caution. As reported in Medscape:
The World Health Organization (WHO) announced today that radiation from cell phones can possibly cause cancer. According to the WHO's International Agency for Research on Cancer (IARC), radiofrequency electromagnetic fields have been classified as possibly carcinogenic to humans (group 2B) on the basis of an increased risk for glioma that some studies have associated with the use of wireless phones.
More specifically, the IARC Monograph Working Group discussed and evaluated literature that included several exposure categories involving radiofrequency electromagnetic fields:
Occupational exposures to radar and to microwaves;
Environmental exposures associated with transmission of signals for radio, television, and wireless telecommunication; and
Personal exposures associated with the use of wireless telephones.
"Given the potential consequences for public health of this classification and findings," ...."it is important that additional research be conducted into the long-term, heavy use of mobile phones. Pending the availability of such information, it is important to take pragmatic measures to reduce exposure such as hands-free devices or texting."
...study results have been inconsistent, although some European countries have taken precautionary measures aimed specifically at children.
Some of the strongest evidence supporting a link between brain tumors and cell phone use comes from a series of Swedish studies.. showed that risk increased with the number of cumulative hours of use, higher radiated power, and length of cell phone use. They also reported that younger users had a higher risk. (Int J Oncol. 2006;28:509-518; Int Arch Occup Environ Health. 2006;79:630-639; Arch Environ Health. 2004;59:132-137; Pathophysiology. 2009;16:113-122).
...to date, the industry-funded Interphone studies found no increased risk for brain tumors from cell phone use, with only 4 exceptions. The findings contradicted the Swedish studies, which were independent of industry funding."
Citation source: http://www.medscape.com/viewarticle/743673?sssdmh=dm1.691953&src=nl_newsalert. To be release online soon in The Lancet Oncology and in print in its July 1 issue.
June 2, 2011 - Greetings from the San Diego Zoo!
Photo: Lee Jung
June 2, 2011 - A Lifetime of Good Health: Your Guide to Staying Healthy
So, as I bring to a close this more than a month long series of blog entries (http://www.womenshealth.gov/whw/events/event-detail.cfm?eventID=6878") "Focus on Women's Health Issues" in collaboration with womenshealth.gov's National Women's Health Week, I am hoping you have enjoyed this adventure of learning about all the public health issues facing women today. And, here is a recent quote that I found to capture it all:
"And we as women in particular and this is such an important message starting today, you all have to be supportive of each other. You can't be jealous, and push and trip, you know? It's hard enough." (Michelle Obama [May 26, 2011]; Q&A at London's Elizabeth Garrett Anderson School) [Citation Source: http://news.yahoo.com/s/yblog_exclusive/20110526/pl_yblog_exclusive/michelle-obama-on-her-cute-husband-hillary-clinton-and-how-she-raises-her-daughters)
For additional information, check the Women's Health Index for all the health topics available on the Web site pertaining to women's health.
May 31, 2011 - Asian Women & Breast Cancer Risk Assessment
In a May 16th NIH news release,"Breast cancer risk calculator updated for Asian-Americans," the National Cancer Institute reported:
Researchers have developed a more accurate method for estimating breast cancer risk for Asian and Pacific Islander American (APA) women. Most current risk estimates rely on data from non-Hispanic white women, but researchers have now come up with a statistical model that more specifically assesses risk for American women who identify themselves as Chinese, Japanese, Filipino, Hawaiian, other Pacific Islander, or other Asian.
"The new model is the latest step in our ongoing effort to improve NCI's Breast Cancer Risk Assessment Tool by updating it with newly obtained data for specific subgroups of the population,"
Each year in the general population, there are about 93.7 new cases of breast cancer per 100,000 APA women, and 127.3 new cases per 100,000 non-Hispanic white women, according to SEER data. In a 2007 SEER study, researchers found that among APA subgroups, native Hawaiian women had the highest breast cancer incidence rates (175.8 per 100,000), followed by Japanese-Americans (126.5 per 100,000). For Chinese-Americans, the largest subgroup, there are approximately 77.6 new cases per 100,000 women.
The new model may overestimate risk for women who have recently immigrated to the United States from certain regions of Asia where breast cancer risk is low. Further, the tool may not be appropriate for women living outside the United States.
Citation source: Matsuno RK, Costantino JP, Ziegler RG, Anderson GL, Li H, Pee D, Gail MH. Projecting Individualized Absolute Invasive Breast Cancer Risk in Asian and Pacific Island American Women. J Natl Cancer Inst; May 11, 2011; as reported at http://www.nih.gov/news/health/may2011/nci-16.htm
In a May 7th report on research funded by National Institute of Neurological Disorders and Stroke and the National Center on Minority Health and Health Disparities, researchers reported that those living in a Washington, DC underserved community (catchment area of the Washington Hospital) did not know the importance of getting medical help for stroke in a timely manner:
The issue is important because African Americans -- the vast majority of the respondents (91.3%) -- are at greater risk of stroke than are whites and are more likely to die.
And the time between the onset of the stroke and arrival at hospital is a critical factor, since the success of thrombolysis depends on early treatment,
"With every minute that passes, more brain cells die,"
"we found that virtually no one knew that treatment was available and that getting to the hospital quickly means right now -- as in drop everything."
"89% of the survey participants said they would call 911 first, but only 12% of the patients actually did so.
63% of survey participants said they would first call a friend or family member, while 75% of patients did just that.
Most of the patients 89% -- reported a significant delay in seeking medical attention, and almost half of those said the delay resulted from thinking the symptoms were not serious or that they would self-resolve.
Of the patients who suspected they were having a stroke, only half came to hospital by ambulance, and 35% of those said they had no other transportation options.
Only 25% said ambulance would be faster, although use of emergency medical services has several advantages, including speed, that the hospital can be alerted in advance, and that patients who arrive by ambulance are given priority and treated sooner.
"If you show up in your car, the hospital has to triage and figure out how serious your symptoms are, which takes more time."
Citation source:
Hsia AW, et al "Understanding reasons for delay in seeking acute stroke care in an underserved urban population" Stroke 2011; 42: DOI:10.1161/STROKEAHA.110.604736; as reported in Medpage Today
According to girlshealth.gov's "Why fitness matters" - "
".... 15 years ago type 2 diabetes was rare among adolescents, but now it accounts for almost 50 percent of new cases of diabetes in young people.
New research shows that exercise during the teen years (beginning at age 12) can help protect girls from breast cancer when they are older. Also, regular physical activity can help prevent colon cancer later in your life.
"Exercise can also improve your overall mood. A workout at the gym or a brisk 30-minute walk will make your brain produce chemicals that will make you happier and more relaxed than before you started working out.
Regular exercise can help you fall asleep faster and help you sleep deeper. A good night's sleep can improve your concentration and productivity in school the next day.
In 2008, an estimated 4.9 million nonfatal violent crimes were committed in the United States. Males were more likely than females to experience nonfatal violent crime victimization overall (21.3 versus 17.3 per 1,000 persons aged 12 and older; data not shown), however, females were more likely to report nonfatal intimate partner violence than males (4.3 versus 0.8 per 1,000 persons aged 12 and older).
Intimate partner violence (IPV) refers to any physical, sexual, or psychological harm by a current or former partner or spouse. IPV can take on many forms and vary in frequency and severity, ranging from threats of abuse to chronic, severe battering. IPV often is underreported, especially with regard to sexual and psychological violence.
In 2007, females with disabilities reported higher rates of violent crime victimization than females without disabilities. Nearly 35 per 1,000 females aged 12 and older with disabilities (age-adjusted) experienced violent crime victimization; this was nearly twice the rate of females without disabilities (18.9 per 1,000; data not shown).
Among female victims of violent crimes, the relationship of the victim to the offender varied by disability status. For instance, more than one-quarter of nonfatal violent crimes committed against females without disabilities were by an intimate partner, compared to 16.1 percent of crimes against females with disabilities. Females with disabilities were more likely to be victims of crimes committed by strangers than females without disabilities (33.5 versus 24.2 percent, respectively), and by non-intimate relatives, such as parents, siblings or cousins (12.5 versus 8.7 percent, respectively).
This map shows the unfortunate reality in today's world - the existence of human trafficking. It is an international public health issue - the sexual abuse of women and children that knows no borders.
"One of today's biggest human rights crises is the international trafficking of women and girls (and, to a lesser extent, boys) into sex slavery. Human trafficking is the third largest criminal industry in the world, outranked only by arms and drug dealing. The United Nations estimates that trafficking in persons generates $7 to $10 billion annually for traffickers.
Unlike some human rights abuses which are primarily regional, sex trafficking is global in nature. Victims come from virtually all developing countries and are trafficked into or through virtually all developing and developed countries. It is estimated, for example, that 50,000 people are trafficked into the United States every year, most of whom are sold into prostitution." (Citation source: http://www.thefuturegroup.org/id20.html)
P>For more information, see Women's Health - Social issues
May 25, 2011 - FDA Goes After Bogus STD Products
It is unfortunate that there are unscrupulous people trying to sell fraudulent products for treating STIs that basically do not work. Here is a video produced by the FDA about these bogus products.
Unlike men, women can be left infertile from untreated sexually-transmitted infections/diseases (STIs/STDs) that are most commonly caused by Chlamydia and Gonorrhea. Such STIs can result in pelvic inflammatory disease (PID). When PID is not treated it can damage the reproductive organs so a woman cannot bear a child.
If you are sexually active, then you should practice safe sex to avoid contracting STIs. If you have unprotected sex and you think you may have contracted something, then see a health care provider promptly for proper treatment.
For this year's April Alcohol Awareness Month, the CDC focused on how alcohol affects women. Its site reports:
"In 2009, more than 1 out of every 10 women reported binge drinking during the past 30 days. On average, women who binge drink said they engaged in this risky behavior at least three times per month. Among women binge drinkers, they consume, on average, almost six drinks per drinking occasion, which exceeds the threshold for binge drinking.
Binge drinking is a risk factor for sexual assault, especially among young women in college settings. The risk for rape or sexual assault increases when both the perpetrator and victim have used alcohol before the attack.
Women who binge drink are more likely to have unprotected sex and multiple sex partners, which can increase their risk of acquiring HIV and other sexually transmitted infections (STIs).
Female binge drinkers are more likely to engage in unsafe sexual activities compared with women who are not binge drinkers. Binge drinking increases the risk for unintended pregnancy which may lead to a delay in recognizing pregnancy.
Upon drinking equal amounts, women tend to absorb more alcohol when they drink, and take longer to break it down and remove it from their bodies compared to their male counterparts. These differences are caused by differences in body composition and chemistry between men and women. Even when they drink the same amount of alcohol, women tend to have higher levels of alcohol in their blood than men, and the immediate effects of impairment occur more quickly and last longer.
Alcohol tends to leave the body at a slower rate in women who take birth control pills compared with those who do not. The result can be greater alcohol impairment in women who take birth control pills.
No amount of alcohol is safe to drink while pregnant. There is also no safe time during pregnancy to drink, and no safe kind of alcohol.
Women who drink alcohol while pregnant increase their risk of having a baby with fetal alcohol spectrum disorders (FASDs).
Women are often more vulnerable than men to the long-term effects of alcohol on their health. Over time, drinking too much alcohol can lead to cancer, liver disease and heart problems.
During the reproductive years, women need to take care of themselves as best as they can so if they should decide to have children they will be able to provide the best "internal" environment they can for the growing fetus. This is more important these days because women are waiting longer to start a family so there are more years in which chronic diseases can develop if proper care is not taken to eat, sleep and exercise well.
The CDC has published an exellent fact sheet that provides an overview of how chronic disease, risk behaviors, and risk factors impact pregnancy and infant outcomes.
On April 19th, Diabetes Care reported online that those with diabetes are at increased risk for cancer. Men with diabetes have a greater risk for developing colon, pancreas, rectum, urinary bladder, kidney or prostate cancer, while women with diabetes were at increased risk for developing breast cancer, leukemia or cancer of the womb. Citation source: http://care.diabetesjournals.org/content/early/2011/04/18/dc11-0020
JAMA researchers reported on May 4th that structured exercise is important for controlling diabetes:
"...the researchers found that exercising for longer periods of time was better at bringing blood sugar levels down than exercising more intensively.
People with type 2 diabetes should engage in regular exercise training, for more than 150 minutes per week, this would be more beneficial concerning their glucose control. However, if they cannot reach this amount of weekly exercise, lower exercise amounts are also beneficial.
Currently, exercise guidelines recommend that people with type 2 diabetes perform at least 150 minutes a week of moderate-intensity aerobic exercise, and resistance training, such as weight lifting, three times a week
Exercise improves insulin sensitivity; it makes insulin work better
Citation source: Beatriz Schaan, M.D., professor, Hospital de Clinicas de Porto Alegre, Brazil; Joel Zonszein, M.D., director, clinical diabetes center, Montefiore Medical Center, New York City; May 4, 2011 Journal of the American Medical Association; as reported on HealtDay
During the 2007-2008 time period, comparisons of the obesity prevalence between men and women show that women were more obese than men, regardless of race/ethnicity. While there was a slightly higher percentage of obese White women when compared to White men, the percentages were much higher for Black women when compared to Black men, and Hispanic women when compared to Hispanic men.
Unfortunately, regardless of how much education, men and women have become more obese over time. Fortunately, more education seems to be a bit more protective for women than for men, especially for those who are college educated.
Having less education had a greater impact on whether or not women were obese. For example, for the 2005-2008 period, 42% of women with less than a high school education were obese vs. 32.1% of men with a similar education background.
May 19, 2011 - U.S. Female Obesity Prevalence, Globally & Over Time
Graphic source: Graphic created by BCJung, using https://apps.who.int/infobase/Comparisons.aspx
According to the WHO Infobase 2005 data, the percentage of obese American women is greater than in most countries.
According to NIH.gov, over one-third of U.S. adults are obese. All adults: 33.8 percent; Women: 35.5 percent; Men: 32.2 percent. (Citation source: http://win.niddk.nih.gov/statistics/#overweight)
Between 1988 and 2008, the prevalence of female obesity in the U.S. has increased over time, regardless of race and/or ethnicity. However, the increase in percentage has been greater for Black and Hispanic women over the two decades.
According the NIH.gov:
Among women, the age-adjusted prevalence of obesity (BMI > 30) in racial and ethnic groups is higher among non-Hispanic Black and Hispanic women than among non-Hispanic White women.
Non-Hispanic Black Women: 49.6 percent; Hispanic Women: 43 percent; Non-Hispanic White Women: 33 percent
According to the University of Medicine and Dentistry of New Jersey:
"Stroke is the No. 3 cause of death in the U.S., behind heart disease (with which it is closely linked) and cancer.
Stroke affects more than 700,000 individuals annually in the United States (approximately one person every 45 seconds). About 500,000 of these are first attacks, and 200,000 are recurrent attacks.
Someone in the U.S. dies every 3.3 minutes from stroke.
Stroke is the leading cause of disability among adults in the U.S.
Women account for approximately 43 percent of strokes that occur each year, but they account for 61 percent of stroke deaths.
Stroke risk increases with age. For each decade after age 55, the risk of stroke doubles.
Each year, 28 percent of people who suffer a stroke are under age 65.
In African-American females, the incidence is 79 per 100,000, with a death rate of 39.2 percent.
Stroke Survival Rates:
10 percent of stroke victims recover almost completely.
25 percent of stroke victims recover with minor impairments.
40 percent of stroke victims experience moderate to severe impairments requiring special care.
10 percent of stroke victims require care in a nursing home or other long-term care facility.
15 percent die shortly after the stroke.
More than 75 percent of Americans cannot name the most common warning sign of stroke sudden numbness or weakness of the face, arm or leg, especially on one side of the body according to the American Stroke Association.
Fewer than half of all individuals over 50 are actually aware of what stroke is, its signs and symptoms, and the importance of seeking immediate medical attention.
May 17, 2011 - Tobacco & Breast Cancer Risk in Women
According to an April 3rd news release from American Association for Cancer Research, based on data from the Women's Health Initiative study and were recruited between 1993 and 1998 and followed until 2009:
"There's a significant link between smoking and breast cancer risk in postmenopausal women, but it depends on their body weight.
Breast cancer risk was higher than normal among female smokers who were not obese, but this strong association was not evident in obese female smokers
Non-obese smokers with a body-mass index (BMI) of less than 30 had a significantly increased risk of cancer compared to nonsmokers. Those who smoked for 10 to 29 years had a 16 percent higher risk, those who smoked for 30 to 49 years had a 25 percent increased risk, and those who smoked for 50 years or more had a 62 percent greater risk.
But obese women who smoked didn't appear to be at increased risk for breast cancer."
Citation source: As reported in HealthDay, http://www.nlm.nih.gov/medlineplus/news/fullstory_110581.html
The take-home message is tobacco may contribute to breast cancer, and not that obesity does not. Other studies have shown obesity increases the risk for breast cancer. Other confounding factors to consider is that people who develop cancer commonly lose a lot of weight, and many smokers use nicotine to control appetite and their weight so that smokers with a normal BMI do not necessarily mean they are healthy. For more information, see Breast and Other Cancers of Women and Cancer
Cancer is the second leading cause of death in the U.S. Here is a line graph from the American Cancer Society's "Cancer Facts & Figures 2010" showing the overall trend in cancer deaths for women.
Over time, cancer of the lung or bronchus has overtaken breast cancer so that now it is the #1 cause of cancer deaths for women (26%), followed by breast cancer deaths (15%). It should be noted that the "incidence of lung cancer is strongly correlated with cigarette smoking, with about 90% of lung cancers arising as a result of tobacco use."(Source: http://www.webmd.com/lung-cancer/guide/lung-cancer-causes)
On March 31, 2011, the NIH reported that many cancer rates are declining. According to the news release:
"...for the first time, lung cancer death rates decreased in women, more than a decade after rates began dropping in men.
In women, incidence rates decreased for breast, lung, colorectal, uterine, cervical, bladder, and oral cavity cancers, but increased for kidney, pancreas, and thyroid cancers as well as for leukemia and melanomas of the skin."
This trend in decreasing lung cancer deaths for women can continue as more women quit smoking, or never start. So, if you smoke, it is never too late to stop. For more information, see Tobacco Resources, Cancer Resources
May 12, 2011 - Women & Cancer
Cancer of the lung and bronchus is the #1 cause of cancer in women. This can be directly attributed to smoking. This is followed by breast cancer and colon and rectum cancer, which can be caught early with screening. Women can take preventive measures by simply eating more fruits, vegetables and fiber, exercising daily for an hour, getting adequate sleep and going for regular checkups with their health provider.
Invasive cancer statistics show a slightly different story regarding women and cancer. Breast cancer has the highest rates for invasive cancer, and this is true for all women, regardless of race/ethnicity. Know your family history and work with your healthcare provider on the best strategy if you have been diagnosed with breast cancer. For all women, it is essential to get regular clinical breast examinations and mammograms, as early detection will allow for earlier treatment and better outcomes.
Here is a sobering map of mortality rates for women dying from heart disease. While heart disease is the leading cause of the death in the U.S., it is also the leading cause of death for women as well. Once again, Mississippi leads in the number of deaths from heart disease.
According to NIH's "Lower Your Heart Risk" webpage:
"An astonishing 80 percent of women ages 40 to 60 have one or more risk factor for heart disease. Having one or more risk factors dramatically increases a woman's chance of developing heart disease because risk factors tend to worsen each other's effects...having just one risk factor doubles your chance of developing heart disease.
..among U.S. women ages 18 and older, 17.3 percent are current smokers, 51.6 are overweight (BMI of 25 or greater), 27 percent have hypertension, 35 percent have high cholesterol, and 53 percent do not meet physical activity recommendations.
African American and Hispanic women, in particular, have higher rates of some risk factors for heart disease and are disproportionately affected by the disease compared to white women. More than 80 percent of midlife African American women are overweight or obese, 52 percent have hypertension, and 14 percent have been diagnosed with diabetes. Some 83 percent of midlife Hispanic women are overweight or obese, and more than 10 percent have been diagnosed with diabetes. Learn more about the risk factors of heart disease.
By doing just 4 things eating right, being physically active, not smoking, and keeping a healthy weight you can reduce your risk of heart disease by as much as 82 percent.
Here is an excellent comprehensive resource about heart disease and women, what the risk factors are, how to estimate your risk, how to develop an action plan if you have been diagnosed with heart disease, etc. Click on the graphic to access the handbook.
Where do women get health information from? According to the Kaiser Family Foundation's Women's Health Care Chartbook, "...women are still most
likely to turn to a provider when seeking information, with 44% reporting providers as their leading source....more than a quarter of women (28%) turn
to {the Internet} first for health information, making it the second leading provider of information; 16% of women first turn to family and friends when they are searching for health information." (Citation source: http://www.kff.org/womenshealth/upload/8164.pdf)
According to the CDC's "Health Information Technology Use Among Men and Women Aged 18-64: Early Release of Estimates From the National Health Interview Survey, January-June 2009":
From January through June 2009, 51% of adults aged 18-64 had used the Internet to look up health information during the past 12 months ;
Among adults aged 18-64, women were more likely than men to look up health information on the Internet (58.0% versus 43.4%) and were also more likely to use online chat groups to learn about health topics (4.1% versus 2.5%).
Since the Internet is fast becoming the go-to source for health information, credibility becomes a key consideration, especially if you are going to use the information for making health care decisions. To help you determine whether or not a Web site is a credible source, use the Web site Evaluation Grid I have developed to help you critique a Web site.
May 9, 2011 - National Women's Checkup Day: May 9, 2011
The purpose of the 9th annual National Women's Checkup Day is to:
Encourage women to visit health care professionals to receive or schedule a checkup.
Promote regular checkups as vital to the early detection of heart disease, diabetes, cancer, mental health illnesses, sexually transmitted infections (STIs), and other conditions.
Check out the (http://www.womenshealth.gov/whw/activity-planning/materials/screening-chart.pdf) General Screenings and Immunizations for Women Chart to see what you should be getting at your age.
(http://www.womenshealth.gov/whw/check-up-day/)National Women's Checkup Day: May 9, 2011 Page to make a pledge to schedule an appointment with your healthcare provider. I have! Your quality of life depends on it!
And, when you take the pledge, enter the state you are from and get a certificate to show your commitment to take care of yourself!
Happy Mother's Day to all women who believe in the power of nurturing! On this day, take a moment to reflect on how important it is to take care of ourselves so we can continue to nurture those we love!
Womenhealth.gov wants to raise awareness of why women should adopt the "It's Your Time" attitude. (http://www.womenshealth.gov/whw/activity-planning/materials/womens-health-week.pdf)
Today is Military Spouse Appreciation Day, and it is always celebrated on the Friday before Mother's Day. I only discovered this as I was researching topics for this month's focus on women's public health issues.
Military Spouse (or, Milspouse) Facts:
Live in all 50 states. In the US there are more than 5,900 military installations of varying sizes
Typical military spouse is a female under the age of 35 (80% are under 35)
95% of all military spouses are female
37% have children average is two children
Military spouses often fill the role of single parent due to deployments
54% of active duty spouses are employed
63% of active duty enlisted spouses are employed
Military spouses are ethnically diverse and hail from around the world
Source: 2002 demographic report published by the Military Family Resource Center, as reported on http://awtr.blogspot.com/2008/03/i-stumbled-upon-this-site-today-and.html
In last year's proclamation by President Obama, he notes:
"As we mark Military Spouse Appreciation Day, we reaffirm our steadfast commitment to supporting and honoring the husbands, wives, and loved ones of our Nation's servicemembers.
At the heart of our Armed Forces, servicemembers' spouses keep our military families on track. They balance family life, military life, and their careers all while supporting other military families and giving back to their communities. Many have served in uniform themselves and, understanding the obligations involved, can provide unparalleled support. They are pillars of strength in their families, often celebrating their children's life milestones while the other parent is away.
Military spouses also care for our wounded warriors and honor the memory of our Nation's fallen heroes, including their own loved ones. They impact countless lives on military bases and in schools, places of worship, and neighborhoods across our Nation. Their contributions help protect our freedom by strengthening our communities and our servicemembers.
The U.S. Department of Veteran Affairs host the National Center for PTSD (Post-Traumatic Stress Disorder). The Center provides a Webpage called "Issues Specific to Women." It addresses, unfortunately, the reality of women caught in the crossfire of combat (as female soldiers) and war (as civilian casualties). This site offers fact sheets about what can cause PTSD in women.
Rape of Women in a War Zone (Summarizes the prevalence and effects of war-related rape on women in a war zone, such as in Kosovo and Bosnia).
Sexual Assault against Females (Defines sexual assault, how often it occurs, and the characteristics of perpetrators. Discusses women's reactions to sexual assault and what to do if you have been sexually assaulted).
Traumatic Stress in Women Veterans (Discusses stressors faced by women Veterans and what can help).
Women, Trauma and PTSD (Learn about trauma and PTSD in women).
Women's Mental Health Services in the VA (Describes services offered to women Veterans, including the Women Veterans Health Care Program).
(Source: Post-Traumatic Stress Disorder - Issues Specific to Women)
It's a sad fact that the consequences of war could reach so far as to affect half of the world's population that truly has no interest in the devastating effects of brutality. But it's good to know that the US Department of Veteran Affairs is cognizant of the plight of women and has offered information that is useful to those who suffer from PSTD and those who care for them. It is also good to see that military spouses (predominantly women) are recognized for the important roles they play in supporting those serving in the armed forces.
Yes, heart disease is the leading cause of death for women. Heart disease is responsible for 1/4 of all deaths, followed by cancer and then stroke. The one to watch out for is type 2 diabetes. Though it may seem diabetes is responsible for "only" 3.0% of female deaths, this statistic is deceptive.
"Diabetes is likely to be underreported as a cause of death. Studies have found that about 35 to 40 percent of decedents with diabetes had it listed anywhere on the death certificate and about 10 to 15 percent had it listed as the underlying cause of death. Overall, the risk for death among people with diabetes is about twice that of people of similar age but without diabetes."
"In 2004, heart disease was noted on 68 percent of diabetes-related death certificates among people ages 65 years or older. In 2004, stroke was noted on 16 percent of diabetes-related death certificates among people ages 65 years or older. Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes. The risk for stroke is 2 to 4 times higher among people with diabetes."
"Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States.
Diabetes is a major cause of heart disease and stroke." Citation source: http://diabetes.niddk.nih.gov/dm/pubs/statistics/
Mayo Clinic's "Women's health: Preventing the top 7 threats" provides some basic approaches to reducing your risk of dying from the top 7 causes of death. But if you just eat healthy, exercise regularly, get adequate sleep and don't smoke, you will pretty much be on your way to a lifetime of good health.
Do gender differences exist? You bet. According to the 2008 PEW study, Men or Women: Who's the Better Leader? A Paradox in Public Attitudes : "...on seven of eight leadership traits measured in this survey, the public rates women either better than or equal to men," "Men prevail over women on decisiveness (their lone victory in the battery of eight traits), with 44% of respondents saying that men are more decisive and 33% saying women are."
It is also interesting that respondents reported gender differences for common traits. "...for men, gender solidarity goes only so far. Overall, they give their gender the better ratings on just five of the 12 traits (decisiveness; hard work; ambition; not being emotional; not being manipulative) and they give themselves inferior ratings on seven (honesty; intelligence; compassion; creativity; being outgoing; being stubborn; being arrogant). By contrast, while women say they are more emotional and more manipulative than men, they give themselves higher marks than men on the 10 other traits measured."
"Of all demographic groups, black women are distinctive in the degree to which they say women are superior to men in their evaluations of character traits. Nearly eight-in-ten (78%) black women (compared with 51% of white women and 50% of all adults) say women are more honest than men. About two-thirds (65%) of black women (compared with 37% of white women and 38% of all adults) say women are smarter than men. And about half (49%) of black women (compared with 33% of white women and 28% of all adults) say women are more hardworking than men."
"By a ratio of nearly two-to-one, Americans say that, all things considered, men rather than women have a better life in this country. Women believe this in greater numbers than men do, and younger and middle-aged adults believe it in greater numbers than older adults do. In 1972, during the early days of the modern gender revolution, slightly more adults said women had the better life than said that about men."
Since the Substance Abuse & Mental Health Services Administration (SAMHSA) has designated today as National Children's Mental Health Awareness Day, I decided to start this month's blog entries with a look at mental health, one of the basic foundations for overall wellness.
Did you know that 1/2 of all mental illnesses start before the age of 14? It may be the result of child abuse, and maybe not, but mental health problems that are not identified and addressed early on can result in behaviors that compromise quality of life later on in life. Common mental health problems affecting women more than men include eating and anxiety disorders and major depression.
Click on the "Women's Mental Health" graphic for the SAMHSA publication that provides a comprehensive look at the importance of mental health for women, how to identify problems and when to seek help. The second graphic is a link to the SAMHSA webpage with links to resources pertaining to children's mental health.
Womenshealth.gov once again is celebrating National Women's Health Week, this year during May 8 - 14, 2011. I have decided to collaborate with Womenshealth.gov (http://www.womenshealth.gov/whw/events/event-detail.cfm?eventID=6878) with Online Event devoting May's blog entries to women's health issues. So, be prepared to be enlightened!
My goal for this month is to highlight and raise awareness of the variety of public health issues facing women today. I will offer a Public Health perspective of how members of over 1/2 of the U.S. population are affected. Most telling is, even within the female population, differences exist.
For example, I was surprised to find how many women, in 2008, lived below the poverty level, especially among women of color, and not necessarily those who are older. Most shocking is about 1/4 of African-American, Hispanic and Native American/Alaska Native women age 18-44 live below the poverty level!
When possible I will provide online resources for additional information and support. I will do my best to make these entries not only educational but interesting as well! Please feel free to E-mail Me your thoughts and ideas for what you want to see and I will try and do my best to include them. Thank you for your interest, and I hope you learn something new about the "human condition" of being a woman!
May 1, 2011 - Thank you, Columbia University-Presbyterian Hospital Alumni Association!
Graphic source: http://cuphsonaa.com/awards.html
I would like to offer heartfelt thanks to my alma mater's Distinguished Awards Committee of the Columbia University-Presbyterian Hospital Alumni Association for honoring me with this year's Distinguished Alumni Neighbor's Award on April 29th at the New York Athletic Club. It was a memorable day!
Also, special thanks to the Association's President, Dr. Suzanne Hawes, who nominated me; Dr. Joan Hagen, Awards Committee Chair, for giving a wonderful introduction, and to my colleagues for writing letters of support for me: Dr. William Faraclas, Dr. Jadwiga Goclowski, Mary Nescott, Dr. Michael Perlin & Lara Reintz.
Indeed, it was a once in a lifetime honor, and the best part was having the opportunity to acknowledge the contributions of 3 of my nursing professors to my education, who also happen to be alums and attending the meeting.
April 29, 2011 - Cost of Chronic Diseases
Graphic source: McKinsey Quarterly Chart Focus Newsletter March 2011
German Statutory Health Insurance (public payor)
If you live long enough you will have the opportunity to experience what most older people experience, chronic diseases. This graphic plots what German Statutory Health Insurance (public payor) [~US's Medicare] pays for in terms of chronic diseases. (Source: McKinsey Quarterly Chart Focus Newsletter March 2011)
While the majority of costs for patients is greater for those with chronic diseases, I just find it interesting that for chronic diseases: cardiovascular disease, diabetes, cancer and pulmonary diseases make up only 37% of the total, with "other" chronic conditions making up 35% and non-chronic diseases affecting those with chronic conditions - 27%. So, what exactly are these "other" chronic conditions?
While tobacco is the most preventable cause of death, people continue to smoke and chew tobacco. This graphic illustrates the hazards of nicotine addiction from smoking and how difficult it is for those who use tobacco, to quit. Chewing is just as lethal.
Still, if you smoke (or chew tobacco), it is best to quit, and if don't, don't start.
April 27, 2011 - Healthy Living Cuts Death Rate in Half for Nonsmokers
An April 19th American Cancer Society news release on findings from the Cancer Prevention Study reports:
A healthy lifestyle nearly halves nonsmokers' risk of death from cancer, cardiovascular disease and other causes,
...the risk of cardiovascular-related death was 58 percent lower for women and 48 percent lower for men, and the risk of cancer death was 24 percent lower in women and 30 percent lower in men.
The findings were similar for both never and former smokers.
Citation source: American Cancer Society, news release, April 14, 2011, online study at Cancer Biomarkers, Epidemiology, and Prevention, as reported in HealthDay
Let's Move.gov advocates for children to exercise an hour a day as a strategy to addressing the childhood obesity epidemic. Great idea!
If you know your height and weight, then you can use this simple graph to see where your BMI is. I remembered learning about graphing data when I was in junior high school, so even if you don't have a high school diploma you should be able to use this to see if you are within the normal weight range, or if you need to lose some pounds. If you do, then this is a good time to start since it's getting nice outside and there is no excuse....
If you like calculators and want to learn more about obesity, see Obesity
Here is an interesting Infographics visualization of how increasing BMI increases the risk for death. Will this make people think twice about portion control? It should.
Carrying excess weight is like dragging around excess baggage, and you know how that feels in an airline terminal!
In this last blog entry using the WHO Global Infobase, I decided to look at the global prevalence of obesity.
While the data are more current (2010) by gender (maps below), I had to look on another page to get a global picture of obesity.
This map includes the most recent data for "BMI % Obese >=30." Unfortunately, the US leads in global obesity, along with the Middle East.
When looking at obesity by gender, high male obesity prevalence is found for all countries in the Western Hemisphere, Australia, Egypt, Saudi Arabia. High female obesity prevalence is found for all countries in the Western Hemisphere, Egypt, South Africa and Mongolia! (Gender graphics generated by BCJung at: https://apps.who.int/infobase/Comparisons.aspx)
From a preventive standpoint, addressing obesity will definitely impact the mortality rates for diabetes, heart disease and stroke.
April 21, 2011 - A Visual Guide to High Blood Pressure
High blood pressure (hypertension) puts people at risk for cardiovascular disease and strokes. It is considered a modifiable risk factor, which means you can do something about it. An easy first step is to cut out salt from your diet. Current recommendation: "less than 1,500 mg for all African Americans and those with hypertension, diabetes, and chronic kidney disease (including children), as well as persons older than 50; everyone else is advised to consume under 2,300 mg of sodium a day." (Citation source: http://www.medpagetoday.com/PrimaryCare/DietNutrition/24597)
You can easily achieve this by cutting out sodas, fast food, junk food, canned and frozen foods. Check the labels, you will be surprised at how much sodium is found in what we eat.
According to a 2007 MMWR report,
"Approximately 98.1% of adults with self-reported HBP reported taking at least one action to lower or control their blood pressure, and a majority of respondents reported taking each of the five actions: 70.9% changed their eating habits, 79.5% decreased use of salt or did not use salt, 79.2% reduced consumption of alcohol or did not drink alcohol, 68.6% exercised, and 73.4% took antihypertensive medication.
Women were more likely than men to report changing eating habits and reducing consumption of alcohol or not drinking alcohol. Reducing use of salt or not using salt and taking antihypertensive medicine increased with age. A higher proportion of non-Hispanic blacks (90.0%) compared with other racial/ethnic groups reported reducing use of salt or not using salt." (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5617a2.htm)
To learn more about high blood pressure, click on the graphic for WebMD's "A Visual Guide to High Blood Pressure," which is an excellent slideshow of the main points you need to know.
Graphic generated by BCJung at: https://apps.who.int/infobase/Comparisons.aspx
Using the WHO Global Infobase I decided to continue looking at mortality statistics, this time for stroke (cerebrovascular disease). Stroke is the 3rd leading cause of death in the U.S., and causes major disabilities for those who survive it.
If you look at global mortality rates, stroke is more of a major player than ischemic heart disease! Practically all of Asia have high stroke mortality rates, as well as several African countries.
When looking at stroke mortality, by gender, Chinese men have higher stroke mortality than Chinese women, as well as women of several African countries.
Who would have ever thought that stroke would be such a great health issue for women than it is for men?
According to the American Heart Association, the following stroke risk factors can be changed, treated or controlled: High blood pressure; Cigarette smoking; Carotid or other artery disease; Atrial fibrillation; Other heart disease (coronary heart disease or heart failure; Dilated cardiomyopathy (an enlarged heart), heart valve disease and some types of congenital heart defects)); Sickle cell disease (also called sickle cell anemia); High blood cholesterol; Poor diet; Physical inactivity and obesity. (Citation source: http://www.americanheart.org/presenter.jhtml?identifier=4716)
Beer consumption averaging 2-3 drinks/day is now associated with stomach (gastric) cancer, and almost nine-fold for beer drinkers who also had a key genetic variant.
European Prospective Investigation into Cancer and Nutrition (EPIC) researchers report:
"Relatively uncommon in the U.S., gastric cancer is the second leading cause of cancer death worldwide...environmental factors play a prominent role in the risk,
Heavy alcohol consumption, irrespective of the type of drink, boosted gastric cancer risk by 65% compared with very light consumption.
...beer as the principal culprit, associated with a 75% greater risk of gastric cancer in people who averaged 30 g of alcohol daily from beer (two to three per day),...
The presence of a mutation in the alcohol dehydrogenase gene cluster (ADH1) greatly exacerbated the cancer threat. The combination of the variant and regular high intake of beer resulted in a relative risk for gastric cancer risk more than 700% higher, as compared with light consumption and absence of the mutation.
Beer contains certain compounds not found in wine or spirits, notably nitrosamines,.... The difference offers a plausible explanation for the lack of risk specifically attributable to other forms of alcohol.
Infection with Helicobacter pylori is one of the best-known environmental contributors to gastric cancer risk. However, suspicion also has fallen on diet, smoking, and alcohol consumption, among other potential factors.
Biologic explanations for the findings:
Accumulation of potentially toxic acetaldehyde in the stomach
Excessive generation of nitrosamines (found in beer), known to be carcinogenic in animals
Excess bacteria in the stomach resulting from atrophic gastritis (which can lead to accumulation of acetaldehyde and nitrosamines)
Excess in the combination of acetaldehyde and nitrosamines
Source: American Association for Cancer Research -
Duell EJ, et al "Polymorphisms in the alcohol dehydrogenase (ADH1) gene cluster, alcohol consumption, and interactions in relation to gastric cancer risk in the EPIC cohort" AACR 2011; Abstract 3748; as reported http://www.medpagetoday.com/MeetingCoverage/AACR/25842?utm_source=WC&utm_medium=email&utm_campaign=Meeting_Roundup_AACR
In the recent Pediatrics report,"Clinical Report - The Impact of Social Media on Children, Adolescents, and Families Pediatrics" that was posted online last month, researchers explore the pros and cons of social media.
"Using social media Web sites is among the most common activity of
today's children and adolescents. Any Web site that allows social interaction
is considered a social media site, including social networking
sites such as Facebook, MySpace, and Twitter; gaming sites and virtual
worlds such as Club Penguin, Second Life, and the Sims; video sites
such as YouTube; and blogs.
Such sites offer today's youth a portal for entertainment and communication and have grown exponentially in recent years. For this reason, it is important that parents become aware of the nature of social media sites, given that not all of them are healthy environments for children and adolescents.
Pediatricians ...encourage healthy use and urge parents to monitor for potential problems with cyberbullying, Facebook depression, sexting, and exposure to inappropriate content."
"Facebook depression" is "With in-your-face friends' tallies, status updates and photos of happy-looking people having great times, Facebook pages can make some kids feel even worse if they think they don't measure up. It can be more painful than sitting alone in a crowded school cafeteria or other real-life encounters that can make kids feel down, ....because Facebook provides a skewed view of what's really going on. Online, there's no way to see facial expressions or read body language that provide context." (Source: http://www.msnbc.msn.com/id/42298789/ns/health-mental_health/)
NSAIDS (nonsteroidal anti-inflammatory drugs) are very popular drugs used for the relief of pain. However, you should be aware that taking this class of drugs can put you at risk for a cardiovascular event.
Earlier this year, the British Medical Journal reported on a meta-analysis that looked at credible evidence and were shocked at the increased risk they found for myocardial infarctions (heart attacks), strokes and cardiovascular deaths.
This table (from Medscape's "All Nonsteroidal Anti-Inflammatory Drugs Have Cardiovascular Risks") summarizes the rate ratios for 7 NSAIDs. Probably, the most popular is Ibuprofen (aka Motrin, Advil), which you can get over the counter.
Think of a value of 1 as no risk, so that anything above 1 means an increased risk. Thus, in the case of Ibuprofen, there is over 3x the risk for stroke. And, I should note that rofecoxib (Vioxx) is associated with the highest risk for myocardial infarction (with a rate ratio of 2.12), and this drug was taken off the market in 2004 due to concerns over cardiotoxicity.
If you are taking any of these NSAIDs, you should probably talk to your health care provider about the cardiovascular risks involved and maybe think of other ways to control the pain than with this class of drugs. (Citation source: BMJ. 2011;342:c7086; as reported http://www.medscape.org/viewarticle/736051?src=cmemp)
The AHRQ has recently released "Care Coordination Measures Atlas" which
is to provide guidance on how to measure the extent to which care coordination activities are being implemented.
Here is the "Care Coordination Ring" they came up with to depict all the parties involved with coordinating the care for a patient. Though this looks well thought out, one would have think there has got to be a better way. Why are so many people involved? Are all these people absolutely necessary to provide services to the patient? Of course, good communication is key, but we really have to find a way to simplify this!
April 13, 2011 - HHS.gov's New Media Web site (8/23/2013 - This site no longer exists)
Newmedia.gov is the excellent social media Web site of the U.S. Department of Health and Human Services. It is truly amazing how the agency has found inexpensive ways to reach the public it serves, in timely ways, through social media venues. This will definitely help the nation in achieving the goals and objectives of the new Healthy People 2020!
Extremely easy to navigate, you will be able to find a wealth of resources you can use in your Public Health work, especially in the area of health education and health promotion. Not only does it provide links to health and related information that you can add to your Web presence, but, technical-oriented documents such as "Social Media 101" to best practices in a particular media venue.
Need to brush up on your analytical skills? This online publication should do the trick. While it is entitled "Analytic Methods in Maternal and Child Health," it pretty much covers the basics you need to know to be a good public health analyst. Topics covered include:
Module 1: Descriptive Epidemiology and Statistical Estimation
Module 2: Measures of Association and Hypothesis Testing
Module 3: Analytic Epidemiology and Multivariable Methods
Module 4: Methods for Summarizing Data
Module 5: Methods for Analyzing Trend Data
Module 6: Creating Target Population Estimates Using National Survey Data
Here we are, in the 21st century, and we thought that at least we have conquered infectious diseases, if not the growing number of chronic diseases. Wrong!
Infectious diseases are experiencing a resurgence with the growth of antibiotic-resistant superbugs, such as methicillin-resistant Staphylococcus aureus (MRSA), NDM-1, etc. Even as I am writing this, Southern California is dealing with carbapenem-resistant Klebsiella pneumoniae, or CRKP (Source: http://abcnews.go.com/Health/Wellness/deadly-antibiotic-resistant-superbug-spreads-southern-california/story?id=13218978)
The over-usage of antibiotics has killed off the weaker bacterial strains, leaving us with antibiotic-resistant superbugs, which are fatal to those who are most susceptible. Many are found in health care facilities, and the victims are those most vulnerable, such as the very young, very old and those who are immunocompromised.
Click on the graphic to get to the CDDEP. You can also find a link to site, along with information about drug resistance at Infectious Disease
The Center for Disease Dynamics, Economics & Policy (CDDEP) offers on its Web site the "Extending the Cure's ResistanceMap" which consists of a carousel of U.S. maps for 2000-2009. Annual maps highlight the prevalence of each known superbug over time. "The numbers used to make the maps are stratified by isolate source into inpatient and outpatient samples, where inpatient includes ICU and nursing home admissions." (Graphic and Citation Source: http://www.cddep.org/resistancemap)
April 8, 2011 - In Case the Federal Government Shuts Down...
Then all links to government Web sites (.gov) may not be functional. I hope that they will all be back online when budget issues are resolved. All links I have to federal government sites provide the best information possible for the public health topics I track so they are critical to advancing knowledge in those areas. I have always appreciated that those agencies that address public health issues have tried over the years to make their information as accessible as possible for anyone who wants to learn more and be informed.
Up until now the treatment for high cholesterol has been to lower low density lipoproteins (LDLs). This is basically what the statin class of drugs mainly do. Those who are being treating for coronary heart disease must take statins to control LDLs. However, the more important lipoprotein when considering cardiovascular risk is high density lipoprotein (HDL), which basically scrubs the vascular system of any LDL buildup. Having a high HDL level is cardioprotective.
Current pharmaceutical approaches is to raise HDL. Some drugs can raise HDL (e.g., Fibrates raise HDL about 5% to 10%, and the average in most trials is about 6%; Nicotinic acid HDL probably more than fibrates, 15% to 25% ) Citation source: HDL: The Next Frontier in Reducing Atherosclerosis and Cardiovascular Risk; http://www.medscape.org/viewarticle/
734620_transcript ), but there are problems with tolerance and side effects. The most effective way to raise HDL levels is through aerobic exercise, whick involves working the large muscles in our body. So, running, jogging, brisk walking, swimming and biking will do the trick.
Recent research has found that "5 infusions of an HDL-like particle actually led to ...coronary atheroma regression." Citation source: Emerging HDL Therapies: What Is on the Horizon to Further Reduce Cardiovascular Risk?; http://www.medscape.org/viewarticle/734621_transcript . So, current drug strategies to raise HDL is based on blocking CETP inhibition.
They have found "...cholesteryl ester transfer proteins move cholesteryl esters from HDL to the atherogenic LDL. That means that HDL decreases and the LDL increases. The CETP inhibitors act to make lipoproteins more atherogenic. By blocking this, you could increase the HDL and decrease the atherogenic LDL. That's the principle of CETP inhibition." (Citation source: Novel CETP Inhibitors in Clinical Development; http://www.medscape.org/viewarticle/734623_transcript)
However, I should mention that this approach was used in the development of Torcetrapib in the mid-2000s, but the ILLUMINATE study (http://www.medscape.com/viewarticle/569609_2) reported: ...patients who received torcetrapib and atorvastatin had an increased risk of death and cardiac events compared to patients who only took atorvastatin. (Citation source: http://heartdisease.about.com/od/cholesteroltriglycerides/
a/torcetrapib1.htm)
So, for now, stick to aerobic exercise to raise your HDL levels.
While I am talking about cholesterol, here is a simple way to get up to speed about cholesterol. Cholesterol 101 Slideshow: What Your Levels Mean is a visually appealing tour of everything you need to know about cholesterol.
A basic understanding of cholesterol is necessary to appreciate the importance of this substance to our physical well-being and why too much of this can be detrimental to our heart. Check out the slideshow and learn something that will improve your quality of life!
April 6, 2011 - Low HDL and Obesity in Middle-school Children
The April 3rd Medpage Today article,"ACC: CVD Risk Seen in Middle School Students" reports:
"...children as young as 11 showed worrisome signs of future cardiovascular danger -- with 16% of them found to have low HDL cholesterol levels (40 mg/dL)
Low HDL cholesterol (≤40 mg/dL) was associated strongly with a higher BMI (P=0.001 for trend). In the group of children with low HDL levels, 60.3% were overweight, compared with 28.8% in the group with high levels.
...low HDL cholesterol levels were also associated with a higher body mass index, worse lipid profiles, and higher blood pressures.
Both low HDL cholesterol levels and worse heart rate recovery were associated with increased prevalence of traditional cardiovascular risk factors, such as increased body mass index, poorer lipid profiles, and decreased physical activity levels,...
About half of the children with low HDL had at least two additional components of the metabolic syndrome -- which includes high LDL and triglycerides, elevated blood pressure, and abdominal obesity.
According to practice guidelines from the American Academy of Pediatrics, certain children should be screened for dyslipidemia -- including those with a family history of either significant hyperlipidemia or premature heart disease, and overweight children regardless of family history or other cardiovascular risk factors.
...the National Heart, Lung and Blood Institute recommends lipid screening in children as early as age 2 if they have a parental history of high cholesterol (total cholesterol >240 mg/dl) or a family history of early heart disease.
In children with low HDL cholesterol in particular, lifestyle modifications should be tried, because studies show -- at least in adults -- that exercise can raise HDL cholesterol levels."
Citation source: Flynn S, et al "Decreased high-density lipoprotein cholesterol in a cohort of 6th-grade children: association with cardiovascular risk factors and lifestyle behaviors" ACC 2011; Abstract 1097-429; as reported in: http://www.medpagetoday.com/MeetingCoverage/ACC/25691
For more information, see Obesity and encourage children to get active!!!
April 5, 2011 - HDL's Critical Role in Heart Disease and Cancer
High Density Lipoprotein (HDL) is considered the good component of cholesterol. Having a low level of HDL puts a person at risk for heart disease. Presently, the best way to raise HDL in our bodies is through aerobic exercise. It basically keeps the arteries clean of bad cholesterol (low density lipoprotein [LDL]) by transporting it back to the liver so it can be eliminated from the body.
However, a 4/1 research report of mice studies from MD Anderson and University of North Texas indicates that HDL may also play a role in control the spread of cancer cells. This is really promising research that may lead to the possibilty of a cancer cure, and possibly shoring up people's HDL levels to fight heart disease.
Findings from the study include:
"good cholesterol" can... act as a special delivery vehicle of destruction for cancer.
Previous studies have shown that cancer cells attract and scavenge HDL by producing high levels of its receptor, SR-B1. As cancer cells take in HDL, they grow and proliferate. The only other site in the body that makes SR-B1 receptor is the liver. This selectivity for cancer cells protects normal, healthy cells from side effects.
The team developed a synthetic version of HDL, called rHDL, because it's more stable than the natural version.
rHDL has not shown to cause immunologic responses, helping to minimize potential side effects,...it exhibits longer time in circulation...because SR-B1 is found only in the liver, an rHDL vehicle will help block and treat metastasis to that organ.
The siRNA/rHDL formulation alone reduced the size and number of tumors by 60 to 80 percent. Combinations with chemotherapy caused reductions above 90 percent."
Public Health gets taken for granted when it is doing its job. While it is "public" in scope, most of what happens for the good of the public goes on behind the scenes. It is only when things break down do we realize just how important Public Health is to our daily lives.
Enjoy the American Public Health Association's video that summarizes what falls under the purview of Public Health.
To learn more about Public Health practice, check my Public Health Practice Page and the rest of this Web site, which is predominately devoted to Public Health.
April 1, 2011
Just launched, promises to provide more accessible data to the public. The government Web site organizes data into communities, of which Health.Data.gov is one.
The purpose of Data.gov is to increase public access to high value, machine readable datasets generated by the Executive Branch of the Federal Government.
A primary goal of Data.gov is to improve access to Federal data and expand creative use of those data beyond the walls of government by encouraging innovative ideas (e.g., web applications). Data.gov strives to make government more transparent and is committed to creating an unprecedented level of openness in Government. The openness derived from Data.gov will strengthen our Nation's democracy and promote efficiency and effectiveness in Government.
Citation source: http://www.data.gov/about
Here is a super data site that I accidentally came across while looking for some data. Covers a variety of data that would be of interest to any epidemiologist at heart, globally and for the USA, down to state-level. Primary sources of data they use to compile their statistics come from the WHO, World Bank, UNESCO, CIA and individual country databases for global health and causes of death, and the CDC, NIH and individual state and county databases for verification and supplementation for USA data. Developed and maintained by by LeDuc Media, it is worth exploring.
After learning about how exposure to tobacco either from smoking or from others can result in birth defects (3/8/2011 blog entry), I decided to look into birth defects some more. Interestingly enough, the CDC just recently posted birth defects statistics.
Did you know that cleft palates/lips are the most common form of birth defects? Preliminary studies indicate "a combination of genes and other factors, such as exposures in the environment, maternal diet, and medication use" with an increased risk for those who smoke and/or have diabetes. (Source: http://www.cdc.gov/ncbddd/birthdefects/CleftLip.html)
But, this graphic was the most interesting to me. Many times when we think of infant deaths, we most likely associate that with SIDS, which is not as common as deaths from birth defects, followed by deaths from low weight and prematurity. Though some defects may be the result of genetic aberrations, many are preventable.
The following guidance comes from the CDC for preventing birth defects:
Take 400 micrograms (mcg) of folic acid every day.
Don't drink alcohol.
Don't smoke.
Don't use street drugs.
Talk to a health care provider about taking any medications.
Kids get fat for various reasons, from eating poorly to not getting enough exercise. Parents and caregivers need to take an active role in helping their kids, especially if they are overweight, to develop healthy habits.
Participating together in leisure activities that are physically active is one strategy that's not only good for the kids, but for the parents as well. It nurtures the familial relationship and creates emotional bonds kids need to face the stress in their lives (yes, they have that, too!) Make sure they get enough sleep will also help them to handle stress, which includes dealing with peer pressure.
Though much have been made about the dangers of visceral fat, a University of Cambridge's 3/11 report in Lancet contends that fat is bad for you, period.
"...being obese boosts the likelihood of a heart attack or stroke regardless of where the excess fat is stored in the body.
...it doesn't matter where your fat is located. If you're overweight you're at risk, full stop."
The study concluded that being obese certainly raises the overall risk for heart disease, but that those who carry much of their excess fat in the stomach region do not appear to face a particularly higher risk, compared with those whose fat deposits are distributed differently.
They also found that tracking a person's blood pressure and cholesterol levels, as well as monitoring their history of diabetes, appeared to be best way to assess heart disease risk. When such indicators were readily available, they noted, adding in BMI and waist measurement information did not improve risk diagnosis.
Excess weight, they said, remains a key culprit in the onset of medical conditions that boost the risk for cardiovascular illness.
...the factors that proved most useful in assessing heart risks -- such as high blood pressure and cholesterol -- are themselves the product of the "adverse effects of overweight."
Citation source: Emanuele Di Angelantonio, M.D., Ph.D., lecturer, medical screening, University of Cambridge, England; March 11, 2011, The Lancet, online; as reported http://www.nlm.nih.gov/medlineplus/news/fullstory_109713.html
According to a March 23rd American Heart Association news release, " sleep-deprived adults ate almost 300 calories more a day on average than those who got enough sleep.... Women...ate an average of 329 more calories a day if they weren't well-rested, while men ate 263 more calories on average."
(http://www.nlm.nih.gov/medlineplus/news/fullstory_110167.html)
Hmmm. Let's do a little arithmetic. If a woman were to do this for one year (365 days) x 329 calories (per day), that would come to a whopping excess average intake of 120,085 calories, OR, 34.51 pounds (3,500 calories = 1 pound). For a man, it would be 95,995 excess calories, or 27.43 pounds!!!
Here is a graphic from the CDC's Insufficient Sleep Is a Public Health Epidemic page which shows all the other problems one can have with insufficient sleep. "The National Sleep Foundation suggests that school-age children (5-10 years) need 10-11 hours of sleep daily, teens (10-17 years) need 8.5-9.5 hours, and adults need 7-9 hours According to data from the National Health Interview Survey, nearly 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007.3 In 2009, only 31% of high school students reported getting at least 8 hours of sleep on an average school night." (Source: http://www.cdc.gov/Features/dsSleep/)
So-o-o, it would be more sensible to go to sleep than stay up. For more information, see Sleep
March 23, 2011 -
Tohoku Earthquake Shaking Intensity
Here is a new rendering of earthquake intensity from NASA's Earth Observatory for the 3/11 Japan earthquake:
On March 11, 2011, the largest earthquake in Japan's modern history struck off the northeast coast, about 130 kilometers (81 miles) east of the mainland region of Tohoku. Initially categorized as magnitude 8.9, the quake was later revised upward to magnitude 9.0 by the Japanese Meteorological Agency (JMA) and the U.S. Geological Survey (USGS). The event shook buildings and damaged infrastructure hundreds of kilometers away. Closer to the main shock, coastal regions were devastated by the quake and the resulting tsunami.
This map shows the ground motion and shaking intensity from the earthquake at dozens of locations across Japan. Each circle represents an estimate of shaking as recorded by the USGS, in conjunction with regional seismic networks. Shades of pale yellow represent the lowest intensity and deep red represents high intensity. The ground shaking data is overlaid on a map of population density provided by Oak Ridge National Laboratory.
A shaking intensity of VI is considered strong and can produce “light damage, while a IX on the scale is described as violent and likely to produce heavy damage.
Note the number of VIIs and VIIIs near Tokyo, well away from the epicenter; the lack of a severe human toll in that metropolitan area is surely a testament to the quality of the nation's earthquake preparedness.
In the week after the main quake, Japan endured 262 aftershocks of at least magnitude 5, according to JMA. Forty-nine of them were magnitude 6 or greater, and three were magnitude 7 or higher. (For comparison, the Christchurch earthquake of February 2011 was a magnitude 6.3.) The aftershocks have been almost entirely offshore, in a zone stretching about 500 kilometers (300 miles) from Iwate to Ibaraki prefectures.
According to a recent report from the US DHHS, "Enhancing Use of Clinical Preventive Services Among Older Adults: Closing the Gap":
"Critical gaps exist between older Americans who receive potentially lifesaving preventive services and those who do not...
Clinical prevention services examined...include vaccinations that protect against influenza and pneumococcal disease (e.g., bloodstream infections, meningitis, and pneumonia), screenings for the early detection of breast cancer, colorectal cancer, diabetes, lipid disorders, and osteoporosis, and smoking cessation counseling.
About 10,000 Americans turn 65 every day; by 2030, about 1 in 5 Americans will be 65 older.
"We know prevention is critical to healthy living and independence,"
...49 percent of Asian/Pacific Islanders and 47 percent of Hispanics reported not being screened for colorectal cancer, in comparison to 34 percent of whites. More than 50 percent of Hispanics, 47 percent of blacks and Asian/Pacific Islanders, and 36 percent of whites report never receiving a pneumococcal vaccination."
It should be noted only starting this year that changes to Medicare coverage for those 65 and older have changed from a one-time Medicare entry-only comprehensive physical to expanded clinical preventive services coverage.
It is good that the US DHHS has taken this approach to raise awareness that preventive clincial services are critical for quality of life among those who are at the age of vulnerability. People who are 65 or older can benefit from early detection of diseases and conditions that can compound and exacerbate already existing chronic conditions.
Now the only thing left is to ensure health care providers are adequately compensated to continue to provide care to those who are on Medicare!
Click on graphic for the report. For more information, see Senior Health
March 21, 2011 - NIH's Diabetes Research Strategic Plan
On 3/18, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) announced the release of its Diabetes Research Strategic Plan, which will be available in print on 4/1. The plan...focuses on 10 areas of diabetes research with the most promise. The goal is to accelerate discovery on several fronts, including:
-- the relationship between obesity and type 2 diabetes, and how both
conditions may be affected by genetics and environment
-- the autoimmune mechanisms at work in type 1 diabetes
-- the biology of beta cells, which release insulin in the pancreas
-- development of artificial pancreas technologies to improve
management of blood sugar levels
-- prevention of complications of diabetes that affect the heart,
eyes, kidneys, nervous system and other organs
-- reduction of the impact of diabetes on groups disproportionately affected by the disease, including the elderly and racial and ethnic minorities.
Diabetes eventually damages nearly every organ system in the body. People with diabetes are at increased risk for blindness, kidney failure, and lower limb amputation. Overall, the risk for death among people with diabetes is about twice that of people of similar age without diabetes. In addition, it is a very expensive disease to manage. Total costs of diabetes, including medical care, disability, and premature death, reached an estimated $174 billion in 2007 in the United States. (Source: http://www.nih.gov/news/health/mar2011/niddk-18.htm)
Here's an interesting extrapolation that predicts how lower obesity levels could mean fewer people with diabetes. Analysis of Gallup-Healthways Well-Being Index data report:
"The diabetes rate in the US, which is related to obesity, also remains up from 2008, with 11.3% of American adults reporting in 2010 that they have ever been diagnosed with the disease, similar to 11% in 2009, but up more than 6% from 10.6% 2008.
...the relationship between obesity levels and diabetes diagnoses, revealing that there is an average diabetes rate of 9.9% in the 10 states with the lowest obesity levels, which is almost 28% lower than the average rate of 13.7% in the 11 states with the highest obesity levels.
These data reveal that if the 11 states with the highest obesity levels had the same average obesity rate as the 10 states with the lowest obesity levels, approximately 3.3 million fewer American adults would be obese and there could be as many as 1.6 million fewer diagnosed with diabetes in those 10 states alone.
If the remaining 40 states had the same average diabetes rate as the 10 states with the lowest obesity levels, approximately 4.6 million fewer American adults would have diabetes.
Because of the magnitude of the Japan earthquake, geological changes have occurred:
The quake caused a rift 15 miles below the sea floor that stretched 186 miles long and 93 miles wide,
The areas closest to the epicenter of the quake jumped a full 13 feet closer to the United States,
The 9.0 magnitude quake (the fourth-largest recorded since 1900) was caused when the Pacific tectonic plate dove under the North American plate, which shifted Eastern Japan towards North America by about 13 feet
The quake also shifted the earth's axis by 6.5 inches, shortened the day by 1.6 microseconds, and sank Japan downward by about two feet. As Japan's eastern coastline sunk, the tsunami's waves rolled in.
Why did the quake shorten the day? The earth's mass shifted towards the center, spurring the planet to spin a bit faster. Last year's massive 8.8 magnitude earthquake in Chile also shortened the day, but by an even smaller fraction of a second. The 2004 Sumatra quake knocked a whopping 6.8 micro-seconds off the day.
I tried to do a little more research online about the earth shifting axis but ended up with numerous sites about what's going to happen in 2012 and others with apocalyptic doomsday warnings. I'll report more when I find good scientific evidence worth passing along.
March 16, 2011 - Most Dramatic Footage of the Japan Earthquake/Tsunami
March 15, 2011 - FDA Takes on Fraudulent Dietary Supplements
Today the FDA released its "Beware of Fraudulent 'Dietary Supplements'" fact sheet to raise awareness of tainted products.
The Food and Drug Administration (FDA) has found nearly 300 fraudulent products promoted mainly for weight loss, sexual enhancement, and bodybuilding that contain hidden or deceptively labeled ingredients, such as the active ingredients in FDA-approved drugs or their analogs (closely-related drugs)
other compounds, such as novel synthetic steroids, that do not qualify as dietary ingredients
These products are masquerading as dietary supplements they may look like dietary supplements but they are not legal dietary supplements, says Michael Levy, director of FDA's Division of New Drugs and Labeling Compliance. Some of these products contain hidden prescription ingredients at levels much higher than those found in an approved drug product and are dangerous.
I am so glad that the FDA is taking an aggressive approach to warning the general public about fraudulent dietary supplements. It's a start. I would like to see the FDA regulate anything that is called a dietary supplement so the public can be assured that they are getting what they are paying for. Additionally, they have released a widget that will provide a continuous feed of the latest news regarding tainted products. The widget can be found on Home Page, the Nutrition Page, and right here!
March 14, 2011 - Mercalli -> Richter -> Moment Magnitude Scales
Japan's 8.9 earthquake/tsunami catastrophe is totally devastating. Earthquakes are measured in magnitude and energy released. Many people will probably remember the Richter Scale, but it has been superceded when the Moment Magnitude Scale was introduced in 1979. Both have its strengths and weaknesses, but generally speaking, the Richter Scale is more accurate for measuring smaller earthquakes (<3.5), and the Moment Magnitude Scale for larger earthquakes (7 or greater).
This graphic compares the magnitudes of large earthquakes and other energy-releasing phenomena. They will probably update this with the historic Japan earthquake (between San Francisco and Alaskan earthquakes).
Sometimes we forget the force of Nature until something catastrophic happens. It's good that globallly, emergency preparedness has become a priority to protect the Public's health. Having tools, like NOAA's Tsunami Travel Times and Energy Plot, help to prepare for sometimes inevitable natural disasters, and save lives in the process.
Recently released CDC 2008 county estimates of physical inactivity look very bleak, especially for southeastern states that already have a high prevalence of obesity, heart disease and diabetes. Physical inactivity in these areas will continue to perpetuate the hold of chronic diseases on those who live in these areas.
According to a recent British Medical Journal, people are not eating enough vegetables. "Researchers found that eating an extra 1.5 servings (about 4 extra ounces) of green leafy vegetables was associated with a 14% reduction in diabetes risk. Beneficial green, leafy vegetables include cabbage, Brussels sprouts, broccoli, and spinach." (Citation source: 1.Carter P, Gray LJ, Troughton J, et al. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;341:c4229, as reported by
http://www.medscape.com/viewarticle/737196?src=mp&spon=34)
"Leafy vegetables are ideal for weight management as they are typically low in calories. They are useful in reducing the risk of cancer and heart disease since they are low in fat, high in dietary fiber, and rich in folic acid, vitamin C, potassium and magnesium, as well as containing a host of phytochemicals, such as lutein, beta-cryptoxanthin, zeaxanthin, and beta-carotene. One study showed that an increment of one daily serving of green leafy vegetables, lowered the risk of cardiovascular disease by 11 percent."
Womenshealth.gov reports, "The ranking is for all races and ages combined. Different races have different rankings. For example, homicide is the fourth highest cause of death for black men and HIV/AIDS is the seventh, neither of which is in the top ten for all races. For Hispanic men, homicide is sixth, followed by chronic liver disease." Source: http://www.womenshealth.gov/mens/health/index.cfm
According to the CDC's "Health Information Technology Use Among Men and Women Aged 18-64: Early Release of Estimates From the National Health Interview Survey, January-June 2009":
Let's Move.gov advocates for children to exercise an hour a day as a strategy to addressing the childhood obesity epidemic. Great idea!
