Caution: ‘Acceptable’ Black Women’s Hairstyles May Harm Health

(U.S. Army)

(U.S. Army)

This spring, the Pentagon issued Army Regulation 670-1, which included bans on several hairstyles worn mainly by black women, including twists and multiple braids. After a major backlash that included accusations of racial bias, that grooming policy is now under review. Here, researchers at the Connors Center for Women’s Health at Brigham and Women’s Hospital argue that this is more than an issue of racial fairness; it could also cause harm to women’s health — and disproportionately impact black women, whose life expectancy is already five years less than white women’s.

By Tamarra James-Todd and Therese Fitzgerald
Guest contributors

We are encouraged by the news that the Pentagon is reviewing the Army’s grooming policy, Army Regulation 670-1, which many deemed to be racially biased because it banned hairstyles worn primarily by black women.

Such policies set unreasonable standards for what is appropriate or acceptable in our society, and promote the idea that natural “black” hair is somehow inappropriate and unacceptable.

But perhaps most disturbing is the growing evidence that the process involved in straightening curly hair and maintaining acceptable hairstyles is harmful to women’s health, disproportionately affecting black women and making the pervasive practice of banning “black” hair styles a major health equity issue.

Nearly half of black women and girls use hair products that contain endocrine-disrupting chemicals compared to just 8 percent of whites.

The military’s previous position on this reflects a precedent that unfortunately continues to exist in corporate and private sector settings throughout the country. Labeled as “grooming” issues, companies have fired employees for wearing dreadlocks and a private school in Orlando, Florida, threatened to expel a young girl if she refused to straighten or cut her natural black hair.

The public discourse around these biased policies should not only focus on the racism they perpetuate but also on the potential harmful health outcomes and health disparities they may leave in their wake now and for future generations.

In order to conform to the standards of appearance that these policies demand, black women and girls are often encouraged to straighten or otherwise change the texture of their natural “black” hair. Unfortunately, many of the hair relaxers, oils, creams and other products used to straighten or alter curly hair contain synthetic chemicals that disrupt the normal functioning of the human body’s endocrine system, which regulates and secretes hormones.

Based on hair product labels, nearly half (49 percent) of black women and girls use hair products that contain endocrine-disrupting chemicals compared to just 8 percent of whites, which could leave blacks with higher levels of these chemicals in their bodies compared to whites.

For example, phthalates, a class of endocrine-disrupting chemicals used in hair products, are known to be found at higher levels in blacks than whites. Research led by Dr. Tamarra James-Todd at the Connors Center for Women’s Health at Brigham and Women’s Hospital has revealed that higher phthalate levels are associated with a variety of poor health outcomes that disproportionately impact black women and girls including:

Type 2 diabetes, a condition twice as common among black women compared to white women, as well as insulin resistance and other associated conditions. Continue reading

If You Find A Tick: Why I Resorted To Mooching Pills To Fight Lyme Disease

A March 2002 file photo of a deer tick under a microscope in the entomology lab at the University of Rhode Island in South Kingstown, R.I. (Victoria Arocho/AP)

A March 2002 file photo of a deer tick under a microscope in the entomology lab at the University of Rhode Island in South Kingstown, R.I. (Victoria Arocho/AP)

I’ve never done anything like this before. I’m a good little medical doobie. I’m wary of pills, take them only with prescriptions, and follow the instructions to the letter. But last month, I “borrowed” a friend’s extra 200 milligrams of doxycycline — the onetime antibiotic dose shown to help prevent Lyme disease soon after a prolonged tick bite.

What brought me to that desperate point? A doctor declined to prescribe the pills, even though this is prime Lyme disease season and the patient, my family member, fulfilled every one of mainstream medicine’s requirements for the single dose aimed at preventing Lyme. To wit:

• The tick was a fully engorged deer tick that had been attached for more than 36 hours.

• We sought treatment within three days of removing it.

• The tick came from a Lyme-endemic area.

• And the patient had no medical reason to avoid antibiotics.

The antibiotics I “borrowed” from a generous friend (Carey Goldberg/WBUR)

The antibiotics I “borrowed” from a generous friend (Carey Goldberg/WBUR)

But still. The doctor argued that the chances of contracting Lyme from the tick were very small, perhaps 1 in 50, and that overuse of antibiotics contributes to the growing problem of drug-resistant bacteria. This is what he would do for his own family member, he said: skip the doxycycline, wait to see if Lyme develops, and treat it with a full 10-day course of antibiotics if it does.

I was frustrated and frankly a bit appalled. WBUR ran a series on Lyme disease in 2012, and I knew that controversy raged around many aspects of the disease, particularly the use of long-term antibiotics to treat long-term symptoms. But I was just trying to follow the widely accepted guidelines written by the Infectious Disease Society of America, to be found in reputable medical venues like UpToDate. And I knew from that same series that Lyme is rife in New England, and so are personal stories of health and lives ruined or seriously harmed.

Still, maybe I was overreacting? I’ve since sought a reality check from three experts, including the lead author of the guidelines. And here’s what I come away with: No, I was not unreasonable in seeking the preventive doxycycline. Arguably, though I hate to admit it, the doctor was not being totally unreasonable in declining it. The guidelines say a doctor “may” prescribe the antibiotic; it’s not a “must.”

In the end, I think, the crux of the question may lie in how you see the doctor’s role: Is it to lay out the risks and benefits and then let the patient choose? Or to impose his or her own best medical judgment on the patient? (You can guess where I come down on that one.) Also, “better safe than sorry” tends to rule when it comes to my loved ones. But what if the risk is small and the benefit uncertain? Continue reading

Cautious Optimism That New State Insurance Site Will Work

connector

An image from a previous interface for the Connector.

The first test of a new Massachusetts health insurance website was a success, a top state official says, leaving him cautiously optimistic that it will be up and running for a critical Nov. 15 deadline. That’s Opening Day for anyone who plans to buy insurance through the Health Connector, or is seeking free or subsidized coverage.

But Maydad Cohen, a top aide to Gov. Deval Patrick, says he’s not sure yet if the site, developed by hCentive, will be ready. So the state will continue to build out both a state and federal option for one more month. If the hCentive site clears a second test in early August, Massachusetts will drop plans to merge with the federal HealthCare.gov for 2015. Work would continue on the state site so that it would be ready for 2016.

Cohen is scheduled to update the Connector board Thursday morning, two months after the state gave up on the idea of trying to fix a site built by Canada-based CGI that never worked.

Some 230,000 residents who could not sign up for insurance online were placed in a temporary coverage plan because the state could not figure out what, if any, insurance assistance program they might qualify for. Each of those men and women will have to a reapply through a new site this November. And 101,000 residents who qualified for subsidized coverage last year, and whose plans have been extended this year, will also have to apply again.

Cohen says the cost of building out two options will be less than the original $121 million estimate, but he can’t say how much. An update on how much the state is spending to keep 230,000 people in temporary coverage is expected at Thursday’s board meeting.

How Addiction Can Affect Brain Connections

As much of the country grapples with problems resulting from opioid addiction, some Massachusetts scientists say they’re getting a better understanding of the profound role the brain plays in addiction.

Their work is among a growing body of research showing that addiction is a complex brain disease that affects people differently. But the research also raises hopes about potential treatments.

Among the findings of some University of Massachusetts Medical School scientists is that addiction appears to permanently affect the connections between areas of the brain to almost “hard-wire” the brain to support the addiction.

They’re also exploring the neural roots of addiction and seeking novel treatments — including perhaps the age-old practice of meditation.

Meditation As Part Of Addiction Treatment

After spending 40 minutes lying on the floor with his eyes closed, being led through a meditation exercise, one of the students in a recent mindfulness class said something that many of the other students appeared to be thinking.

“I’m irritated,” he said, as several of the 30 other students murmured in agreement. Some giggled.

“I can’t really sit this long with my eyes closed without falling asleep,” he added. “I think this is overall positive. Maybe I just have a long way to go.”

Mindfulness has been touted as a way to boost quality-of-life issues, and the students in the class were there for various reasons: some to learn to relax, others to cope with health issues, and — at least one student — to support her recovery from alcoholism.
Continue reading

Ritalin Nation: ADHD Drugs Not Studied Enough For Rare Or Late Risks

The ADHD drug Ritalin (Wikimedia Commons)

The ADHD drug Ritalin (Wikimedia Commons)

If we’re going to keep putting millions of American children on ADHD drugs, we really need to study the meds longer and better to pick up rare and late-onset side effects.

That’s my takeaway from a study just out from Boston Children’s Hospital. It found that in many cases, ADHD drugs had not been studied for long enough — really, can a clinical trial of a few weeks be long enough for a drug that’s typically taken for many years? — or in enough people. And drug company promises to keep studying the drugs’ effects even after the FDA approves them have often fallen by the wayside.

From the press release:

Over the last 60 years, the U.S. Food and Drug Administration (FDA) approved 20 medications for attention deficit/hyperactivity disorder (ADHD) based on clinical trials that were not designed to study their long-term efficacy and safety or to detect rare adverse events, researchers at Boston Children’s Hospital report today in PLOS ONE. The study highlights gaps in how the long-term safety of drugs intended for chronic use in children is assessed as part of the FDA approval process.

“This study doesn’t address whether ADHD drugs are safe, though their safety has since been established through years of clinical experience,” says study senior author Kenneth Mandl, MD, MPH, Boston Children’s chair in biomedical informatics and population health and director of the Intelligent Health Laboratory in Boston Children’s Informatics Program. “Instead, we point to the need for an agenda emphasizing improved assessment of rare adverse events and long-term safety through post-marketing trials, comparative effectiveness trials and more active FDA enforcement.”

The numbers: Continue reading

Study: Could Bro Or Sis Affect Weight More Than Mom Or Dad?

sisters

Veronica Thomas
CommonHealth Intern

My adolescence was a blur of rushing from school to dance classes with my older sister. After hours of practice, we couldn’t wait to get home and make berry smoothies that we’d slurp from the blender. My sister and I did almost everything together.

A new study suggests this relationship may have played a key role in keeping me healthy and fit.

The study, released online by the Journal of Preventive Medicine, found that siblings may have a greater influence on a child’s risk of obesity than parents do. Specifically, having an obese older sibling is associated with more than double the risk of being obese compared to having an obese parent. The association is even greater among siblings of the same gender.

It may seem obvious that family members influence a child’s chances of being obese, but the importance of the type of family relationship has been less clear. This new study, led by Dr. Mark Pachucki at the Mongan Institute for Health Policy at Massachusetts General Hospital, is the first to compare the influence of sibling obesity and parent obesity on a child’s obesity risk.

Dr. Pachucki and his team surveyed almost 2,000 only-child and two-child families from the larger Family Health Habits Survey. One parent from each family reported on the food environment, physical activity, weight and height for themselves and their children. The researchers also considered and analyzed the parents’ socioeconomic status, demographic background and overall health. Continue reading

Project Louise: Lose Ugly Belly Fat Fast! Yeah, Not So Much

(Photo: TORCH magazine via Compfight)

(Photo: TORCH magazine via Compfight)

By Louise Kennedy
Guest contributor

I had an epiphany of sorts over the weekend: I hate my belly.

Actually, you can’t really call it an epiphany if it’s something you’ve felt for just about your entire life. And ever since I got a little chubby in second grade – a chubbiness that lasted until puberty, returned with the classic “freshman 15” in college and has waxed and waned ever since – I have gazed down at the extra flesh between my navel and my hips with a mixture of shame, disgust and self-loathing.

And let’s just say that passing the 50-year mark hasn’t helped with any of this. Here’s how we know Mother Nature has a sense of humor: Just when your body stops being capable of pregnancy, it starts looking as if you’re already about 4 months along. Permanently.

But that’s no reason to hate myself, is it? Sure, I’d like to lose the weight. But if I don’t, I don’t want to carry around this toxic mix of negativity along with the extra pounds.

So here’s the real epiphany: I don’t want to hate myself anymore, not even one imperfect part of myself. I don’t have to love my belly; I just want to stop hating it. I want to make peace with my body.

My, that sounds sane. But you may come up with another adjective when I tell you what I did next: I Googled “belly fat.”

Here’s a quick tip: Don’t do that.

Oh, go ahead if you want to. But I can save you the trouble. Here’s what I learned: Continue reading

Study: Pregnant Women Hungry For Better Info Earlier On

Pregnancy test (Wikimedia Commons)

Pregnancy test (Wikimedia Commons)

The “+” sign pops up on your pregnancy test. You call the office of the obstetrician you’ve chosen for just this eventuality, and the receptionist congratulates you and sets you an appointment four or six or eight weeks away.  “But,” you think, “I have so many questions now!” The books aren’t enough. So you turn, of course, to Google, and navigate the thickets of information alone.

If this was your pregnancy experience and it struck you as odd or off or wrong, you’re not alone, according to a recent small study that likely reflects a far broader opinion. Writes one pregnant friend: “My docs are wonderful and insanely knowledgeable, and I call them for the big stuff. However, there’s so much little stuff when you’re pregnant, especially for the first time. It’s constant googling, is this normal? Everything from symptoms, food, exercise routines, massages, whether to dye your hair – it’s endless.”

And some things you need to know early, she notes. “I did have the books – I found the Mayo Clinic guide to a healthy pregnancy to be quite good. But, not so easily searchable, especially when you’re at dinner and you’re like, ‘Can I eat xyz?’ My husband downloaded a few apps right away that allow you to search what you can eat, what to avoid. Some are obvious: alcohol, sushi, some way less so – um, lunch meat?”

From the study’s press release:

Pregnant women are using the Internet to seek answers to their medical questions more often than they would like, say Penn State researchers.

“We found that first-time moms were upset that their first prenatal visit did not occur until eight weeks into pregnancy,” said Jennifer L. Kraschnewski, assistant professor of medicine and public health sciences, Penn State College of Medicine. “These women reported using Google and other search engines because they had a lot of questions at the beginning of pregnancy, before their first doctor’s appointment.” Continue reading

NY Times Sees Partners Merger As Cautionary Tale For Obamacare Era

partners

In case you missed this New York Times editorial — The Risks Of Hospital Mergers — the Times weighs in on the recent agreement that would allow Partners HealthCare to expand but restrict later growth and cap prices.

As the Times editorial board sees it, the 1994 merger of Massachusetts General Hospital and Brigham and Women’s Hospital was a mistake that offers lessons for the Obamacare era:

The experience in Massachusetts offers a cautionary tale to other states about the risks of big hospital mergers and the limits of antitrust law as a tool to break up a powerful market-dominating system once it is entrenched.

And it sees the agreement that Partners and attorney general Martha Coakley reached as possibly a “dubious bargain”:

As this case moves forward, it will be important to find an appropriate balance between two concerns that tug in opposite directions. The Affordable Care Act has incentives that encourage hospitals and doctors to integrate their operations and collaborate to control costs and improve care, and Partners has been a leader in doing that. At the same time, such collaborations must not be allowed to accrue such market power that they stifle competition and drive up prices, as seems to have happened in Massachusetts in past years.

Read the full Times editorial here. Agree? Disagree? The public has until July 21 to submit comments on the agreement to Coakley’s office, and the next court hearing on the agreement is set for Aug. 5.

In Search Of ‘Computational Psychiatry:’ Why Is It A Hot New Field?

By Suzanne Jacobs
WBUR Intern

It’s around 10 a.m. on a weekday when I walk into a coffee shop that apparently doubles as the preferred study spot of every student on the Boston University campus. My instinct is to leave immediately and find a quieter place to caffeinate, but I’m not here for the coffee. I’m here for information — information on what I’m hearing is one of the hottest new trends in brain science.

Winding my way through tables of frazzled co-eds, I search every face for that “Are you who I’m looking for?” stare, but no one acknowledges me. So I step back out onto the sidewalk and wait. I’m early anyway.

About five minutes later, a young man who would have otherwise been indistinguishable from the crowd of students locks eyes with me from about 20 feet away. “That’s my guy,” I think to myself.

Lights of Ideas (Andrew Ostrovsky)

(Andrew Ostrovsky)

Minutes later, coffees in hand, we’re seated at a small back table, and I put my digital recorder down on it. “Is it okay if I record this?” I ask. He says that’s fine.

At this point, what I really want to do is grab him by the shoulders and yell, “What are you people doing? Let me into your world!” For weeks, I’ve been looking into this new field of research called computational psychiatry, but for the life of me, I can’t figure out what it is. More frustratingly, I can’t figure out why I can’t figure it out, despite a strong science background and hours of reading what little I could find about the topic on the Internet.

But I hold back, press the little red circle on my digital recorder and let the man speak.

In computational psychiatry, “What you try to do is come up with a toy world…,” he begins.

This all started a few weeks earlier when I was perusing the latest edition of Current Opinion in Neurobiology. Don’t ask me why I was perusing Current Opinion in Neurobiology — I don’t know. To avoid doing something else, probably.

One article caught my eye. It was titled “Computational approaches to psychiatry.” A longtime subscriber to the drugs-and-therapy stereotype of psychiatry, I found the idea of new “computational approaches” intriguing, so I read on. Continue reading