public health

RECENT POSTS

May 8, 2012 | 4:20 PM | By

Blogger Examines FDA’s Drug-Safety Problems And Asks If Anyone Cares

Alison Bass raises several excellent points in her post today about a recent Institute of Medicine report on deficiencies at the FDA when it comes to drug-safety oversight.

Basically, she writes, the IOM’s takeaway is that the FDA isn’t doing an adequate job of assessing the risks and benefits of drugs:

Two weeks ago, I headlined my blog with this question: Is the FDA violating its own mandate to approve safe drugs? Four days later, the national Institute of Medicine (IOM) released a 233-page report concluding that FDA’s current approach to drug oversight “is not sufficiently systematic and does not ensure consistent assessment of benefits and risks associated with a drug over its lifecycle.” In other words, the FDA may indeed be violating its own mandate.

It’s troubling enough that the FDA may not be safeguarding the drug supply, Bass notes, but it’s particularly frustrating that the media isn’t paying attention:

Last week, the British Parliament came out with a report concluding that Rupert Murdoch is unfit to run News Corp., and its findings made headlines on this side of the Atlantic. How come when the Institute of Medicine comes out with a 233-page report concluding that the FDA is not doing its job, the only mention I can find of it is near the bottom of a short news article in one scientific journal? Why doesn’t this report merit front-page news too?

FILED UNDER: Medicine/Science, drug safety, fda, public health
May 2, 2012 | 4:40 PM | By

The Whooping Cough Misnomer, And Other Facts About Pertussis

Brady Alcaide died of pertussis at the age of two-months. His parents are now trying to raise awareness about the disease. (Courtesy: Kathy Riffenburg)

The most important thing I learned from my reporting on two-month old Brady Alcaide, who died of pertussis, or whooping cough in January is this: it shouldn’t be called “whooping cough.”

I came to this conclusion yesterday, after recording a segment on pertussis for Radio Boston. Appearing on the program with me was Dr. Ben Kruskal, a pediatrician and director of infection control and travel medicine at Harvard Vanguard and director of infectious diseases at Atrius Health. When asked what clinicians should do when confronted with infants like Brady, who had contracted pertussis, a bacterial disease, but didn’t exhibit the “classic” violent cough or whooping sound associated with it, Dr. Kruskal said this:

“Actually it turns out that most people who have whooping cough don’t show the classic signs of whooping cough. Continue reading →

FILED UNDER: Medicine/Science, Personal Health, pertussis, public health, vaccines, whooping cough
May 1, 2012 | 8:45 AM | By

Just Thinking About Cell Phone Calls While Driving Can Lead To Crashes, Study Finds

(Mike "Dakinewavamon" Kline/flickr)

Making calls while you’re driving is bad — we know this. But new research suggests that even thinking about cell phone calls when you’re driving can lead to accidents.

This distressing new research that underscores how profoundly distracting cell phone use (even anticipated use) can be was presented this week as part of the Pediatric Academic Societies annual meeting held in Boston. Here’s the news release:

New research…shows that even anticipating calls or messages may distract drivers, increasing the risk of a crash.

Jennifer M. Whitehill, PhD, postdoctoral fellow at Harborview Injury Prevention and Research Center at the University of Washington, and her colleagues sought to determine whether compulsive cell phone use is associated with motor vehicle crashes. They enlisted undergraduate students to complete the Cell Phone Overuse Scale (CPOS), a 24-item instrument that assesses four aspects of problematic cell phone use: 1) frequent anticipation of calls/messages, 2) interference with normal activities (e.g., impacting friends/family), 3) a strong emotional reaction to the cell phone and 4) recognizing problem use.
Continue reading →

FILED UNDER: Medicine/Science, Personal Health, cell phone use, driving, pediatrics, psychology, public health
April 27, 2012 | 3:11 PM | By

From First Cold To Grave: How Two-Month-Old Brady Died Of Pertussis

Brady Alcaide, of Chicopee, Mass., died at two months old of pertussis.

Brady Alcaide — a happy, healthy six-week-old baby — got his first cold shortly after the new year.

His mother, Kathy Riffenburg, had seen her share of sniffles (she has two older daughters, 8 and 5) and didn’t think much of it. “It was just a little cough and sneeze,” she said. “I wasn’t too worried.”

But a few days later, on January 6, Brady’s fever spiked to 104 degrees. So, in the middle of the night, Riffenburg and her husband Jonathan decided to take the baby to the emergency department at Baystate Children’s Hospital in Springfield, Mass. near their home in Chicopee. Brady tested negative for flu and a common respiratory virus. By early morning, his fever was gone and the family was sent home.

Three weeks later Brady would be dead, a victim of pertussis, or whooping cough, a preventable but highly contagious bacterial disease that has been on the rise in recent decades.

At home, Brady’s breathing became slightly more labored; he’d been diagnosed with bronchiolitis, a swelling and buildup of mucus in the tiny air passages of the lungs, usually due to a viral infection. After another examination later in the week, a pediatrician prescribed albuterol to ease Brady’s symptoms.

On January 16, the Martin Luther King Jr. holiday, Brady started spitting up more and his breathing worsened. This time he was admitted to Baystate’s pediatric ICU, his mother said. A medical team assessed him; and an infectious disease doctor suggested he might have pertussis, though the diagnosis remained uncertain. Indeed, the family didn’t get confirmation of Brady’s pertussis until after his death, when a test for the disease came back positive. “I could have bet my whole life that it wasn’t pertussis,” Riffenburg said, recalling her reaction when the illness was first mentioned. “He wasn’t coughing like I would have imagined. And I didn’t know any infant who ever had pertussis.”

But pertussis, or whooping cough, or “the cough of 100 days” for its generally long duration, has been on the rise since the 1980s, according to the U.S. Centers for Disease Control and Prevention. The disease is characterized by violent, uncontrollable coughing (including the characteristic “whoop” sound) that can make it hard to breathe. But sometimes there is no “whoop.” And infants with pertussis don’t always cough, but may have apnea, a long pause in their breathing. The disease is most common in young children; babies under one are particularly vulnerable and face the greatest risk of death. Continue reading →

FILED UNDER: Medicine/Science, Personal Health, CDC, pertussis, public health, vaccines
April 24, 2012 | 3:01 PM | By

Weight Of The Nation Is ‘Out Of Control’ So What Can Parents Do?

A new HBO documentary that is really more of a desperate public health plea aims to shock viewers off their couches and away from their sugary sodas in order to reverse a raging national obesity epidemic among children and adults. “Obesity will crush the United States in oblivion,” notes one Texas official, echoing the mood of impending disaster that permeates the series, “The Weight of the Nation.”

At the House of Blues in Boston last night, various public health officials came together to screen one segment of the show: Part three, which focuses on “Children in Crisis” and the alarming number of obese kids in the country. The series takes a hard look at the challenges — from high cholesterol and fatty liver to intense bullying and social stigma — these kids and their parents face.

I spoke with Elsie Taveras, MD, MPH, who is featured in the film and is director of the One Step Ahead clinic, a multidisciplinary childhood overweight prevention and early management program at Children’s Hospital Boston.

Dr. Taveras sees children who are already suffering the effects of obesity. In the film she examines kids with dark rings around their necks, an early sign of insulin resistance. Her patients have signs of pre-diabetes; they have high blood pressure; and some of her 7-and-8-year-olds have adult levels of high cholesterol. Continue reading →

FILED UNDER: Medicine/Science, Personal Health, children's health, obesity, public health
April 10, 2012 | 12:13 PM | By

Perspective: Poverty, Health And Forced Eviction In The Slums Of Bangladesh

By Venita Subramanian and Maria A. May
Guest Contributors

(Note: Venita and Maria live and work in Dhaka, Bangladesh at BRAC, a poverty alleviation organization. Maria passes through Korail every day on her way to work. This piece represents our personal views, though draws on observations of our colleagues and the information we’ve been able to find in local sources.)

On April 4, one of the largest forceful slum evictions in Bangladesh’s history took place in Dhaka’s Korail bustee. Households, schools and shops within twenty meters of the road were bulldozed, with approximately 3,500 individuals affected.

“Our water supply was cut off and we have no place to go,” explained one of the affected women.

“The way the whole process was carried out was very inhumane. We received an announcement on April 3rd and the next morning, the eviction began. We were given just one night to dismantle our homes, gather our belongings and relocate ourselves. Where will we go?” said another victim.

Local shops and bazaars, the main sources of food for the community, were closed.

Many non-profit organizations, including BRAC, provide health services within the slums. Bangladesh’s recent successes in improving women’s health demonstrate that despite significant challenges, innovative, low-cost strategies can have a major impact. Under normal conditions, workers at BRAC’s health program are concerned that slum-dwellers may miss out on the continuum of care because of high rates of migration, both within slums and from slum to village. The recent demolition of Korail exacerbates this challenge for regular programming and introduces new challenges. The network of communication between field-based community health workers and residents is also disrupted, creating a rift in access to basic primary health services, including maternal and child health services.

Korail slum sits alongside Gulshan Lake. Its 30,000 residents are threatened by eviction (April 5). Photo by Ishtiaque Hussain

Few can boil their water, lacking money for fuel or wood to burn, and the few existing latrines often empty directly into the lake. The combination of crowding and unsanitary conditions creates the perfect environment for an outbreak of diarrheal disease. Continue reading →

FILED UNDER: Money, Personal Health, foreign aid, poverty, public health
April 3, 2012 | 3:22 PM | By

How Healthy Is Your County?

Premature deaths in Massachusetts counties. (County Health Rankings & Roadmaps, Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute)

Massachusetts counties ranked by the number of premature deaths. (County Health Rankings & Roadmaps, Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute)

Check out your county’s health with this just-released, data-drenched interactive tool that includes a broad range of health measures from 3,000 counties and the District of Columbia.

You can spend hours comparing counties on everything from mortality and binge drinking rates to teen births, motor vehicle crash deaths, access to healthy food and obesity rates. (In Massachusetts, for example, the obesity rate in Barnstable County is 18 percent, compared to 29 percent in Bristol County — though Bristol has a higher ratio of mental health providers — and Middlesex County ranks #1 in the state when it comes to mortality.) There’s even a cool health calculator that let’s you see how income and education directly impacts the health of a region.

NPR reports on one of the new measures included in this year’s rankings: the number of fast-food restaurants by county.

There are 30 counties where 100 percent of the restaurants are fast-food, but in many of these cases there are only one or two restaurants in the county, Dr. Bridget Booske Catlin, deputy director of the study and senior scientist at the University of Wisconsin Population Health Institute, writes in an email to Shots.

Among counties with more than 10 restaurants, these five counties had the most fast-food places — (in descending order) Scott County in Tennessee, Fayette County in Indiana, Letcher County in Kentucky, Charlton County in Georgia and Sanpete County in Utah. Perhaps not surprisingly, all of these counties were in the bottom half of overall health rankings within their respective states, according to Booske Catlin.

From the County Health Rankings news release:

Published online by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, the Rankings assess the overall health of nearly every county in all 50 states, using a standard way to measure how healthy people are and how long they live. The Rankings consider factors that affect people’s health within four categories: health behavior, clinical care, social and economic factors, and physical environment. This year’s Rankings include several new measures, such as how many fast food restaurants are in a county and levels of physical inactivity among residents. Graphs illustrating premature death trends over 10 years are new as well…

Within each state, even the healthiest counties have areas where they can improve. Healthier counties (those where people live longer and have a better quality of life) have lower rates of smoking, physical inactivity, teen births, preventable hospital stays, unemployment, children in poverty, and violent crime and higher levels of education, social support, and access to primary care physicians. But healthier counties are no more likely than unhealthy counties to have lower rates of excessive drinking or obesity or better access to healthy food options. Continue reading →

FILED UNDER: Personal Health, public health
April 3, 2012 | 1:53 PM | By

Five Reasons To Celebrate Public Health (Including A Cartoon)

If you’ve ever been vaccinated, if you wear your seat belt or bike helmet, if you wash your hands routinely, you’ve benefited from public health.

And now it’s time to celebrate: April 2-8 is National Public Health Week!

Here are four animated videos and one interactive timeline, all bringing public health alive.

Every Little Action Counts

The American Public Health Association shows how public health campaigns can help us become a healthier country in just one generation:

Obamacare: The Cartoon Version

The Kaiser Family Foundation offers up an entertaining 101 for the Affordable Care Act:

Continue reading →

FILED UNDER: Personal Health, public health
April 2, 2012 | 4:26 PM | By

How Western Psychology Needs To Rethink Depression

Psychology's Ghosts by Jerome Kagan (Courtesy of Yale University Press)

(Courtesy of Yale University Press)

Quick: Think of 10 people you know.

Surprising fact: One of those 10 people is likely to have experienced depression in the last two weeks (based on CDC data).

But that’s just the surface. Consider the role of employment — someone without a job is three times more likely to be depressed than someone working. As for education — those who didn’t graduate from high school are 2.5 times more likely to be depressed than those with some college or greater. (For more statistics fun, check out this CDC table.)

The take home lesson is that we have to understand context in order to understand depression. Jerome Kagan, a pioneer in the field of psychology, argued this point powerfully in a Radio Boston interview late last week. His new book, “Psychology’s Ghosts,” challenges psychology and psychiatry to approach their patients in a radically different way.

What The Psychologist Says…

Here are some of my favorite Kagan sound bites from his interview with host Meghna Chakrabarti. (To listen to the full interview or read the transcript, visit Radio Boston.) Continue reading →

FILED UNDER: Medicine/Science, Personal Health, depression, mental health, mental illness, psychiatry, psychology, public health
March 20, 2012 | 1:05 PM | By

Video: Why Should Movie Theaters Be Exempt From Calorie Labeling?

There are approximately 1,200 calories in medium-size popcorn at Regal Cinemas, according to the nonprofit Center for Science in the Public Interest. And that’s without the added butter.

Twelve-hundred calories is about what I eat in an entire day. So why, asks this video posted by CSPI, should movie theaters in most states remain exempt from new rules requiring that food sold to the public include calorie counts? The group asks that viewers write to President Obama and “urge him to strengthen the final menu labeling regulations to include movie theaters.” (You’d think Michelle Obama would be interested in this issue too, with her telling kids “Let’s Move” and all.)

FILED UNDER: Money, Personal Health, calories, food labeling, obesity, public health