Recently in Community Health Category

The Wall Street Journal (11/10, Dalton) reports that some countries' governments have stopped focusing on individual discipline to combat obesity, and instead are working to make entire communities more healthy by reducing the opportunities to live unhealthily. Laura Kettel Khan, an obesity expert at the CDC, says that "people are finally acknowledging that the obesity problem is so pervasive that it isn't just because people are making bad choices." The Journal describes obesity programs across Europe and in the US, noting that these initiatives are taking off because obesity has become too expensive a problem to handle on an individual basis.

The World Health Organization has discovered that the "AIDS virus is the leading cause of death and disease among women between the ages of 15 and 44." Indeed, "women enjoy a biological advantage because they tend to live six to eight years longer than men," WHO chief Dr. Margaret Chan pointed out. "But in many parts of the world they suffer serious disadvantages because of poverty [and] poorer access to healthcare:. The 91-page report by the organization "lays out the hurdles women face in getting the healthcare they need at various stages of life."  The report said that "accidental injuries take a toll on girls and younger women," while "chronic diseases account for almost half of the deaths among older women." Dr. Chan noted, however, that the "obstacles that stand in the way of better health for women are not primarily technical or medical in nature." Rather, "they are social and political, and the two go together." Thus, the world "will not see significant progress as long as women are regarded as second-class citizens," Dr. Chan argued.

The Los Angeles Times (10/14, Stein) "Booster Shots" blog reported that as bicycles ride a wave of popularity, "cyclists may be suffering more injuries," according to University of Colorado researchers. After looking at "accident rates and severity from 1996 to 2006," they noted that "among 329 bicycle accident cases admitted to the Rocky Mountain Regional Trauma Center at Denver Health Medical Center, the length of stay increased substantially over those years." What's more, "an increase was seen in chest injuries (up 15 percent), and abdominal injuries tripled over the last five years of the study. About one-third of 118 patients had head injuries." Comment: Cycling is certainly more dangerous in the US than Europe where most roads have dedicated bicycle lanes, There are very few such lanes on US roads, particularly in housing areas.  This absence in planning oversight contributes to obesity by limiting opportunities for exercise, the same neighborhoods usually lack sidewalks for walking safely, as well.

The Commonwealth Fund just released its State Scorecard on Health System Performance.

The scorecard points to substantial opportunities to improve. If all states could reach the level achieved by the top performing states:

•Twenty-nine million more people would have health insurance—cutting the number of uninsured by more than half;

•Nearly 78,000 fewer adults and children would die prematurely every year from conditions that could have been prevented with timely and effective health care;

•Nine million more adults age 50 and older would receive recommended preventive care, and almost 800,000 more children would receive key vaccinations;

•Five billion dollars could be saved annually by avoiding preventable hospital admissions and readmissions for vulnerable elderly and disabled residents.

USA Today reports, "Uninsured patients aren't the only ones using the [emergency department (ED)] for non-urgent care. With too few primary-care doctors to go around, many patients turn to the [ED] when they can't get an appointment with their regular physician, says Sandra Schneider, president of the American College of Emergency Physicians." Ted Epperly, president of the American Academy of Family Physicians, pointed out that "in some ways, insurance payments contribute to the shortage...by discouraging physicians from going into primary care." Medicare "pays doctors far more to perform procedures than to monitor a patient's overall health, Epperly says. In the past decade, only 10 percent of new doctors -- who graduate from medical school with an average of $140,000 in student loans -- have gone into primary care," according to Epperly.

Everyone who has an interest on the Congressional approaches to health care reform should read the current issue of ‘Health Affairs’ and note the monetary costs of the various approaches.  In the papers we find the expectation that the reforms would consume more than 50% of GDP, while others show that in 75 years the reforms would cost more than the entire GDP.  It is clear that the various activists have never taken economics 101.  The financial projections indicate totally unrealistic expectations for reform,.  There have to be limits to new expenditures. Anyway you wish to make changes there has to be some form of rationing.  There also has to be some reduction in money devoted to research.  Too much research money funneled to medical schools results in too little immediate benefit to the public but solves much of the fiscal problems of the teaching hospitals.

The AP reports that six cases of childhood lead poisoning "in Maine last year came from an unusual source -- lead dust tracked into the family car." Officials from the CDC and the Maine Department of Health and Human Services said that the cases were "the first ever attributed to lead dust on childhood safety seats. The car seats themselves weren't the source; the inside of family cars were contaminated through a parent's workplace." The CDC explained that children's parents, who worked in paint removal or metals recycling, did not change and shower before going home, and so tracked lead dust into their cars and onto children's car seats. Then, "Kids chew on the sides of those seats ... Or they put a cookie down" on the seat and then eat it, Mary Jean Brown, chief of the CDC's Lead Poisoning Prevention Branch said. "Maine officials said they now include checks of cars and child safety seats in their lead investigations."