Category Archives: Access to Health Care
Media Coverage of Mass Shootings Harms Attitudes on Mental Illness
Media coverage of mass shootings by people with mental illness can increase support for policies to reduce gun violence, but can also increase the stigmatization of people with mental illness and lessens the chance they will seek help, according to a new study in the American Journal of Psychiatry. “The aftermath of mass shootings is often viewed as a window of opportunity to garner support for policies to reduce gun violence, and this study finds public support for such policies increases after reading news stories about a mass shooting,” said study author Emma E. McGinty, MS, a PhD candidate with the Johns Hopkins Center for Gun Policy and Research, part of the Johns Hopkins Bloomberg School of Public Health. “However, we also found that the public’s negative attitudes toward persons with serious mental illness are exacerbated by news media accounts of mass shootings involving a shooter with mental illness.” Read more on violence.
Study Links Excessive Television Viewing, Antisocial Behavior in Young Children
Antisocial behavior is more likely in young children who watch three or more hours of television a day, according to a new study in the Archives of Disease in Childhood. Researchers found that five-year-olds in that demographic were more likely to exhibit such behavior by the age of seven. Study author Alison Parkes, of the University of Glasgow in Scotland, said the findings support the decision by many parents to limit television time. Still, the researchers noted that this correlation does not equal causation. Excessive television watching by kids has also been linked to poorer physical health and performance in classrooms. Read more on mental health.
Cutting Medical Interns’ Hours Reduces Training Time, Increase Risks to Patients
Efforts to increase the amount of sleep by medical interns by reducing the number of continuous hours they work actually decreases the number of training opportunities and increases the risk to patients, according to a new study in the journal JAMA Internal Medicine. They also don’t get any more sleep in an average week. "Despite the best of intentions, the reduced work hours are handcuffing training programs, and benefits to patient safety and trainee well-being have not been systematically demonstrated," said study leader Sanjay Desai, an assistant professor of medicine at the Johns Hopkins University School of Medicine and director of the internal medicine residency program at the Johns Hopkins Hospital. "We need a rigorous study. We need data to inform this critical issue." Read more on access to health care.
Study: One-quarter of Doctors’ Offices Not Equipped for Patients in Wheelchairs
Despite the requirements of the Americans with Disabilities Act, about one quarter of doctors’ offices are not equipped to treat patients in wheelchairs, according to a new study in the Annals of Internal Medicine. The biggest obstacle to treatment was being able to transfer patients to exam tables. “This is affecting a large number of patients, certainly the 3 million who use a wheelchair, but many more than that who have difficulty getting up to an exam table,” said lead author Tara Lagu, an academic hospitalist at Baystate Medical Center in Springfield, Massachusetts, and an assistant professor at Tufts University School of Medicine. “The point of the study is to help doctors realize what the problems are and to help them become more aware of the Americans with Disabilities Act and to identify what the difficulties patients who use wheelchairs are having in accessing health care.” Read more on access to health care.
FDA: Voluntary Recall of Tainted Medical Med Prep Consulting Inc. Products
The U.S. Food and Drug Administration (FDA) has announced a voluntary recall of all products produced by Med Prep Consulting Inc. of Tinton Falls, N.J., after fungus was found in several bags of magnesium sulfate intravenous solution in Connecticut. The magnesium sulfate products may also have been shipped to New Jersey, Pennsylvania and Delaware. While no illness has been reported, FDA is working with the U.S. Centers for Disease Control and Prevention to identify the scope of the contamination. “Giving a patient a contaminated injectable drug could result in a life-threatening infection,” said Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research. “We do not have reports of patient infections. However, due to a lack of sterility assurance at the facility and out of an abundance of caution, this recall is necessary to protect patients.” Read more on infectious disease.
New Insight into Why Black Kids Receive Fewer Antibiotics
Among all demographics, black children are the least likely to receive antibiotics, according to a new study in the journal Pediatrics. Researchers say this racial disparity in terms of treatment is likely because non-black children are actually over-prescribed the drugs. "The fact that black kids are given fewer antibiotics and fewer broad-spectrum antibiotics may come across as a bad thing to the casual reader, but perhaps it's not an issue of under-treating black kids, but over-treating non-black kids," said Allison Bartlett, MD, a pediatric infectious disease specialist at LaRabida Children's Hospital in Chicago. Read more on prescription drugs.
Study: Better Fitness Equals Better Grades for Kids
Getting kids more exercise may also make them more likely to get better grades, according to a new study in the Journal of Pediatrics. The study found that physically fit elementary and middle school students were 2.4 times more likely to pass math tests and about 2 times more likely to pass reading tests . The findings are especially significant at a time when schools across the country are cutting physical education programs. "Schools sacrificing physical education and physical activity time in search of more seat time for math and reading instruction could potentially be pursuing a counterproductive approach," said lead researcher Robert Rauner, MD, of Creighton University and Lincoln Public Schools in Lincoln, Neb. Read more on physical activity.
Personalized Risk Assessments Lead to Smarter Patient Decisions
Providing patients with personalized risk assessments instead of generalized assessments makes them more likely to make educated decisions about screening tests, according to a new review of 41 studies published in the Cochrane Library. The personalized evaluations include factors such as age, race, gender, weight, lifestyle and family history. "Knowing your individual risk for a particular health problem may help you make an informed choice about what screening services you might be interested in," said Michael LeFevre, MD, MSPH, co-vice chair of the government-backed U.S. Preventive Services Task Force. "Over time, what would be ideal is that we're able to make more specific, individualized recommendations and fewer population recommendations.” Read more on access to health care.
Study: ADHD, Autism, Depression May Share Genetic Link
Autism, attention-deficit/hyperactivity disorder (ADHD), major depression and other mental disorders may share genetic risk factors, according to a new study in The Lancet. Bipolar disorder and schizophrenia were also linked. Researchers do not yet understand the link between the gene variants and the disorders, but the knowledge may help improve prevention and treatment methods. "This is the first clue that specific genes and pathways may cause a broader susceptibility to a number of disorders,” said lead researcher Jordan Smoller, MD, a professor of psychiatry at Harvard Medical School in Boston. “Now the important work will be to figure out how this actually happens.” Read more on mental health.
Poll: 3 p.m. to Bedtime Offers Challenges to Fighting Obesity
Parents’ and kids’ activity during the “crunch time” period of 3 p.m. to bedtime—commuting, extracurricular activities, getting ready for the next day—can make it especially difficult to maintain a healthy lifestyle, according to a new poll from the Robert Wood Johnson Foundation, NPR and the Harvard School of Public Health. The poll looked at families' eating and physical activity habits. Among other results, it found that 60 percent of parents said their children ate or drank something unhealthy and that 28 percent of kids did not get enough physical activity during this time window. Read more on obesity.
Mistakes in Primary Patient Care Can Cause Serious Complications
While there’s much focus on mistakes during surgery and medication prescribing, missed and incorrect diagnoses in primary care may lead to even more injuries and deaths, according to a new study in the journal JAMA Internal Medicine. Researchers determined most mistakes were linked to doctors getting inaccurate patient histories, not doing full exams or ordering incorrect tests. "We have every reason to believe that diagnostic errors are a major, major public health problem," said David Newman-Toker, MD, Johns Hopkins University School of Medicine. "You're really talking about at least 150,000 people per year, deaths or disabilities that are resulting from this problem." Read more on access to health care.
Targeted Pregnancy Prevention Program Increases Teens’ Use of Condoms, Birth Control Pills
A prevention program designed specifically for teenage girls at high risk of pregnancy made them more likely to use contraception methods, according to a new study in the journal JAMA Pediatrics. The Prime Time program at primary care clinics utilizes personal case management and youth leadership opportunities. "Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth," according to the study. According to the U.S. Centers for Disease Control and Prevention, girls between the ages of 15 and 19 gave birth to 329,797 babies in 2011. Read more on sexual health.
Study: No Link Between Hospital Deaths, Readmission Rates
Hospital readmission rates—which Medicare can use to penalize health care providers—and death rates are not linked, according to a new study in the Journal of the American Medical Association. Researchers, who looked at rates for heart attack and pneumonia patients, say this means hospitals can still keep the number of returning patients down without increasing the number who die. "The concern was that their performance in one area is going to compromise their performance in another," said Harlan Krumholz, MD, lead author from the Yale University School of Medicine in New Haven, Connecticut. The U.S. Centers for Medicare and Medicaid Services reduces payments to hospitals with high readmission rates. Read more on access to health care.
HUD, HHS Grants to Provide Housing for Low-income People with Disabilities
The U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Health and Human Services (HHS) is granting approximately $98 million in funding to help prevent homelessness and unnecessary institutionalization of extremely low-income people with disabilities. Thirteen state housing agencies will use the grants to provide rental assistance. “By working together, HUD and HHS are helping states to offer permanent housing and critically needed supportive services to offer real and lasting assistance to persons who might otherwise be institutionalized or living on our streets,” said HUD Secretary Shaun Donovan in a release. “We’re helping states reduce health care costs, improving quality of life for persons with disabilities, and ending homelessness as we know it.” Read more on housing and disability.
High-calcium Diets, Supplements May Increase Death from Heart Disease for Women
High-calcium diets and supplements may increase the risk of death by heart disease for women, according to a new study in BMJ. Another recent study found a similar link among men. Calcium supplements are taken to prevent bone loss and had been speculated to also improve cardiovascular health. Instead, researchers found diets very low or very high in calcium can causes changes in blood level. Most adults should intake 1,000 to 1,200 milligrams of calcium daily, according to the U.S. Office of Dietary Supplements. Read more on heart health.
Explaining the what and how of the Affordable Care Act, much of which goes into effect next January, is much easier to do now thanks to a new short video from the Minnesota Health Insurance Exchange, a collaboration of state agencies including the Department of Health.
The video was shown, to high marks, this week during a session on state implementation and consumer assistance of the Affordable Care Act at the AcademyHealth National Health Policy Conference in Washington, D.C. Some of the labeling and messaging differs state to state (Maryland calls its program the Maryland Health Connection, while Mississippi—gotta love it—calls its program “One Mississippi”).
States are in deep communication with each other on issues such as training for the operators who will man the state consumer call centers and on communication strategies for consumers, said Rebecca Pearce, executive director of the Maryland Health Benefit Exchange, who spoke at the conference. The exchanges open for consumer signup for 2014 health coverage on October 1.
New CT Device Offers Improved Imaging, Substantially Reduced Radiation
A new type of CT scanner from National Institutes of Health (NIH) researchers and engineers at Toshiba Medical Systems offers improved image quality while reducing the amount of potentially harmful radiation to patients by as much as 95 percent. This device will enable doctors to better diagnose conditions such as heart disease, according to coauthor Andrew Arai, MD, chief of the Cardiovascular and Pulmonary Branch at the NIH’s National Heart, Lung, and Blood Institute (NHLBI). Author Marcus Chen, MD, a clinician in the NHLBI’s Advanced Cardiovascular Imaging Laboratory, said the “improvements could help clinicians identify problems in even the smallest blood vessels or enable them to conduct complicated tests like measuring blood flow in the heart while limiting radiation exposure.” The U.S. Food and Drug Administration has approved the CT scanner, which still requires additional study. Read more on heart health.
Study: Black Patients Less Likely to Receive Kidney Transplants before Needing Dialysis
Patients who are black or do not have private insurance are less likely than others to receive a kidney transplant before having to go on dialysis, according to a new study in Clinical Journal of the American Society of Nephrology. The study was conducted by researchers at the Johns Hopkins University School of Medicine, including lead author Morgan Grams, MD, who told Reuters it shows "just another disparity" for African American patients. Douglas Scott Keith, MD, head of the kidney transplant program at the University of Virginia Medical Center in Charlottesville and not part of the study, said studies "over the last 10 to 15 years have consistently shown that minorities have poorer access to transplantation. This article basically shows that it's persisting, it hasn't gotten much better.” African American patients are about 56 percent less likely than white patients to receive a kidney transplant before needing dialysis. Read more on health disparities.
Medical School Conflict of Interest Policies May Affect New Doctors’ Prescription Habits
Doctors who graduate from medical schools with policies restricting gifts from pharmaceutical companies may be less likely to prescribe new medications over current options, according to a new study in the BMJ. "Our findings suggest that conflict of interest policies, which have been increasingly adopted by medical schools since 2002, may have the potential to substantially impact clinical practice and reduce prescribing of newly marketed pharmaceuticals," wrote Marissa King, an assistant professor of organizational behavior at the Yale University School of Management, and colleagues. The researchers say further study is needed to determine whether the measures affect the prescription of all new medications, or if the effect is more selective. Read more on prescription drugs.
Many ‘Facts’ About Weight Loss Not Supported by Science
Many pieces of common weight-loss advice have in fact little-to-no supporting evidence, according to a study in the New England Journal of Medicine. These include the “facts” that small dietary and exercise changes lead to steady and sustained weight loss, as well as that slow, gradual weight loss is better than large, rapid weight loss. Study author David Allison, director of the nutrition obesity research center at the University of Alabama, Birmingham, said that while these ideas makes sense, researchers and physicians still need to make sure that health advice is backed up by data so that patients receive the best care possible. "It's an ethical obligation to be honest,” he said. “It's great to be enthusiastic, as long as you're promoting something you know is true.” Read more on obesity.
Study: Pairing Yoga with Meds Could Improve Irregular Heartbeat
Pairing yoga with traditional medications could help people with atrial fibrillation (AF) better manage the problem while also feeling better in general, according to a new study in the Journal of the American College of Cardiology. AF causes an irregular heartbeat that disrupts the flow of blood, according to the U.S. Centers for Disease Control and Prevention. Researchers found that the addition of yoga cut down heart quivering, lowered the heart rate and reduced anxiety. "People feel more empowered, they feel better, they feel stronger," said W. Todd Cade, a physical therapy researcher from Washington University School of Medicine in St. Louis. Researchers noted that people with AF should consult with their physicians before starting yoga. Read more on heart health.
New IRS Affordable Care Act Regulations Makes Health Insurance Too Costly for Some Families
Under final rules released by the Internal Revenue Service yesterday, some families who have access to employer-based health insurance may not be eligible for federal subsidies to help them buy less expensive coverage through the new insurance exchanges to be set up under the Affordable Care Act (ACA). That’s because the new rules base the eligibility on the cost of health insurance for the employee only, not on the generally higher cost of covering a spouse and/or children. Penalties set to kick in for families and individuals who don’t buy health insurance under the ACA may not apply to people who find themselves ineligible for the subsidies, but unable to afford employer-based coverage. Read more on access to health care.
Add electronic health records to the critical weapons health professionals have against the flu, as 48 states currently deal with widespread flu activity and the U.S. Centers for Disease Control and Prevention (CDC) reports at least 30 pediatric deaths so far. At least half of those children had not received a flu shot, according to CDC Director Thomas Frieden.
A CDC report from September 2012 found that about 128 million people, or about 42 percent of the U.S. population, got the flu shot during the 2011-2012 season, which started later and proved milder than the one we’re in now. That number has been holding steady for several years, but is below the CDC’s goal of 80 percent of the U.S. population receiving a flu shot.
Kaiser Permanente in Northern California, however, has seen a 6 percent increase in its two-million plus members getting the 2012-2013 flu shot over previous years, for which it gives credit to HealthConnect, the largest civilian health record data base in the United States. Randy Bergen, MD, the vaccine lead at Kaiser in Northern California, says the system lets Kaiser Staff “proactively reach out to all its members and even identify those at greatest risk from contracting the flu [which includes children, the elderly and people with chronic diseases] to give them an extra nudge.”
Quitting Smoking Adds Back Years to Life Expectancy
The earlier someone quits smoking, the greater the health benefits, according to two new studies in the New England Journal of Medicine. The first study found that smoking reduces life expectancy by an average of 10 years, but people who quit between the ages of 25 and 34 can gain those 10 years back. People who quit late also gain years, though not as many. The second study found women now have the same death rates as men for lung cancer, chronic obstructive pulmonary disease and other tobacco-related diseases. “These studies are a timely reminder to the nation's elected officials that the battle against tobacco is far from over, but they can accelerate progress by implementing proven strategies to help smokers quit and prevent kids from starting to smoke in the first place,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, in a release. Read more on tobacco.
Study: Rotavirus Vaccine in Kids also Helps Protect Unvaccinated Adults
By reducing the amount of rotavirus in a community, vaccinating children against the disease can also help unvaccinated adults stay healthy, according to a new study in the journal Clinical Infectious Diseases. The disease causes several gastrointestinal problems, including diarrhea and vomiting, and can be deadly. Researchers compared patient samples from before and after widespread implementation of the vaccine in children, finding the number of unvaccinated adults who contracted the disease was cut in half after implementation. Rotavirus in adults costs about $152 million in inpatient hospital charges annually. Read more on vaccines.
Report: ‘One Size Fits All’ Approach Wrong For Treating Veterans with CMI
The U.S. Department of Veterans Affairs should tailor its treatment of chronic multisymptom illness (CMI) to meet the different needs of veterans, rather than rely on a “one size fits all” approach, according to a new report from the Institute of Medicine. Veterans with CMI (formerly called Gulf War Syndrome) have chronic symptoms in at least two of six categories for at least six months: fatigue; mood and cognition; musculoskeletal; gastrointestinal; respiratory; and neurologic. “[W]e endorse individualized health care management plans as the best approach for treating this very real, highly diverse condition,” said committee chair Bernard M. Rosof, chair of the board of directors at Huntington Hospital, Huntington, N.Y., in a release. Among the report’s recommendations is that veterans receive a comprehensive health examination immediately after leaving active duty, and making the results available to health care providers both inside and outside the VA health system. Read more on access to health care.