Category Archives: Obesity
Workplace Injuries Cost U.S. Healthcare System $13.1B in 2011
With nearly the highest injury rate of all U.S. industries, workplace injuries cost the U.S. healthcare system approximately $13.1 billion and more than 2 million lost workdays in 2011, according to a new study in the journal Professional Safety. “Healthcare worker injury rates are only less than outdoor wilderness professions, such as commercial loggers and fishermen. The injury rates are sky high," said report author Scott Harris, PhD, MSPH, the director of EHS advisory services for UL Workplace Health and Safety. The study found that 15.2 million employees were injured that year alone, with the most common injuries coming from slips, trips, falls, violence and chemical exposure; nurses experienced the highest rates. The report concluded that hospitals “would benefit from more rigorous and frequent inspections from the Occupational Safety and Health Administration.” Read more on injury prevention.
Even Healthy Overweight People at Increased Risk for Heart Disease
Even overweight people who are otherwise healthy are at increased risk for heart disease, according to a new study in JAMA Internal Medicine. Previous research indicated that higher-than-normal risk was linked to a collection of risk factors known as “metabolic syndrome,” including large waist circumference, high blood pressure, high triglycerides, low "good" cholesterol and diabetes. People have metabolic syndrome if they have at least three of the risk factors. However, in a study of 71,527 adults without heart problems, researchers determined that risk went up as weight went up, even if metabolic syndrome factors were absent. "Whether you call someone as having or not having metabolic syndrome as kind of a yes/no variable, is not helpful clinically and it doesn't make sense biologically," said Meir J. Stampfer, from the Harvard School of Public Health, according to Reuters. "It's basically just that the metabolic syndrome is waiting to happen to those people." Read more on obesity.
New Statin Guidelines Call For Greater Use
New guidelines from the American Heart Association and American College of Cardiology could dramatically increase the number of people taking cholesterol-lowering statins. The guidelines call for people to take statins if they already have heart disease, if their bad (LDL) cholesterol is extremely high (190 milligrams per deciliter of blood or more) or if they're middle-aged with type 2 diabetes. They also advise statins for people who are 40-75 years old with an estimated 10-year risk of heart disease of 7.5 percent or more. Previous guidelines had advised doctors to follow rigid clinical guidelines that trigger statin use when cholesterol levels reach a certain threshold. The new policy "suggests treatment should be individualized and that, depending on your risk, you may need a higher dose of a more potent statin than if your risk is lower," said Hector Medina, MD, a cardiologist at Scott & White Healthcare in Round Rock, Texas, according to HealthDay. Read more on heart health.
Harvard Pilgrim Health Care Foundation’s work on childhood obesity is driven by one startling fact: one in three Massachusetts children are overweight or obese. To find out why, Executive Director Karen Voci and her colleagues went to the places where children learn and play—schools, after school programs and child care centers— and found that children were sitting for most of the day and foods were heavy on starch and sugar. With a limited budget, Voci and her team found opportunities and partners in Massachusetts, New Hampshire and Maine to improve childhood obesity rates.
“It’s hard to measure what you’re accomplishing,” said Voci at one session during the American Public Health Association (APHA) 2013 meeting. “These environments look and feel different, but it’s hard to capture this feeling in a meaningful statistic that can be used further down the road.”
As a result, most of the results shared focused on process and intermediate outcomes rather than actual health outcomes—for now—but the communities are optimistic that they’re moving in the right direction.
Voci underscored the importance of staying committed, noting that Harvard Pilgrim and its partners had been at this for years and they were in fact moving the needle. Session presenters shared successes from Massachusetts, New Hampshire and Maine.
Harvard Pilgrim partnered with the Massachusetts Department of Public Health and other foundations and businesses on the Mass in Motion initiative to combat childhood obesity in its home state. Led by their elected officials, 14 communities developed health improvement plans and received technical assistance to improve local food sources and increase physical activity. The multifaceted initiative included a “call to action” report, as well as a Governor’s Executive order establishing a nutrition standard for the food procured for the state of Massachusetts. In addition, the program implemented a body mass index (BMI) regulation that required schools to screen children’s BMI in order to identify potential issues early. The Department of Public Health worked within these communities to share information on physical activity and nutrition, all culminating in growth of the program to 52 communities in the state.
Communities in Eastern Massachusetts are showing concrete signs of progress on the childhood obesity front. Reports from this summer have shown that the obesity rate for the region’s children under six years of age has decreased by 21.4 percent—likely due in part to initiatives such as Mass in Motion, the Cambridge Healthy Children Task force and Shape Up Somerville.
CATCH Kids Club is an evidence-based, after-school environment that has been adopted by 117 sites in nine of New Hampshire’s ten counties. The CATCH program promotes exercise and healthy eating in elementary school children with a four-phased approach:
- Curriculum development
- Staff and booster training
- Staff support
- Environment and policy assessment
In the environment and policy assessment phase, CATCH found that 93 percent of participating after-school programs made four or more changes to improve children’s physical activity and healthy eating. In addition, most sites now offer programs that promote these goals between three and five times a week.
In Maine, the Let’s Go! 5210 Goes to School program offers resources to help schools create a culture of health. It aims to take the focus off of the highly charged weight management issue and shift it toward four simple and embraceable goals for each day:
- Eat 5 fruits and vegetables
- Limit screen time to 2 hours or less
- Get at least 1 hour of exercise
- Drink 0 sugary drinks
While each school decides which of these four goals it would like to adopt, they often end up promoting all four points of the program as time goes on. In fact, the 5210 initiative reaches children in all 16 Maine counties in schools, after school programs, early childhood education, doctors’ offices and more locations.
One of the key lessons learned was to engage busy school representatives at a level that made sense for them. “Don’t ask them to do something unrealistic,” said Torey Rogers of the Let’s Go! 5210 Goes to School Program and The Barbara Bush Children’s Hospital at Maine Medical Center.
Representatives from each of these programs offered insights and lessons learned when it comes to working with schools. When speaking with school representatives, organizations are often successful when they relate the goal back to the mission of schools: education. By highlighting the secondary benefits to attendance and active participation of students, organizations can engage teachers as partners in public health initiatives.
>>For more information on the successes of state and community efforts to reduce childhood obesity, view an interactive map on the signs of progress on childhood obesity.
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Follow the coverage here.
In 2012 alone, the fast food industry spent $4.6 billion to advertise mostly unhealthy products, with many of those ads specifically targeting children and teens. A new report, Fast Food FACTS 2013, examined 18 of the nation’s top fast-food restaurants, following up on a 2010 report to see how the food selection and advertising landscapes have changed. And while there have been some positive developments—healthier sides and beverages are available in most kids’ meals—the findings indicate there is still a very long way to go.
Detailed findings from the report, which was supported by a grant from the Robert Wood Johnson Foundation, will be presented today at the American Public Health Association’s (APHA) annual meeting in Boston.
>>Read more on the Fast Food FACTS 2013 report.
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders, hearing from attendees on the ground and providing updates from sessions, with a focus on building a culture of health. Follow the coverage here.
NewPublicHealth spoke with Jennifer Harris, the Yale Rudd Center for Food Policy & Obesity’s director of marketing initiatives and lead author of the report, and Marlene Schwartz, the Center’s director, about their findings and how fast food advertising continues to impact our nation’s youth.
NewPublicHealth: Has any progress been made in the nutritional quality of fast food kids' meals?
Jennifer Harris: There have been a lot of changes in kids’ meals over the past three years and a lot of it has been good. Most of the restaurants have added healthy sides and healthy beverages to their kids’ meals. Now it’s possible to get a fairly healthy kids’ meal at most of the restaurants we looked at. But the problem is it’s kind of like finding a needle in a haystack. Almost all of the meals they offer are high in fat, sugar or sodium.
Marlene Schwartz: The odds of you getting the healthy combination when you go are extraordinarily low. For every healthy combination, there are roughly 250 unhealthy combinations.
HPV Vaccines Less Effective in African-American Women than in White Women
Perhaps because of their lower participation rates in clinical trials, African-American women are less likely to benefit from available human papillomavirus (HPV) vaccines that guard against cervical cancer, according to new findings presented at the 12th annual International Conference on Frontiers in Cancer Prevention Research. The two most popular vaccines in use protect against infection by HPV 16 and HPV 18, which are responsible for about 70 percent of cervical cancers. However, these two subtypes are half as likely to be found in black women as they are in white women. Researchers found that the most common infections for white women are from subtypes 16, 18, 56, 39 and 66; the most common for black women are 33, 35, 58 and 68. "Since African-American women don't seem to be getting the same subtypes of HPV with the same frequency, the vaccines aren't helping all women equally," said study author Adriana Vidal, Ph.D., assistant professor of obstetrics and gynecology at Duke University School of Medicine. Read more on health disparities.
San Francisco Proposes Tax on Soda, Other Sugary Beverages
In an effort to curb the growing rate of obesity and obesity-related health issues, a San Francisco, California city supervisor has proposed a ballot measure that would impose a 2-cents-per-ounce tax on soda and other sugary beverages with at least 25 calories per ounce. This would be the first and strongest such city measure in the country, amounting to an additional 24 cents for a normal 12-ounce can of soda. Supervisor Scott Wiener said the tax proceeds, which he estimates would be $30 million annually, would go toward physical education and healthy lunch programs in city schools, as well as city parks, recreation programs and community health organizations. The California cities of Richmond and El Monte last year failed to enact similar taxes. A ballot measure requires a two-thirds majority to pass. "We know that this will be a long road," said Wiener. "This type of proposal has occurred in other cities and the beverage industry always comes out full guns blaring, so we're going to need to pull together to make sure that this wins." Read more on obesity.
Study: Young Cancer Patients at Increased Risk for Suicide
The stress of a cancer diagnosis means that teens and young adults who are diagnosed should be carefully monitored for behavior changes and other issues that could be a sign of suicidal thoughts, according to a new study in the Annals of Oncology. While there is an elevated risk of suicide for cancer patients of all ages, “because adolescents and young adults are still developing their coping strategies for stress, they may be more affected than adults when facing major adversity such as a cancer diagnosis," said lead researcher Donghao Lu, from the department of medical epidemiology and biostatistics at the Karolinska Institute in Stockholm, Sweden. Lu and his team found that Swedes ages 15-30 with a cancer diagnosis were at a 60 percent greater risk of suicide or attempted suicide, compared to people in the same age group but without cancer; in the first year after the diagnosis the risk was 150 percent higher. Lu said the findings indicate the need for greater communication and cooperation among medical professionals, psychological professionals, family members and social workers. Read more on cancer.
Study: Erratic Bedtimes Linked to Kids’ Behavior Problems
Children with erratic bedtimes also exhibit more behavior problems at home and at school, according to a new study in the journal Pediatrics. Researchers analyzed date on more than 10,000 children who were part of long-term sleep studies, finding that kids without a regular bedtime scored worse on a measure of behavior problems including acting unhappy, getting into fights and being inconsiderate. "If you are constantly changing the amounts of sleep you get or the different times you go to bed, it's likely to mess up your body clock," said study leader Yvonne Kelly, from University College London. "That has all sorts of impacts on how your body is able to work the following day," Kelly, from University College London.” However, the researchers also found that when a child went from no set bedtime to a scheduled bedtime, their behavior improved. Read more on pediatrics.
Overweight Teens at Increased Risk of Later Esophageal Cancer
People who are overweight or obese as teens have nearly twice the risk of developing esophageal cancer later in life when compared to their peers with healthy weights, according to a new study in the journal Cancer. The study also found that social status, economic status and education levels can all be factors in the development of gastric cancers; poor teens are at twice the risk of developing stomach cancer, as are teens with nine years of fewer of education. The study included more than 1 million male Israeli teens. "We look at obesity as dangerous from cardiovascular aspects at ages 40 and over, but here we can see that it has effects much earlier," said study author Zohar Levi, MD, of the Rabin Medical Center in Israel. However, the study did not prove cause-and-effect, so further research is needed to determine whether losing weight or gaining higher social or economic status later in life can reduce the risks. Read more on cancer.
USDA: California Plants Linked to Salmonella Can Stay Open
After making “immediate substantive changes to their slaughter and processing,” three California poultry processing plants tied to a salmonella outbreak in 17 states will remain open, the U.S. Department of Agriculture (USDA) has determined. The plants will implement new food safety controls and the USDA will monitor the plants products for the next three months. The outbreak has sickened 278 people since May; the normal hospitalization rate is about 20 percent, but antibiotic resistance means about 42 percent of the people sickened in this outbreak were hospitalized. Read more on food safety.
Study: Top Athletes Endorse Junk Food More Often Than Healthy Food
A new study of professional athletes’ food and beverage endorsements found that more often than not their paid support is given to products that are energy-dense and nutrient-poor, according to a new study in the journal Pediatrics. The study looked at 512 brands endorsed by 100 different athletes, finding that “Seventy-nine percent of the 62 food products in athlete-endorsed advertisements were energy-dense” and “93.4% of the 46 advertised beverages had 100% of calories from added sugar.” Denver Broncos player Peyton Manning and Miami Heat player LeBron James had the most endorsements for the energy-dense, nutrient-poor food and beverages. "I hope this paper inspires some reflection on the part of America's athletes and professional sports leagues, as well as all other celebrities for that matter,” said Center for Science in the Public Interest Executive Director Michael F. Jacobson, in a statement. Read more on nutrition.
U.S. Task Force Recommends Against Blood Pressure Screening for Kids, Teens
Despite recommendations from several expert groups, the U.S. Preventive Services Task Force is not recommending that health care professionals respond to the growing obesity crisis by screening children and teens for high blood pressure. The panel concluded that more study into the issue is needed, and that in the mean time there are other, known avenues toward lowering youth obesity and improving cardiovascular health. "We don't know if lowering blood pressure in youth leads to improved cardiovascular health in adulthood,” said panel member Kirsten Bibbins-Domingo, MD. “We also don't know the long-term benefits and harms for children and adolescents who initiate blood pressure medications when they are young. While there is much we don't know, we do know that eating a healthy diet, being active, and maintaining a normal weight are ways children and teens can improve their cardiovascular health." Read more on heart health.
Study: Tobacco Advertisements Connecting with Young Kids in Many Low-, Middle-income Countries
The global pervasiveness of tobacco advertisements means that most very young children in many low-and middle-income countries are familiar with cigarette brands, and nearly 70 percent of kids ages 5 and 6 can identify at least one cigarette logo, according to a new study in the journal Pediatrics. The study is from the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health. The findings demonstrate the significant steps countries and public health organizations still need to take to limit the influence of tobacco ads. “Evidence-based strategies exist to reduce the ability of tobacco companies to market their products to children, such as implementing and enforcing bans on tobacco advertising, promotion and sponsorship,” said Joanna Cohen, PhD, co-author of the study and director on the institute. “Putting large picture warnings on the front and back of cigarette packs and requiring plain and standardized packaging, as Australia has done, also helps to reduce the attractiveness of cigarette packs among young children.” Read more on global health.
Even Healthy Weight Adults with High Body Fat at Increased Risk of Heart Disease
Even older adults with healthy body weights can be at increased risk of cardiovascular diseases if they have high percentages of body fat, according to a new study The American Journal of Cardiology. "Just because someone has a normal BMI does not necessarily mean they are metabolically normal," said lead researcher Dr. John Batsis, a geriatrician at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. The study found that women with excess body fat (above 35 percent) were 57 percent more likely to die from heart-related causes within 11 years than were women with healthy body fat levels. Javier Salvador, MD, an endocrinologist at the University Clinic of Navarra in Pamplona, Spain, who was not involved in the study, said the findings demonstrate the limits of body mass index (BMI), which measures weight in relation to height. Read more on heart health.
‘Image Discrepancies’ of Job Roles Can Hurt Job Satisfaction, Performance and Pay
The lack of client understanding of the actual job roles of nurse practitioners and other professionals can negatively impact job satisfaction, performance and pay, according to a recent study in the Academy of Management Journal. "If people don't understand what you do, they tend to devalue what you do," study co-author Michael Pratt, a professor of management and organization at Boston College. "They don't understand why you're making all this money—'Why should I pay you all this money?' is a common question these professionals keep hearing." The study looked at “image discrepancies” in four professions—nurse practitioners, architects, litigation attorneys and certified public accountants—finding a noticeable and negative lack of understanding by clients for each. For example, many patients don’t realize that nurse practitioners can examine patients and prescribe medicine, and instead insist on seeing a doctor. "I assumed professionals would actually get over it, that there would be frustration, it would be an interpersonal problem, and that would be the extent of it," Pratt said. "I didn't think it would have such a big impact on how they did their job, how it affected their pay and how they performed. I was surprised at the depth of how this affected job performance. It's not simply annoying -- it has real impact.” Read more on mental health.
CDC Emphasizing Electronic Laboratory Reporting to Improve Public Health’s Response to Disease Outbreaks
The U.S. Centers for Disease Control and Prevention’s (CDC) emphasis on the widespread adoption of electronic laboratory reporting (ELR) has helped improve public health’s response to dangerous infections, according to data from CDC’s Morbidity and Mortality Weekly Report (MMWR). ELRs enable labs to report disease outbreak information quickly and in a usable format. The number of labs that utilize ELRs has more than doubled since 2005, and CDC has helped fund their increased use since 2010 in 57 state, local and territorial health departments. Current estimates are that about 62 percent of lab reports were received electronically. “Electronic laboratory reporting can give health officials better, more timely and complete information on emerging infections and outbreaks than they have ever received before,” said Robert Pinner, MD, associate director for surveillance, programs and informatics in CDC’s National Center for Emerging and Zoonotic Diseases. “Implementing these systems is a complex task that requires substantial investment, but ELR will provide health departments the tools they need to quickly identify and respond to disease threats and monitor disease trends now and in the future.” Read more on technology.
State AGs Urge FDA to Adopt New Regulations Covering E-cigarettes
The Attorneys General of 41 states are urging the U.S. Food and Drug Administration (FDA) to follow through on a pledge to issue regulations that would expand its oversight to include e-cigarettes. In a letter to FDA Commissioner Margaret Hamburg, they asked “the FDA to move quickly to ensure that all tobacco products are tested and regulated to ensure that companies do not continue to sell or advertise to our nation's youth.” The FDA was given authority to regulate cigarettes, cigarette tobacco and roll-your-own tobacco in 2009, as well as the authority to expand its authority after it issued new regulations. Last week a similar plea related to FDA authority was made to President Obama by the American Academy of Pediatrics and 14 other public health organizations, including the American Lung Association and American Heart Association. E-cigarettes continue to increase in sales (a projected $1.7 million in 2013) even while dropping in price. At the same time, there are no advertising restrictions for e-cigarettes. "Consumers are led to believe that e-cigarettes are a safe alternative to cigarettes, despite the fact that they are addictive, and there is no regulatory oversight ensuring the safety of the ingredients in e-cigarettes,” according to the Attorneys General’s letter. Read more on tobacco.
Expert: People Should Get Now-available Flu Vaccine As Soon As Possible
This season’s influenza vaccine is now available and people shouldn’t hesitate to go ahead and get it, according to Stephen Russell, MD, associated professor in the general internal medicine division at the University of Alabama at Birmingham and a lead physician at the university’s Medicine Moody Clinic. This year’s vaccine protects against four types of flu viruses (as opposed to the three of previous vaccines) and comes as either a traditional shot or a nasal spray. "Contrary to some beliefs, getting the flu shot in September is a good thing and will offer protection for the entirety of the flu season," he said. The U.S. Centers for Disease Control and Prevention recommends the vaccine for people ages 6 months and older, particularly for seniors, pregnant women, caregivers and people with chronic medical conditions. "Many people will say they do not need the vaccine, as they have never had the flu before, but that is like saying you don't need to wear your seatbelt because you have never had a wreck," Russell said. "You may have been fine in the past, but that should not offer security or protection for future exposures to the flu." Read more on influenza.
Study: Losing 10 Percent of Weight Can Greatly Reduce Arthritic Knee Pain, Put Off Knee Replacement
Losing just 10 percent of their weight could go a long way toward easing the knee pain from osteoarthritis in overweight and obese people ages 55 and older, according to a new study in the Journal of the American Medical Association. That would mean better knee function, improved mobility, enhanced quality of life…and reducing the odds of needed a knee replacement. "We've had a 162 percent increase in knee replacements over the last 20 years in people 65 and over, at a cost of $5 billion a year," said lead author Stephen Messier. "From our standpoint, we think this would be at least a good way to delay knee replacements and possibly prevent some knee replacements." The study tracked 454 overweight and obese people in three groups—diet-only, exercise-only and a combination—finding that people who did the combination were the most successful at losing weight and thus reducing knee pain. "We're not talking about people getting down to ideal body weight," said Patience White, MD, the Arthritis Foundation’s vice president of public policy and advocacy. "They just have to lose 10 percent of their total weight. Someone who is 300 pounds only needs to lose 30 pounds. I think that's within reach for people." Read more on obesity.
CDC: ‘Tips From Former Smokers’ Campaign Created Spikes in Quitline Calls, Website Visits
An additional 150,000 U.S. smokers called the tobacco cessation helpline 1-800-QUIT NOW as a direct result of the U.S. Centers for Disease Control and Prevention's (CDC) 2013 “Tips From Former Smokers” campaign, which ran for 16 weeks, according to CDC’s latest Morbidity and Mortality Weekly Report. That’s an increase of about 75 percent. It also generated approximately 2.8 million visits to the campaign website, or a nearly 38-fold increase. "The TIPS campaign continues to be a huge success, saving tens of thousands of lives and millions of dollars; I wish we had the resources to run it all year long," said CDC Director Tom Frieden, MD, MPH. "Most Americans who have ever smoked have already quit, and most people who still smoke want to quit. If you smoke, quitting is the single most important thing you can do for your health – and you can succeed!" A recent study in The Lancet concluded that the campaign helped as many as 100,000 people quit smoking permanently. Read more on tobacco.
FDA, NIH Award as Much as $53M for 14 Tobacco Regulation Research Centers
The U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH) have joined together to award as much as $53 million in funding to create 14 Tobacco Centers of Regulatory Science (TCORS). The first-of-its-kind program will bring together a diverse array of scientists, public health experts, communications veterans and marketing experts to generate research to inform the regulation of tobacco products to protect public health. “While we’ve made tremendous strides in reducing the use of tobacco products in the U.S., smoking still accounts for one in five deaths each year, which is far too many,” said NIH Director Francis S. Collins, MD, PhD. “FDA/NIH partnerships like the Tobacco Centers of Regulatory Science keep us focused on reducing the burden and devastation of preventable disease caused by tobacco use.” Read more on research.
Overweight, Underweight Pregnant Women See More Complications and Longer Hospital Stays
Pregnant women who are either too thing or too heavy as measured by body-mass index (BMI) are at increased risk for complications and additional hospitalization, according to a new study in BJOG: An International Journal of Obstetrics and Gynaecology. Women with higher BMIs saw increased complications; severely obese women were three times as likely as normal weight women to have high blood pressure and gestational diabetes, as well as longer overall hospitalizations. Lower-weight women also had higher rates of additional hospitalization (8 percent) compared to normal-weight women, though not as high as the rates for overweight and obese women. The findings indicate the need to fine and implement new approaches to combating obesity. "Longer-term benefits of reducing maternal obesity will show improvements, not only in the health outcomes of mothers and their babies, but the workload and cost to current maternity services," said study co-author Fiona Denison, MD, of Queens's Medical Research Institute in Edinburgh. Read more on maternal and infant health.
Higher Education Linked to Better Obesity Rates for Women in Poorer Areas
Higher education is a key factor that helps protect women in economically disadvantaged areas from obesity, according to a new study in the American Journal of Health Promotion. “It is possible that education is a marker of an individual’s access to health information, capacity to assimilate health-related messages, and ability to retain knowledge-related assets, such as nutrition knowledge,” wrote the study’s authors. Previous studies have shown that women living in area with fewer economic resources have higher body mass index (BMI) than other women. The results indicate that both low education and personal income should be addressed by obesity prevention initiatives. Read more on obesity.
Regular Exercise May Help Decrease Depression
Increases in exercise may be linked to decreases in depression, according to a new review of existing research by The Cochrane Library. The researchers found people with depression who also exercised saw a “moderate” reduction in their symptoms when compared to people who did instead used relaxation techniques or received no treatment. Antidepressant medications and psychotherapy are the most common treatments for depression, which affects about 10 percent of Americans, according to the U.S. Centers for Disease Control and Prevention. More research is needed to better understand the relationship between exercise and depression symptoms. Still, Madhukar Trivedi, MD, a professor of psychiatry at the UT Southwestern Medical Center in Dallas, who was not a part of the study, said one of the keys is making sure patients stick with the exercise regimen. "Once people are prescribed exercise or they choose exercise, the big challenge is to make the exercise real," he said. "If the recommendation from the treating clinician is that you should be exercising with some frequency and intensity…it's important that the patient follow that regimen week after week.” Read more on mental health.
Predominantly Black Nursing Homes Deliver Lower Levels of Care, Perform Worse Financially
Nursing homes that are predominantly populated by black residents deliver overall poorer care and are less successful financially than homes with few or not minority residents, according to a new study in Health Services Research. The study looked at issues such as the ratio of nursing staff to patients, success in preventing pressure ulcers, help with walking, help with getting out of bed, prevention of urinary tract infections, the incidence of medication errors and citations by governmental agencies. However, the study noted that black and white patients living in the same facilities received equal treatments, meaning the disparity is not due to any biases of health care workers. One factor leading to the disparity could be the fact that older black Americans are more likely to rely on Medicaid, which means lower reimbursement rates. Still, Latarsha Chisholm, assistant professor at the University of Central Florida and study author, believes something more must be at play. "It isn't only the financial performance [of nursing homes] that affects performance," she said. "There has to be something else affecting quality. I want to understand what management practices promote improved care in nursing homes with high proportions of minorities that don't have disparities in care.” Read more on health disparities.