Category Archives: Aging
Study: The Longer People Are Obese, the Greater Their Risk for Heart Disease
At a time when obesity rates for both U.S. adults and children are rising, new research indicates that the longer someone is obese, the greater their risk for heart disease. The study appeared in the Journal of the American Medical Association. "Each year of obesity was associated with about a 2 to 4 percent higher risk of subclinical coronary heart disease," said study lead author Jared Reis, an epidemiologist with the U.S. National Heart, Lung, and Blood Institute. "Those with longest duration of both overall obesity and abdominal obesity tended to have the highest risk [for subclinical disease].” Subclinical heart disease includes arterial damage indicated by markers such as calcium buildup on arterial walls, but which “has not yet developed into symptomatic illness,” according to HealthDay. The study is yet more evidence of the need to focus on the prevention and treatment of childhood obesity, according to the researchers. Read more on heart health.
EHRs Would Help Doctors’ Offices Cut Costs Slightly
Doctors’ offices that utilize electronic health records (EHRs) will spend less per patient than offices that use traditional paper records, according to a new study in the journal Annals of Internal Medicine. While the savings is expected to be small—about $5 per patient per month—they will add up over time. With a government commitment of about $30 billion for the widespread adoption of EHRs, the hope is the decrease in inefficiencies, incorrect care and errors will lead to better, cheaper health care. Previous studies have shown conflicting results. Rainu Kaushal, MD, who wrote an editorial that accompanied the study, said that while she does not expected the EHRs to contribute significantly to cost savings, their adoption is still vital. "EHRs may or may not directly contribute to those savings… but without investing in them you cannot achieve new models of healthcare delivery," said Kaushal, director of the Center for Healthcare Informatics and Policy at Weill Cornell Medical College in New York. Read more on technology.
No Evidence of Benefits of Community-wide Dementia Screening
New research has found no proof that there are any clinical, economic or emotional benefits to programs that use community-wide screening to identify people with dementia. "We found no evidence that population screening would lead to better clinical or psychosocial outcomes, no evidence furthering our understanding of the risks it entails and no indication of its added value compared to current practice," said author Carol Brayne, a professor of public health medicine from Cambridge Institute of Public Health, in the United Kingdom. The debate over the strategy’s efficacy has been going on for quite some time, with one side noting that there isn’t even a cure for Alzheimer’s disease, and the other noting that as many as half of the people with dementia remain undiagnosed. The researchers, however, did emphasize that family and friends should be aware of the warning signs of dementia so they can help loved ones get treatment. Read more on community health.
The final plenary session at this year’s NACCHO Annual included a talk by Christopher Murray, MD, DPhil, director of the Institute for Health Metrics and Evaluation at the University of Washington on how data is used to measure health, evaluate interventions and find ways to maximize health system impact. Dr. Murray was a lead author on three pivotal studies published last week that used data to assess the state of health in the United States compared with 34 other countries and county level data on diet and exercise. One of the key findings is that Americans are living longer, but not necessarily better—half of healthy life years are now lost to disability instead of mortality; and dietary risks are the leading cause of U.S. disease burden.
NewPublicHealth spoke with Dr. Murray about the study findings, their impact and upcoming research that can add to the data public health needs to improve the health of all Americans.
NewPublicHealth: Tell us about the three studies that were published this week using the Institute’s research.
Dr. Murray: The study in JAMA [Journal of the American Medical Association] is an analysis of a comprehensive look at the health of the United States in comparison to the 34 OECD [Organisation for Economic Co-operation and Development] countries. The study looks at both causes of death and premature mortality through over 290 different diseases and puts them all together in a comprehensive analysis of what the contributors are to lost healthy life. That study also looks at the contribution to patterns of health in the U.S., from major environmental, behavioral, and metabolic risk factors. In each of those categories, there are important findings:
- The U.S. spends the most on healthcare but has pretty mediocre outcomes and ranks about 27th for life expectancy among its peer countries.
- For many large, important causes of premature death, the U.S. does pretty poorly. And we also see a big shift towards more and more individuals having major disability—from mental disorders, substance abuse, and bone and joint disease.
- On the risk factor front, the big surprise is that diet is the leading risk factor in the U.S. It is bigger than tobacco, which is second and then followed by obesity, high blood pressure, high blood sugar, and physical inactivity. Diet in this study is made up of 14 subcomponents, each analyzed separately and then put together.
Gulf States Partner with East, Midwest States to Share Health Records After Disasters
Four Gulf Coast states have partnered with six East and Midwest states to help ensure that patients and providers have access to health records in the event of hurricanes or other major disasters, according to the U.S. Department of Health and Human Services. In concert with the Department of Health and Human Services Office of the National Coordinator for Health IT, health information exchange (HIE) programs in Alabama, Georgia, Louisiana, Florida, South Carolina, North Carolina, Virginia, Michigan, Wisconsin and West Virginia will share information on residents forced to move from their homes because of a disaster. “Through disasters like Hurricane Katrina and Hurricane Sandy and large tornadoes in Alabama and Joplin, Missouri, in 2011 and more recently in Moore, Oklahoma, we have learned the importance of protecting patients’ health records through electronic tools like health information exchanges,” said Farzad Mostashari, MD, national coordinator for health IT. “Patients are better off when states and health information exchange organizations work together to ensure that health information can follow patients when they need it the most.” Read more on preparedness.
Physical Punishment of Kids Tied to Obesity, Other Adult Health Problems
Obesity and other health problems are more likely in children who are punished through violence such as pushing, shoving and slapping, according to a study in the journal Pediatrics. Previous studies have also connected violent discipline with negative mental health outcomes. Researchers found that people who were punished physically “sometimes”—without more extreme physical or emotional abuse—were 25 percent more likely to have arthritis and 28 percent more likely to suffer from cardiovascular disease. About 31 percent of those punished physically were obese; about 26 who were not punished physically were obese. "Changes in sleep, risk-taking behaviors, immune functioning and regulation of stress hormones that result from chronic or intense stress may be important factors," said Michele Knox, a psychiatrist who studies family and youth violence at the University of Toledo College of Medicine, who was not involved in the study. "If we want what's best for our children, we need to choose discipline that does not come with these risks.” Read more on violence.
Putting Off Retirement May Also Help Put Off Alzheimer’s
Staying longer in the workforce may help decrease the risk of Alzheimer’s disease, according to new research looking at more than 429,000 workers in France. It found a 3 percent reduction in risk for each extra year at the age of retirement. The study is to be presented today at an Alzheimer's Association conference in Boston. About 5.2 million U.S. adults live with Alzheimer’s and it is the country’s sixth-leading cause of death. "There's increasing evidence that lifestyle factors such as exercise, mental activities, social engagement, positive outlook and a heart-healthy diet may reduce the risk of developing Alzheimer's disease and other forms of dementia," said James Galvin, MD, director of the Pearl Barlow Center for Memory Evaluation and Treatment at the NYU Langone School of Medicine, who was not involved with the research. "Now we can add staying in the workforce to this list of potential protective factors." About one-third of U.S. adults earning less than $100,000 annually said they would need to work until the age of 80 to retire comfortably, according to a 2012 Wells Fargo survey of 1,000 Americans. Read more on aging.
Study: Americans Living Longer…But Not Necessarily Healthier
A new study in the Journal of the American Medical Association paints a broad, sweeping picture of life expectancy and health in the United States, finding that while people are living long in general, they’re also spending more of their lives in poor health as illnesses that used to lead to early deaths have been replaced with chronic conditions. The overall average U.S. life expectancy in 2010 was 78.2 years. The new findings are part of the Global Burden of Disease Study, which is a collaboration of 488 researchers in 50 countries. "It's rare these days that you get information or studies that give you the big picture," said study author Christopher Murray, MD, director of the Institute for Health Metrics and Evaluation at the University of Washington, in Seattle. "It's pretty uncommon to step back and say, 'What does all the evidence tell us about the most important health problems, and where does the U.S. fit in that landscape?'" While the United States has been making improvements, they’ve not been coming as quickly as they have in other countries. The main causes of earlier death in the country are heart disease, lung cancer, stroke, chronic obstructive pulmonary disease and road injuries, and the top causes of disability are lower back pain, depression and other musculoskeletal disorders. Read more on global health.
Five Daily Servings of Fruits, Vegetables Tied to Longer Lives
Eating plenty of fruits and vegetables is directly tied to living a longer life, according to a new study in the American Journal of Clinical Nutrition. Researchers found that consuming fewer than five servings a day—the recommended amount by many public health organizations—was tied to a higher chance of early death. They did not find that people who consumed more than the recommended level saw greater returns. They also found that while people who ate fewer fruits and vegetables were more likely to smoke, to eat more red meat, to eat high-fat dairy products and to be undereducated, the overall study results did not change even after accounting for gender, smoking, exercise, alcohol consumption and body weight. Read more on nutrition.
Red Cross: Emergency Call for Blood, Platelet Donations
A recent drop in blood donations has led the American Red Cross to issue an emergency request for more donors of all blood types. Donations were down about 10 percent in June and more is needed to ensure enough blood and platelets for the summer months. "We're asking for the public's help now to prevent a more serious shortage," said spokesperson Stephanie Millian in a release. "Each day donations come up short, less blood is available for patients in need. It's the blood products on the shelves today that help save lives in an emergency." To see if you are eligible to make a donation or to make an appointment either call 1-800-RED CROSS (1-800-733-2767) or go to RedCrossBlood.org. Read more on preparedness.
Just a few metro stops can mean the difference between an extra five to ten years added to your lifespan. Using new city maps, the Commission to Build a Healthier America, which reconvened recently after a four year hiatus, is illustrating the dramatic disparity between the life expectancies of communities mere miles away from each other. Where we live, learn, work and play can have a greater impact on our health than we realize.
For too many people, making healthy choices can be difficult because the barriers in their communities are too high—poor access to affordable healthy foods and limited opportunities for exercise, for example. The focus for the Commission’s 2013 deliberations will be on how to increase opportunities for low-income populations to make healthier choices.
The two maps of the Washington, D.C. area and New Orleans help to quantify the differences between living in certain parts of the region versus others.
Living in Northern Virginia’s Fairfax and Arlington Counties instead of the nearby District of Columbia, a distance of no more than 14 miles, can mean about six or seven more years in life expectancy. The same disparity exists between babies born at the end of the Washington Metropolitan Transit Authority’s (known as the Metro) Red Line in Montgomery County—ranked second out of 24 counties in the County Health Rankings, metrics developed by the Robert Wood Johnson Foundation and the University of Wisconsin to show the health of different counties—and those born and living at the end of the Metro’s Blue Line in Prince George’s County, which ranked 17th in the County Health Rankings.
HHS Launches HealthCare.gov to Help Americans Prepare for New Coverage Opportunities
The U.S. Department of Health and Human Services (HHS) has launched the new HealthCare.gov to help Americans prepare for new coverage opportunities through the Affordable Care Act. Open enrollment in the Health Insurance Marketplace begins in just a few months, on October 1. The website (also available in Spanish) includes social media integration, sharable content and engagement destinations, and will later incorporate web chat functionality. “The new website and toll-free number have a simple mission: to make sure every American who needs health coverage has the information they need to make choices that are right for themselves and their families—or their businesses,” said HHS Secretary Kathleen Sebelius. Read more on access to health care.
USPSTF Recommends Hep C Screenings for All ‘Baby Boomers’
All “Baby Boomers”—Americans born between 1945 and 1965—should be screened for hepatitis C, according to new final recommendations from the U.S. Preventive Services Task Force (USPSTF). Earlier recommendations in November had only suggested that doctors consider screening. The new recommendations appear in the Annals of Internal Medicine. Researchers concluded that even the “moderate” net benefit made screening worthwhile; they also recommended screening for people at higher risk, such as injection drug users. "New evidence came out since the draft recommendation, which gave us greater confidence in the linkage between a sustained viral response and important outcomes," said Albert Siu, MD, co-vice chair of the task force, to Reuters. The majority of the 3 million Americans who have hepatitis C are Baby Boomers, according to the U.S. Centers for Disease Control and Prevention. Read more on aging.
Study: Diet, Exercise Don’t Decrease Heart Health Risk for People with Diabetes
While the weight loss associated with diet and exercise does not necessarily improve heart health for people with type 2 diabetes, the positive lifestyle changes can decrease the chances of kidney failure and eye damage, according to a new study in the New England Journal of Medicine. "Intensive lifestyle intervention reduced the risk of chronic kidney disease by 31 percent," said study author Rena Wing. "So we had a very, very marked effect on the development of high-risk chronic kidney disease. We also showed a benefit in terms of self-reported eye disease." Researchers said one possibility for the lack of heart health improvement was the relatively small weight losses of both of the study groups—the one that incorporated exercise, and the one that did not. Frank Sacks, MD a professor of cardiovascular disease prevention at the Harvard School of Public Health who saw the study but did not participate, said he believed it was “stopped too soon,” which affected the results. Read more on diabetes and heart health.
Racial and Ethnic Minorities Face Greater Subtle Housing Discrimination
Blatant acts of housing discrimination faced by minority prospective home buyers are declining in the United States, but more subtle forms of housing denial persist, according to a new study by the U.S. Department of Housing and Urban Development (HUD) and the Urban Institute. The study found that African-Americans, Hispanics and Asians learn about fewer housing options than equally qualified whites. According to the study, which sent out pairs of “mystery home buyers” — one white and one minority — to contact real estate agents and rental housing providers, the minority pairs were recommended and shown fewer available homes and apartments, which can increase their costs and restrict housing options, according to HUD. “Fewer minorities today may be getting the door slammed in their faces, but we continue to see evidence of housing discrimination that can limit a family’s housing, economic and educational opportunities,” said HUD Secretary Shaun Donovan. Read more on housing.
After Second or Third Concussion Kids Take Longer to Recover
Children and adolescents who suffer a concussion have a much longer recovery time if they have had a concussion in the past, according to a new study in Pediatrics. The study authors evaluated 280 patients between the ages of 11 and 22 who were treated for concussion symptoms in emergency departments. Children who had a second concussion within a year had nearly three times the average duration of symptoms compared to children whose concussions occurred more than one year apart. The number of previous concussions also affected recovery time. Two or more prior concussions resulted in a much longer duration of symptoms compared to those who experienced no or one previous concussion. Other factors that resulted in a longer recovery time included being age 13 or older and having more severe symptoms at the time of the emergency room visit. Read more on injury prevention.
Hearing Loss in Seniors Can Increase Hospitalizations and Poor Health
A new study published in JAMA finds that seniors with hearing loss are at increased risk for hospitalization, illness, injury and depression. The study authors reviewed records of more than 1,000 men and women age 70 and older with hearing loss, finding that over a four-year period they were 32 percent more likely to have been admitted to the hospital than a comparison group the same age with normal hearing. The hearing-impaired seniors in the study were also 36 percent more likely to have extended stretches of illness or injury and 57 percent more likely to have extended episodes of stress, depression or bad mood. According to the researchers, hearing loss affects two-thirds of men and women aged 70 and older. Among their recommendations to reduce the health burdens of hearing loss are expanding Medicare and Medicaid reimbursement for hearing-related services; increased installation of amplification technology in more facilities; and more accessible and affordable approaches for treating hearing loss. Read more on aging.
Smoking in Youth-rated Movies Up Dramatically
Smoking scenes in youth-rated movies is back up to the same levels as about a decade ago, with approximately half of such movies in 2012 providing 14.8 billion “tobacco impressions,” according to a new study funded by Legacy. Tobacco impressions are calculated by multiplying incidents of tobacco use by the number of film tickets. From 2010 to 2012 alone the rate was up 169 percent; 2010 was an historic low for tobacco impressions. This trend is dangerous because of the way movies can influence youth behavior. "Increases in smoking imagery in the movies are discouraging," said Tom Frieden, MD, director of the U.S. Centers for Disease Control and Prevention. "Every day in the United States approximately 3,800 youth under 18 smoke their first cigarette, and approximately 1,000 become daily cigarette smokers. Reducing smoking and tobacco use in youth-oriented movies will help save lives, money, and years of suffering from completely preventable smoking-related chronic diseases." Read more on tobacco.
Online Tool Helps Family, Friends Determine Whether an Older Driver is Safe
A new free online tool can help family members and caregivers of drivers age 65 and older determine whether they’re safe to continue going out on the roads. The Fitness-to-Drive Screening Measure questionnaire, developed by researchers at the University of Florida (UF), provides a rating profile, recommendations on how to move forward and links to an array of resources. Sherrilene Classen, PhD, MPH, an associate professor of occupational therapy at the UF College of Public Health and Health Professions and the tool’s lead developer, said it’s designed to give a realistic assessment of the driving abilities without requiring an on-the-road evaluation. “We know from our research and others’ that drivers do not give valid self-reports,” said Classen, “Most everybody thinks they are driving better than they actually are. Because we don’t have the evaluators to assess the 36 million older adults who may potentially at some stage require a driving evaluation, we went to the next-best step, which is involving their caregivers or family members.” Read more on aging.
Study Links Breakfast Cereal, Healthier BMIs for Kids
Helping kids maintain a low BMI could be as simple as giving them cereal for breakfast, according to a new study in the Journal of the Academy of Nutrition and Dietetics. The study found that children who had cereal for breakfast four out of nine mornings were in the 95th percentile for BMI; kids who had cereal every day were in the 65th percentile. Researchers say the study shows the ability to combat childhood obesity by making breakfast cereal available to low-income kids; one in four U.S. kids live in a “food insecure household,” according to lead author Lana Frantzen, PhD. "(Cereal) is an excellent breakfast choice, it's simple, and gets those essential nutrients that children need, especially low income minority children," she said. Read more on obesity.
U.S. Spends More on Dementia than Either Heart Disease or Cancer
At as much as $215 billion annually, the cost of dementia care in the United States is now higher than the costs for either heart disease or cancer, according to a new study in the New England Journal of Medicine. That includes the costs for both professional and family care. And the costs will only rise as the population ages, with as many as 14 million Americans expected to have Alzheimer’s by 2050, according to HealthDay. "It's not a happy situation," said lead researcher Michael Hurd, a senior principal researcher at the nonprofit research institute RAND. "A lot of the costs fall on families, and right now, there's no solution in sight." Read more on aging.
Brain Stimulation Could ‘Turn Off’ Compulsive Drug-Taking
Targeting a specific region of the brain could help turn off addictive behavior, according to a new study in the journal Nature. Researchers at the Intramural Research Program of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and the University of California, San Francisco were able to reduce compulsive cocaine-seeking in rates by stimulating their prefrontal cortexes. They believe this technique could ultimately be used to stop compulsive drug-taking in humans. “We already knew, mainly from human brain imaging studies, that deficits in the prefrontal cortex are involved in drug addiction,” said NIDA Director Nora D. Volkow, MD. “Now that we have learned how fundamental these deficits are, we feel more confident than ever about the therapeutic promise of targeting that part of the brain.” Read more on addiction.
Study: Black Men Wait Longer to Begin Prostate Cancer Treatment
Black men wait longer than white men to begin prostate cancer treatment after diagnosis, according to a new study in the journal Cancer. Researchers at the University of North Carolina found a delay of seven days with early prostate cancer and nine days with aggressive prostate cancer. As the study looked at Medicare data, the researchers know all the men were insured so it wasn’t a lack of insurance stopping them from seeking treatment earlier. Multiple studies also show that black men in general are less likely to be screen for cancers and to receive aggressive treatment. "Now we have shown that African American patients also wait longer for treatment,” said study leader Ronald Chen, MD, an assistant professor at UNC's Lineberger Comprehensive Cancer Center. “I think all of these disparities together add up to contribute to worse long-term survival outcomes for African American patients." Read more on health disparities.
Harvard Study: Public Supports Policy Interventions to Reduce Disease Burden
A survey by the Harvard School of Public Health finds that the public greatly supports government action with the goals of changing lifestyle choices that can lead to obesity, diabetes and other non-communicable diseases. However, the survey found that people are less likely to support actions that seem intrusive or coercive. The survey was published in Health Affairs. In a second poll from the Harvard School of Public Health, National Public Radio and the Robert Wood Johnson Foundation, researchers found a large gap between parents’ perceptions of their children’s weight and expert definitions. According to the parents, 15 percent of children are a little or very overweight; national data suggest more than twice as many, or 32 percent of all children, are overweight or obese. Read more on obesity.
Is Facebook Biased Against Older People?
Researchers at the Yale School of Public Health reviewed publicly available Facebook pages and found that many sites created by younger people often included negative age stereotypes. Some even suggested (possibly in jest) that older people should be killed. One Facebook group description, for example, stated that anyone “over the age of 69 should immediately face a firing squad.”
“Facebook has the potential to create new connections between the generations,” says Becca Levy, the lead author of the study. “Instead, it may have created new obstacles.” The study was published in The Gerontologist. Read more on aging.
Drug Use and Mental Health Issues Linked to Dropping Out of College
Marijuana and other illegal drug use, as well as mental health problems, are associated with an increased likelihood of dropping out of college, according to research from the University of Maryland School of Public Health. The research was part of the College Life Study, a longitudinal prospective study of health-risk behaviors among 1,253 college students between 17-19 years old, who were interviewed annually for four years, beginning with their first year of college. The study was published online in the Journal of Studies on Alcohol and Drugs. Read more on substance abuse.