More on breast cancer and screening

NPR tries to flush out the Task For Prevention's recommendation on breast cancer screening, sans politics. The piece also addresses the puzzling high rate of breast cancer among African Americans.

Cancer from the Kitchen

NYT op-ed piece on preventive medicine

Perspectives from the NEJM

A recent issue of the NEJM addresses several emerging public health issues; including "sin foods," health care reform, the H1N1 vaccine, cervical-cancer screening, and the recent US Preventive Services Task Force recommendation on mammograms .

NPR on Pain Management & eHealth

NPR piece on pain and on eHealth

Emerging Issues for College Students

It used to be that health care for college students was easy - parents' health insurance covered the big expenses and the student health center covered the more immediate needs. It wasn't until grad school that we had to choose between unaffordable premiums or going without insurance and hoping for the best. This WSJ article illustrates the rising percentage of college students who are going without health insurance due to changes in their parents' employment.

More reaction to the IOM Report on heart attacks and smoke-free laws

This release from the American Medical Association includes several reactions from public health leaders, as well as a chronology of key moments in the smoke-free movement.

Smoking policies

Restrictions on smoking and secondhand smoke have been gaining popularity in the U.S. since 1971, with federal and state governments and their agencies cracking down on lighting up. As of Jan. 4, 37 states had laws requiring 100% smoke-free workplaces, restaurants and/or bars.

1964: U.S. surgeon general issues first report on adverse health effects of smoking.

1965: Congress enacts a law requiring health warnings on cigarette package labels.

1971: Surgeon general proposes a federal smoking ban in public places.

1972: Surgeon general report identifies secondhand smoke as posing a health risk.

1973: Arizona becomes the first state to restrict smoking in several public places.

1973: Civil Aeronautics Board requires no-smoking sections on all commercial airline flights.

1974: Connecticut passes the first state law on smoking restrictions in restaurants.

1986: Surgeon general report says secondhand smoke causes lung cancer in healthy nonsmokers.

1987: Dept. of Health and Human Services establishes smoke-free environments in its buildings.

1987: Gallup Poll finds, for the first time, that most American adults favor a ban on smoking in all public places.

1988: Smoking ban takes effect on domestic airline flights of two hours or less.

1992: Joint Commission requires hospitals applying for accreditation to develop policy prohibiting smoking by patients, visitors, employees, volunteers and medical staff.

1994: Occupational Safety and Health Administration proposes a smoking ban in most workplaces.

1994: San Francisco passes a ban on smoking in restaurants and workplaces.

2000: New Jersey Supreme Court strikes down a clean-indoor-air ordinance adopted by city of Princeton on grounds that state law preempts local smoking restrictions.

2003: Dozens of airports, including airline clubs, passenger terminals and nonpublic work areas, are designated smoke-free.

2004: International Agency for Research on Cancer issues a new monograph identifying secondhand smoke as "carcinogenic to humans."

Abandon Hope?

University of Michigan study suggests closure, rather than hope, may a better coping mechanism for some people.

The WSJ reviews recent innovations in health care

Much of the debate over health care reform has focused on health insurance. One often ignored component of reform is the relatively non-partisan issue of innovations to reduce the costs of health care. This report by the Wall Street Journal reviews six innovations in cost-effective health care delivery - including remote monitoring, infection prevention, and electronic records.

Accidents Of History Created U.S. Health System

An interesting NPR piece on the convoluted and more than a little Byzantine approach to health insurance that we have in the US.

Emerging Scientific Consensus

Last month two separate meta-analyses concluded that heart attack admissions had dropped significantly following the implementation of smoke laws. Today, yet another review conducted by the Institute of Medicine reached the same conclusion.

"CONCLUSION

Data consistently demonstrates that secondhand-smoke exposure increases the risk of coronary heart disease and heart attacks and that smoking bans reduce heart attacks. Given the prevalence of heart attacks, and the resultant deaths, smoking bans save more than half a million lives each year in the U.S. alone. The savings, as mea- sured in human lives, is undeniable."

If Air Travel Worked Like Health Care

Humor from the National Journal

Smoke-free laws and heart attacks

The results from two independent meta-analyses indicate that a scientific consensus is emerging regarding the reductions in heart attacks following the implementation of smoke-free laws. Both studies found substantial reductions in heart attacks after smoke-free laws went into effect. The study by James Lightwood and Stanton Glantz also found that these reductions increased with time. The NYT and USAT provide summaries of these studies.

Tax on sugar drinks?

This NYT piece highlights the recommendations of a a team of prominent doctors, scientists and policy makers that includes Joseph W. Thompson (Arkansas surgeon general), "estimates that a tax of a penny an ounce on sugary beverages would raise $14.9 billion in its first year, which could be spent on health care initiatives. The tax would apply to soft drinks, energy drinks, sports beverages and many juices and iced teas — but not sugar-free diet drinks".

NYT editorial highlights the 800 gorilla in the room - Big Food

Michael Pollan addresses the disconnect between government "subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup."

We knew this back in '65

The NYT comments on the viral video produced by the Gwent Police Department. The video presents the potential, horrific consequences of texting while driving. The authors reference the worst-case driver-education films, and quote several researchers and advocates on issues related to changing behavior with fear-based appeals. I wish more people in public health would read the literature (sample) on fear-based appeals. At best, these messages only serve to temporarily change behavioral intentions.

Little Debbie has a tax for you

The LA Times explores the viability and pitfalls of a tax on junk food. One key limitation is the operationalization of the term 'junk food.' That is, what exactly is and is not junk food.

Swine Vaccination?

This Washington Post article describes efforts to quickly produce a vaccination - and a large-scale vaccination program - for the swine flu. The pros and cons are highlighted, as well as the history of other flu vaccines.

National Health Security Strategy

Be Prepared

Summary of Health Reform Issues

Two foundations have recently released policy briefs intended to provide objective summaries of some of the key issues in health reform and the proposed reform plans. The Robert Wood Johnson Foundation's Key Issues in Health Reform address's the role of the Federal Government, the lowering of Medicare spending, and Advanced Care Planning. The Henry J. Kaiser Family Foundation's Focus on Health Reform provides side-by-side comparisons of the leading reform proposals. The Kaiser Foundation anticipates updating this document as these proposals are revised during the health reform debate.

Vintage PSAs

Public Service Announcements (PSAs) are one approach to disseminating information in order to promote health. Here are few amusing PSAs.

Immunizations - R2D2 and CP30

Smoking - R2D2 and CP30

Smoking - Yul Brynner - released after his death, and a little creepy, etc, etc, etc

Debunking Certain Myths About Health Care

Paul Krugman debunks many of the misconceptions about the government's role in health care.

Criticism of the law that allows the FDA to regulate tobacco

In a recent article in the journal PLoS Medicine, Stan Glantz and his colleagues highlight several of the strengths and weaknesses of the new law granting FDA authority regulating tobacco products.

a new assessment puts sunbed use on a par with smoking or exposure to asbestos

A recent assessment from the International Agency for Research on Cancer (IARC) puts sunbed use on a par with smoking or exposure to asbestos. This assessment appears in Lancet Oncology and is based on a review of existing research on the use of sunbeds and the risk of melanoma. The authors concluded that this risk was increased by 75% in people who started using sunbeds regularly before the age of 30.

The IARC is an expert committee that makes recommendations to the World Health Organization. The Sunbed Association (TSA) disputes these conclusions of the IARC assessment.

Cost of treating obese patients soars to $147 billion

The USA Today reports that obese Americans cost the country an estimated $147 billion in weight-related medical bills in 2008, double what it was a decade ago, a new study shows. This issue of rising health care costs for conditions perceived by some to be the consequence of personal behavior plays prominently in the debate over universal health care.

E-Cigarettes Pose a Health Hazard, FDA Warns

The HealthDay Reporter is reporting that testing of electronic cigarettes, known as e-cigarettes, has shown that they contain cancer-causing chemicals and other toxins, including a compound used in antifreeze, U.S. health officials said Wednesday. The article focuses on the harmful ingredients of the e-cigarette and the its potential to normalize and cue smoking behavior. The issue of whether this vapor is harmful to others in the vicinity was not specifically addressed. However, the ingredients are toxic and I would argue that the precautionary principle should guide states and communities to prohibit the use of these devices in indoor public places, and these restrictions should only be removed if scientific consensus emerges that indicates the vapors from these devices poses no harm to others.

Restaurants across the country may have to post calorie-counts

The Economist recently published an article on calorie labels in restaurants. IMHO, this policy intervention can help to inform consumers, while placing little undue government regulation on businesses. As Kelly Brownell points out, we have labels on your clothes to tell us what’s in it and where it’s made, and the consumer has a right to know the calorie-count of a restaurant meal.

Reactions to the Family Smoking Prevention and Tobacco Control Act

President Obama signed this bill in to law on 22 June 2009. Below are some of the reactions to this controversial bill.

NPR notes the President's own struggles with nicotine addiction.

CNN highlights the support from the voluntary health organizations, and also includes a dissenting opinion from Stan Glantz - "The bill creates a 12-member advisory board through which all regulations will flow. Tobacco industry representatives will hold three nonvoting seats. Putting three guys on this committee would be a little bit like putting three mobsters on the Department of Justice committee on organized crime." This article also notes the objection to the Philip Morris involvement in drafting the bill from rival tobacco companies.

Michael Siegel - is frustrated by the PR coup that Philip Morris is experiencing from this bill.

The Campaign for Tobacco Free Kids highlights the harms of tobacco and the key benefits of this bill

Lance Armstrong Appeals for More Funding for Cancer Prevention and Research

Seven-time Tour de France winner pushes Washington to put more dollars to cancer research and prevention in this op-ed from the The Hill. In recognition of the role of tobacco in cancer, Armstrong highlights the need for higher tobacco taxes and more smoke-free legislation. He also cites the importance of the FDA Bill to regulate tobacco (it passed the Senate today).

Taxes on Junk Food

The NYT recently published an editorial on the issue of using taxes on junk food to reduce obesity. This editorial highlights two of the major issues facing obesity researchers; 1) the obesity epidemic is a complex problem, and there is no magic bullet that will solve this problem (moreover, many of the proposed remedies are not yet sufficiently supported by the literature), and 2) many of the potential remedies face stiff opposition due the cost of implementation or - as in this case - industry opposition.

Cigarettes in Popular Films Are Target of Health Groups

The NYT has piece on a summer public health campaign being led by the American Medical Association Alliance. “Which Movie Studios Will Cause the Most Youth to Start Smoking This Summer?" is designed to increase awareness of illegal product placement of tobacco products in movies and the impact that this product placement has on youth smoking. This movement is based on research led by Jim Sargent (Dartmouth). Dr. Sargent's research and the response to this research provide a fascinating look into inferring causality from correlational research.

The 50 Cent increase in the state cigarette tax

Mississippi no longer has the third lowest cigarette tax in the Nation. On 15 May, the state raised the cigarette tax from 18 to 68 cents. There are several reasons why raising this tax is good for the state. Whereas the most important reason is that it will improve health by reducing smoking, this tax will also create new revenue for the state. This clip demonstrates the history of state cigarette tax and revenue over the past 9 nine years. The chart displayed in this clip illustrates how far Mississippi had fallen behind the other states - and the increased revenue that other states generated after raising the cigarette tax.

Mississippi Health Summits

The Communities for a Clean Bill of Health are hosting a series of Health Summits this week to discuss the health and economic benefits of increasing the state cigarette tax. Anna Hill and I spoke at the summits in Meridian and Tupelo. WCBI's coverage of the summit in Tupelo can be found here under the News section

BPA and the Precautionary Principle

On Morning Edition this morning, NPR spent several minutes covering the issue of BPA and the Precautionary Principle. The story does a good job of capturing the tension between the need to protect public health and the complexities of interpreting the precautionary principle. Guest on the program, Ted Schettler defines the Precautionary Principle as such "When there are credible threats of harm from some proposed activity, precautionary action should be taken even if some cause-and-effect relationships are not fully understood."

And there is the rub. How do we establish the point at which the evidence of risk from correlational research is sufficient to justify government regulation of some product or activity? The situation is obviously complicated by the fact that the product or activity in question may be very profitable to an industry or the activity might be very popular among many voters.

Obama Makes Health Reform Office Official

Nancy-Ann DeParle will oversee this office.

CL reports that Governor Barbour mum on cigarette tax level he'll OK

The Clarion Ledger quotes Governor Barbour on his position and concerns regarding an increase in the state cigarette tax. One of his concerns is that some Legislators will over estimate new revenue, particularly in a poor state during a recession. This issue has been addressed many times by health policy economists. Based on years of socioeconomic studies, conservative models developed by the Campaign for Tobacco Free Kids project that a $1 increase in the state cigarette tax can prevent 26,300 kids form smoking and raise $135 million in new revenue. It's important to understand that the estimates are based on conservative assumptions, in order not overestimate the benefits of a tax increase.

This NYT article on health insurers highlights rising costs of health care, as well as the changing forces on the health insurance industry. One point that resonates with me - the industry must prove that it does more than serve as a middleman between doctors and hospitals providing the care and those who pay for it. This issue is critical, given that many people and businesses can no longer afford to pay for health plans and the AND the mood of the President and Congress.

Cigarette tax logjam ridiculous this session

Sid Salter offers a scathing rebuke of the Mississippi Legislature for failing to reach a compromise on the state cigarette tax increase. In this column, he refers to the strong public support for an increase in the tax. Indeed, findings from the 2008 Mississippi Social Climate Survey of Tobacco Control demonstrate that less than 30% of Mississippi adults are opposed to a one dollar increase in the state cigarette tax.

Legislators: Higher car tags or higher cigarette taxes?

Sid Salter continues to push the Mississippi Legislature to increase the state cigarette tax

Fighting cancer a win for both parties

Interesting perspective on the history and future of the War on Cancer