Watchdog Report -- Playing With Fire:
Fear Fans Flames for Chemical Makers
Manufacturers of fire retardants rely on questionable testimony, front groups to push standards that boost demand for their toxic -- and ineffective -- products
Patricia Callahan and Sam Roe
(Chicago Tribune, May 6, 2012)
"[A] decades-long campaign of deception...has loaded the furniture and electronics in American homes with pounds of toxic chemicals linked to cancer, neurological deficits, developmental problems and impaired fertility. The tactics started with Big Tobacco, which wanted to shift focus away from cigarettes as the cause of fire deaths, and continued as chemical companies worked to preserve a lucrative market for their products, according to a Tribune review of thousands of government, scientific and internal industry documents. These powerful industries distorted science in ways that overstated the benefits of the chemicals, created a phony consumer watchdog group that stoked the public's fear of fire and helped organize and steer an association of top fire officials that spent more than a decade campaigning for their cause. Today, scientists know that some flame retardants escape from household products and settle in dust...Blood levels of certain widely used flame retardants doubled in adults every two to five years between 1970 and 2004. More recent studies show levels haven't declined in the U.S. even though some of the chemicals have been pulled from the market. A typical American baby is born with the highest recorded concentrations of flame retardants among infants in the world. People might be willing to accept the health risks if the flame retardants packed into sofas and easy chairs worked as promised. But they don't...The U.S. Environmental Protection Agency, meanwhile, has allowed...flame retardants onto the market and into American homes without thoroughly assessing the health risks...Since the 1970s manufacturers have repeatedly withdrawn flame retardants amid health concerns. Some have been banned by a United Nations treaty that seeks to eliminate the worst chemicals in the world...In the last quarter-century, worldwide demand for flame retardants has skyrocketed to 3.4 billion pounds in 2009 from 526 million pounds in 1983...As evidence of the health risks associated with these chemicals piled up, the industry mounted a misleading campaign to fuel demand. There is no better example of these deceptive tactics than the Citizens for Fire Safety Institute, the industry front group."
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Patricia Callahan and Sam Roe
(Chicago Tribune, May 8, 2012)
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John J. Monahan
(Telegram & Gazette, Massachusetts, May 9, 2012)
"State Senate leaders [in Massachusetts] have unveiled their version of proposed fundamental changes in the way people pay for health care and medical treatment, calling for conversion of subsidized insurance plans to a global payment system within the next two years. The proposed new payment system provides for insurers to pay medical providers' charges based on fixed allocations for people covered by insurance, instead of the current fee-for-service system. The bill offered by...leaders in the Senate is expected to be voted on next [week]...It also provides incentives for new cost control measures for all health care systems...electronic medical records and a new $100 million preventive health initiative aimed at reducing costs for major chronic diseases. It follows a similar package of health care reforms proposed by House."
Chris Holt
(San Francisco Chronicle, May 8, 2012)
"[T]he Black Barbershop Health Outreach Program...[is] the brainchild of Los Angeles podiatric surgeon Bill James Releford...the Diabetic Amputation Prevention Foundation...[began] in 2007, taking advantage of the unique place barbershops occupy in the black community. Part club, part town hall, they are places people trust and share information. To Releford, they seemed like the perfect place to spread the word...the program [offers]...diabetes and hypertension [screenings and provides education on]...symptoms and prevention -- diet, exercise and a healthy lifestyle...[while linking] local providers who offer free or low-cost health care [with participants]. In rare cases, according to the program's website, men have been sent directly to the emergency room because of abnormal findings."
Sarah Jane Tribble
(The Plain Dealer, Cleveland, May 6, 2012)
"Early last month, federal health officials made an announcement that brought cheers in hospital boardrooms nationwide...the big news from the Centers for Medicare Medicaid Services was that there would be a one-year delay in implementing tens of thousands of new medical billing codes, part of an arcane system that directly affects every patient in America. Medical billing codes tell the story of a patient's treatment, dictating how much is paid to medical providers and, ultimately, who pays it -- an insurance company, Medicare or Medicaid, or you...The world of billing problems is as vast as medicine itself...Insurance companies and medical providers share the blame for the problems, which are common, maddening and expensive. The Plain Dealer will spend the next year examining these issues."
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The Most Common Errors, Explained
Sarah Jane Tribble
(The Plain Dealer, Cleveland, May 6, 2012)
(The Economist, London, May 5, 2012)
"[L]ocal concentrations of unvaccinated children pose a growing risk to public health. For the most common shots, vaccination rates for America overall...are still...at or near the levels considered necessary to provide 'herd immunity' for a population. But in places the rates have been falling for almost a decade. In many counties, towns and nursery schools -- within Washington state, Oregon, Vermont and California, especially -- vaccination rates are now far below the herd-immunity level. This trend, predictably, is leading to the resurgence of diseases considered vanquished long ago. In 2010, for example, California had an outbreak of whooping cough...Elsewhere there have been outbreaks of measles. The case for vaccination is clear...The case against vaccination, by contrast, is not clear...All states save Mississippi and West Virginia allow a religious exemption for vaccinations, and 20 states also allow a more vague philosophical exemption. So what can health officials do?"
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Roselyne Sachiti
(The Herald, Zimbabwe, May 10, 2012)
"The Zimbabwe Demographic Health Survey 2010-11...confirms that 93 percent of Zimbabwean women and 91 percent of men do not have health insurance...As expected, women who live in urban areas and those in the highest wealth quintile are most likely to have health insurance...This is despite the arguable fact that women need health insurance more than men...Of the women...in urban areas...88,5 percent are not covered by any form of insurance...[while women]...in rural areas are less insured with...97 percent [lacking]...coverage...83,3 percent [of men living in urban areas] are not covered by any medical aid...95,5 percent [of men in rural areas] are not covered under any medical aid scheme. With such shocking statistics, The Herald made several inquiries with some medical aid societies to find out what really deters people from seeking health insurance."
Marni Jameson
(Orlando Sentinel, May 8, 2012)
"Americans without health insurance experienced cost as an obstacle to medical care more often...Florida...ranked third worst in the nation...following closely behind Mississippi and Texas...Nationally, the number of adults who said cost stood between them and needed medical care rose 6 percent over the same 10 years to nearly one in five adults. At the healthier end of the spectrum were North Dakota, Massachusetts and Hawaii, where fewer than one in 10 residents did not get care because of cost...researchers...relied on federal government data compiled from surveys conducted by state health departments [on Americans ages 19 to 64 between the years 2000 and 2010]. They studied how often Americans had not had their medical needs addressed due to cost, and whether they had a routine physical and dental visit in the past year."
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Retired Couples May Need $240,000 for Health Care
Mark Jewell
(The Associated Press, May 9, 2012)
Jim O'Rourke
(The Sydney Morning Herald, May 6, 2012)
"Thousands of Australians who are frustrated at waiting up to 14 months for elective surgery, or cannot afford a private hospital, are travelling to developing countries for much cheaper operations as part of a booming $60 billion international 'medical tourism' industry...Australians are travelling to India, Thailand, Singapore, South Korea, Turkey and the Middle East for treatment to avoid public hospital surgery queues, which are as long as 420 days for non-urgent elective operations in NSW [New South Wales]. While Australian doctors warn that such patients are taking a risk with their health, the globalisation of medicine is making the journeys too tempting for many patients."
Sharon Begley
(Reuters, May 8, 2012)
"America's obesity epidemic is so deeply rooted that it will take dramatic and systemic measures...to fix it...[a report from the] Institute of Medicine [IOM]...embraces policy proposals that have met...stiff resistance from the food industry and lawmakers, arguing that multiple strategies will be needed to make the U.S. environment less 'obesogenic'...Officials at the IOM and CDC [Centers for Disease Control and Prevention] are trying to address the societal factors that led the percentage of obese adults to more than double since 1980...Obesity is responsible for an additional $190 billion a year in healthcare costs, or one-fifth of all healthcare spending...plus billions more in higher health insurance premiums, lost productivity and absenteeism...The IOM panel...scrutinized...programs and interventions to identify those that can significantly reduce the incidence of obesity within 10 years."
Related graphic:
Sizable Problem
(The Wall Street Journal, New York, May 8, 2012)
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Getting Fatter
(Los Angeles Times, May 8, 2012)
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Mark Trumbull
(The Christian Science Monitor, May 8, 2012)
"A bake-sale ban in Massachusetts schools, designed to combat youth obesity, has spawned a sort of nationwide food fight...Although it's a Massachusetts policy that has drawn the sudden attention, the issue of school food guidelines is national. It's under review by everyone from local school boards to the US Agriculture Department. As public officials consider ways to improve nutrition and reduce childhood obesity, rules and norms are changing in sometimes controversial ways...a state law...becomes effective in [Massachusetts this] August [and] will limit access to junk food (including bake sale treats) at schools from a half-hour before the school day until a half-hour after it ends...New guidelines from the state Department of Public Health go further, encouraging schools to apply the nutrition standards at all times."
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Massachusetts Pols Kowtow on Cupcakes
Chris Cassidy and Laurel J. Sweet
(Boston Herald, May 11, 2012)
U.S. Government Urged to Fight Fat at School
Susan Heavey
(Reuters, May 9, 2012)
Joe DeCapua
(Voice of America, May 9, 2012)
"It’s estimated nearly 400,000 children become infected with the AIDS virus every year -- mostly in low and middle income countries. In 2010, 250,000 children under age 15 died of HIV-related causes. UNAIDS officials said around 3.4 million children under the age of 15 are currently living with HIV. What’s more, about 42,000 women die annually from complications relating to HIV and pregnancy. The [new]...campaign ['Believe it. Do it']...aims to raise awareness of the Global Plan endorsed by leaders to end new childhood HIV infections by 2015. Karusa Kiragu of Kenya is a UNAIDS senior advisor on child and maternal health. Kiragu said there are only two regions of the world where mother-to-child-transmission continues to a major problem. But they are big regions."
Patrick Bodenham
(The Guardian, London, online, May 9, 2012)
"Doctors in Burma are calling for the 'devastating gap' between people's need and access to treatment for HIV and Aids to be bridged. There are approximately 240,000 people with HIV in Burma, half of whom are in urgent need of life-saving antiretroviral treatment (ART)...According to national estimates in 2010, less than 30,000 of them were receiving it. Burma is the least developed country in south-east Asia and receives only a fraction of the aid from which some of its neighbours benefit. With the Burmese ministry of health underfunded, around 70% of all healthcare expenditure is left to households. In a country where nearly 33% of people live below the poverty line, thousands of Burmese are unlikely ever to be able to afford ART."
Donald G. McNeil Jr.
(The New York Times, May 7, 2012)
"Whatever debate may linger about the government’s harsh early tactics...Cuba now has one of the world’s smallest [HIV/AIDS] epidemics...Its infection rate is 0.1 percent, on par with Finland, Singapore and Kazakhstan. That is one-sixth the rate of the United States, one-twentieth of nearby Haiti...elements [that] have contributed to Cuba’s success [beyond its small population are] free universal basic health care...high rates of H.I.V. testing...[extensively available] free condoms, concentrating on high-risk groups...[and] graphic safe-sex education...[besides the tracing of] sexual contacts of...[those who] tests positive...Cuba has succeeded even though it has the most genetically diverse epidemic outside Africa...Cuba has 21 different strains...And Cuba’s success has come despite its being a sex tourism destination."
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Cuba's Fortresses Against a Viral Foe
Donald G. McNeil Jr.
(The New York Times, May 7, 2012)
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Paige Winfield Cunningham
(The Washington Times, May 7, 2012)
"Health insurers gave a tentative thumbs-up...to the Food and Drug Administration’s [FDA] proposal to make drugs treating chronic conditions available without a prescription by classifying them in an all-new category...If the FDA decides to move ahead with the plan, it would create a third category for classifying drugs. Called 'safe use' drugs, patients wouldn’t need a prescription but neither could they obtain them over the counter. Instead, people could only buy the drugs after diagnosing their ailments online or in the pharmacy. Seeking a way to expand access to drugs for Americans who struggle with common conditions such as high cholesterol, migraines and diabetes, the FDA has raised the idea several times over the past decade and brought it up again in March, asking the public to weigh in."
Lindsey Hoshaw
(The Boston Globe, May 7, 2012)
"Alexandrium fundyense, an alga growing off the coast of Maine that releases natural toxins when it blooms in the spring...is the only species responsible for paralytic shellfish poisoning in humans...Because states close shellfish beds before toxin concentrations reach levels that can cause illness, poisoning reports are rare. The Centers for Disease Control and Prevention receive about 30 reports of poisoning by marine toxins annually in the United States...[a] team at Woods Hole [Oceanographic Institution] hope to make that number even smaller. Their...new robotic sensor is intended to improve red tide forecasting...With the new device, scientists and shellfish managers will be able to predict, with greater accuracy, where and when red tide will appear."
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Aaron Marshall
(The Plain Dealer, Cleveland, May 7, 2012)
"Emergency rooms across Ohio could not be used as pit stops for addicts or prescription drug dealers looking to stock up on supplies of painkillers, under fresh guidelines...Gov. John Kasich...announced a new policy under which emergency rooms and urgent care centers will limit prescriptions for opiates and other painkillers to a 72-hour supply, except in rare cases. The new guidelines agreed to by hospitals, emergency room doctors and nurses are aimed at curbing the diversion of prescription drugs handed out at emergency rooms...Ohio Department of Health director Ted Wymyslo said the guidelines are designed so that emergency room doctors will be looking to tide over those in severe pain until they can get in to see their regular doctor."
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Kay Lazar
(The Boston Globe, May 7, 2012)
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Benedict Carey
(The New York Times, May 8, 2012)
"In a rare step, doctors on a panel revising psychiatry’s influential diagnostic manual have backed away from two controversial proposals that would have expanded the number of people identified as having psychotic or depressive disorders...But the panel, appointed by the American Psychiatric Association to complete the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., did not retreat from another widely criticized proposal, to streamline the definition of autism. Predictions by some experts that the new definition will sharply reduce the number of people given a diagnosis are off base, panel members said, citing evidence from a newly completed study. Both the study and the newly announced reversals are being debated this week at the psychiatric association’s annual meeting in Philadelphia."
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Related story:
How Do Controversial Revisions in Psychiatry's Guidebook Make You Feel?
Stacey Burling
(The Philadelphia Inquirer, May 5, 2012)
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Elizabeth Lopatto and Eben Novy-Williams
(Bloomberg, May 8, 2012)
"For several years, researchers have been trying to understand a condition that’s haunting players of contact sports with symptoms similar to Alzheimer’s disease...Junior Seau, the former professional football player...played almost 30 years of football from high school through the National Football League [NFL]. Now his family is weighing whether to donate his brain to research. If so, his longevity may offer new insight into the condition known as CTE, or chronic traumatic encephalopathy...CTE is thought to be a progressive condition that affects those with a history of repetitive brain trauma, including concussions...Researchers aren’t sure whether the athletes’ condition as they get older is due to a sped-up version of the aging process, or whether CTE is a separate, distinct neurological illness."
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Help for Pro Athletes When the Cheers Stop
David Wallis
(The New York Times, May 9, 2012)
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Patricia Wen
(The Boston Globe, May 8, 2012)
"[P]ublic health officials...are legally powerless to regulate private rooming houses for recovering substance abusers, but propose financial inducements for property managers...to get training...the [Massachusetts] Department of Public Health calls for a carrot-and-stick approach: voluntary training for managers of these...sober homes, combined with legislation that would prohibit state agencies...and their vendors, from referring clients to any sober home that did not undergo the instruction...The 16-page report...comes amid growing complaints...that some landlords, aware that droves of men and women were getting out of detoxification facilities with no place to go, were taking about $150 a week from them and promising a supportive environment, only to put them in unsafe, chaotically run boarding houses where relapses were common. The remedy, however, was elusive because of these properties’ unusual legal status."
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Bob Egelko
(San Francisco Chronicle, May 5, 2012)
"Claims of systematic delays and neglect in mental health care for the nation's military veterans [vets] are beyond the power of courts to address, a federal appeals court in San Francisco ruled [this week]...in ordering dismissal of a 5-year-old suit by veterans groups. At a trial in 2008, Department of Veterans Affairs [VA] documents [led]...a panel of the Ninth U.S. Circuit Court of Appeals [to rule]...a year ago that vets groups could ask a federal judge to order changes in the system. But at the Obama administration's request, the full appeals court granted a new hearing before a larger panel, which ruled...that courts lack authority to order system-wide changes in veterans' health care...[and] that Congress had created special tribunals in 1988 to review veterans' benefits, effectively prohibiting constitutional challenges in conventional courts."
Peter Walker
(The Guardian, London, May 8, 2012)
"Niger is the worst country on earth in which to be a mother, according to a...charity's annual Mothers' Index [that] uses statistics covering female and child health and nutrition, as well as prospects for women's education, economic prosperity and political participation in its assessment of 165 countries. Niger's current food crisis bears much of the blame...Afghanistan, which came last the previous two years, was credited for providing skilled assistance at more births and a reduction in female mortality rates, among other factors. Hunger and deprivation are the chief factors keeping other developing nations...near the bottom of the list. Of 73 developing nations on the table, which account for 95% of child deaths, the Save the Children report rates only four as 'very good' for child nutrition...The authors stress that income is not the only thing that matters."
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Related opinion:
Global Health Within Our Grasp, If We Don't Give Up
Jeffrey D. Sachs, director of The Earth Institute at Columbia University and author
(CNN.com, May 9, 2012)
Rachel Saslow
(The Washington Post, May 7, 2012)
"It has been 20 years since the American Academy of Pediatrics (AAP) first recommended that parents place their babies on their backs to sleep for the first year of life to prevent sudden infant death syndrome, or SIDS. The rate of SIDS in the United States has plummeted more than 50 percent since the government launched its 'Back to Sleep' campaign in 1994. In 2006, 2,327 infants died from SIDS in the United States. Still, about 25 percent of U.S. babies sleep on their stomachs or sides, according to a national infant sleep position study...For some parents, there’s also a credibility issue. Despite the correlation between back sleep and the drop in SIDS deaths, scientists still don’t know the precise cause of SIDS. In fact, SIDS is by definition a death without a known cause."
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(The Economist, London, May 5, 2012)
"Critics call it a 'hearth bonus' or 'keep-your-kids-out-of-school money.' The [German] government prefers Betreuungsgeld ('child-care benefit'). Few of its ideas are as contentious as a planned €150 ($199) monthly payment to parents who do not put their children into crèches [or, day-care]...German women work fewer hours than women in most other OECD countries...The gap in median pay is the third-widest in the club, after South Korea’s and Japan’s. That is partly because mothers stay at home. In 2008 just 18% of children under the age of three were in formal child care, against an OECD average of 30%...By 2013 parents will have a legal right to a day-care place after a child’s first birthday...Yet Betreuungsgeld goes in the opposite direction. Women will be induced to interrupt their careers."
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Related graphic:
Some Women at Work
(The Economist, London, May 5, 2012)
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Michelle Roberts
(BBC News, May 8, 2012)
"One in six cancers -- two million a year globally -- are caused by largely treatable or preventable infections...estimates...which looked at incidence rates for 27 cancers in 184 countries, found four main infections are responsible. These four -- human papillomaviruses, Helicobacter pylori and hepatitis B and C viruses -- account for 1.9m cases of cervical, gut and liver cancers. Most cases are in the developing world. The team from the International Agency for Research on Cancer in France says more efforts are needed to tackle these avoidable cases and recognise cancer as a communicable disease. The proportion of cancers related to infection is about three times higher in parts of the developing world, such as east Asia, than in developed countries...Nearly a third of cases occur in people younger than 50 years. Among women, cancer of the cervix accounted for about half of the infection-related cancers. In men, more than 80% were liver and gastric cancers."
Denis Campbell
(The Guardian, London, online, May 8, 2012)
"The official assessment of the risks involved in the government's NHS shakeup will never be published after the cabinet exercised its rare right of veto to keep it secret. The move ends a 19-month campaign...for publication of the Department of Health's own analysis of the damage its radical NHS overhaul may cause...an array of medical leaders argued during the stormy passage of the health and social care bill that MPs [ministers of Parliament] and peers needed to see the details in the transition risk register before they could consider the coalition's NHS plans properly. Andrew Lansley, the health secretary, said ministers had taken the 'exceptional' step of opting against disclosure -- a tactic used only three times before in the previous decade -- because releasing it would undermine the process of policy-making by reducing the quality of advice civil servants gave governments in future."
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