Public Health
Public Health is the science of protecting and improving the health of communities through education, promotion of healthy lifestyles, and research for disease and injury prevention. (What is Public Health? Association of Schools of Public Health )

Five Minutes Or Less For Health


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Too much medicine
The BMJ’s Too Much Medicine campaign aims to highlight the threat to human health posed by overdiagnosis and the waste of resources on unnecessary care.
There is growing evidence that many people are overdiagnosed and overtreated for a wide range of conditions, such as prostate and thyroid cancers, asthma, and chronic kidney disease.
Through the campaign, the journal plans to work with others to increase awareness of the benefits and harms of treatments and technologies and develop ways to wind back medical excess, safely and fairly. This editorial by Fiona Godlee, editor in chief of The BMJ and overdiagnosis researcher Ray Moynihan, senior research fellow at Bond University, Australia, explains more about the campaign:
Dr Godlee said: “Like the evidence based medicine and quality and safety movements of previous decades, combatting excess is a contemporary manifestation of a much older desire to avoid doing harm when we try to help or heal.
"Making such efforts even more necessary are the growing concerns about escalating healthcare spending and the threats to health from climate change. Winding back unnecessary tests and treatments, unhelpful labels and diagnoses won’t only benefit those who directly avoid harm, it can also help us create a more sustainable future."
The BMJ was a partner in the international scientific conference, Preventing Overdiagnosis, held in September 2013 in Hanover, New Hampshire. The conference brought together the research and researchers, advanced the science of the problem and its solutions, and developed ways to better communicate about this modern epidemic.
(From The British Medical Journal, BMJ)

Too much medicine

The BMJ’s Too Much Medicine campaign aims to highlight the threat to human health posed by overdiagnosis and the waste of resources on unnecessary care.

There is growing evidence that many people are overdiagnosed and overtreated for a wide range of conditions, such as prostate and thyroid cancers, asthma, and chronic kidney disease.

Through the campaign, the journal plans to work with others to increase awareness of the benefits and harms of treatments and technologies and develop ways to wind back medical excess, safely and fairly. This editorial by Fiona Godlee, editor in chief of The BMJ and overdiagnosis researcher Ray Moynihan, senior research fellow at Bond University, Australia, explains more about the campaign:

Dr Godlee said: “Like the evidence based medicine and quality and safety movements of previous decades, combatting excess is a contemporary manifestation of a much older desire to avoid doing harm when we try to help or heal.

"Making such efforts even more necessary are the growing concerns about escalating healthcare spending and the threats to health from climate change. Winding back unnecessary tests and treatments, unhelpful labels and diagnoses won’t only benefit those who directly avoid harm, it can also help us create a more sustainable future."

The BMJ was a partner in the international scientific conference, Preventing Overdiagnosis, held in September 2013 in Hanover, New Hampshire. The conference brought together the research and researchers, advanced the science of the problem and its solutions, and developed ways to better communicate about this modern epidemic.

(From The British Medical Journal, BMJ)

UK: The health and care system explained
The new health and care system became fully operational on April 1, 2013 to deliver the ambitions set out in the Health and Social Care Act. NHS England, Public Health England, the NHS Trust Development Authority and Health Education England will take on their full range of responsibilities.
Locally, clinical commissioning groups – made up of doctors, nurses and other professionals – will buy services for patients, while local councils formally take on their new roles in promoting public health. Health and wellbeing boards will bring together local organisations to work in partnership and Healthwatch will provide a powerful voice for patients and local communities.
(More from Department of Health, Gov.UK)

UK: The health and care system explained

The new health and care system became fully operational on April 1, 2013 to deliver the ambitions set out in the Health and Social Care Act. NHS England, Public Health England, the NHS Trust Development Authority and Health Education England will take on their full range of responsibilities.

Locally, clinical commissioning groups – made up of doctors, nurses and other professionals – will buy services for patients, while local councils formally take on their new roles in promoting public health. Health and wellbeing boards will bring together local organisations to work in partnership and Healthwatch will provide a powerful voice for patients and local communities.

(More from Department of Health, Gov.UK)

pulitzercenter:

Journalist Michael Edison Hayden and photojournalist Sami Siva report on a broad cross-section of urban and rural healthcare issues in West Bengal, Gujarat and Andhra Pradesh, including the routine discrimination against patients with HIV/AIDS in state hospitals, a promising public health insurance program and the country’s high infant mortality rates. In this video, Hayden discusses the reporting project.

View their whole project: India’s Hospital Crisis

Hospitals turning to data brokers for patient information

(From PBS Newshour)

forbes:

In our new ebook, Inside Obamacare: The Fix For America’s Ailing Health Care System, Bruce Japsen looks at the myriad ways the health law, private and government insurers, and medical care providers are working to reduce emergency room costs.
gov-info:

SAMHSA Gov Doc: A Practitioner’s Resource Guide: Helping Families to Support Their LGBT Children 
This guide offers information and resources to help practitioners throughout health and social service systems implement best practices in engaging and helping families and caregivers to support their lesbian, gay, bisexual, and transgender (LGBT) children.

gov-info:

SAMHSA Gov Doc: A Practitioner’s Resource Guide: Helping Families to Support Their LGBT Children

This guide offers information and resources to help practitioners throughout health and social service systems implement best practices in engaging and helping families and caregivers to support their lesbian, gay, bisexual, and transgender (LGBT) children.

kirkwa:

And This Is Why You Shouldn’t Get Sick In America

Many believe that the US healthcare system is the best in the world. Not so according to the World Health Organization’s ranking of the world’s health systems. The US doesn’t even rank in the top 25. It ranks 37th and is the most expensive in the world. I would argue that even if we had the best healthcare system in the world, what good is it, if no one can afford to access it.

Most companies are buying 60/40-policys for their employees these days, but even if you are lucky enough to have good insurance with 80/20-policy coverage, that 20 percent your responsible for can drive you right into bankruptcy as easily as the 60-40 policy given the cost of healthcare.

Insurance cost have been going up dramatically in the last two decades, long before the new Affordable Healthcare Act has taken affect, in some cases as much as 35% per year.

But have you noticed the latest trick the insurance companies have roll out?

Yes, Higher Deductible… most averaging $5,000 per year, per person, but I have seen some as high as $10,000 per year. For those of you that are wondering, this tactic is specifically designed too stop you from using your insurance. It reduces the insurance companies out of pocket liability by shift costs onto consumers, especially those dealing with chronic illness such as diabetes and arthritis. Consequently, because consumers can’t afford the deductible they will avoid necessary care to save money.

Although insurance companies are a problem, the real crocks is the healthcare system it self. A corrupt and bloated system desperately in need of reform!

Insurance coverage among immigrants vs US-born population.


A Push to Sell Testosterone Gels Troubles Doctors
By  ELISABETH ROSENTHAL
The barrage of advertisements targets older men. “Have you noticed a recent deterioration of your ability to play sports?” “Do you have a decrease in sex drive?” “Do you have a lack of energy?”
If so, the ads warn, you should “talk to your doctor about whether you have low testosterone” — “Low T,” as they put it.
In the view of many physicians, that is in large part an invented condition. Last year, drug makers in the United States spent $3.47 billion on advertising directly to consumers, according to FiercePharma.com. And while ever-present ads like those from AbbVie Pharmaceuticals have buoyed sales of testosterone gels, that may be bad for patients as well as the United States’ $2.7 trillion annual health care bill, experts say.
Sales of prescription testosterone gels that are absorbed through the skin generated over $2 billion in American sales last year, a number that is expected to more than double by 2017. Abbott Laboratories — which owned AbbVie until Jan. 1 — spent $80 million advertising its version, AndroGel, last year.
Once a niche treatment for people suffering from hormonal deficiencies caused by medical problems like endocrine tumors or the disruptive effects of chemotherapy, the prescription gels are increasingly being sold as lifestyle products, to raise dipping levels of the male sex hormone as men age.
“The market for testosterone gels evolved because there is an appetite among men and because there is advertising,” said Dr. Joel Finkelstein, an associate professor at Harvard Medical School who is studying male hormone changes with aging. “The problem is that no one has proved that it works and we don’t know the risks.”
Dr. Eric Topol, a cardiologist and chief academic officer at Scripps Health in San Diego, is alarmed by the high percentage of patients he sees who use the roll-on prescription products, achieving testosterone levels that he described as “ridiculously high.”
The gels are of questionable medical benefit for many of the millions of men who now take them, he and other doctors say, and their side effects may well prove dangerous.
“These medicines come with a risk of coronary artery disease,” Dr. Topol said.
“When I ask patients why they’re on it, the instant response, is, ‘I have low T.’ I ask, ‘Why would you even get tested for that?’ There isn’t really a normal,” he said. Other side effects include an enlarged prostate, he added.
Nevertheless, many insurers cover the cost of the high-priced hormone treatments, requiring only a small co-payment from patients. AndroGel and another popular testosterone gel, Axiron, by Eli Lilly & Company, sell for more than $500 a month retail, and about $400 with pharmacy coupons.
Many experts say that pharmaceutical advertising promotes excessive and inappropriate drug use by convincing patients that they are ill — or have a more serious condition than is genuinely the case — and need medicine to treat it. While television viewers are barraged with advertising warning men they may have “low T,” Dr. Finkelstein said, “There is no such disease.”
Such advertising also leads patients to seek out more expensive treatments, rather than cheaper ones that are often equally effective. Drugs that are advertised are almost always the ones that are costly.
In response to an article Sunday in The New York Times on prescription drug costs for asthma medicines in the United States, a number of readers complained about the high price of inhalers, and that the costs were inflated by the millions of dollars pharmaceutical companies spend on advertising for them.
Jack D. from Philadelphia, for example, wrote that he mail-ordered his prescription steroid nasal spray from overseas, for 20 percent of the price in the United States. “I refuse to pay for ads featuring talking bees with Spanish accents,” he wrote. Merck spent $46.3 million last year advertising Nasonex, its popular steroid spray.
Patients of any age may benefit from testosterone replacement if their levels are severely low because of serious medical problems, experts say. But testosterone normally declines as men age — just as estrogen does in women.
The F.D.A. has approved the gels “for use in men who either no longer produce the male sex hormone testosterone or produce it in very low amounts.” But that directive is ambiguous, and the F.D.A. office did not respond to questions because of the government shutdown.
Should testosterone be replaced in older men, and will it safely redress frequent ordinary symptoms of male aging, like decreased muscle mass and libido? And what constitutes a very low amount?
Dr. Finkelstein said, “Until there are big long-term studies to address the issues of testosterone replacement, we’re not ready to make recommendations on that.”
But drug companies defend their efforts to reach out to potential users. Testosterone deficiency is “a recognized clinical condition, with signs/symptoms that can impact millions of patients,” said Morry B. Smulevitz, a director of communications for Lilly, which makes Axiron. While he said the company did not condone the use of medicine for purposes other than those approved by the F.D.A., it “encouraged patients to talk to their physicians to weigh the risks and benefits.”
David Freundel, director of public affairs for AbbVie, which makes AndroGel, said the company’s “low testosterone efforts” were “developed to educate men who may be at risk for, or have, low testosterone, so they can have the appropriate dialogue with their physician to determine if testing and treatment may be appropriate.”
Studies are just beginning to yield results to address the appropriate use of the drug in older men. For example, scientists have found that age-related male changes in body fat depend on a different hormone, estradiol, which also decreases with age. Likewise, while strength and libido do decrease with falling testosterone levels, that effect may not be significant until testosterone levels are very low, Dr. Finkelstein said. Low testosterone is rarely the main cause of erectile dysfunction.
Finally, he added, no one has really defined what is a “normal” or “physiological” testosterone level. And yet, physicians often order tests for “low T.”
A survey this year by CMI/Compass found that more than half of physicians felt that pharmaceutical advertising to consumers should be scaled back, and 63 percent said it misinformed patients.
“I really don’t understand why it’s tolerated at a time we’re struggling with health care costs,” Dr. Topol said. “A lot of people bounce their legs in meetings, but that doesn’t mean you have restless leg syndrome, and you shouldn’t be taking drugs for that.”
(From The New York Times)

A Push to Sell Testosterone Gels Troubles Doctors

The barrage of advertisements targets older men. “Have you noticed a recent deterioration of your ability to play sports?” “Do you have a decrease in sex drive?” “Do you have a lack of energy?”

If so, the ads warn, you should “talk to your doctor about whether you have low testosterone” — “Low T,” as they put it.

In the view of many physicians, that is in large part an invented condition. Last year, drug makers in the United States spent $3.47 billion on advertising directly to consumers, according to FiercePharma.com. And while ever-present ads like those from AbbVie Pharmaceuticals have buoyed sales of testosterone gels, that may be bad for patients as well as the United States’ $2.7 trillion annual health care bill, experts say.

Sales of prescription testosterone gels that are absorbed through the skin generated over $2 billion in American sales last year, a number that is expected to more than double by 2017. Abbott Laboratories — which owned AbbVie until Jan. 1 — spent $80 million advertising its version, AndroGel, last year.

Once a niche treatment for people suffering from hormonal deficiencies caused by medical problems like endocrine tumors or the disruptive effects of chemotherapy, the prescription gels are increasingly being sold as lifestyle products, to raise dipping levels of the male sex hormone as men age.

“The market for testosterone gels evolved because there is an appetite among men and because there is advertising,” said Dr. Joel Finkelstein, an associate professor at Harvard Medical School who is studying male hormone changes with aging. “The problem is that no one has proved that it works and we don’t know the risks.”

Dr. Eric Topol, a cardiologist and chief academic officer at Scripps Health in San Diego, is alarmed by the high percentage of patients he sees who use the roll-on prescription products, achieving testosterone levels that he described as “ridiculously high.”

The gels are of questionable medical benefit for many of the millions of men who now take them, he and other doctors say, and their side effects may well prove dangerous.

“These medicines come with a risk of coronary artery disease,” Dr. Topol said.

“When I ask patients why they’re on it, the instant response, is, ‘I have low T.’ I ask, ‘Why would you even get tested for that?’ There isn’t really a normal,” he said. Other side effects include an enlarged prostate, he added.

Nevertheless, many insurers cover the cost of the high-priced hormone treatments, requiring only a small co-payment from patients. AndroGel and another popular testosterone gel, Axiron, by Eli Lilly & Company, sell for more than $500 a month retail, and about $400 with pharmacy coupons.

Many experts say that pharmaceutical advertising promotes excessive and inappropriate drug use by convincing patients that they are ill — or have a more serious condition than is genuinely the case — and need medicine to treat it. While television viewers are barraged with advertising warning men they may have “low T,” Dr. Finkelstein said, “There is no such disease.”

Such advertising also leads patients to seek out more expensive treatments, rather than cheaper ones that are often equally effective. Drugs that are advertised are almost always the ones that are costly.

In response to an article Sunday in The New York Times on prescription drug costs for asthma medicines in the United States, a number of readers complained about the high price of inhalers, and that the costs were inflated by the millions of dollars pharmaceutical companies spend on advertising for them.

Jack D. from Philadelphia, for example, wrote that he mail-ordered his prescription steroid nasal spray from overseas, for 20 percent of the price in the United States. “I refuse to pay for ads featuring talking bees with Spanish accents,” he wrote. Merck spent $46.3 million last year advertising Nasonex, its popular steroid spray.

Patients of any age may benefit from testosterone replacement if their levels are severely low because of serious medical problems, experts say. But testosterone normally declines as men age — just as estrogen does in women.

The F.D.A. has approved the gels “for use in men who either no longer produce the male sex hormone testosterone or produce it in very low amounts.” But that directive is ambiguous, and the F.D.A. office did not respond to questions because of the government shutdown.

Should testosterone be replaced in older men, and will it safely redress frequent ordinary symptoms of male aging, like decreased muscle mass and libido? And what constitutes a very low amount?

Dr. Finkelstein said, “Until there are big long-term studies to address the issues of testosterone replacement, we’re not ready to make recommendations on that.”

But drug companies defend their efforts to reach out to potential users. Testosterone deficiency is “a recognized clinical condition, with signs/symptoms that can impact millions of patients,” said Morry B. Smulevitz, a director of communications for Lilly, which makes Axiron. While he said the company did not condone the use of medicine for purposes other than those approved by the F.D.A., it “encouraged patients to talk to their physicians to weigh the risks and benefits.”

David Freundel, director of public affairs for AbbVie, which makes AndroGel, said the company’s “low testosterone efforts” were “developed to educate men who may be at risk for, or have, low testosterone, so they can have the appropriate dialogue with their physician to determine if testing and treatment may be appropriate.”

Studies are just beginning to yield results to address the appropriate use of the drug in older men. For example, scientists have found that age-related male changes in body fat depend on a different hormone, estradiol, which also decreases with age. Likewise, while strength and libido do decrease with falling testosterone levels, that effect may not be significant until testosterone levels are very low, Dr. Finkelstein said. Low testosterone is rarely the main cause of erectile dysfunction.

Finally, he added, no one has really defined what is a “normal” or “physiological” testosterone level. And yet, physicians often order tests for “low T.”

A survey this year by CMI/Compass found that more than half of physicians felt that pharmaceutical advertising to consumers should be scaled back, and 63 percent said it misinformed patients.

“I really don’t understand why it’s tolerated at a time we’re struggling with health care costs,” Dr. Topol said. “A lot of people bounce their legs in meetings, but that doesn’t mean you have restless leg syndrome, and you shouldn’t be taking drugs for that.”

(From The New York Times)

plannedparenthood:

Watch this two-minute video to find out everything you need to know about Obamacare. Get informed. Get covered.

Re-blog to help spread the word!