Kim’s public health blog

Reporting on a major success in preventing children from being born with one form of mental deficiency UNICEF has just released a report of international efforts to ensure that all salt, worldwide, is iodized. Similarly flour has had folic acid added to it while early detection of PKU allows nutritional intervention to prevent mental deficiency in children. We do not tell enough about our successes in nutritional intervention, but the media focus in supposed benefits (usually spurious) of over the counter nutritional supplements

In the USA and other developed countries we tale access to safe drinkable and cooking (potable) water for granted. Today the WHO released a new booklet calling for attention to this need to save millions of people world wide from disease and death because of lack of access to potable water. We have been working to ensure such access for everyone in the U.S.for 200 years, but we still have many families in rural areas without access to safe drinking water.

Those With A Specific Gene Mutation, and cat exposure at birth, may increase a child’s risk of developing eczema during their first year according to a new study by researchers from University Hospital, Copenhagen, Denmark. Eczema runs in families and evidence suggests it is caused by genetic and environmental factors. The same researchers recently discovered that two common “loss-of-function” variants in the gene encoding filaggrin (FLG) predispose people to eczema. Filaggrin is a protective protein normally found in skin. It acts as a physical barrier to potentially harmful substances in the environment.

The AP reports that “Google, Inc., Microsoft Corp., and a hodgepodge of health care providers and insurers have agreed on ground rules for protecting the privacy of the sensitive information” contained in personal health records (PHRs). The companies are “hoping to persuade more people to store their medical records online,” by “reassuring patients that they can enjoy the convenience of keeping their medical histories in online filing cabinets, without worrying that will open a door for outsiders to peruse the data without their knowledge.”  Comment: It is unfortunate that so many physicians are Luddites, using every excuse they can dredge up to avoid using technology to improve practice outcome, prevent medication errors, and limit E.R. access to patient records.  No other developed nation is as far behind the use of PHR as tHe U.S. We should not have to wait for Google and Microsoft to manage patient records for us.

From the Wall street Journal we learn that an increasing array of Americans, many with health insurance, are delaying or forgoing medical care because of concern about cost, according to a report from the Center for Studying Health System Change. About 20% of the respondents in a 2007 survey of 18,000 people said that they had put off or gone without needed medical treatment at some point in the year earlier, up from 14% in a 2003 survey. Comment:The longer we wait to fix our disabled health care system the worse the problem will get. The experience in Massachusetts shows we cannot do this state by state, or just by increasing the reimbursement system.

In the Journal of Abnormal Child Psychology, Benjamin Lahey and his team from the University of Chicago examined how much mothers stimulated their baby intellectually, how responsive they were to the child’s demands, and the use of spanking or physical restraint. Child conduct problems in later childhood included cheating, telling lies, trouble getting on with teachers, being disobedient at home and/or at school, bullying and showing no remorse after misbehaving. The findings support the hypothesis that “interventions focusing on parenting during the first year of life would be beneficial in preventing future child conduct problems…Greater emphasis should be placed on increasing maternal cognitive stimulation of infants in such early intervention programs, taking child temperament into consideration.” Comment: This finding should not be surprising and should encourage better training for child rearing in schools, and possibly for better assistance for new mothers by a team of public health and child care workers similar to the family visitors in the UK system.

A move in the right direction ot reduce complexity of vaccine schedule. The UPI (6/24) reports that the “Food and Drug Administration has licensed a vaccine against five childhood ailments in a single dose” Sanofi Pasteur’s Pentacel vaccine, the “first five-in-one pediatric combination vaccine”, is “approved for use in infants and children six weeks through four years of age.” The vaccine provides protection against invasive disease due to Haemophilus influenza type b, diphtheria, tetanus, pertussis, and poliomyelitis. Presently, children in the United States receive up to 23 injections by the time they’re 18 months old, as recommended by the Centers for Disease Control and Prevention. HealthDay (6/23) noted in its Health Highlights section. The use of Pentacel could reduce that number of shots by as many as seven

June 24, 2008 — Diabetes now affects nearly 24 million people in the United States, an increase of more than 3 million in approximately two years, according to new 2007 prevalence data estimates released today by the Centers for Disease Control and Prevention (CDC), which provide estimates for every county in the US..Comment:How much of this is related to more overweight? How much is due to earlier diagnosis? How much is due to increased sensitivity of tests? How much is due to increased push for doctors to diagnose diabetes earlier? How much is due to improved access of Medicaid? Probably some or all. This is a disease which can be treated and for many people prevented if we take responsibility for our own behaviors.

Another Editorial in today’s (June 20) Lancet quotes Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases (NIAID), said that the number of new HIV infections per year in the USA was closer to 50 000 than 40 000. Fauci does not talk about diagnoses but new infections. He says that 52 000 is a new number that will soon become an official statistic. the figure shows that US efforts to prevent HIV have failed dismally. The CDC must not fail US citizens further by delaying the release of the data behind this fact.

In an editorial in the Lancet today: The cost of allergic rhinitis in the USA is nothing to be sniffed at. According to a report published last week by the Agency for Healthcare Research Quality, in 2005, Americans spent US$11bn on doctors’ bills, prescription drugs, and other medical care to relieve allergy symptoms. Although there is no consensus on the reasons for the increased prevalence of allergies, the “hygiene hypothesis” has solid support. First proposed by David Strachan in the 1980s, this hypothesis suggests that children exposed to poor hygiene and increased infections in early life have lower levels of IgE sensitization and allergic diseases. In other words, squeaky-clean modern life could be a contributing factor, and may indeed be harmful to children. Comment: All the activists who rail about dangers from exposures to compounds considered harmful, may be causing the entire population harm . Remember how infections brought from Europe to North American decimated a number of indigenous populations. We need to reconsider how clean our environment should be and whether too clean is harmful.