Kim’s public health blog

In today’s Lancet [Volume 373, Issue 9669, 28 March 2009-3 April 2009, Pages 1055-1056] is a commentary of the latest European study of body mass and longevity; the Prospective Studies Collaboration (PSC), with data from almost 900 000 participants, 57 prospective studies, and four continents, assesses the association between body-mass index (BMI) and total and disease-specific mortality. The study commentator states “it is clear that obesity, as defined by BMI, imposes a substantial toll on life expectancy and that people who have normal or mildly elevated bodyweight need other measurements to better assess their health risk in relation to their content and distribution of adipose tissue.” Comment: This report will not stop the obese activists crying out that this study promotes discrimination but, like most activist chants, it is the individual behavior for the most part that results in obesity, even though the behavior often starts in infancy.

Also in today’s Lancet [Volume 373, Issue 9669, 28 March 2009-3 April 2009, Page 1054] we learn that Danes determined that night shifts lead to breast cancer and have decided to award shift workers who develop breast cancer with occupation disease compensation! Comment; There is little data published to support such a policy but as noted in other blogs politics and science are rarely linked!

Just as Congress is planning a bill to give oversight of tobacco use to the FDA we see one more reason to be skeptical. The truth is emerging about FDA opposition to use of over the counter dispensing of the ‘Plan B’ pill. In today’s media there are revelations about the FDA’s failure to release p[an B because of opposition from the previous administration, not because of public health science. The FDA is overworked by too many responsibilities and not enough staff or funds. It is hampered by continuous interference from Congress. It cannot keep our food supply safe yet Congress wants it to use scarce resources to control tobacco use, which has no public health purpose.

Speaking of politics and science now we have another story about the dangers of red meat [Arch Intern Med. 2009;169(6] There is little evidence that a vegetarian diet is more suitable for omnivores (humans) than a mixed diet, but we can expect the vegan activists will use the data from the latest study out of context.

There is broad consensus that electronic health records (EHR) have the potential to improve the efficiency and effectiveness of healthcare providers. Yet, to date, there has been no reliable estimate of the prevalence of EHR use among U.S. hospitals. In a new study, researchers from the Harvard School of Public Health (HSPH), Massachusetts General Hospital and George Washington University found that less than 2% of surveyed hospitals had implemented comprehensive EHR; further, less than 8% had basic EHR in place. It is the first nationally representative study of the prevalence of EHR in hospitals. Comment: Like other policy issues the adage “Follow the money” applies. Insurance companies reimburse billing costs, but little reimbursement is provided to improve medical records, yet almost all other developed countries have integrated record medical systems and better health outcomes than the US.

Now a new study finds that light-to-moderate drinking has been linked to a lesser risk of ischemic stroke and coronary heart disease. Other studies have shown that more social support is linked to less risk of mortality and cardiovascular disease. A Japanese examination of the effects of social support on the relationship between drinking and cardiovascular disease has found that the health benefits of light-to-moderate drinking are more pronounced in men with greater social support. Comment. Just like diets. you can find anything you want to support a social theory on diet or alcohol use as science.

In the New York Times we learn that 85,000 Americans choose to travel abroad for medical procedures each year, according to a recent report by the consulting firm McKinsey & Company. Treatment includes dental implants, hip and knee replacements, heart valve replacements and bypass surgery. The cost of surgery performed overseas can be as little as 20 percent of the price of the same procedure in the United States, according to a recent report by the American Medical Association. Comment: When one considers the thousands of dollars these procedures cost in the US the airplane fare and hotel costs associated with medical tourism are minimal.

FDA alerts consumers to the finding of new undeclared drug ingredients. The U.S. Food and Drug Administration is expanding, for the second time, its nationwide alert to consumers about tainted weight loss products containing undeclared, active pharmaceutical ingredients. The products listed in this announcement, some of which are marketed as dietary supplements, are promoted and sold on various Web sites and in some retail stores and beauty salons. Some of the products claim to be “natural” or to contain only “herbal” ingredients, but actually contain potentially harmful ingredients not listed on the products’ labels or in promotional advertisements. These products have not been approved by the FDA, are illegal, and include the following undeclared active pharmaceutical ingredients. Comment – The Weight Loss Hucksters are probably taking as much out of the economy as Bernie Madoff or AIG.

From the University of Oxford in the UK, a new analysis of almost one million people from around the world has shown that obesity can trim years off life expectancy. The Oxford University research found that moderate obesity, which is now common, reduces life expectancy by about 3 years, and that severe obesity, which is still uncommon, can shorten a person’s life by 10 years. This 10 year loss is equal to the effects of lifelong smoking.

According to today’s AMA Morning News “More than half of this year’s bumper crop of future physicians got their first choice in the annual residency match,” but, “unfortunately, according to the American College of Physicians, the first choice of most of the 29,890 applicants was not a career in primary care,” MedPage today “For this year’s match, dermatology, neurosurgery, orthopedic surgery, and otolaryngology ‘were the most competitive specialties for medical school seniors.’” And, even though family medicine “reduced the number of residency slots by 101 this year…only 91 percent of the positions were filled, and most of the slots — 58 percent — were filled by international medical graduates.”