November 2010


Perusing the ABC News exit polling data, I found some interesting tidbits about health care reform and how people handled the issue in the midterm elections.

Coupled with that, McClatchy Newspapers released a poll last week on health care reform. Of course, the usual turnout in a midterm is about 37 percent of registered voters; the McClatchy poll surveyed a wider swath of Americans.

The McClatchy results showed that 51 percent want to keep the health care reform law as it is, or change it to do more.

There is a lot of (justifiable) skepticism about the health care reform law but the widely promoted idea that average Americans are bitterly opposed to it is a myth.

I have several problems with the law myself, which I’ve explained in detail on this blog so I won’t bore anyone with a rehash. But I do find it interesting that general opposition to the law is taken for granted and the idea is parroted by the mainstream media almost daily.

Even among midterm election voters, the health care law was not overwhelmingly unpopular, as many of the Republican winners like to portray. They often hoot that they’ve been sent to Washington with a mandate to overturn and repeal, but they clearly have not.

The ABC exit polling showed that 47 percent wanted to either keep the law as it is (31 percent) or expand it (16 percent). Slightly more respondents, 48 percent, did say they supported repeal.

More telling is that when voters were asked to rank economic issues compared to all other issues, 63 percent identified the economy. In a direct comparison question about which issue was most important: 63 percent said the economy; 18 percent said health care; 8 percent said illegal immigration; and 7 percent said the war in Afghanistan.

It doesn’t take a rocket scientist to see that the midterm election anger was focused on the economy, not health care. Voters unfortunately have only two choices in this country: Keep the current officials in office if things are OK; or throw the bums out if they aren’t.

Returning to the McClatchy survey, many people said the one thing they don’t like about the reform law is the insurance mandate. On the other hand, they solidly support requiring insurance companies to take on consumers with pre-existing conditions.

I understand their position, but you can’t have one without the other. If you said insurers have to take all applicants with pre-existing conditions, with no mandate to buy coverage, people would just wait until something goes wrong to purchase a policy.

The problem with the Obama legislation, in my view, was that decisions were made inside the existing health care box – there was basically no innovation. There was no real attempt to increase the number of health care providers, for example, to deal with the growing demand for access. There was a meek attempt to address the primary care physician shortage, but nothing of substance.

Both the Obama plan and the Republican alternative from soon-to-be-Speaker U.S. Rep. John Boehner, are built on the rickety foundation of the flabby, inefficient American health care system.

But at least the current law offers coverage to adult children up to age 26, requires 80-85 percent of insurance profits be spent on actual care, and allows for direct, streamlined comparison premium shopping online. So until someone offers a bolder and more creative plan, elected officials ought to tread carefully.

The only other alternative is a destructive partisan free-for-all. Hmm. I wonder which one we’ll see?

Photo: Health care reform demonstration, New Orleans (Wikimedia Commons)

The marketing of cigarettes has a long and colorful history. There have been very clever print campaigns on billboards and in magazines, and memorable TV spots, too. Tobacco companies have, over the years, hired some of the most creative talent to help peddle their products.

One that comes to mind, when cigarette advertising was still allowed on TV prior to 1970, was the campaign for Benson & Hedges 100s. “Oh, the disadvantages of Benson & Hedges 100s,” the announcer laments as smokers are comically shown with their extra-long cigarettes getting in the way of everything they do.

“Benson & Hedges must taste pretty good,” the voice over says. “Just look at what people have to put up with to smoke them.”

Over the years, cigarette advertising has dwindled away, although print ads are still legal. Marketing these days is pretty much limited to what you see on the shelves, and the packaging is a big key to selling the product.

All this seemed to be working pretty well, as smoking declined steadily until a few years ago. But in 2006, our favorite anti-smoking tools – educational efforts, bans on public smoking, and taxation – began losing their luster.

Here are the stats. Forty-five years ago, two in five Americans smoked. By 2006, that percentage had been more than cut in half to 20.8 percent. The figures have remained steady since then with 24.8 million men and 21.1 million women smokers, according to the American Heart Association.

In order to nudge the rate down even further, more public smoking bans are under consideration. And of course increasing the cigarette tax remains politically popular. Who can argue with making people pay more for a product that has such disastrous effects on public health?

The American Academy of Pediatrics would like to see a ban on all media advertising and require that when movies show cigarette smoking, they must be preceded by an anti-smoking ad. Their recent policy position announced in September wanders uncomfortably close to First Amendment territory, I think.

But I do agree that it may be time to start taking some other, more innovative approaches to discourage cigarette consumption. Here’s one idea out of the UK that I like for a lot of different reasons: Sell cigarettes – all of them, regardless of brand – in a plain brown paper package.

What better way to take the glamor and cache out of smoking cigarettes than to lump them into one giant, generic, visual bore?

Photo: http://www.flickr.com/photos/x-ray_delta_one/3850537531/sizes/m/in/photostream/

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Caution: Is your teen a hyper-texter? If so, you’d better keep your eyes peeled for risky behavior, from binge drinking to smoking and having multiple sexual partners.

Or so a widely reported study indicated last week. The truth may not be quite as stark as what’s portrayed in the study, but I’ll get to that in a minute.

The conclusions come from a study by Case Western Reserve School of Medicine. They were presented at the American Public Health Association’s 138th Annual Meeting and Exposition in Denver.

The first thing that caught my attention was the definition of hyper-texting. That’s more than 120 messages per school day. Do the math. If it takes an average of 30 seconds to compose a text, and another 30 to read and digest a response, that’s two hours out of what is probably a six hour day. That would mean 33 percent of a student’s time is devoted to this rather vacuous pastime.

And I somehow doubt that the subject of the texts are along the lines of: “wassup Trace, hey u know the form for finding area of a circle?”

No, it’s more like: “Hey babe, havin prty 2nite, u goin?”

So this is bad enough. But the researchers at Case insist that hyper-texting is more sinister since it’s related to other risky behaviors. Hyper-texters made up 19.8 percent of the teens in the study, mostly young girls from the poor side of town who did not have a father in the home.

Researchers said they are 40 percent more likely to have smoked cigarettes, twice as likely to have tried alcohol, and 43 percent more likely to be binge drinkers. They are also 41 percent more likely to have tried illegal drugs, 55 percent more likely to have been in a fight, and 90 percent more likely to have four or more sexual partners.

The association to risky behavior also showed up among teens who were engaged in hyper-networking, defined as spending three or more hours a day on Facebook or other social networking website.

“The startling results of this study suggest that when left unchecked, texting and other widely popular methods of staying connected can have dangerous health effects on teenagers,” said Scott Frank, lead researcher.

“This should be a wake-up call for parents to not only help their children stay safe by not texting and driving, but by discouraging excessive use of the cell phone or social websites in general.”

But this brings up another point. Can we really say there’s a cause and effect? In other words, does the texting itself lead to drinking, smoking, and promiscuous sexual behavior? Or, is just that teens who already engage in these behaviors tend to be hyper-texters?

Benjamin Caldwell, a San Diego marriage and family therapist and an associate professor for the MFT Program at Alliant International University in San Diego, points out in a blog post that the study did not show a cause and effect relationship, only correlations.

“If we know that one behavior (texting, in this case) is more common among people who also do another behavior (let’s use drinking), then we can say the two behaviors are correlated,” he said. “But that leaves at least three very different possibilities when it comes to cause and effect:

“Texting causes drinking. Drinking causes texting. Some other thing (lack of parental supervision, maybe?) causes both drinking and texting.

“A correlational study (like this one) does not tell us which of those three possibilities is most likely (the third strikes me as by far the most plausible).”

Caldwell concludes: “Frank is promoting a conclusion his study simply does not support. And some media outlets appear to be all too happy to run a story confirming parents’ worst fears about teenagers and technology, even when the story and the data do not match.”

I’m with Caldwell on this. But I also have to say that if one out of every five teens is a hyper-texter, parents, teachers and school administrators ought to be paying attention. Whether there’s causation or not, it’s pretty obvious these kids aren’t keeping their eye on the academic ball.

The real question: How in the world can you expect improvements in public education when a third of the day is taken up with the exchange of irrelevant chit-chat?

Photo: http://www.flickr.com/photos/growwear/3651002777/

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Attention shoppers. Please put on your pair of latex safety gloves before proceeding to the checkout counter!

That’s right. If you have OCD – and who doesn’t have at least a touch of it in these uneasy times – researchers have given you a whole new environmental worry, and one that can’t be so easily avoided: cash register receipts.

The little printouts you get at the supermarket, clothing shop or electronics store contain something called bisphenol A (BPA), which can be easily absorbed through the skin. The journal Nature recently looked at BPA levels in “thermal paper” used in producing the register receipts, and raised a few red flags.

Some scientists believe that BPA, found in much of the plastic products that are used these days for everything from water bottles to food storage, can cause a range of health problems from obesity to sexual dysfunction.

Although the risks presented by BPA exposure are a matter of debate, even the National Institutes of Health said an expert panel assigned to investigate the chemical determined that there was “some concern” for fetuses, infants and children.

The U.S. government tends to tread lightly when evaluating materials so widely used by domestic manufacturers. But last month, the Canadian government declared BPA to be a toxic chemical and is setting the stage for limiting its use.

Rick Smith, executive director of a Canadian group called Environmental Defense, would prefer to see BPA banned but predicted quick further action by officials in Ottawa.

A Canadian government report said BPA was present in the bodies of 91 percent of its citizens, prompting Smith to tell Reuters: “We are literally marinating in it on a minute-by-minute basis.”

Back to the report in the November 4 issue of Nature News. In a separate piece of research, investigators found that cashiers have unusually high levels of BPA since they handle each and every one of these receipts as customers come through the line.

The data on cashiers was collected by Harvard University, where researchers assessed BPA concentrations in 389 women broken down by occupation. Cashiers had much higher levels than either teachers or women who were working in manufacturing. (Previous studies, though, have shown high levels in male factory workers.)

If you handle just a few of these receipts every now and then, you probably aren’t at much risk, according to these scientists. But for me it’s another reminder that chemical contamination has gradually infiltrated our environment over the last century or so.

It was undoubtedly kicked off by the industrial revolution. But over the years short cuts to increase the food supply, speed up transportation, and, ironically, even some medical advances have made life riskier.

Medications for antidepressants and cholesterol lowering drugs have ended up in public water supplies, for example. In many places tap water contains trace parts of these medications that were deposited into waste water and can’t be filtered out.

So if you’re convinced health and wellness are completely in your hands, think again. The risks are out there and in many cases, they’re unavoidable.

Photo: http://www.flickr.com/photos/sophistechate/3289227443/

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I used to hear it a lot on Halloween: “Trick or treat for UNICEF.” Not so much lately in my neck of the woods, but the campaign is still going strong and this year the program marked its 60th anniversary.

But since this is 2010, the event came along with an extra helping of controversy, thanks to some members of the medical community.

The Lancet, a medical journal, published an editorial criticizing a fundrasing partnership between UNICEF Canada and Cadbury, the candy bar maker. UNICEF allowed Cadbury to use its logo on Halloween candy packaging in exchange for a $500,000 donation over three years to fund construction of schools in Malawi and Rwanda.

On the back of the packages a company statement says: “Just by purchasing this product you are helping to give children in Africa a chance at a better life.”

The Lancet editorial, published online today, contends that the half-million dollar donation is “a drop in the ocean” and urged the United Nations organization to “take a hard look” at how it allows companies to use its name.

“In a country where more than 20 percent of adults are clinically obese, encouraging products which are undeniably unhealthy is irresponsible,” the editors said.

And they added this comment from Amir Attaran, a professor of law and medicine at the University of Ottawa: “For an organization such as UNICEF whose raison d’être is to promote childhood health and nutrition, and to do so in an evidence-based way, this cuts straight to the organization’s credibility”.

I understand that obesity and diabetes are major problems in both the U.S. and Canada but I think the medical community may be jumping the shark on this one. It’s candy, for Pete’s sake, and isn’t that what Halloween is all about?

When I was a kid, parents who put an apple in our trick or treat bags were destined for ridicule and scorn among my peers. I had apples at home in my refrigerator. We wanted the good stuff.

The time to develop healthy eating habits is during the 364 days of the year that aren’t connected to Halloween, and responsible parents don’t condone an orgy of candy consumption at any time, including holidays.

I have to admit I was taken aback when The Toronto Globe and Mail reported that UNICEF is also “prepared to consider alliances with corporate affiliates in the alcohol or tobacco industry” under certain restrictions. If that’s the case, UNICEF definitely does need to reevaluate its sponsorship policies.

About the UNICEF trick or treat anniversary: The concept of trick or treating for a cause was developed by a Presbyterian minister, Clyde Allison, and his wife, Mary Emma in Bridesburg, Pennsylvania in 1950. Originally, the benefactors were kids in war-torn Europe who needed a lot of basics, like shoes, to return to a normal life.

Since then, Trick-or-Treat for UNICEF has raised $160 million for children’s causes.

Photo: http://www.flickr.com/photos/juushika/260823789/

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