November 1st, 2011 by PJSkerrett in Opinion, Research
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Heart disease. Stroke. Diabetes. Asthma. Osteoporosis. These common scourges are often pegged to genes, pollution, or the wear and tear caused by personal choices like a poor diet, smoking, or too little exercise. David Barker, a British physician and epidemiologist, has a different and compelling idea: these and other conditions stem from a developing baby’s environment, mainly the womb and the placenta.
Barker was the invited speaker at this year’s Stare-Hegsted Lecture, which is a big deal at the Harvard School of Public Health. In just over an hour, he covered the basics of what the British Medical Journal used to call the Barker hypothesis. It has since come to be known as the developmental origins of chronic disease. (You can watch the entire talk here.)
It goes like this: During the first thousand days of development, from conception to age 2, the body’s tissues, organs, and systems are exquisitely sensitive to conditions in their environment during various windows of time. A lack of nutrients or an overabundance of them during these windows programs a child’s development and sets the stage for health or disease. Barker and others use low body weight at term birth is a marker for poor fetal nutrition.
When a fetus is faced with a poor food supply, it Read more »
*This blog post was originally published at Harvard Health Blog*
September 19th, 2011 by KerriSparling in Opinion
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What I’ve learned in the last twenty-five years with type 1 diabetes:
- Some of what “they” said is wrong. It just is.
- There are times when “they” make a good point, and it’s up to us as patients to figure out what information we react to.
- The needles don’t hurt as much now as they did then. Lancets have become smaller and sharper, syringes can make the same claim. Insulin pump sites, once they’re in, usually go without being noticed. Same goes for Dexcom sensors. (But “painfree” is a misnomer and so subjective that medical device advertisers had best just steer clear of that word entirely. All needles pinch at least a little bit.)
- Progress isn’t always shown in tangible technological examples. Sometimes progress is being able to look at a blood sugar number without feeling judged by it. Or to look in the mirror without wishing you were different.
- There is life after diagnosis.
- Diabetes is sometimes funny. It has to be. Read more »
*This blog post was originally published at Six Until Me.*
July 27th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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The National Institute for Healthcare Management Foundation is a nonprofit, nonpartisan organization focused on healthcare. The foundation just published an excellent report on the distribution of healthcare costs in the population.
The results indicate that reducing healthcare cost is all about reducing and managing chronic diseases.
U.S. healthcare spending has sharply increased between 2005 and 2009 by 23 percent from $2 trillion to $2.5 trillion per year.
This is a result of a combination of factors. Chief among them is the increasing incidence of obesity.
Who spends the money? Read more »
*This blog post was originally published at Repairing the Healthcare System*
March 29th, 2011 by admin in Health Policy, Opinion
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According to American Medical News, the U.S. health system is demonstrating better performance on most measures of health care quality, but it’s failing to improve access to care or cut racial and ethnic health disparities, according to two reports released in February by the Agency for Healthcare Research and Quality. “Quality of care continues to improve, but at a slow rate,” said Ernest Moy, MD, leader of the team at AHRQ that produced the reports. ”In contrast to that, focusing on issues of access to care, not much has changed. Focusing on disparities in care, not much changed…Those are bigger problem areas than overall quality of care.” Measures related to hospital quality are showing the most improvement. For example, in 2005, just 42% of patients with heart attacks received angioplasties within the recommended 90 minutes of arriving at the hospital. That figure improved to 81% by 2008.
While the quality improvement indicators are encouraging, the disappointing access and disparities numbers are not very surprising.
The US health care system is still largely focused on acute hospital based care. It says we are doing better at what we are doing. Read more »
*This blog post was originally published at CFAH PPF Blog*
March 14th, 2011 by DrWes in Health Policy, Opinion
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Give me your medication list and I’ll tell you your health problems. It happens every day in emergency rooms across the country as confused elderly patients present for an acute problem unable to describe their past medical history, but equipped with a list of medications in their wallet:
Metformin = Type-2 diabetes
Synthroid = Hypothyroidism
Lipitor + Altace + Lasix + Slo-K = Ischemic cardiomyopathy
Lexapro = A little anxious or depressed
Viagra = Well, you know…
I bet I’d be right better than 90 percent of the time. Now, imagine you’re a pharmaceutical company wanting to target people with those chronic diseases. Where might you find them?
No problem. Just pay the insurers to provide you patients’ drug lists. No names need be exchanged in keeping with HIPAA requirements. But the drugs list attached to folks’ cable TV box? Perfect. You’re in — with no legal strings attached. Then, according to the Wall Street Journal, just fire away with that targeted direct-to-consumer advertising on TV, courtesy of your local healthcare insurance provider.
No wonder our healthcare industry movers and shakers love the electronic medical record. Healthcare privacy? What healthcare privacy?
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
