Undergraduate Public Health Education Expands

Some good news from the excellent Public Health Newswire:

At Worcester Polytechnic Institute in Massachusetts, all first-year students participate in a “great problems” seminar focusing on issues such as food sustainability, the world’s water supply or chronic disease. The early public health exposure means a number of those students end up doing public health work in their junior and senior years.

At Kapi’olani Community College in Hawaii, students choose from the service learning “pathways” of health, the environment and elder care as part of their general education curriculum. A recent service project matched Native Hawaiian students with native elders to work on health literacy.

“Their curriculum is just shot through with public health,” Susan Albertine, PhD, vice president at the Association of American Colleges and Universities, told The Nation’s Health. “It’s a beautiful thing.”

Retired Generals and Admirals See Obesity Epidemic as a National Security Issue

Calling the obesity epidemic among America’s young people a national security issue, a group of retired generals and admirals have begun a project called Mission: Readiness to urge the civilian sector to join the military’s effort to bring healthier foods to schools, dining facilities and vending machines. 

This letter from Lt. Gen Norman Seip explains:

I am one of more than 100 retired generals and admirals who supported the Healthy, Hunger-Free Kids Act that Congress passed with bipartisan support in 2010.

The retired generals and admirals of Mission: Readiness know that the poor state of nutrition among children is more than just a national health issue. It is a national security issue and an economic security issue.

The Department of Defense reports that being overweight or obese is the leading medical reason why young adults cannot enlist, with 1 in 4 too overweight to join.

In a time of record deficits, the Department of Defense spends well over $1 billion per year treating weight-related illness among those who have served and their dependents. That pales beside the $150 billion annual medical price tag of obesity in the general population.

The experts at the Institute of Medicine and U.S. Department of Agriculture used the best-known dietary science and consulted widely with stakeholders around the country before establishing the updated school meal standards that have gone into effect this fall. Many schools are doing a creative job in making healthy meals appealing. We need to give the standards a chance to work and give kids a chance to adjust to eating more fresh fruits and vegetables and a little less sugar, salt, and fat.

Schools should not undermine parents’ efforts to instill better eating habits in their children.  Today, hundreds of retired generals and admirals stand alongside nutritionists and parents across America who believe that children deserve to eat healthful meals at school based on sound dietary science, not politics or special interests.

We need to keep in mind that the childhood obesity crisis is serious and is not going away. Any retreat from these new standards would mean turning our backs on the obesity crisis and on the future well-being of our children. With 1 in 4 young adults too overweight to serve our country in uniform, failure is not an option.

Some voices in Congress are intent on blocking and/or rolling back all efforts to decrease calories and increase nutrient density in foods. As noted in a Think Progress article about Mission: Readiness:

Some Republican lawmakers stand in stark disagreement with the generals’ call to regulate nutrition standards in school lunches. Rep. Todd Akin (R-MO), for one, does not believe that schools should provide lunch programs at all. Rep. Steve King (R-IA) — who has referred to efforts to cap calories in school lunches as “the nanny state personified” — claims that constituents have told him “kids are starving in school” and introduced the No Hungry Kids Act to remove the calorie limits on school lunches that are currently in place.

However, even with the current calorie limits, junk foods in school lunches already account for almost 400 billion calories — which, according to the generals’ study, would weigh more than the aircraft carrier Midway if converted to candy bars.

h/t The Schwartz Report

Russia Suspends Import of Monsanto GMO Corn After Study Finds Cancer Link

This French study is clearly having a political impact, causing governments to look more closely at the supposed safety of GMOs. From my point of view, that heightened scrutiny is long overdue. Whether this particular study holds up on further review and is replicated in further studies is at this point unknown. I would also suggest that such review is urgently needed for the industry-funded studies claiming safety.

The biotech industry and university researchers involved in GM research have mounted a major PR campaign over the last year to win over sceptical consumers.

In the past week, pro-GM scientists have been lining up to undermine the French experiments and criticise the way they were conducted.

However, a number of independent academics have praised the French team’s work, describing it as the most thorough and extensive feeding trials involving GM to date.

Mustafa Djamgoz, the Professor of Cancer Biology, at Imperial College, London, said the findings relating to eating GM corn were a ‘surprise’.

Prof Djamgoz, who describes himself as a neutral on GM, said: ‘The results are significant. The experiments are, more or less, the best of their kind to date.’

However, he said that it is now important to ensure they are repeated with more animals by independent laboratories to confirm the outcome.

‘We are not scaremongering here. More research, including a repetition of this particular study are warranted,’ he said.

The professor said it will take two to three years to get a definitive answer.


Sweet Times for Cows as Gummy Worms Replace Costly Corn Feed

This is so wrong on so many levels that I am posting it without comment, while encouraging you to read the whole article to see what is happening to America’s food supply.

KANSAS CITY, Missouri (Reuters) – Mike Yoder’s herd of dairy cattle are living the sweet life. With corn feed scarcer and costlier than ever, Yoder increasingly is looking for cheaper alternatives — and this summer he found a good deal on ice cream sprinkles.

“It’s a pretty colorful load,” said Yoder, who operates about 450 dairy cows on his farm in northern Indiana. “Anything that keeps the feed costs down.”

As the worst drought in half a century has ravaged this year’s U.S. corn crop and driven corn prices sky high, the market for alternative feed rations for beef and dairy cows has also skyrocketed. Brokers are gathering up discarded food products and putting them out for the highest bid to feed lot operators and dairy producers, who are scrambling to keep their animals fed.

In the mix are cookies, gummy worms, marshmallows, fruit loops, orange peels, even dried cranberries. Cattlemen are feeding virtually anything they can get their hands on that will replace the starchy sugar content traditionally delivered to the animals through corn.

h/t The Schwartz Report

Labeling Calories, Saturated Fat and Sodium on Restaurant Menus Leads to Lower Levels of Each

One of the many policies included in the Patient Protection and Affordable Care Act is a requirement that chain restaurants list the calories, saturated fat, and sodium levels in their offerings.

A study just published in the Journal of the Academy of Nutrition and Dietetics (formerly known as the Journal of the American Dietetic Association) demonstrates that when forced to list the amounts of these problematic dietray components, restaurants change their recipes so that they contain lower amounts.

This is not rocket science. It’s common sense. Unless required to do the right thing, corporations will too often keep doing the wrong thing.

People should have the right to know what’s in their food.

Bruemmer B, Krieger J, Saelens BE, Chan N. Energy, Saturated Fat, and Sodium Were Lower in Entrées at Chain Restaurants at 18 Months Compared with 6 Months Following the Implementation of Mandatory Menu Labeling Regulation in King County, Washington. Journal of the Academy of Nutrition and Dietetics. 2012;112(8):1169-1176.


“Watchful Waiting” Yields Outcomes Equal to Surgery for Early Stage Prostate Cancer

Unnecessary and/or overaggressive treatment is one of the great weaknesses of the healing arts. Prostate cancer treatment is one of the current flashpoints, because most prostate cancers are slow to grow and begin when the men are old enough that they will eventually die “with prostate cancer” rather than “of prostate cancer.”

This article from the New York Times Well Blog sums it up well:

This year, about 240,000 men will be given a diagnosis of prostate cancer. Although 81 percent of them will discover the disease at a very early stage, and although prostate cancer usually grows very slowly, most of these men will choose aggressive treatment, opting for removal of the prostate, or radiation treatments that often render them impotent or incontinent — or both.

But about 10 percent of men choose a different strategy: no treatment at all. The decision to forgo surgery or radiation is controversial, and is often met with resistance from a man’s own doctors and family members.

The strategy is often called “watchful waiting,” but some experts term it “active surveillance” or “expectant management.” In older men, watchful waiting may mean that nothing at all is done; doctors intervene only for pain relief or minor procedures if there are signs the cancer has spread.

In younger men, doctors typically conduct regular blood tests and biopsies to monitor the cancer. The idea is that they may recommend surgery or treatment later if it appears the cancer is aggressive and beginning to spread.

Few men choose watchful waiting and few doctors recommend it, but that may soon change. Last week, a groundbreaking new study showed that men with early-stage disease who opt for watchful waiting are just as likely to survive as men who undergo surgery.

The findings, published in The New England Journal of Medicine, come from a 15-year study of 731 men with early-stage prostate cancer who, surprisingly, had agreed to be randomly assigned to surgery or a program of watchful waiting. The fact that so many men had agreed to leave their treatment to chance is remarkable in itself. But so were the findings.

During the study, the largest of its kind, 52 men, or about 7 percent of the study subjects, died of prostate cancer. There was no statistical difference in the prostate cancer mortality rate or the overall death rate between the groups. Most men survived the disease whether they had surgery or did nothing.

And some men who had surgery died, as did some men who did nothing.


House Budget Slashes Public Health, Nutrition Assistance to the Poor

The House of Representatives seems hellbent on destroying (or if that fails, undercutting) the nation’s public health efforts, cutting whatever they can whenever they can.

From today’s Public Health Newswire:

House passes bill that cuts health programs while sparing defense
On Wednesday, the American Public Health Association sent a letter to House members that urged lawmakers to vote against the bill, which includes provisions to repeal the healthcare reform law’s Prevention and Public Health Fund; reduce funding for both Medicaid and CHIP; and cut about $36 billion from the Supplemental Nutrition Assistance Program, which the association said would eliminate benefits to about 2 million Americans.

Cutting food aid to the poor at a time when more have need for it is quite a statement of principles on the part of the House Republican majority.



What About the Uninsured?

Ron Brownstein’s article in the National Journal goes straight to the heart of why health reform is needed.

But the debate over health care reform—which will intensify again next week as the Supreme Court hears oral arguments on challenges to the law’s mandate on individuals to buy insurance—involves more than competing philosophies or political strategies. At its core, it raises an irreducibly tangible question: what, if anything, to do about the nearly 50 million Americans who today lack health insurance?

Those millions of uninsured rarely intrude into the promises from GOP congressional leaders and the party’s presidential field to defend liberty by repealing Obama’s plan. But ignoring them doesn’t make them go away. If the 2012 election rewards Republicans with enough leverage in Washington to erase Obama’s initiative, they will face the choice of finding an alternative means to expand coverage or allowing the number of those without insurance to grow, with far-reaching consequences not only for the uninsured but for those with insurance as well.

Without some policy intervention, there’s little question that access to health insurance will continue to decline. Since 2000, the number of the uninsured has jumped from 36.6 million to 49.9 million, about one-sixth of all Americans.

That number would have been even higher if an additional 20 million people over that period had not obtained coverage through Medicaid and the Children’s Health Insurance Program. This growth partially offset the unrelenting erosion in employer-based care: The share of Americans obtaining coverage from their employer has declined every year since 2000, in good times and bad.

Earlier this month, the Congressional Budget Office forecast that, absent the new health care law, the number of uninsured would rise to 60 million by 2020.

Maine’s Top Court Backs State Authority To Limit Health Plan’s Profits

Among the most important issues facing the American body politic is the extent to which insurance companies and other corporate entitites are allowed to use their financial and political muscle to dominate the delivery of health care. For those who do not believe that corporations should have unlimited powers, yesterday’s Maine Supreme Court decision limiting the premium increases by Anthem Health Plans marks a step in the right direction.

One of the many moving parts of the Patient Protection and Affordable Care Act (aka Obamacare) is the power it grants the Secretary of Health and Human Services to limit unreasonable premium increases by insurers. This Maine decision is based on state rather than federal law, but it tracks well with the issues in play at the federal level:

In a case closely watched by the insurance industry, Maine’s top court Tuesday upheld state regulators’ authority to hold down rate increases sought by Anthem Health Plans of Maine.

In its ruling, the Supreme Judicial Court said that Maine’s insurance superintendent had “properly balanced the competing interests” in arriving at an approved rate increase of 5.2 percent. The insurer, a unit of Wellpoint, the nation’s largest insurer, had sought a 3 percent profit margin as part of an overall 9.2 percent increase in health insurance rates for policies sold to individuals in 2011. It argued that state regulators’ decision to grant a 1 percent profit margin violated state law and the U.S. Constitution by depriving the company of a “fair and reasonable return.”

The Maine Supreme Court is essentially affirming that “reasonable return” is not an area where corporations have the final say. This case, or one like it, may well reach the U.S. Supreme Court. Perhaps one day we will have a Supreme Court that does not consider corporations to be people and remembers that corporations are permitted to exist under law in order to serve a public purpose.

It is not widely appreciated in this country that while many nations allow private companies to provide insurance services, all but the United States limit these to the nonprofit sector. Allowing life-and-death health matters to be influenced by the constant urge to maximize shareholder profits is only permitted here.

That is unlikely to change anytime soon. For now, passing and enforcing laws limiting the more rapacious instincts of corporate CEOs is a necessary step in defense of the public.