On Wellness in WV

From the West Virginia Center on Budget and Policy:

As states prepare for full implementation of the Affordable Care Act (ACA) next year, West Virginia could take advantage of one of the Act’s lesser-known provisions to extend Children’s Health Insurance Program (CHIP) coverage to public employees. According to a report released today by the West Virginia Center on Budget and Policy, such a move could save the state and its public employees tens of millions of dollars while providing more comprehensive health coverage to thousands of children.

Until the ACA was passed, children of state and local employees covered by public employees’ insurance were prohibited from enrolling in CHIP. Now at least seven states have allowed their public employees to enroll their children in CHIP, including Alabama, Georgia, Kentucky, Montana, Pennsylvania, Texas and Vermont.

In its report “West Virginia Should Extend CHIP Coverage to Public Employees,” the West Virginia Center on Budget and Policy estimates that nearly 9,000 children under the age of 19 currently enrolled in the Public Employees’ Insurance Agency (PEIA) may qualify to enroll in CHIP. Depending on how many families move their children from PEIA to CHIP, state and local budgets could save up to $6.7 million a year while the families themselves could save $4.7 million.

“In an era of budget cuts where every dollar matters, West Virginia stands to save millions in state and local funds by allowing public employees to enroll their children into CHIP. Thousands of working West Virginia families will benefit from lower-cost, comprehensive health insurance for their children. It’s a win-win,” explained Brandon Merritt, Health Policy Analyst with the West Virginia Center on Budget and Policy.

Governor Tomblin can request federal approval to implement this change which would save the state, and local governments, and their public employees tens of millions of dollars over the next decade. It would help state and local governments balance their budgets and put more money into the pockets of thousands of West Virginia families while improving access to health care for thousands of children in low-income families.

The full report is available here.

Reactions to Smoking Ban Study

My recent story Study says smoking bans beneficial to state received some feedback. Some positive, some not so positive. Basically, a recent study said that indoor smoking bans have been good for West Virginia businesses, despite them being hotly contested at first.

Here’s some emails I received:

Linda Bricker, VA: I AM SOOOOOO ALLERGIC TO CIGARETTE SMOKE. When I go to other states it shocks me to go into a smoking restaurant.  My hair dresser and her clan smoke in a back room and in alley and the place smells bad to me.  I am grateful for smoking laws and the fact that the smoking bullys haven’t gotten any of them changed back despite the whining about “no one will come in and drink, gamble eat” etc.  PS I am nurse for VA and so many of our vets were given cigarettes while in service they are all dying now.”

Sarah Blyler, Fayetteville, WV: With regard to the following article:  Study says smoking bans beneficial to state Monday, 12 August 2013. I searched and found only 2 pieces of potential “news” in this sentimental and opinionated rehash. One:  “West Virginia counties with indoor smoking bans showed a 1 percent increase in restaurant employment as compared to those counties where smoking was allowed. The remaining eight states saw no significant association between smoke-free laws and employment or sales in restaurants and bars.”  Seriously, right now?…you wrote an article based on this?…Do you understand the term, “statistically insignificant”? Two:  “…smoking causes some $2.4 billion in total economic loss in West Virginia annually.”  Again, this may well be another re-hash, but it is completely unsubstantiated within the context of this article.   What about all of the bar/restaurants that closed in WV as a result of same smoke-free laws? This article’s only possible purpose would have to be a fluffy confirmation that infringing on smokers’ rights is somehow justified.  Since we are so very limited in the ‘news’ available in the valley, please at least have the decency to minimally appear to imagine that there are actually two sides to the issue. “

Christina Mickey, WV (Smoke Free Initiative of WV): Thanks for reporting on the latest study on economic impact of smoke free laws in WV.   Kanawha Charleston was in the for front in 2007 when it amended it’s regulation to expand protection to most workplaces and joined many other capitol cities across the nation going smoke free. Before 2007, WV had many smaller rural counties already laying a strong foundation for other counties to expand protection. Today, 24 WV counties eliminate smoking in all workplaces and public places, with 14 of those counties boosting some of the highest protection level in the nation from secondhand exposure in workplace and public place.  Let me know if you ever need any information or questions about smoke free laws in WV and the nation.”

Let me know your thoughts.

HealthDay News put out a release recently about men skipping breakfast. Those who do have a 27 percent higher chance of suffering a heart attack or developing heart disease than those who eat breakfast.

 

The study confirms earlier findings that have linked eating habits to elevated risk factors for heart disease, the Harvard researchers said.

“Men who skip breakfast are more likely to gain weight, to develop diabetes, to have hypertension and to have high cholesterol,” said Eric Rimm, senior author and associate professor of epidemiology and nutrition at Harvard School of Public Health and associate professor of medicine at the Harvard Medical School.

For example, breakfast skippers are 15 percent more likely to gain a substantial amount of weight and 21 percent more likely to develop type 2 diabetes, earlier studies have reported.

The new study, published July 22 in the journal Circulation, found that these men also indulged more heavily in other unhealthy lifestyle choices. They were more likely to smoke, engage in less exercise and drink alcohol.

“We’ve focused so much on the quality of food and what kind of diet everyone should be eating, and we don’t talk as often on the manner of eating,” said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City. “This study is not even discussing the type of food. It’s just talking about behavior and lifestyle choice. Part of heart-healthy living is eating breakfast because that prevents you from doing a lot of other unhealthy things.”

For the new report, researchers analyzed data culled from a 16-year study of nearly 27,000 male health professionals that tracked their eating habits and overall health from 1992 to 2008. During the study period, 1,572 of the men developed heart disease.

The study also found a 55 percent increased risk of heart disease in men who regularly indulge in late-night snacking. However, the researchers did not consider this a public health risk because few men reported eating after they’d gone to bed.

Rimm said there are several possible explanations why skipping breakfast can have such a drastic effect on heart health.

The Harvard study found that men who skip breakfast do not pick up another meal later in the day, which Rimm said indicates that they tend to “feast” on higher-calorie meals when they do eat. Previous studies have found that feasting can result in high cholesterol and elevated blood pressure, compared with nibbling smaller meals.

“It’s the extra strain on the body of eating more calories during the few times in a day they do eat,” he said.

The type of food that a person consumes during breakfast also might be a factor. “Breakfast is typically a time when people tend to eat a healthy meal,” Rimm said. “By skipping a meal that usually features fiber or fruit or yogurt, you’re missing out on an occasion where people can get healthy nutrients.”

Younger men tend to skip breakfast more frequently than older men, the investigators found, which leads to another possible explanation. “It may be in line with the fact that these are men who are rushing out to stressful jobs and not eating along the way,” Rimm said, noting that stress is bad for heart health and is associated with negative lifestyle choices such as drinking or smoking.

The study did not include women, but Steinbaum believes the same pattern likely occurs in women who skip breakfast. “There haven’t been any studies independently on women, but I would suspect we would find the same outcomes,” she said.

Rimm said the study reinforces the age-old emphasis on breakfast as a key to good health.

“There is so much we know about reducing risk of heart disease, and some things like exercise or quitting smoking take quite a bit of effort,” Rimm said. “But it is easy without a big huge financial or time commitment to have breakfast, even if it is a bowl of oatmeal or a bit of cereal before you start the day.”

More information

SOURCES: Eric Rimm, Sc.D., senior author and associate professor, epidemiology and nutrition, Harvard School of Public Health, and associate professor, medicine, Harvard Medical School, Boston; Suzanne Steinbaum, M.D., preventive cardiologist, Lenox Hill Hospital, New York City; July 22, 2013, Circulation

The Centers for Disease Control and Prevention released info from a press conference held today about the HPV vaccine being underused. In girls ages 13 to 17, there was no increase in use between 2011 and 2012. And there was actually a decrease in the three-dose coverage from 2011 to 2012.

 

HPV vaccine: Safe, effective, and grossly underutilized

In a press conference held today, top officials from CDC and the American Academy of Pediatrics announced that HPV vaccination rates in girls aged 13-17 years failed to increase between 2011 and 2012, according to data from the Centers for Disease Control and Prevention (CDC).  Three-dose coverage actually declined slightly from 2011 to 2012.

The article in CDC’s Morbidity and Mortality Weekly Report (MMWR) drew on data from the 2012 National Immunization Survey-Teen (NIS-Teen).

Among girls unvaccinated for HPV, 84 percent had a healthcare visit where they received another vaccine (such as one aimed at meningitis or pertussis), but not HPV vaccine. If HPV vaccine had been administered, vaccination coverage for ≥1 dose could be nearly 93 percent rather than 54 percent.

“Progress increasing HPV vaccination has stalled, risking the health of the next generation.,” said CDC Director Tom Frieden M.D., M.P.H. “Doctors need to step up their efforts by talking to parents about the importance of HPV vaccine just as they do other vaccines and ensure its given at every opportunity.”

According to CDC, for each year the 3-dose HPV vaccine series coverage remains near the current level of 33 percent instead of achieving the Healthy People 2020 goal of 80 percent coverage, an additional 4,400 women will be diagnosed with cervical cancer and 1,400 cervical cancer-attributable deaths will occur in the future.

The 2012 NIS-Teen data show that not receiving a healthcare provider’s recommendation for HPV vaccine was one of the five main reasons parents reported for not vaccinating daughters.  Healthcare providers are urged to give a strong recommendation for HPV vaccination for boys and girls aged 11 or 12 years.

The other responses parents provided indicate gaps in understanding about the vaccine, including why vaccination is recommended at ages 11 or 12.

“Parents need reassurance that HPV vaccine is recommended at 11 or 12 because it should be given well in advance of any sexual activity,” said Dr. Frieden.   “We don’t wait for exposure to occur before we vaccinate with any other routinely recommended vaccine.”

Parents also reported safety concerns as a reason for not vaccinating. In the seven years of post-licensure vaccine safety monitoring and evaluation conducted independently by federal agencies and vaccine manufacturers, no serious safety concerns have been identified.  According to today’s MMWR article, reports of adverse events after HPV vaccination to the Vaccine Adverse Event Reporting System (VAERS) have steadily decreased from 2008 to 2012 and the numbers of serious adverse events reported has also declined since 2009.

Approximately, 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that nearly all sexually-active men and women will get at least one type of HPV at some point in their lives.

Parents and caregivers are encouraged to ask about vaccination every time they take children for a healthcare visit.  If a preteen boy or girl (aged 11 or 12 years) has not started the HPV vaccine series, make an appointment to get him or her vaccinated.  Teens who haven’t started or finished the 3-dose series should do so—it’s not too late for them to receive HPV vaccine.

For many, it’s easier than ever to get the HPV vaccine. Because of the Affordable Care Act, most private health insurance plans must cover the HPV vaccine at no out-of-pocket cost, meaning no co-pay or deductible. Visit https://www.healthcare.gov/what-are-my-preventive-care-benefits/#part=3 for more information.

CDC officials urge healthcare providers to increase the consistency and strength of how they recommend HPV vaccine, especially when patients are 11 or 12 years old. Reviewing vaccination status at every healthcare encounter and taking advantage of every visit, including acute care visits, can increase HPV vaccine coverage in the United States.

HPV vaccine is an anti-cancer vaccine. Preteen and teens are relying on the adults in their lives to help protect them.

This article came out a week or so ago, but it has some interesting information on life expectancy. There have been other reports with similar conclusions: McDowell County has some low life expectancies.

From the piece:

“In some counties, such as McDowell County, WV and Sunflower County, MS, life expectancies are lower than Bangladesh for males and Algeria for females.”

Females were second from the bottom (only above Perry, Kentucky) in McDowell, WV. Life expectancy is at 72.9. Compare that to the top – Marin, California at 85.02.

Males don’t fare any better. McDowell, WV is at the very bottom for life expectancy for males – 63.9.

The article offers readers this:

“The complete failure by some communities to increase life expectancy from levels seen now in very poor countries likely has many distal and proximate causes. But most importantly, this slow progress should be viewed as a call for action to improve health and reduce inequalities in the US.”

Why is this? Poor working conditions? Diet? Health issues? Combination of all three?