Leaded aviation fuel a threat to public health, children
Filed under: Children, Health data, Hot Health Headline, Public health, Public records
KUOW’s John Ryan used federal data and a few key sources to delve deep into issues surrounding one of the few remaining sources of airborne lead in the United States, a leaded aviation fuel known as “avgas.” In the process, he reveals damage that even low levels of lead exposure could be doing to children.
Avgas accounts for less than 1 percent of the nation’s liquid fuel use. Yet enough piston–engine planes fly enough miles on avgas to belch out half of all the lead going into the nation’s air.
Lead paint in old buildings remains a bigger threat, but even low levels of childhood exposure, one source tells Ryan, can manifest itself in “Decreases in IQ, changes in test scores, changes in attention, hearing threshold, all sorts of things like that.”
Earlier this month (January), an expert panel advising the Centers for Disease Control and Prevention cut in half the levels of lead in children that should alarm parents or doctors. Researchers have yet to find any level of lead exposure that doesn’t cause harm.
Michael Kosnett, a medical toxicologist at the University of Colorado, told Ryan, “In any one child, it’s not something that’s going to necessarily cause them to display any kind of signs and symptoms. But if you can lower the lead exposure of a population of children, you’re going to give that population more of an opportunity to have gifted children and to have children who have higher IQs, and that’s certainly a desirable public health goal.”
Marie Lynn Miranda, an environmental health scientist and a dean at the University of Michigan, points out that “Living close to an airport can increase your blood lead level anywhere from 2 to 4 percent,” acknowledging that is a small amount but that evidence indicates even small amounts of lead are bad. She also notes that “lead is especially a problem for the low–income families that are most likely to live near airports.”
Pilots who still use avgas say their businesses would be dead in the water if they couldn’t get the leaded fuel, an argument Ryan contrasts with quotes from a Europe-based lead-free avgas producer, who sells it for 40 cents less a gallon, but hasn’t been able to break into the U.S. market “Because no one thinks that there will be demand for an unleaded–grade aviation gasoline.”
The federal database Ryan used, The National Emissions Inventory, is posted online by the EPA.
Investigation delves into Wash.’s prescription drug problem
Filed under: Aging, Children, Europe, Government, Health care reform, Health data, Health policy, Hot Health Headline, Pharmaceuticals, Public health, Public records
Everything time we think prescription drug abuse stories have peaked, something comes along to push the story further. This time, InvestigateWest’s Carol Smith sets herself apart by starting from square one and clearly explaining the origins and dimensions of Washington’s particularly nasty drug issues, tracing back each facet of the problem to its source and spotlighting what makes the Evergreen State unique.
Washington has been one of the hardest hit states in the country, in part because of aggressive prescribing practices. That, coupled with lack of oversight of doctors who over-prescribe, has led to the spectacular run-up in the number of deaths from prescription overdoses.
The backdrop for her work is an epidemic that shows no signs of abating, despite a recently implemented state law Smith calls “a bold attempt to reduce overdose deaths by launching the first-ever dosing limits for doctors and others who prescribe these medicines.”
Prescription drug abuse is at epidemic levels throughout the state, and elsewhere in the country, despite lawmakers’ attempts to get a grip on it. Washington now has one of the highest death rates in the nation. Deaths from prescription drug overdoses in this state have skyrocketed nearly twenty-fold since the mid-1990s, and now outstrip those from traffic accidents.
Why caused it to leap so quickly? Smith tracks down several key tipping points. “There’s plenty of blame to go around for what caused the epidemic,” she writes. “Aggressive marketing of opiates by drug companies, nonexistent tracking of overprescribing, lack of insurance coverage for alternative treatments for pain, and demand by patients for quick fixes, to name a few.”
She drills down into many of those causes, with my personal favorites being two key origin stories:
- How marketing by OxyContin maker Purdue Pharma led to relaxed guidelines for chronic pain treatment and a “1999 law specified ‘No disciplinary action will be taken against a practitioner based solely on the quantity and/or frequency of opiates prescribed,’” both of which helped cause a jump in prescriptions.
- How “the rise in the death rates of Medicaid patients tracks along with the state’s cost-saving decision to move many of its poorest residents to the cheapest, most potent pain reliever available: Methadone.”
See the upper right-hand sidebar for more stories from the six-month investigation.
Antipsychotic use booms among Canadian kids
Filed under: Children, Hot Health Headline, Pharmaceuticals
Writing for The Vancouver Sun and Postmedia News, Sharon Kirkey and Pamela Fayerman, report that, in an environment where the rate at which physicians are recommending certain antipsychotics for children has doubled since 2006, a local children’s hospital has launched what the reporters call “the world’s first clinic to help children cope with the side effects of such medications.”
The clinic, which helps children and their parents prepare for antipsychotic use or cope with its side effects, opened in April and has a four-week waiting list.
(Dr. Jana Davidson, a child and adolescent psychiatrist who helped establish the specialized clinic) said she helped create the clinic because of her increasing alarm over the side effects of treatment in her patients. While she believes the medications are sometimes prescribed inappropriately, they are often useful for a range of disorders including severe aggression, mania in bipolar disorder and schizophrenia. But the side effects can be serious.
“I would see kids with psychosis in the emergency department and then I would see them again 10 months later and they would be 30 to 50 pounds heavier,” she said.
Despite sometimes serious neurological side effects, more Canadian families are turning to the drugs and antipsychotic drug recommendations for youth jumped 114 percent in Canada from 2005 to 2009.
The drugs — which have not been approved in Canada for use in children under 18 — are being used for attention-deficit/hyperactivity disorder, conduct disorders, irritability related to autism, mood disorders, physical or verbal aggression and other behavioural problems.
Find health data at Childstats.gov, a clearinghouse for kid numbers
Filed under: Children, Government, Health data, Health journalism, Public records, Tools
Time to add another link to your “federal data clearinghouses” folder, if you haven’t already. Childstats.gov, published by the Federal Interagency Forum on Child and Family Statistics, synthesizes data from the CDC, NCHS, National Children’s Survey, AHRQ, Census and other specialized programs.
Photo by nasa hq photo via FlickrThe site is anchored by its annual report, “America’s Children: Key National Indicators of Well-Being,” and the easy-to-navigate nature of its databases seems to have already inspired some discussion on Twitter, particularly in relation to child homelessness.
Many of the data tools are simply links to general surveys (like AHRQ’s National Healthcare Cost and Utilization Project) that just happen to contain child-related information, but there are some more specifically relevant data sources, the best of which I’ve listed below.
- Data Resource Center for Child & Adolescent Health
- The National Children’s Study
- The National Center for Education Statistics
- Find Youth Info (findyouthinfo.gov)
- Census Child Care data
Battle against childhood obesity is complicated
Maureen O’Hagan and her colleagues at The Seattle Times have put together a sprawling package of stories on the fight against childhood obesity in their new series, “Feeling the Weight.” We’ll break it down story-by-story.
Kids battle the lure of junk food
Local agencies are spending millions to provide healthy alternatives to Seattle-area youth, but they — to say nothing of the youth themselves — are faced with a seemingly insurmountable deluge of tasty treats that tempt teens at every turn.
State still seeks winning strategy against childhood obesity
For a decade, Washington’s anti-obesity strategy has focused on providing kids with access to health alternatives.
So far, the results are discouraging. A push to put more fresh produce in poor neighborhoods’ corner stores, for instance, is struggling. And recent studies suggest the proliferation of farmers markets has done little to change diets or behavior. The number of overweight and obese kids continues to climb.
In other words, we might be spending a whole lot of money on efforts that miss the mark.
How to help your kids lose weight healthfully
The trick, she writes, is to focus on healthy behavior rather than on weight loss.
Parents stand between kids and junk food
O’Hagan’s profiles of parents of obese children shatter a few stereotypes and illustrate just how complex the issue is.
What readers had to say about childhood-obesity topic
Readers weighed in with advice, criticism, observations and more.
Related
Covering Obesity: A Guide for Reporters
The prospect of covering such a broad, engaging and important topic as obesity can be overwhelming. This guide, supported by the Robert Wood Johnson Foundation, is designed to help journalists cover a wide range of stories, whether writing on deadline or researching a multipart series. It offers assistance on calculating body mass index, finding obesity statistics on the state level, gauging the quality of school district wellness policies, finding innovative school nutrition policies and much more.
Fla. juvenile justice system relies on heavy antipsychotic use
Filed under: Children, Conflicts of interest, Health journalism, Hot Health Headline
In looking into the state Department of Juvenile Justice’s use of powerful prescription antipsychotics, The Palm Beach Post’s Michael LaForgia “analyzed department drug purchasing information and state Medicaid billing data and reviewed thousands of pages of DJJ inspection reports, drug company disclosure records and court documents.” It shows, as he surfaces with some powerful numbers and equally alarming anecdotes (Part 1, Part 2, Infographic).
…in state-run jails and residential programs, antipsychotics were among the top drugs bought for kids - and they routinely were doled out for reasons that never were approved by federal regulators, a Palm Beach Post investigation has found.
A key concern is that the prescriptions may be driven by their improper use as chemical restraints, or by the hefty speaker (and related) fees being paid from pharmaceutical companies to the most prolific prescription writers. Unfortunately, specifics are hard to come by as most homes are run by private contractors and the state doesn’t have the resources for close monitoring. For this story, the reporters were only able to obtain two years worth of data for 25 jails and three programs – a fraction of the statewide total. Those data still paint what LaForgia calls a “startling story.”
A look at the sheer numbers of drugs purchased … suggests a startling story is unfolding in state homes for wayward kids.
In 2007, for example, DJJ bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children.
That’s enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day.
Unlocking the brain’s response to trauma, violence
Scott Johnson of The Oakland Tribune writes about the science of chronic trauma and puts it in the perspective of Oakland, Calif., residents who are regularly exposed to chronic levels of stress and trauma. There were 95 homicides in Oakland in 2010.
Scientists are finding that trauma affects how the brain functions and, especially in children, can create long-term debilitating problems, including anti-social behavior, dissociation, emotional numbness and trouble forming social relationships.
Fortunately, scientists also are finding there are therapeutic tools that can help.
The science around chronic trauma is evolving quickly and in exciting new ways. Even as scientists discover new evidence about what is happening in the brains of chronically traumatized people, intriguing new techniques are emerging for coping with the effects.
Johnson, the Oakland Tribune’s Violence Reporting Fellow, is blogging at OaklandEffect.com, where he has written about his own experiences and about attending the recent “Healing Moments in Trauma Treatment” conference. Johnson’s position is funded by the California Endowment and he will be with the Tribune for a year, reporting on a wide range of issues, including those related to the impacts of violence on the mental health of Oakland residents.
Reporter looks at black infant mortality in Wis.
Filed under: Children, Health data, Hot Health Headline
The Milwaukee Journal Sentinel’s Crocker Stephenson took a look at disparities in infant mortality in that area and explored both their cases and ramifications. In Wisconsin, black babies die at twice the rate of white babies, a finding which may just be the tip of the iceberg. For national and international comparisons, see the companion infographic. According to Stephenson, infant mortality rates are an early indicator of a community’s degeneration. When mortality rises, so do other dire indicators.
The bottom third - the group of ZIP codes with the most poverty and lowest college graduation rates - had the highest infant mortality rate.
It also had the highest premature death rate, chlamydia rate, HIV rate and teen birthrate.
It had the greatest percentage of low birth weights; preterm births; uninsured adults; people who hadn’t seen a dentist in a year; births to mothers who received no prenatal care during their first trimester; smokers; pregnant smokers; obesity; violent assaults within the past year; single-parent households; and children who tested positive for lead poisoning.
Milwaukee’s health commissioner called it a “crisis,” one that Stephenson found is as much a social matter as it is one of access to proper care. For more, see the “Problem Areas” section of the story.
More antipsychotics prescribed to foster children
Filed under: Children, Government, Health policy, Hot Health Headline, Pharmaceuticals
Need To Know, the PBS newsmagazine, recently took a look at the use of antipsychotics in foster children. Shoshana Guy’s piece opens with an anecdote about one 10-year-old foster child (now adopted) in Texas and expands from there. In nine years as a ward of the state, the boy was prescribed 20 different drugs by nine different doctors. After his adoption, a new, private physician diagnosed him only with ADHD, treatable with a single medication.
Antipsychotics are designed primarily to treat bipolar disorder and schizophrenia, diseases which affect about 3 percent of the population. Yet somehow, they’re the top selling class of drugs in the United States with $14.6 billion in sales in 2009.
Specific numbers on foster children are hard to come by, but the 2010 paper cited in the broadcast, Antipsychotic Medication use in Medicaid Children and Adolescents (48-page PDF), is a good start. Broader forces, such as pharmaceutical marketing and the increasing frequency of mental illness diagnoses for children are at work here, Guy found, but that doesn’t mean that the foster care environment itself isn’t also a factor. It’s a system in which people are frequently looking for ways to “manage” problematic children. Judging by a companion post on Need to Know, this sounds like a story that will develop significantly in the coming year.
…foster care children are prescribed drugs at a rate much greater than that of other kids. Concern over their well-being — not to mention the amount it costs to treat them — has prompted the Government Accountability Office to investigate potentially abusive prescribing practices in America’s state foster care systems. The GAO findings are expected to come out later this year.
Watch the full episode. See more Need To Know.
You can find Need to Know’s health stories on this landing page, but as of yet I haven’t been able to find a health-specific RSS feed.
Program for disabled kids has unintended effects
Patricia Wen, of The Boston Globe, examines the Supplemental Security Income (SSI) program for children and finds the program “has gone seriously astray” and describes it as “a fast-growing alternative welfare system.”
And once a family gets on SSI, it can be very hard to let go. The attraction of up to $700 a month in payments, and the near-automatic Medicaid coverage that comes with SSI approval, leads some families to count on a child’s remaining classified as disabled, even as his or her condition may be improving.
Wen found that the program, which was intended to serve children with severe physical disabilities, now mainly serves children with behavioral, learning and mental conditions and carries financial incentives to put children on psychotropic drugs. She writes that preschoolers are the fastest-growing group to qualify for SSI, “largely because of a 12-fold spike in cases of speech delay. The government is aggressively trying to help these young children, but spends little time to see if they’re getting any better.”
Another, unintended, effect of the program is that teenagers on the program are declining to take part-time jobs despite their desire to start careers and not be dependent on the government. Wen explains “they fear working will jeopardize their disability checks. Their families are poor and need the money.”
Of interest to reporters interested in localizing the story, the package contains a data-driven interactive map that shows how many children in each state are receiving SSI assistance, the percentage who became eligible because of mental disabilities and the top five diagnostic categories.
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New at HealthJournalism.org
- Data gives depth to investigation of patient safety
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- AHCJ asks Supreme Court to permit broadcast of arguments in health reform case
- Tips for print, online journalists to embrace broadcast opportunities
- Numbers reveal how often, or how rarely, states check doctors’ disciplinary records
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
