House nixes COBRA help, opens “jungle”
Filed under: Health care reform, Hot Health Headline
On Prepared Patient Forum, AHCJ Immediate Past President Trudy Lieberman examined the fallout of the Friday House vote to toss a proposed extension of COBRA subsidies through the end of the year. The Senate has yet to vote on the extension, which Lieberman says would cost about $8 billion.
The up-to-65-percent subsidy had already been extended four times since it first passes in 2009. Lieberman says that without this latest extension all the unemployed Americans who have been relying on COBRA will be forced to wade into what she called the “insurance market jungle” to get quotes on the unsubsidized market. Lieberman even did a bit of bushwhacking of her own, wading into the online insurance market to see just what consumers are up against.
Best science blogs, Dartmouth Atlas, more care
Expect some short posts today – I’m at our Rural Health Journalism Workshop in Kansas City and I hope to post some about that. In the meantime, here are some links of interest:
- The U.K.’s Guardian is looking for suggestions for their list of the “sharpest, funniest, most fascinating science blogs.” They already list some that are worth a look – take a look and then let them know what your essential science blogs are.
- The New York Times has published a piece about the Dartmouth Atlas, “Critics question study cited in health debate.”
- NPR’s Shots blog, “Despite Evidence, Patients Want More Health Care,” looks at a Health Affairs survey of more than 1,500 patients that found people believe that more care and newer care is better, despite the efforts of many experts to explain that isn’t necessarily true. (Reminder: AHCJ members get free access to Health Affairs.)
GAO sting spotlights sketchy herbal meds
Undercover sting operation reports may not be the meatiest documents released by the Government Accountability Office, but they’re almost always the most entertaining.
This time, the target was herbal supplements marketed to elderly patients. In addition to reviewing marketing materials and chemical compositions, investigators posing as elderly customers called supplement companies and received all sorts of bad advice. Check the highlights page for a nifty table of the most common and egregious errors, all of which involved garlic, gingko biloba or ginseng. You can also hear recordings of sellers peddling these treatments here.
All claims were deceptive, but two were also potentially dangerous. They are reproduced, along with GAO commentary, below.
Claim: Ginseng cures diseases, including cancer.
Comment: NIH specifically recommends that breast and uterine cancer patients avoid this product, as it may have an adverse interaction with some cancer drugs.
Claim: Ginkgo biloba can be taken with a daily aspirin prescription.
Comment: Taking this product with aspirin may increase the risk of bleeding.
And, of course, there’s also the matter of toxic substances lurking in the supplements.
GAO also found trace amounts of at least one potentially hazardous contaminant in 37 of the 40 herbal dietary supplement products tested, though none in amounts considered to pose an acute toxicity hazard. All 37 supplements tested positive for trace amounts of lead; of those, 32 also contained mercury, 28 cadmium, 21 arsenic, and 18 residues from at least one pesticide. The levels of heavy metals found do not exceed any FDA or Environmental Protection Agency (EPA) regulations governing dietary supplements or their raw ingredients.
Practical concerns facing NPs in rural areas
Filed under: Health journalism, Hospitals, Hot Health Headline
Susan Presley, writing for the American Journal of Nursing, examines the role nurse practitioners are playing in addressing the well-documented shortage of primary care physicians in rural areas. The number of rural NPs is growing, but those looking to work in underserved and often remote areas still face numerous practical challenges.
Mary Jo Goolsby, director of research and education for the American Academy of Nurse Practitioners, said that just over 20% of NPs practice in rural areas. “This is actually about the same percentage of the U.S. population we have living in rural areas and more than twice the percentage of physicians who practice in rural areas.” And the trend is moving upward, albeit slowly. Thirty years ago, a small cohort study from the Department of Health, Education, and Welfare (published in the October 1978 issue of the American Journal of Public Health) showed that only 16% of NPs worked in rural settings.
She then enumerates the challenges facing NPs who are looking to practice in rural areas, challenges which include setting up their own private practices, insurance, relatively low salaries and opposition from physician groups.
Rural health journalism workshop
AHCJ’s one-day workshop on covering rural health issues will take place tomorrow (June 4) in Kansas City. It’s free to AHCJ members, go here to register or to learn more about the day’s training.
Factory that made recalled Tylenol was cited
Filed under: Government, Hot Health Headline, Pharmaceuticals
The U.S. House of Representatives’ oversight committee will hold a hearing today about an April 30 recall of children’s Tylenol and other medicines. In advance of that hearing, Alison Young of USA Today reports that the manufacturing place responsible for the medicine “was cited last year by regulators for ‘knowingly’ using a bacteria-tainted ingredient, according to a 2009 inspection report.”
The U.S. Food and Drug Administration also cited the McNeil Consumer Healthcare plant for a similar violation last month. The April inspection, which found serious manufacturing violations and drugs that were potentially too potent, prompted the current recall.
Young also reports that the FDA issued 43 warning letters since January 2009 to drug factories about poor practices that may have endangered patients.
Violations serious enough to prompt warning letters from the U.S. Food and Drug Administration include plants using equipment and ingredients contaminated with bacteria or insects, failing to do proper testing to ensure drug strength and purity, and ignoring consumer complaints that products were making them sick.
Among the cases Young cites are possible bacterial contamination of propofol, reports of bug parts in another company’s medicines and bacteria in calcium carbonate, which is used in antacids and a menopause drug.
That House hearing starts at 10 a.m. ET and will be webcast. To watch, click here.
NPR’s Scott Hensley has been staying on top of the recall story on the Shots blog.
(Hat tip to the Donald W. Reynolds Center for Business Journalism)
AHCJ welcomes 95 new members
AHCJ welcomes these new members:
- Jill Adams, independent journalist; Delmar, N.Y.
- Janet Adamy, health policy reporter, The Wall Street Journal; Washington, D.C.
- Michael Alexander, Conscious Living Television; Chicago
- Kristina Anderson, independent producer; Burke, Va.
- Bob Babinski, independent journalist; Montreal, Canada
- Elizabeth Bahm, Medill; Chicago
- Frank Bass, reporter, Bloomberg
- Emily Baucum, reporter, KOLR/KSFX; Springfield, Mo.
- Emily Bazar, senior writer, CHCF Center for Health Reporting; Sacramento, Calif.
- Charlyne Berens, professor, University of Nebraska; Lincoln, Neb.
- Ashley Bone, staff reporter, Stephens Media Inc; Spring Hill, Tenn.
- Guy Boulton, reporter, Milwaukee Journal Sentinel; Milwaukee, Wis.
- Hara Bourgani, health editor, Elle magazine; Neo Psihiko, Athens, Greece
- Anne Boyd, health & science reporter; Chicago
- Karrey Britt, health reporter, Lawrence Journal World; Lawrence, Kan.
- Megan Brooks, independent journalist; Weston, Conn.
- Michelle Brooks, independent journalist; Cartersville, Ga.
- Sara Burrows, independent journalist; Chicago
- Carole CarMichael, assistant managing editor, The Seattle Times; Seattle
- Sonya Colberg, staff writer, The Oklahoman; Oklahoma City
- Chelsea Conaboy, business reporter, The Philadelphia Inquirer; Cherry Hill, N.J.
- Vikki Conwell, independent journalist; Lithonia, Ga.
- Christopher Donnelly, student, University of Delaware; Philadelphia
- Jim Doyle, reporter, St. Louis Dispatch; St. Louis
- Lindsey Dunn, reporter/asst., ASC Communications; Chicago
- Jennifer Evans, web reporter, Kaiser Health News; Washington, D.C.
- Jeanne Faulkner, independent journalist; Portland, Ore.
- Dana Felty, features reporter, Savannah Morning News; Savannah, Ga.
- Deborah Flapan, director, Medscape Medical News; Chicago
- Maggie Fox, health and science editor, Reuters; Silver Spring, Md.
- Althea Fung, independent journalist; Brooklyn, N.Y.
- Alicia Gallegos
- Greg Gillespie, editor in chief, Health Data Management; Chicago
- Washington Ginkunju, reporter, The Columbia Missourian; Columbia, Mo.
- Adriana Godoy Leiss, communications officer, The California Wellness Foundation; Woodland Hills, Calif.
- Jenny Gold, reporter, Kaiser Health News; Washington, D.C.
- Barbara Goldberg, independent journalist; Maplewood, N.J.
- John Gonzales, senior writer, CHCF Center for Health Reporting; Alhambra, Calif.
- Serena Gordon, independent journalist; Croton on Hudson, N.Y.
- Steven Gorelick, professor, Hunter College; New York
- Judith Graham, health reporter, Chicago Tribune; Denver
- Valerie Gregg, independent journalist; Lilburn, Ga.
- John Hacker, managing editor, The Carthage Press; Carthage, Mo.
- Kimberly Hayes Taylor, independent journalist; Detroit
- Lisa Holton, independent journalist; Evanston, Ill.
- Lena Huang, fitness & nutrition editor, CURE Magazine; Dallas
- Bunmi Ishola, editorial assistant, CURE Magazine; Dallas
- Wendy Johnson, publisher, Fierce Healthcare; Washington, D.C.
- Paula Kamen, independent journalist; Chicago
- Louise Kertesz, independent journalist; Chicago, Ill.
- Kathleen Kimball-Baker, managing editor, CIDRAP Business Source; Minneapolis
- Richard Kirkner, independent journalist; Phoenixville, Penn.
- Bobby Kirkwood, program coordinator, CHCF Center for Health Reporting; Alhambra, Calif.
- Lizbeth Kowalczyk, reporter, The Boston Globe; West Roxbury, Mass.
- Jan Kulhavy, professional journalist; Praha 5, Czech Republic
- Jim Landers, Washington correspondent, The Dallas Morning News; Washington, D.C.
- Terri Langford, reporter, Houston Chronicle; Houston
- Kathy LaTour, editor-at-large, CURE Magazine; Dallas
- Kay Lazar, health reporter, The Boston Globe; Manchester, Mass.
- Darcy Lewis, independent journalist; Riverside, Ill.
- Nina Lill, independent journalist; Itasca, Ill.
- Everett Long, student, University of Georgia; Athens, Ga.
- Jessica Marcy, web reporter, Kaiser Health News; Washington, D.C.
- Kirk McAlpin, student, University of Georgia; Athens, Ga.
- Bob McCoppin, health and fitness reporter, Daily Herald; Arlington Heights, Ill.
- Shannon Mehner, reporter/student, Medill News Service/Medill School of Journalism; Evanston, Ill.
- John Morrissey, independent journalist; Mount Prospect, Ill.
- Andrew O’Connor, reporter, ABC News; Hamersley, Western Australia
- Priti Patnaik, student, New York University; Jersey City, N.J.
- Lori Pindar, student, University of Georgia; Athens, Ga.
- Nadja Popovich, independent journalist, NPR; Bethesda, Md.
- Kelly Rawlings, Diabetic Living Magazine, Meredith Corp.; Des Moines, Iowa
- Monica Reinagel, independent journalist; Baltimore
- Renee Robbins, senior editor, Reed Business Information; Glen Ellyn, Ill.
- Michelle Roberts, independent journalist; Hazelwood, Mo.
- Suzanne Sataline, reporter, The Wall Street Journal; New York
- Jaclyn Schiff, web reporter, Kaiser Health News; Washington, D.C.
- Lisa Scott, independent journalist; Chicago
- Paul Scott, independent journalist; Rochester, Minn.
- Julie Sell; Minneapolis
- Kantha Shelke, editor-at-large, Corvus Blue LLC; Chicago
- Patrick Sinco, managing editor, The DO / American Osteopathic Association; Chicago
- Katie Smith, student, University of Georgia; Athens, Ga.
- Rebecca Stephen, intern, WDAF-Kansas City; Stewartsville, Mo.
- Patricia Sweetser, independent journalist; Canaan, N.H.
- Monifa Thomas, reporter, Chicago Sun-Times; Chicago
- Renee Tomcanin, writer/reporter, ASC Communications; Chicago
- Thomas Tsai, independent journalist; Stanford, Calif.
- Fabio Turone, Agancy Zoe; Milano, Italy
- Andrew Villegas, web reporter, Kaiser Health News; Washington, D.C.
- Arlene Weintraub, independent journalist; Hoboken, N.J.
- David Westphal, editor, CHCF Center for Health Reporting; Los Angeles
- Elizabeth Whittington, web managing editor, CURE Magazine; Dallas
- Howard Witkin, publisher, MedicalCare.org; Beverly Hills, Calif.
- Xiaojian Zhao, Knight Science Journalism Fellow; Cambridge, Mass.
If you haven’t joined yet, see what member benefits you’re missing out on: Access to more than 50 journals and databases, tip sheets and articles from your colleagues on how they’ve reported stories, conferences, workshops, online training, reporting guides and more. Join AHCJ today to get a wealth of support and tools to help you.
HHS shows off tools marrying health, data
Filed under: Health data, Public health, Public records, Tools
This morning’s HHS briefing about the new Community Health Data Initiative, part of the Open Government Initiative, covered a lot of ground, with a number of web application developers showing off what they’ve done with government health data. Among the highlights for me:
Microsoft has launched Bing Health Maps
It’s a little clunky to access now, but we’ll forgive Bing since the application was launched early this morning. Go to http://www.bing.com/maps/explore/ and look for the “Map Apps” button at the bottom of the page. Click on that and, on the next screen, choose Bing Health Maps. From there, you can pick a state and then community health indicators. Those indicators include birth measures, death measures and health risk factors. An overlay on the map shows the results and you can click on specific areas to delve further into the numbers.
Visualizing the data may make it easier to spot some health disparities that might deserve a closer look and it’s an easy way to get numbers on some health measures for an area. I am disappointed that there doesn’t appear to be an option to embed the health maps.
TechCrunch points out that Bing Health Maps are similar to Google’s Flu Maps.
Google Fusion Tables make health data accessible
Not to be outdone, Google demonstrated how its Fusion Tables - “a database service in the cloud” - could be used with HHS data about hospitals. In the example, you can zoom in on a hospital and get stats on whether it is “heart friendly” and “people friendly.”
Tech helps asthma management
Another application gathers data on where and when people are when they suffer asthma symptoms. Asthmapolis showed how its product, the Spiroscout, uses GPS to track the time and geographic location of symptoms. The data can then be displayed and, presumably, patterns can be detected. Asthmapolis produced a video to explain a little more.
Analyze the U.S.
Palantir Technologies announced http://AnalyzeThe.US which uses tools to explore data released by the government as well as datasets compiled by nonprofits and policy centers, in areas that include federal spending, contracting, lobbying, and campaign finance.
And more …
Secretary Kathleen Sebelius announced that HHS will release a Health Indicators Warehouse by the end of the year that will have “currently available and new HHS data on national, state, regional, and county health performance – on indicators such as rates of smoking, obesity, diabetes, access to healthy food, utilization of health care services, etc. – in an easy-to-use ‘one stop data shop.’”
According to the HHS press release, there were 16 applications presented at today’s forum. I’m hopeful that HHS will find a better way to present such things before future announcements. I spent much of my time during the webcast trying to find the web sites and applications that were being demonstrated, and thus missing parts of the discussion. Releasing a list of URLs in advance or providing them via Twitter during the webcast would have helped keep my attention on what was being presented.
In the end, the release of more data is always a good thing and making it accessible to as many people as possible is even better. But journalists will probably still want the underlying datasets so they can perform their own detailed analysis of the data.
For more about some of the applications demonstrated, see “Making community health information as useful as weather data” from Alex Howard.
Study authors don’t always have access to raw data
Filed under: Conflicts of interest, Hot Health Headline, Pharmaceuticals, Studies
John Fauber of the Milwaukee Journal Sentinel reports on outside authors of drug company-funded studies who do not have access to the raw data behind the study.
In the latest installment of Side Effects, a series examining doctors, drug companies and conflicts of interest, Fauber reports that a researcher who co-authored a study of Multaq that led to the drug’s FDA approval “vouched for the accuracy and completeness of the study despite not seeing the raw data.”
The researcher, Richard Page, chairman of the department of medicine at the University of Wisconsin School of Medicine and Public Health, says he trusts the Sanofi-Aventis, the drug’s manufacturer.
Fauber delves into the differing editorial policies of the Journal of the American Medical Association and the New England Journal of Medicine when it comes to studies in which drug company employees perform the data analysis.
In the case of the Multaq trial, published by the New England Journal of Medicine, the FDA got unanalyzed raw data and did its own analysis. Fauber reports that “one FDA panel member questioned differences between the information included in the published February 2009 study and what was submitted to the FDA.”
Related
- Uncovering conflicts of interest in medicine, research
- Health Journalism 2010: Journalists encounter obstacles in identifying conflicts of interest in medical research
Calif. dental care crisis could get worse
Filed under: Health data, Health journalism, Hot Health Headline
Laurie Udesky, writing for The New York Times, has found that that pediatric dental care in the state has reached rock bottom, especially for children from low-income families. Unfortunately, in California, it’s starting to look like there may be a floor even lower than rock bottom. Udesky writes: “If Gov. Arnold Schwarzenegger’s recent proposed cuts remain — amounting to a $16.5 million reduction to Healthy Families and a $523 million reduction to Medi-Cal —more cases of untreated dental-related illnesses are likely.”
California children’s dental health was ranked third from the bottom in the National Survey of Children’s Health, above only Arizona and Texas. In the Bay Area, children and teenagers up to the age of 17 made nearly 1,980 visits to emergency rooms for preventable dental conditions in 2007. The cost of these visits averaged $172, but if a problem required hospitalization it cost an average of $5,000.
Today, experts interviewed said the dental care crisis had reached an even more alarming level. “We can only go up from here,” said Dr. Jared I. Fine, the dental health administrator at Alameda County Public Health Department. “We have an epidemic of dental disease in children that’s absurdly pervasive.”
For more on children’s dental health, check out The Cost of Delay (PDF), a report the Pew Center on the States released earlier this year. It seeks to answer the questions “What can states do to ensure better dental care?” and “How many states are doing those things right now?” and includes a strong body of statistics and analysis within its 74 pages.
The National Survey of Children’s Health, last fully updated in 2007, is still a comprehensive source for national data on pediatric dental health. There are data fields for overall dental health, as well as for specific oral health issues in children. For an overview of the data, I just pulled the overall health numbers and mapped a subset of them.
Package spotlights maternal health in 5 countries
Filed under: Health journalism, Hot Health Headline
The team at the Pulitzer Gateway (a site from the Pulitzer Center on Crisis Reporting) have turned their focus toward worldwide maternal health and produced “Dying for Life,” a package that spans five countries and three continents. Here are its components:
Nigeria
A reminder that despite a slight improvement in global maternal health, the situation in some countries is still deteriorating. The end result will be “Edge of Joy,” a documentary set to be released this summer.
Ethiopia
Hanna Ingber Win visits maternal health programs administered by the UN Population Fund. She filed five dispatches.
Mexico
Samuel Loewenberg investigated the social, medical, economic and political factors behind the “health crises” affecting two impoverished Mexican states. He filed three stories.
Guinea-Bissau
Marco Vernaschi photographed the everyday realities of a region with critical health care access and delivery issues.
India
Hanna Ingber Win investigated maternal health disparities and efforts to improve the situation in India, particularly the province of Assam. She posted five stories.
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