AHCJ-CDC Fellows learn about diabetes project
Editor’s note: This post, from the AHCJ-CDC Health Journalism Fellows‘ visit to the CDC, originally reported the CDC is close to launching a diabetes project. In fact, the National Diabetes Prevention Program launched in April 2010 and the CDC continues to expand the program, which currently has 28 sites.
The Diabetes Prevention Program clinical trial, according to the CDC, is “designed to bring evidence-based programs for preventing type 2 diabetes to communities. The program supports establishing a network of lifestyle intervention programs for overweight or obese people at high risk of developing type 2 diabetes,” including dietary changes, coping skills and group support. More information about lifestyle interventions is available from the YMCA and UnitedHealth Group.
More about the visit to the CDC:
Meredith Matthews, of Current Health Teens magazine/Weekly Reader, wrote a blog post wrote about the visit, reporting that the fellows visited the CDC’s emergency operations center, which is monitoring the cholera outbreak in Haiti. They also heard from CDC director Thomas Frieden, M.D., who Matthews says answered all of the fellows questions.
Other dispatches from the AHCJ-CDC Health Journalism Fellows:
- CDC: Cholera has spread throughout Haiti
- Expect developments in screening, treatment for hepatitis C
Latino diabetes boom caused by range of factors
The Ventura County Star’s Kim Lamb Gregory looked into the high rate of Type 2 diabetes among the local Latino population, a trend which is reflected nationwide. Gregory found that the high incidence of the disease had to be blamed on a range of genetic, environmental and cultural factors and extends to children as well as adults.
Type 2 diabetes typically develops in adults, but doctors are seeing an alarming number of cases in Latino children. If current trends in childhood obesity go unchecked, one out of every two Latino children born in the year 2000 will develop it, according to the Centers for Disease Control and Prevention.
The Latino propensity for diabetes could be even due in part to the genes contributed to the modern Mexican population by Spanish conquistadors, Gregory found. When Mexican families then migrate to the United States they encounter an ideal environment for those genes to run amok and help cause the disease.
Nutritionist Selfa Saucedo described what makes the American landscape so dietarily dangerous, including problems with medical access, no transportation and children experiencing issues at school.
Gregory breaks several of those stressors and other factors down in detail, then steps back for the big picture:
… diabetes and pre-diabetes will cost the U.S. economy $336 billion per year by 2034. Diabetes cost the U.S. more than $174 billion in 2007. Factor in pre-diabetes, gestational diabetes and those who are undiagnosed and it rises to $218 billion, according to the Lewin Group, a healthcare policy research and management consulting firm.
Disparities in health care complex, hard to correct
Seven years after the landmark IOM study which established that racial minorities had worse health and were getting poorer care than the rest of the population even after other factors had been controlled for, disparities still exist (AHCJ resource). Newsweek’s Mary Carmichael seeks to explain exactly why health disparities are so difficult to correct.
She discusses study design, classifications for ethnic groups, whether cultural competency training is useful, the quality of care that ethnic groups receive and much more.
Carmichael reports that the medical profession is working to correct disparities, but complex issues like this take time and resources to resolve. Cultural competency training is more common and health care reform proposals include myriad measures intended to help correct disparities. Even if reform doesn’t pass, Carmichael says, those measures could be used as a model for future legislation.
Speaking of solutions, Chris Metinko, of the Oakland Tribune, writes about one effort to address health disparities in some of that city’s poorest areas. Two nurse practitioners and a school board member are working to start a nonprofit organization that “would be a clinic for studying and confronting root causes of health disparities in Oakland and advocating for health equity.” Nurse practitioner Mahedere Solomon “said it would be a place where people could receive health care and where research into some of the area’s most pressing issues could be conducted.” Solomon recently received a 2009-10 Pfizer Community Innovations award, given to nurses who design projects to foster innovation at the local community level.
Meanwhile, HealthLeaders Media reports on a recent study that found nearly half of U.S. doctors say their patient care is being adversely affected by language and other cultural barriers. According to the study, HSC Issue Brief–Modest and Uneven: Physician Efforts to Reduce Racial and Ethnic Disparities, sponsored by the Robert Wood Johnson Foundation, reveals that 48 percent of doctors “reported difficulties communicating with patients because of language or cultural barriers, and said they considered the situation at least a minor problem affecting their ability to provide high-quality care.”
In their series “Shortened Lives,” Suzanne Bohan and Sandy Kleffman profiled people from different (though nearby) ZIP codes, finiding wide disparities in their expected life spans, based on where they live, their social status and the toll of chronic stress. The series explains the effect these disparities have on health care costs, as well as how they are caused and how they might be addressed. Bohan and Kleffman wrote about the project in a piece for AHCJ members and we have included additional resources for those interested in exploring disparities in health care in their own communities.
KQED profiles those who live with disease, injury
This month’s edition of Health Dialogues, part of KQED’s California Report, focuses on living with disease. In the report, KQED reporters talk to folks living with chronic disease, the effects of traumatic injury and other conditions that can have lasting effects on a person’s quality of life.
To provide insight into the life and routine of someone coping with chronic disease, reporters profile a music programmer ‘coping’ with diabetes, an activist who stumbled upon a forgotten childhood diagnosis of hepatitis B and a cellist with multiple sclerosis. They also talk to a couple dealing with cancer and two sisters on opposite ends of an organ donation chain.
In addition to cancer and disease, KQED reporters also explore how the lasting effects of traumatic injury can shape your life. Pieces include a KPBS reporter talking about his own traumatic brain injury and the story of a surfing-based physical therapy program for veterans.
Diabetes study ups ante for comparing treatments
Filed under: Health care reform, Health data, Pharmaceuticals
Of all the potential reforms to the health-care system, one of the most profound might turn out to be a government-funded effort to independently vet the effectiveness of competing treatments.
You can easily compare various TVs, laundry soaps and cell phones to learn which are best. But good luck trying that with most drugs and medical devices. The stakes, given the more than $2.2 trillion spent on health care each year, could hardly be higher. But many companies — and even some medical specialties — shy away from the risk of performing head-to-head trials that just might put their whiz-bang products or procedures in a bad light.
A big reason for the discrepancy was underscored over the weekend by results of a study that showed pricey stents and some brand-name drugs were no better than insulin in reducing deaths, heart attacks and strokes in patients with type 2 diabetes and stable heart disease.
“It really didn’t matter at all which treatment you had,” epidemiologist Trevor Orchard, who worked on the study, told The Wall Street Journal.
An editorial about the study in the New England Journal of Medicine laid out the broader challenge, “As health care costs continue to spiral upward, physicians, payers, and health economists need to make informed, evidence-based treatment decisions that improve both symptoms and clinical outcomes. ”
Compare This: Uwe Reinhardt, the Princeton economist who spoke about health-care economics at AHCJ’s annual meeting in April, explains comparative effectiveness in this blog post for The New York Times.
Diabetics risking health to save money
Associated Press Business Writer Linda Johnson discovered that diabetics, and others in need of medical attention, were putting their health at risk by cutting back on insulin, medicine and monitoring as they felt the economic pinch of the global recession.
Sales of top-selling drugs and other products used to treat and monitor the disease have dropped since the economic crisis accelerated last fall, the AP analysis found. There are even signs that some patients are choosing less-expensive insulin injections over pricier pills to save money.
People with other health problems also are cutting back on care amid the recession, but diabetics who don’t closely monitor and control the chronic disease risk particularly dire complications: amputations, vision loss, stroke — even death.
Johnson found that a broad spectrum of patients were attempting to cut corners and save money. She cited a variety of anecdotal examples and wider economic metrics, all of which support her main point: Diabetics are spending less, and it’s a threat to their health.
Dr. Steven Edelman, a University of California, San Diego endocrinologist who runs a free clinic staffed by medical students, has seen a 30 percent surge the past six months in patients seeking free diabetes medicines and supplies, which the clinic has to ration. Many had been solidly middle class, but the recession took their jobs, insurance and even some homes.
Seroquel user asks for side-effect documents
Lawyers for a Vietnam veteran who is among the thousands of patients suing AstraZeneca over claims that Seroquel caused diabetes and other ailments have requested the release of confidential documents about the drug’s side effects, AP business writer Linda Johnson reports.
Lawyers obtained the documents in question during the discovery process, and say they contain “internal company analyses of safety data on Seroquel that the lawyers believe FDA staff and advisers have never seen.” The judge in the case has set late March deadlines for the consideration of related motions, deadlines which take into consideration an April 8 FDA hearing FDA on the safety of proposed additional uses of Seroquel.
Lawyers for Ted Baker, 60, of Bastrop, La., have asked New Jersey Superior Court Judge Jamie Happas to unseal 19 specific documents - out of roughly 2.85 million generated so far in the litigation - so that they can present them to the FDA advisory panel members at the hearing.
“We think it’s important that they have the benefit of what we have learned,” Ellen Relkin, one of Baker’s lawyers, told The Associated Press in an exclusive interview Wednesday. “What we believe the FDA does not have are internal memos where they analyze the studies (and state) their real opinions or concerns about the data.”
According to Johnson’s report, “plaintiffs lawyers believe the drug causes Type 2 diabetes through two mechanisms: stimulating appetite and significant weight gain, and by raising levels of blood sugar and cholesterol.”
Related
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New at HealthJournalism.org
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