CDC health overview: Diagnostic scans tripled
Filed under: Health data, Hot Health Headline, Studies
The CDC has released the 2009 version of Health, United States, their annual summary of health numbers and trends. It’s an epic heap of data; get the full PDF here.
For a 574-page, 10.22 MB government document, it’s surprisingly easy to navigate. There’s a table of contents, links and a nifty little feature which allows you to pull up a spreadsheet of the data from any chart or graph. In addition to the lead story on medical technology and scanning, the report includes 150 data tables. That’s a bit too much to summarize here, so we’ll settle for the CDC’s version of the highlights:
- … the rate of magnetic resonance imaging, known as MRI, and computed and positron emission tomography or CT/PET scans, ordered or provided, tripled between 1996 and 2007.
- The rate of adults aged 45 and over discharged from the hospital after receiving at least one knee replacement procedure increased 70 percent from 1996 to 2006 (26.5 per 10,000 population in 1996 to 45.2 per 10,000 in 2006).
- From 1988-1994 to 2003-2006, use of antidiabetic drugs among adults aged 45 years and over increased about 50 percent, and the use of statin drugs to lower cholesterol among this age group increased almost tenfold.
- The number of new organ transplantations per 1 million people increased 31 percent for kidney transplants (43.7 per 1 million in 1997 vs. 57.2 in 2006) and 42 percent for liver transplants between 1997 and 2006 (15.6 per 1 million in 1997 vs. 22.2 in 2006).
- Life expectancy at birth increased more for the black than for the white population between 1990 and 2007, thereby narrowing the gap in life expectancy between these two racial groups. Overall U.S. life expectancy in 2007 was 77.9 years.
- In 2007, 20 percent of U.S. adults were current cigarette smokers, a slight decrease from 21 percent in the previous three years. Men were more likely to be current cigarette smokers than women (22 percent vs. 17 percent).
- In 2005-2006, 30 percent of adults often or almost always had trouble sleeping in the past month.
- In 2007, 20 percent of adults 18 years and over had at least one emergency department visit in the past year, and 7 percent had two or more visits.
- The percentage of the population taking at least one prescription drug during the previous month increased from 38 percent in 1988-1994 to 47 percent in 2003-2006, and the percentage taking three or more prescription drugs increased from 11 percent to 21 percent.
Agency releases latest ‘Profile of Older Americans”
The U.S. Department of Health and Human Services Administration on Aging has released the 2009 version of “A Profile of Older Americans” (PDF), a summary of data taken from the Census and NCHS. 
This year’s version focuses heavily on the demographic’s growth, but includes something for everyone.
Skip to page 3 if you’re just looking for the ever-popular list of interesting numbers related to the 65-and-over set, or check the following page for the narrative version. Highlights include a map marking states based on “Persons 65+ as a percentage of total population” (it’s lowest in Alaska and Utah and increasing rapidly throughout the Mountain West), state-by-state 65+ population numbers, and health insurance coverage numbers.
You’ll even find numbers on poverty, caregivers and breakdowns of the numbers of elderly Americans who are limited in walking, eating, bathing, dressing, etc.
OIG: CDC missed most conflicts of interest in 2007
The Department of Health and Human Services Office of Inspector General’s latest report covers “CDC’s ethics program for special government employees on federal advisory committees” (53-page PDF), which is significantly more interesting than that sentence makes it sound. For the report, OIG went through conflict-of-interest disclosure forms filed in 2007 for 246 members of FDA advisory committees and found that a striking number of them were incomplete or not properly acted upon. On one hand, “federal bureaucrats are real sticklers when it comes to filing paperwork” is hardly a headline, but on the other hand,the CDC’s ethics agreements are key to preserving the integrity of the committee advisory process.
Here are a few highlights taken from the report:
- For almost all special Government employees, CDC did not ensure that financial disclosure forms were complete in 2007. CDC certified OGE Forms 450 with at least one omission in 2007 for 97 percent of SGEs. Most of the forms had more than one type of omission.
- CDC did not identify or resolve potential conflicts of interest for 64 percent of special Government employees in 2007. Sixty-four percent of SGEs had potential conflicts of interest in 2007 that CDC did not identify and/or resolve before it certified their OGE Forms 450.
- CDC did not ensure that 41 percent of special Government employees received required ethics training in 2007.
- Fifteen percent of special Government employees did not comply with ethics requirements during committee meetings in 2007.
Auditors found that measurable conflicts of interest existed in many cases (58 percent) that had, nonetheless, been approved unresolved by CDC officials.
Daschle pushes health IT to Obama, clients profit
Filed under: Conflicts of interest, Hot Health Headline
South Dakota Democrat and former Senate Majority Leader Tom Daschle is not registered as a lobbyist, and has not held public office since he lost a re-election bid in 2004. Instead, Fred Schulte and Emma Schwartz report for the Huffington Post Investigative Fund, that Daschle has existed in a nebulous limbo that’s allowed him to pivot deftly from pushing electronic medical records as an almost-HHS secretary to helping private firms profit handsomely from their implementation.
Daschle, as Obama’s first choice to head the Department of Health and Human Services last year, was a forceful advocate for using billions of dollars in economic stimulus money to help doctors and hospitals buy electronic medical records systems.
Tax problems led him to withdraw his name from consideration for the cabinet post. Then, a few weeks after Obama signed off on a stimulus plan that provided some $45 billion for digitizing the health system, Daschle began assisting private clients seeking to profit from the new law.
Public interest groups take issue with Daschle’s activities:
“He was in a position to drive public policy and develop connections within HHS that could provide his clients with an unfair competitive advantage in receiving taxpayer dollars, at the same time he and his firm benefits from his previous activities,” said Scott Amey, a lawyer with the Project on Government Oversight.
In the rest of the solid, in-depth piece, the reporters track both the breadth of Daschle’s influence (he has the ear of the president) and the impact he’s had on bottom lines across corporate America.
HHS releases FOIA report in less-than-ideal format
Bob Garfield of WNYC’s “On the Media” talked to John Wonderlich, policy director at the Sunlight Foundation, about last week’s announcement of the Open Government Directive.
Wonderlich says the initiative “is the administration making a real commitment to systemic change within the government.” He also brings up the issue of how information will be made available, pointing out that spreadsheets and datasets are more valuable than paper records to journalists as well as other businesses.
He points out that government agencies report each year on how well they are responding to Freedom of Information Act requests and says that last week – for the first time – the Department of Justice released that information for 2008 in spreadsheets.
Unfortunately that’s not quite the case. The reports from most nearly all of the departments are in spreadsheet form but a few, including the report from the Department of Health and Human Services, are in other formats that may be more difficult to analyze.
There is, however, a bit of good news. The 2007 report from HHS showed that there were more than 28,000 pending requests. The agency has made an effort to reduce its backlog and the 2008 tally is just more than 19,000.
HHS blog intended as forum about health IT
Filed under: Government, Health care reform, Health data
The first post on the new Health IT Buzz blog has generated more than 50 comments since it was posted Monday. The blog was launched by David Blumenthal, M.D., M.P.P., the national coordinator for health information technology in the Department of Health & Human Services.
A press release about the blog says it will “allow readers to learn more about health information technology (health IT) and provide a space for consumers, providers, policymakers, and technology experts to share their ideas and concerns regarding health IT.”
That first post emphasizes listening and says it will be a forum for engagement, inviting a wide range of stakeholder to discuss ideas and concerns about electronic health records.
The second post discusses the $80 million in Recovery Act money that will go toward training health IT professionals, saying that it will use community colleges to offer the education resources.
Related
Survey reveals how much patient privacy is at risk
Benjamin: Leaving patients ‘bittersweet’
The U.S. Senate has confirmed Regina M. Benjamin, M.D., M.B.A., to be surgeon general, the Department of Health and Human Services announced.
Benjamin, a doctor who has been practicing in rural Alabama, made news after Hurricane Katrina by rebuilding her rural clinic - and having to rebuild it again after it burned down.
As we noted when Benjamin was nominated, the Associated Press says Benjamin “was the first black woman to head a state medical society, received the Nelson Mandela Award for Health and Human Rights and last fall received a MacArthur Foundation ‘genius grant.’” And “A decade ago, the New York Times called her ‘angel in a white coat,’ a country doctor who made house calls along the impoverished Gulf Coast, paid whatever her patients could scrounge.”
WKRG-Mobile/Pensacola has the news, comments from Sen. Jeff Sessions and reaction from Benjamin:
See President Obama’s announcement in July of Benjamin’s nomination:
Media guide focuses on drug abuse, addiction
Filed under: Health data, Health journalism, Tools
The National Institute on Drug Abuse has released a 27-page media guide condensing up-to-date facts, figures and research on drug abuse and addiction. Get the full PDF here.
The guide is intended to help reporters understand why drug addiction occurs and how it is manifested, which drugs are abused, who abuses them and how they can be dangerous. It also includes a glossary and directions to further resources.
The National Institute on Drug Abuse is part of the National Institutes of Health, which in turn is part of the U.S. Department of Health and Human Services.
Autism news raises question: When is an embargo not an embargo?
Filed under: Government, Health journalism, Hot Health Headline, Public records, Studies
Are embargoes yet another quaint tradition that, like so many before them, has been pushed into obsolescence by the weight of the Internet? Do so many people have access to so much information they can share so easily that artificial restrictions on publication are meaningless?
Consider: In a Friday press conference, the Department of Health and Human Services discussed, under embargo, highly newsworthy data indicating a much higher than expected prevalence of autism in the United States. HHS didn’t mention, however, that in an earlier call it had already given the most newsworthy part of that information to members of the “autism community,” and had not restricted them from publishing the info. The incident raises serious questions about giving special interests privileged access to data at the expense of major media outlets, as well as the validity of embargoes in an era of increasing media fluidity.
Routine embargo?
Friday, at 3 p.m., HHS held a press conference announcing (among other things) that according to a CDC study, the prevalence of autism spectrum disorders, previously thought to be about 1 in every 150 children, is actually closer to 1 in every 100 children. This news, big enough that it led Monday’s health coverage, was embargoed until Monday because it reached conclusions similar to Health Resources and Services Administration (HRSA) findings that would be published in the journal Pediatrics that day.
There is some confusion as to where the embargo originated, as a Pediatrics representative said the journal only enforced an embargo of the HRSA study, and that anybody could have published the results of the CDC study. We are still awaiting a CDC response and more information from AAP, but have talked to representatives of the National Institute of Mental Health (NIMH) and this much, at least, is clear: As applied, the embargo covered both studies and every bit of data released to journalists. It was not, however, applied to information about the CDC study released in the autism community call.
“Both the CDC overview and the HRSA study were embargoed, because the subject nature was obviously so similar,” NIMH spokesman Jim McElroy said. “It just wouldn’t be appropriate to not have the CDC following the same set of guidelines as the HRSA study as it relates to the embargo.”
Special access for special interests
The 2 p.m. autism community call, a hastily organized affair for which invitations went out just hours beforehand, featured a brief appearance by HHS Secretary Kathleen Sebelius and gave autism advocates a broad overview of the CDC study, McElroy said. Because few specifics were discussed, the study’s broad conclusion (that the prevalence of autism spectrum disorders was now thought to be nearer to 1 in 100 children) was not under embargo.
McElroy again:
“The embargo was not in place for the advocacy groups but that’s why it was a far more general overview approach on the part of NIMH, HRSA and CDC… whereas with media it was clearly understood that an embargo was in place so media had the opportunity to ask questions.”
“The advocacy groups are very different by nature.. from media outlets whose job is to disseminate information. It’s two very different audiences and that’s why the embargo certainly is in place.”
In other words, the autism community got less information, but they were allowed to do as they pleased with what they got. The media, on the other hand, got much more information, but were not allowed to publish any of it, not even that part which had been given to the autism community without restrictions.
Autism advocates run with the news
Those on the “autism community” call wasted no time in running with the info they’d learned. For example, Dan Olmsted immediately posted the key stat on Age of Autism, and David Kirby posted a more thorough breakdown on Age of Autism and The Huffington Post soon after. About.com also posted the data (with a reference to the Pediatrics article, even), though it seems to have been taken down since (It’s still indexed in Google news).
Adventures in Autism blogger Ginger Taylor joined the call as well; her Friday post reveals a few key facts about the discussion.
“The conference call was not announced to the press or public, but merely in an e-mail sent out at 9 a.m. inviting around 50 people in the autism community (almost exclusively friendly to the administration) to the 2 p.m. call with a ’sorry for the short notice,’” Taylor wrote.
Journal doesn’t budge
Meanwhile, Pediatrics didn’t drop the embargo. In a brief call Tuesday morning Susan Martin, American Academy of Pediatrics’ director of media relations, said that stories like the Age of Autism and Huffington Post pieces hadn’t broken Pediatrics‘ embargo because they only reported on the similar study to be published by the CDC, and not specifically on the journal’s embargoed article, “Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007.” Martin did acknowledge that About.com had broken the embargo.
Readers take “tardy” media to task
The comments on Kirby’s Huffington Post entry show just how much of a debacle the embargo was for major media outlets. Readers didn’t understand the media’s hands were tied, they just knew that major outlets weren’t reporting on what looked like big news. Here are the most telling entries:
“Thanks to HuffPo for covering the autism issues that are being ignored by so many.”
–Theresa Conrick (Oct. 4)
“I sent this link to all TV news stations in our viewing area,both newspapers and the most popular Newstalk..…silence.”
–KFuller (Oct. 4)
“Stakeholders are just crying this weekend that no news source picked up this story. Thank you from the bottom of my heart Huffington Post and David Kirby.”
–TannersDad (Oct. 4)
The fallout: Do embargoes work anymore?
In the case of the bungled HHS autism release, mainstream outlets with explicit standards and institutional policies were hamstrung while less-established outlets nimbly skipped out front of a major story. It’s a somewhat unique situation that underscores the growing weakness of the embargo process.
Do embargoes work when they don’t apply to everyone equally? What about when they’re not followed by everyone? Is it “good enough” to keep mainstream media off the news while it multiplies with impunity throughout the blogosphere?
A related consideration: How big must an embargo-breaker be before everyone else follows suit? About.com, for example, gets more American traffic than any media outlet but CNN, ESPN and The New York Times and is the 27th most popular site among American Web users. It’s even owned by The New York Times Company, though the independently contracted “guide” who posted the news wasn’t under the control of the Times‘ editorial staff, of course. Despite all that, About.com still wasn’t considered influential enough to have killed the embargo.
Everybody needs to be under the same rules
AHCJ president and ProPublica senior reporter Charles Ornstein said that “If they’re going to be sharing information, it should be shared with the premise that everybody’s under the same rules.”
“I think it’s unfair to hold an embargoed briefing for the media and a non-embargoed briefing for advocates,” Ornstein said. “In a way, I think this punishes the media for abiding by embargoes in an era where information is easily shared by blog posts and by Twitter. When information enters the public domain, embargoes should be lifted.”
“While many people believe that embargoes play a vital role, events like this should cause us to make sure they’re fair to the media, and, even more than that, ask whether they help or hinder the process of conveying information to our readers, viewers and listeners,” Ornstein said.
UPDATE: Pediatrics explains why they didn’t lift embargo
Having made clear that the organization’s embargo only extended to the HRSA study, and not the CDC study discussed on the autism community call, the AAP’s Susan Martin provided AHCJ with the following statement:
The American Academy of Pediatrics (AAP) was notified of an embargo break by About.com on Saturday, Oct. 3, by a journalist for another news organization. The AAP evaluates embargo breaks on a case-by-case basis. In the About.com case, the AAP denied a request to lift the embargo early. Lifting the embargo over the weekend would have only added to the confusion, especially as the About.com post was removed as soon as the reporter learned she had broken the embargo, and many journalists had scheduled their news reports on the study to run Monday, Oct. 5.
In a similar vein, the just-distributed Pediatrics‘ media mailing for the Oct. 12 issue contained an “Editor’s Note” laying out the terms of AAP embargoes and reminding journalists of the sanctions the academy can impose upon outlets who violate those guidelines. The note also reminds folks that “Any decision to lift an embargo early is at the sole discretion of the AAP.”
UPDATE: CDC says no numbers were given to advocates
CDC spokeswoman Artealia Gilliard told AHCJ on Tuesday afternoon that everything in the 3 p.m. press call was under embargo, while nothing that would have been covered by that embargo was mentioned in the earlier call with the autism community. In particular, Gilliard said, no specific prevalence rate numbers were given out on the call.
“We basically said ‘On Monday, two studies will come out. They will update the prevalence estimate we previously had.’ … It didn’t actually have any of the information that was embargoed.”
Gilliard, who was on both calls, specified further: “I know they didn’t put out numbers in the advocacy call. I know we didn’t say 1 in 100. What we’ve been saying is ‘approximately 1 percent of children.’”
The difference between “1 in 100″ and “approximately 1 percent” is up for debate, but via e-mail, Adventures in Autism blogger Ginger Taylor outlined exactly how she and other autism-community bloggers were able to report the numbers without sitting in on the embargoed call: They’ve known them for a while.
Taylor first noted rumors of the new rate in a July blog post, David Kirby confirmed the rate and published conclusions of both the HRSA and CDC studies on the Huffington Post in August, and Tina Cruz noticed relevant changes to the CDC site late last month. So, even if the phrase “1 in 100″ was never uttered, those in the know were quick to connect the dots. Kirby confirmed this via e-mail, here’s an excerpt:
According to my notes for the community call, this is what Dr. Insel said:
“Preliminary analyses indicate an increase in estimated prevalence, to around 1% of children affected.”
1%, obviously, is 1 in 100.
Cruz also notes in the comments on this post that she noticed changes to the numbers on the CDC’s Web site.
So, while the cat may already have been out of the bag, the CDC did not release embargoed information on the autism call because, Gilliard said, “There’s no such thing as embargo with the general public. The only people who respect embargoes are journalists.”
In the autism advocate call, Gilliard said the CDC carefully walked the line between respecting Pediatrics‘ embargo and alerting parents and advocates to the upcoming changes as soon as possible.
OIG: Are we ready for a flu pandemic?
The Department of Health and Human Services’ Office of Inspector General has released two reports assessing just how prepared Americans are for a flu pandemic. Their findings? Communities are on the right track when it comes to preparing for a surge in patient numbers, but they’re not as ready as they could be. Likewise, there’s still more to be done before local organizations will be ready to distribute vaccines and antiviral drugs.
A surge of flu victims
In the Southern Hemisphere, where the flu season has already struck, the biggest systemic issue was lack of space in intensive care units overwhelmed by H1N1 victims. Are American communities doomed to more of the same? After reviewing the coordination, volunteer recruitment/organization, medical equipment, alternate care and triage and admission guidelines of 10 localities as of late summer 2008, the OIG’s answer is a resounding “not quite.” (Get the full 37-page report here.)
The OIG’s to-do list for the assistant secretary for preparedness and response?
- Keep emphasizing those five areas that we evaluated
- Make sure that, when states and localities do medical surge preparedness exercises, they then document and address the lessons they learned from those activities.
- Those lessons everyone just documented? Make sure they share them with everyone else too. Preferably through the CDC. Then the feds can work to address specific local issues.
- Consider working with states (or even the federal government) to “develop appropriate legal protections for medical professionals and volunteers who respond to public health emergencies and who may need to alter standards of care.”
Getting vaccines/antivirals to the right place, at the right time
According to HHS, “even a mild pandemic could cause between 2 million and 7.4 million deaths worldwide” and H1N1 looks to be a “moderate” one. Vaccination is a key component of the prevention plan, which is why the OIG evaluated the pandemic flu plans of 10 communities in the categories of “Receiving & Staging, Dispensing, Tracking, Vulnerable Populations, Priority Groups, Security, Storage, and Transportation.” In general, they found that the communities need to practice more, plan for all eight categories and make those plans “actionable.” In general, folks were best at planning for receiving/staging and dispensing and worst at planning for security, storage and transportation.(Read the whole 57-page report here.)
Based on those findings, the OIG recommended that the CDC:
- Work with states to figure out why folks are still in the “early stages” of planning and help them make some progress
- Prioritize which of the eight areas states should focus on in order to improve local readiness as quickly as possible.
- Emphasize “actionable” plans that “identify the organizations or individuals responsible for carrying out specific actions and the sources that would be necessary to staff distribution and dispensing positions” that are “supported by valid, detailed formal agreements with partnering agencies.”
- Again, make sure locals keep track of what they’ve learned in preparedness exercises and that they make plans to correct any deficiencies. Also, make sure they share plans and “emerging promising practices.”
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
