July - December 2012

We all want to see good health care. But how do we really know what's good health care? Well, the best way to to measure what we're doing? The questions become: How do we measure and what should we measure? The Consumer-Purchaser Disclosure Project has come up with ten criteria for meaningful and usable measures of performance.

1. Make consumer and purchaser needs a priority in performance measurement.
2. Use direct feedback from patients and their families to measure performance.
3. Build a comprehensive dashboard of measures that provides a complete picture of the care patients receive.
4. Focus measurement on areas of care where the potential to improve health outcomes and increase the effectiveness and efficiency of care is greatest.
5. Ensure that measures generate the most valuable information possible.
6. Require that all patients fitting appropriate clinical criteria be included in the measure population.
7. Assess whether treatment recommendations are followed.
8. De-emphasize documentation (check-the-box) measures.
9. Measure the performance of providers at all levels (e.g., individual physicians, medical groups, ACOs).
10. Collect performance measurement data efficiently.
11. Citation source: http://www.rwjf.org/content/dam/web-assets/2011/09/ten-criteria-for-meaningful-and-usable-measures-of-performance

For more information, see Research Resources

12. December 14, 2012 - Newtown CT Sandy Hook Elementary School Carnage
    

    For resources to deal with violence, see Connecticut Public Health Resources, and Kids Health Resources

13. December 14, 2012 -

    HealthData.gov is the place to go if you are looking for data gathered by federal agencies. It is a revamp of HealthData.gov now known as "Health Data Community"

14. December 13, 2012 - Older Americans 2012: Key Indicators of Well-Being

    Graphic source: http://www.agingstats.gov/agingstatsdotnet/main_site/default.aspx

    Selected highlight from the latest report on the well-being of older Americans include: Participation of older women in the labor force has increased significantly over the past 40 years. In 1963, 29 percent of women aged 62-64 worked outside the home; in 2011, that had increased to 45 percent. In 1963, 17 percent of women aged 65-69 were in the labor force; in 2011, that had increased to 27 percent. For women 70 and older, 6 percent worked in 1963, increasing to 8 percent in 2011. Some older Americans work out of economic necessity. Others may be attracted by the social contact, intellectual challenges or sense of value that work often provides. Rising rates of obesity Obesity, a major cause of preventable disease and premature death, is increasing among older people. In 2009-2010, 38 percent of people age 65 and over were obese, compared with 22 percent in 1988-1994. In 2009-2010, 44 percent of people age 65-74 were obese, as were 29 percent of those age 75 and older. Citation source: http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/2012_Documents/Docs/Older_Americans_2012_FINAL_press_note.pdf Click on the graphic to access the report. For additional information, see Senior Health

15. December 12, 2012 - Poverty Census Data

    Graphic source: http://www.nytimes.com/interactive/2011/09/13/us/income-poverty-rate-at-1990s-levels.html

    Here are two September 13, 2011 New York Times graphics of US Census data, showing the current median income, and another showing the nation's 2010 poverty rate reaching 15.1 percent, the highest level since 1993. According to the US Census: "There were 46.2 million people in poverty in 2010, up from 43.6 million in 2009; the fourth consecutive annual increase and the largest number in the 52 years for which poverty estimates have been published. The number of people without health insurance coverage rose from 49.0 million in 2009 to 49.9 million in 2010, while the percentage without coverage −16.3 percent - was not statistically different from the rate in 2009. Source citation: http://www.census.gov/newsroom/releases/ archives/income_wealth/cb11-157.html For more information, see Income, Poverty, and Health Insurance Coverage in the United States: 2011 Census.gov 9/2012 and US Federal Government Statistics

16. December 11, 2012 - Landlines are disappearing

    Graphic source:http://www.marketingcharts.com/direct/landline-phone-penetration-dwindles-as-cell-only-households-grow-22577/cdc-us-household-phone-status-h12008-h22011-jul2012png/ According to June 2012's US National Health Information Survey (NHIS) "Landline Phone Penetration Dwindles as Cell-Only Households Grow Mobile phones (and particularly smartphones) are growing in popularity,...more and more American households are abandoning their landlines and going wireless-only. In fact, from H1 2008 to H2 2011, the proportion of wireless-only households almost doubled, from 17.5% to 34%. At the same time, the percentage of homes with a landline phone (either with or without an accompanying cellphone) decreased from 79.1% to 63.6%. The percentage of children living in wireless-only households is also growing, up from 17% in H1 2008 to 38.1% in H2 2011, while the percentage of children living in households with a landline has fallen from 80% to 59.5% in that period. This drop is reflected in American teens communication habits.

    According to a Pew report released in March 2012, just 14% of all teens said they talk to friends on a landline phone on a daily basis, down from 30% in 2009. At the same time, 31% said they never talk to friends on a landline, up from 19% who indicated this in 2009. Americans without landline phones are also more likely to have cut the TV cord, according to June 2012 survey results from TechBargains.com. Among respondents who had discarded their landline phone, 36% have cut the cable cord, compared to 16% who maintain their landlines. 59.6% of 25-29-year-olds live in cell-only households, while 50.9% of 30-34-year-olds and 48.6% of 18-24-year-olds also report going without a landline. As age increases from 35 years, the percentage of adults living in households with only wireless telephones decreases: 36.8% for adults aged 35-44; 23.8% for adults aged 45-64; and 8.5% for adults aged 65 and older. Per the CDC report, in H2 2011, men (33.7%) were more likely than women (30.9%) to be living in households with only wireless phones. More than three-quarters of adults living only with unrelated adult roommates were in households with only wireless phones. This is the highest prevalence rate for any of the population subgroups examined. Adults living in poverty (51.4%) were far more likely than adults who were not poor (28.9%) to be living in wireless-only households. Hispanic adults (43.3%) were more likely than non-Hispanic white adults (29%) or non-Hispanic black adults (36.8%) to be living in households with only wireless phones. Citation source:http://www.marketingcharts.com/direct/landline-phone-penetration-dwindles-as-cell-only-households-grow-22577/cdc-us-household-phone-status-h12008-h22011-jul2012png/ Imagine the impact this would have on telephone-based surveys, as the Behavioral Risk Factor Surveillance System!

17. December 10, 2012 - The Impact of Health Information on Health Behaviors

    Graphic source: http://www.hschange.org/CONTENT/1260/SP2.htm

    While the source of health information has changed over time, what is the impact of such information on health behavior? According to the Center for Studying Health System Change: "A majority of consumers who actively researched health concerns reported positive impacts from their information searches: 56 percent reported that the information affected their overall approach to maintaining their own health, and 60 percent said that the information affected their understanding about how to treat an illness or condition: 38 percent said the information affected the way they coped with a chronic condition or managed pain; 43 percent said the information affected a decision about whether to see a doctor; 51 percent said the information affected whether they asked their doctor a question; 20 percent said the information affected a decision about seeking a second opinion from another doctor; and 50 percent said the information affected their approach to diet, exercise or stress management. ...the reported level of impact was relatively consistent across demographic subgroups. ...the elderly are less likely to seek health information in the first place, but once they do, they appear at least as likely as younger consumers to find the information useful and empowering. ...education stands out as the one key exception to this pattern of relatively uniform impact across demographic characteristics. The self-reported positive impact of health information rises sharply as the level of education increases. This finding suggests that consumers with more education may be better equipped, first, to locate useful information sources, and then to apply stronger health literacy skills to reap greater benefit from those information sources. ...consumers' education levels, which are likely to be linked closely to their health literacy skills, play an important role in determining how engaged or activated they are as patients, and how useful and actionable they find the health information that they obtain. Citation source: http://www.hschange.org/CONTENT/1260/SP2.htm These findings further support the importance of being discriminating about what kinds of health information are found on the Internet. If people are going to use the information they find, then that information should be credible in nature. See Evaluating Web site Quality

18. December 7 , 2012 - Use of Health Information Technology* Among Adults Aged ≥18 Years National Health Interview Survey (NHIS), United States, 2009 and 2011

    Graphic source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6132a9.htm

    In the August 2012 MMWR report, "Use of Health Information Technology* Among Adults Aged =/>18 Years National Health Interview Survey (NHIS), United States, 2009 and 2011," results show: "Between 2009 and 2011, increases were noted in the proportion of adults aged ≥18 years who used the Internet to fill a prescription (5.9% to 7.1%), schedule an appointment with a health-care provider (2.6% to 4.5%), and communicate with a health-care provider by e-mail (4.6% to 5.5%). The use of online chat groups to learn about health topics also increased (3.3% to 3.7%). The percentage of adults who looked up health information on the Internet did not change significantly between 2009 (45.5%) and 2011 (46.5%), but in both years, looking up health information on the Internet was seven to 14 times as likely to occur as each of the other four activities." Citation source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6132a9.htm For sure, access to the Internet has become an indispensable means to not only seek health information, but to conduct tasks associated with maintaining one's health.

19. December 6, 2012 - Looking for Online Health Information

    Graphic source: http://www.cdc.gov/nchs/data/databriefs/db66.htm According to the July 2011 NCHS Data Brief, "Use of the Internet for Health Information: United States, 2009" "Among adults aged 18 and over, women were more likely than men to have used the Internet for health information. Among adults aged 18-64, non-Hispanic white persons were almost twice as likely as Hispanic persons to have used the Internet for health information. Among adults aged 25-64, higher education was associated with increased use of the Internet for health information. Adults aged 18-64 with higher incomes were more likely to have used the Internet for health information than adults with lower incomes. Employed adults aged 18-64 were more likely than adults who were unemployed or not in the workforce to have used the Internet for health information. Using the Internet for health information was related to health insurance status. Citation source: Cohen RA, Adams PF. Use of the Internet for health information: United States, 2009. NCHS data brief, no 66. Hyattsville, MD: National Center for Health Statistics. 2011; http://www.cdc.gov/nchs/data/databriefs/db66.htm For more information, see Evaluating Online Health Information

20. December 5, 2012 - Education and Information Seeking

    Graphic source:http://www.hschange.org/CONTENT/1260/

    According to the Center for Studying Health System Change (11/2011): "Historically, a consumer's education level has stood out as the factor most strongly associated with information seeking, and that remains true today. Information seeking rises sharply as the level of education increases. Once other personal characteristics are accounted for, people with a graduate education are twice as likely as those with no high school diploma to seek health information (67% vs. 33%)a disparity that has grown since 2007. The gap between the most- and least-educated groups is even wider for Internet use (52% vs. 11%). The socioeconomic profile of health information seekers differed markedly according to the types of information sources they used. The 22 percent of adults who sought health information from both Internet and non-Internet sources ranked as the group with the highest income and education levels. Not far behind that group in affluence and educational attainment were the 9 percent of adults who sought health information only from the Internet the youngest group. Trailing substantially behind those groups on income and education levels were the 18 percent of adults who sought information from non-Internet sources only, and the 50 percent of adults who sought no information about personal health concerns. Citation source: http://www.hschange.org/CONTENT/1260/

21. December 4, 2012 - Online Health Information Still Growing in Popularity

    Graphic source:http://www.hschange.org/CONTENT/1260/

    The Center for Studying Health System Change reported in November, 2011: "In 2010, 50 percent of American adults sought information about a personal health concern, down from 56 percent in 2007, The proportion of consumers seeking health information fell from 56 percent in 2007 but still represents a sizeable increase over the past decade, up from 38 percent in 2001 The likelihood of people seeking information from the Internet and from friends and relatives changed little between 2007 and 2010, but their use of hardcopy books, magazines and newspapers dropped by nearly half to 18 percent. While the reduced tendency to seek health information applied to consumers across nearly all demographic categories, it was most pronounced for older Americans, people with chronic conditions and people with lower-education levels. Across all individual characteristics, education level remained the factor most strongly associated with consumers' inclination to seek health information. Consumers who actively researched health concerns widely reported positive impacts: About three in five said the information affected their overall approach to maintaining their health, and a similar proportion said the information helped them to better understand how to treat an illness or condition. Citation source: http://www.hschange.org/CONTENT/1260/

22. December 3, 2012 - 10 Rules to Expose Medical Junk News

    There is way too many research studies to digest these days. So, how do we separate the chaff from the wheat? George Lundberg, MD, Editor-at-Large, MedPage Today, Editor-at-Large, MedPage Today offers these pointers:

    1. How available is the treatment/test/product/procedure to the likely reader/viewer/listener at the time of the report?
    2. What is the cost or charge for the test/treatment/product or procedure mentioned in the story? To the patient? The insurance company? The government?
    3. Is there evidence of disease mongering in the story? Does it oversell or exaggerate a condition or create unwarranted fear?
    4. Does the story seem to grasp and convey the quality of the evidence supporting the basis for the study?
    5. Does the article provide appropriate balance about harms that might be caused by the treatment/test/product/procedure that constitutes the basis for the story?
    6. Does the story establish the true novelty of the approach? Much that is purported to be new, really is not.
    7. How does the story frame the relative quantitative value of a new treatment, test, product, or procedure and place the benefits in context with others, especially dealing with absolute and relative values?
    8. Did the author and editor of the medical news story rely solely or largely on a press release or did they also seek and quote other sources?
    9. Was there an independent source and were any possible conflicts of interests of sources disclosed in the article?
    10. Does the story provide the context of treatment/test/product/procedure other than those that are being reported?
    
    Citation source: http://www.medpagetoday.com/Columns/At-Large/28605
23. November 30, 2012 - 100 Years of Shipping

24. November 29, 2012 - Stay Up-to-Date with CDC Learning Connection

    For those who are certified health education specialists or master certified health education specialists. See Public Health Continuing Education Opportunities

25. November 28, 2012 - Two celestial events: Penumbral Lunar Eclipse & The Full Beaver Moon

    To learn more, see Penumbral Lunar Eclipse

    November's full Moon was called the Beaver Moon because it was the time to set traps, before the waters froze over. This Moon was also called the Full Frost Moon. Citation source: http://www.almanac.com/content/full-beaver-moon-novembers-moon-guide

26. November 27, 2012 - Strategies to Prevent Stroke

    Strategies for preventing stroke: Control blood pressure. Manage stress and depression. Reduce the risk of blood clots. Control other medical conditions. Talk to the doctor about medications that might increase your parents' risk. Know the early warning signs and seek treatment to prevent a stroke. Sudden numbness or weakness of the face, arm, or leg -- especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing out of one or both eyes Sudden difficulty walking, loss of balance or coordination, dizziness Keep "bad" cholesterol levels low. Follow a heart-healthy diet. Help them stop smoking. Source: http://www.caring.com/articles/prevent-a-stroke?utm_medium=partner&utm_source=yahoo For more information, see Cerebrovascular Disease

27. November 26, 2012 - Stroke Awareness

    Graphic source: http://medicineworld.org/news/news-archives/1083222147-Aug-18-2009.html

    In a recent 11/4 study of stroke patients, researchers found that many do not see a connection between tobacco and stroke. "...nearly 70% of smokers hospitalized for a stroke had stopped smoking by discharge, although only 40% remained abstinent at one year, ...only about one-third of patients associated smoking with an increased risk of stroke. At the time of the stroke, the patients were smoking an average of 27.6 cigarettes per day. About one-third saw an association between smoking and stroke, with an equal proportion perceiving no such association. The rest said they did not know. "This fact is indicative of the lack of awareness regarding stroke risk factors in the general population and highlights the need to improve the information given so as to make progress in the primary prevention of this disease," Citation source: Suer Soler R, et al "Smoking cessation 1 year poststroke and damage to the insular cortex" Stroke 2011; DOI: 10.1161/STROKEAHA.111.630004; reported in Medpage Today.

28. November 23, 2012 - "Anthropocene" by Globa

29. November 22, 2012 - Happy Thanksgiving

    Photo: BCJung, Gozzi Farm Turkeys, CT (11/16/12)

    Graphic source: http://comments.funmunch.com/gratitude-quotes-1.html

    Graphic source: http://inspirationboost.com/category/all-quotes/attitude-quotes/page/2

30. November 21, 2012 - How Much is Life Worth? The Truth About Tobacco

31. November 20, 2012 - Mental Health 2010

    Graphic source: http://store.samhsa.gov/product/Mental-Health-United-States-2010/SMA12-4681?WT.ac=EB_20120425_SMA12-4681

    In March 2012, the Substance Abuse & Mental Health Services Administration (SAMHSA)released "Mental Health, United States, 2010" which covers the nation's mental health system across three themes: people; treatment facility characteristics; and payers and payment mechanisms. Includes state-level data, needs of children and military personnel, and services in non-traditional settings. To access the report, just click on the graphic. For additional statistical information, see Mental Health For more information, see Mental Health

32. November 19, 2012 -

    Gratitude is always a good thing because it helps us to keep Life in perspective. We take so many things for granted that we don't appreciate what we have until we don't have it anymore. I like Research!America's annual "Public Health Thank You Day" because it puts what is my greatest love, Public Health, on the forefront, even if it's just for one day a year. Here's a great video that shows the scope of Public Health. Graphic source: http://www.researchamerica.org/ph_thank_you

    A re-posting of my 2009 blog entry: Here are some of things we can be thankful for, with many thanks to all the Public Health Professionals, at all levels of practice, who have dedicated their careers to protecting the Public's Health in a variety of ways...

    • Waking up this morning from clean bedding that is not contaminated by pathogens;
    • Using a bathroom so human waste is disposed of properly;
    • Being able to drink water from the faucet without getting some disease;
    • Being able to eat breakfast without getting some disease;
    • Dropping off your kids in schools knowing they won't get sick because everyone got their immunizations;
    • Driving to work and not being exposed to harmful emissions from motor vehicles;
    • Going to work and spending the day in an environment that won't make you sick;
    • Going to lunch and eating in a restaurant that's been inspected;
    • Going for a walk and not being exposed to second-hand smoke or rotting garbage;
    • Getting a haircut and knowing those cutting your hair have been licensed;
    • Going to see health care professionals and knowing they are competent because they are licensed to practice;
    • Going to any health care facility and knowing they are licensed;
    • Going to bed and feeling safe because disaster preparedness exists at every level of government.
33. November 16, 2012 - U.S. Stroke Hospitalization Trends

    Hospitalization rates for stroke, by age: United States, 1989-2009 Graphic source: http://www.cdc.gov/nchs/data/databriefs/db95.htm

    Stroke hospitalization trends are changing. According to the CDC: The rate of hospitalization for stroke increased from 32.4 to 34.9 per 10,000 population from 1989 to 1999, but by 2009 the rate had decreased to 31.8 per 10,000. Significant linear trend in rates for stroke was observed from 1999 through 2009 for age groups 65-74, 75-84, and 85 years and over, and for total hospitalizations. The stroke hospitalization rate increased 5% for those aged 65-74 from 1989 to 1999, and then decreased 20% from 1999 to 2009. For those aged 75 and over, the rates did not change significantly from 1989 to 1999, but from 1999 to 2009 the rate decreased 24% for those aged 75-84 and 20% for those 85 and over. Citation source: http://www.cdc.gov/nchs/data/databriefs/db95.htm For more information, see Cerebrovascular Disease

34. November 15, 2012 - U.S. Stroke Hospitalizations

    Rate* of Hospitalization for Stroke, by Sex and Age Group National Hospital Discharge Survey, United States, 2010 Graphic source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6129a7.htm

    Stroke hospitalization statistics were released in July by the MMWR. According to the CDC, *Per 10,000 population. Hospitalization for stroke (cerebrovascular disease) is defined as a first-listed diagnosis on the medical record of 430-438, as coded according to the International Classification of Diseases, 9th Revision, Clinical Modification. This includes hospitalizations for acute strokes, transient ischemic attack, and for late effects of stroke. Rates were calculated using U.S. Census Bureau 2000-based postcensal civilian population estimates. In 2010, hospitalization rates per 10,000 population for stroke for males and females increased with increasing patient age. For males, the rate per 10,000 ranged from 14.7 for those aged <65 years to 285.7 for those aged ≥85 years. For females, the rate ranged from 11.6 per 10,000 population for those aged <65 years to 277.4 for those aged ≥85 years. Within each age group, the rates for males and females were similar. Sources: National Hospital Discharge Survey data (2010). http://www.cdc.gov/nchs/data/databriefs/db95.htm For more information, see Cerebrovascular Disease

35. November 14, 2012 - It's the carbs...

    #1 #2 #3 Graphic source: http://www.medscape.org/viewarticle/771281_transcript

    According to Medscape's "Sickeningly Sweet: Sugar Consumption and Public Health" Dr. Lustig reports: "The question is: "What about our diet constitutes the biggest problem in terms of obesity and metabolic syndrome?" Our research has led to the conclusion that of the various foodstuffs we consume, sugar is the biggest problem. It is the biggest problem because of its metabolism, because of its effect on the brain, and because of how society treats it as a commodity. We are all eating more -- 187 calories per day more for men[3], 335 calories a day more for women[3], and 275 calories a day more in teen boys -- than we did 25 years ago. The question is: "What are we eating more of?" Is it the fat? (#1) No, it is not the fat. Average consumption in teen boys has increased by only 5 g, or 45 calories....Bottom line -- we are not consuming more fat. In fact, as a percent of our total diet, we are actually consuming less fat -- down from 40% to 30% -- because the American Heart Association, the American Medical Association, and the US Department of Agriculture told us to do so back in the early 1980s. Yet, our obesity and metabolic syndrome prevalence has gone through the roof. So, it isn't the fat. (#2 and #3) What is it? It is the carbohydrate. You can see that of the 275-calorie increase in teen boys, 57 g (or 228 calories) were in carbohydrate. What carbohydrate? Soft drinks occupy the major portion as well as, obviously, things like potato chips and other carbohydrate-laden snacks, but in particular we are going to be talking about beverages today." Citation source: http://www.medscape.org/viewarticle/771281_transcript

36. November 13, 2012 - Walking 3 miles for each can of soda you drink

    NYC Campaign I love New York City's campaign about how drinking just one soda a day equals 50 pounds of sugar a year. That's a whole lot of sugar, and it's even worse than that when it's high fructose corn syrup. I also love how this map shows how much exercise you need to work it off. So, are you willing to do the 3 miles to prevent all those excess calories from turning into excess weight?

    Graphic source: http://www.nyc.gov/html/doh/html/pr2011/pr026-11.shtml

37. November 12, 2012 - CDC's Rethink Your Drink

    Graphic source: 9/27/2011 Healthy People, Healthy Places Newsletter

    According to the CDC's 9/27/2011 Healthy People, Healthy Places Newsletter's Help Reduce Childhood Obesity: Rethink Your Student's Drink "Sugar drinks, also called sugar-sweetened beverages, are the largest source of added sugars in the diets of U.S. youth. Sugar drinks are high in calories and consuming too many calories leads to obesity. Recent studies show that nearly two thirds of high school students report daily consumption of regular soda (non-diet), sports drinks, and other sugar drinks. Sugar drinks are those to which sweeteners with calories have been added. High fructose corn syrup, sucrose (table sugar) and other sweeteners add calories to these types of drinks, without adding any nutrients. Some common sugar drinks are: Soft drinks, soda or pop; Fruit drinks, punches; Sports drinks and energy drinks; Sweetened tea and coffee drinks. For more information, see Nutrition Resources

38. November 11, 2012 - Celebrating the U.S. Armed Forces

    2011 West Virginia University Marching Band Armed Forces Salute Thanks, Rose!

39. November 9, 2012 - Duke University's "Lifestyle as Medicine to Combat Diabesity" Presentation

40. November 8, 2012 - The Obesity Epidemic Is Fueling the Rise in Type 2 Diabetes

41. November 7, 2012 - Noreaster 2012: No rest for the weary
    
    Graphic source: http://www.cbsnews.com/video/watch/?id=50134675n
42. November 6, 2012 - November is Diabetes Awareness Month

    For more information, see Diabetes

43. November 5, 2012 - Health Care Reform 101

44. November 2, 2012 - Why We Need Health Care Reform

45. November 1, 2012 - Geographic Variations with Health Services

    Graphic source: http://authoring.commonwealthfund.org/sitecore/shell/ Controls/Rich%20Text%20Editor/~/media/ Images/Publications/Fund%20Report/ 2012/Local%20Scorecard/local%20Ex1%20L.gif

    Does where you live affect your access to health services? You bet it does. According to the March 2012 release of Commonwealth.org's "Rising to the Challenge: Results from a Scorecard on Local Health System Performance, 2012" "The Local Scorecard's evidence of wide variation in health system performance across local areas and within states points to the need for strategic improvement efforts in each community, supported by state and federal policies and resources. ...the Local Scorecard finds wide variation across all four dimensions of performance, based on 43 indicators that were available across the country. National health care system reforms, newly available resources, and expanded state authority can help set the stage for communities to assume greater accountability for improving patient experiences, lowering costs, and achieving better health for all of their residents. Where people live matters: it influences their ability to access care as well as the quality of care they receive. Local areas vary in the provision of health care that is easily accessible, effective, safe, well coordinated, and focused on maximizing population health outcomes." Citation source: http://www.commonwealthfund.org/Publications/Fund-Reports/2012/Mar/Local-Scorecard.aspx

46. October 31, 2012 - Another nasty Halloween

    And, it was only one year ago that I posted this for the 2011 "Once in a lifetime October Nor'easter"....

    

    NYC Flooding Before the Blackout

    NYC Flood Map

    
    Graphic source: http://www.dailymail.co.uk/news/article-2225108/Hurricane-Sandy-2012-pictures-FIFTY-DEAD--NOT-over.html
47. October 30, 2012 - Superstorm Sandy, Nor'ester

    NYC - They don't mind

    
    Graphic source: http://news.yahoo.com/photos/hurricane-sandy-1351517288-slideshow/swans-swim-yard-flooded-storm-surf-kicked-high-photo-232133110.html

    NYC's Subway Flooding

    
    Graphic Source: http://www.yahoo.com

    NYC's Financial District

    
    Graphic Source: http://news.yahoo.com/photos/hurricane-sandy-1351517288-slideshow/sandy-photo--1309981758.html

    NASA's Atmospheric Infrared Sounder (AIRS)infrared image of Hurricane Sandy, with Canadian cold air weather front to the west at 2:17 p.m. EDT Oct. 29.

    
    Graphic source:http://www.nasa.gov/mission_pages/hurricanes/archives/2012/h2012_Sandy.html

    New York City's Gravesend Bay

    
    Graphic source: http://www.nydailynews.com/news/hurricane-sandy-strikes-east-coast-gallery-1.1194577

    New York City's World Trade Center Construction Site

    
    Graphic source: http://www.weather.com/news/weather-hurricanes/hurricane-sandy-pictures-photos2-20121025

    Post-tropical Cyclone Sandy, Landfall, 5 miles SW Atlantic City, NJ

    
    Graphic source: http://www.weather.com/news/weather-hurricanes/hurricane-sandy-pictures-photos2-20121025
    
    Graphic source: http://movieline.com/2012/10/28/hurricane-sandy-grease-meme-frankenstorm/
48. October 29, 2012 - Hurricane Sandy - When Nature Whacked the East Coast....

    10/29/2012 NASA Image

    
    Graphic source: http://goes.gsfc.nasa.gov/

    10/29/2012 Satellite Image

    
    Graphic source: Weather.com

    10/29/2012 6 PM

    
    Graphic source: Weather.com

    10/29/2012 11 AM

    
    Graphic source: Fox News

    Graphic source: http://www.geofffox.com/

    Graphic source: http://www.boston.com/news/weather/weather_wisdom/2012/08/tropical_storm_isaac_getting_s.html What a travesty of horrible weather! 2011's Hurricane Irene was bad enough, and now this???? If you are interested in tracking weather nightmares, see Latest Weather Updates For information, see Hurricanes and Safety

49. October 29, 2012 - WHO's The Atlas of Heart Disease and Stroke

    Graphic source: http://www.who.int/cardiovascular_diseases/resources/atlas/en/

    Graphic source: http://www.worldstrokecampaign.org/2012/Pages/Home.aspx Today is World Stroke Day. Did you know worldwide that 1 in 6 will have a stroke in their lifetime? Stroke is one of the most debilitating diseases around. If a person survives a stroke, they will most likely be left with some disability for the rest of their lives. One of the major risk factors of stroke is high blood pressure. Do you know if you have high blood pressure? Go see your doctor and find out if you are. If you are, it is important to keep it under control, which may require you to take medicine consistently. Good diet practices, like cutting salt, and exercising can all help to reduce the risk for stroke. Click on the graphic to view the World Health Organization & CDC's latest compilation of global heart disease and stroke statistics. A wealth of information!! You can also find this, and other resources at Cerebrovascular Disease (Stroke) and Cardiovascular Disease

50. October 26, 2012 - Drinking Too Many Calories

    Graphic source: http://www.cdc.gov/nchs/data/databriefs/db71.htm According to the NCHS Data Brief (Number 71, August 2011) "Consumption of Sugar Drinks in the United States, 2005-2008" Americans are drinking way too many calories. "On a given day, there is a wide range of sugar-drink consumption. About 50% of the population consumes no sugar drinks; 25% consumes some sugar drinks but less than 200 kcal (more than one 12-oz can of cola); and 5% consumes at least 567 kcal from sugar drinks on any given day (more than four 12-oz cans of cola)."

    Key findings include: Consumption of sugar drinks in the United States has increased over the last 30 years among both children and adults. Sugar drinks have been linked to poor diet quality, weight gain, obesity, and, in adults, type 2 diabetes (4,5). U.S. dietary guidelines issued in 2010 recommend limiting the consumption of foods and beverages with added sugars. ...the American Heart Association has recommended a consumption goal of no more than 450 kilocalories (kcal) of sugar-sweetened beverages or fewer than three 12-oz cans of carbonated colas per week. Males consume more sugar drinks than females. Teenagers and young adults consume more sugar drinks than other age groups. Approximately one-half of the U.S. population consumes sugar drinks on any given day. Non-Hispanic black children and adolescents consume more sugar drinks in relation to their overall diet than their Mexican-American counterparts. Non-Hispanic black and Mexican-American adults consume more than non-Hispanic white adults. Low-income persons consume more sugar drinks in relation to their overall diet than those with higher income. Most of the sugar drinks consumed away from home are obtained from stores and not restaurants or schools." Citation source: http://www.cdc.gov/nchs/data/databriefs/db71.htm For more information, see Nutrition Resources and Nutrition Statistics

51. October 24, 2012 - Diabetes is a global public health issue

    Graphic source: http://www.medscape.org/viewarticle/771100_transcript

    According to Medscape's "Review of Clinical Trials on the Relationship Between CVD and Glycemic Control in Diabetes," Dr. Cho notes: "As all of us know, type 2 diabetes is increasing. Whether you're in Africa, Asia, or North America, the prevalence of diabetes is increasing. In fact, the CDC reports that if you're an African American girl born in United States you have almost a 50% chance of developing diabetes in your lifetime. So type 2 diabetes is truly an epidemic in this country." Citation source: http://www.medscape.org/viewarticle/771100_transcript

52. October 23, 2012 - Fructose and Diabetes

    Graphic source: http://www.thesuperherobody.com/weight-loss-resources/fructose-is-not-glucose/ Here is another reason why you should avoid high fructose corn syrup (corn sugar). December 7th, Boston University researchers/Endocrine Society reported: "Although it negates the dumping of glucose directly into the bloodstream, fructose may not be an ideal sweetener for diabetics, Its links with hypertension, adiposity, and increased uric acid levels could potentially outweigh its immediate blood sugar benefits, especially among patients with diabetes, who already have or are at risk for such comorbidities, Fructose, which is the main sugar found in fruits, is a monosaccharide, like glucose. But unlike glucose, which requires insulin to move it into the body's muscle tissue where it's processed into energy, fructose is metabolized by the liver. There, it's converted into glycogen, a starch, and lipids, ...fructose intake is linked with higher levels of serum triglycerides, potentially contributing to adiposity and weight gain, It's also been tied to increased levels of uric acid, which can lead to gout and kidney stones,.... Chronically high levels of uric acid have also been linked with atherosclerosis - hardening of the arteries is already a known complication of diabetes itself. And fructose overload also may be associated high blood pressure - another common comorbidity among diabetics The same problems could be associated with high-fructose corn syrup, which is a polysaccharide that's chemically similar to plain table sugar, or sucrose. The molecule is half fructose and half glucose, but the gastrointestinal tract breaks it down into its respective monosaccharides, Thus, diabetics get the initial dumping of blood glucose, plus the liver hit of fructose, which generates lipids,...adding that there's no discernible metabolic difference between sucrose and high-fructose corn syrup. Moreover, the American Diabetes Association doesn't recommend fructose as a substitute sweetener for glucose,.... It does, however, recommend fruit intake as part of a healthy diet -- though the amount of fructose in fruits is hardly enough to contribute too significantly to obesity, Citation source: http://www.medpagetoday.com/Endocrinology/Diabetes/30054 For more information, see Diabetes

53. October 22, 2012 - High Fructose Corn Syrup; Adolescents are consuming 40% of their calories or more in sugar alone.

    Graphic source: http://www.medscape.org/viewarticle/771281_transcript According to Medscape's "Sickeningly Sweet: Sugar Consumption and Public Health" Dr. Lustig explains: "In America, we are talking about this substance called high-fructose corn syrup (HFCS). Currently our annual consumption here in America is 63 lb per person. Only the United States, Canada, and Japan routinely use HFCS, with very limited exposure in certain parts of Europe. HFCS is really just a mixture of the substrate glucose,...a 6-membered ring, and the substrate fructose, which is a 5-membered ring. It is the fructose that is causing the problem. It is the fructose that is sweet and it is the fructose that we seek. You will notice that sucrose -- table sugar, cane sugar, the stuff you put in your coffee -- is really just one glucose and one fructose joined together by an o-glycosidic linkage. The enzyme sucrase in your intestine cleaves this almost instantly. In essence these are biochemically equivalent, and the studies that compare HFCS against sucrose head-to-head show that they are biochemically equivalent. The problem is not that one is worse than the other -- the problem is they both have a problem. They are both bad owing to the amount that we consume.

    Our ancestors consumed about 15 g of fructose per day as it came out of the ground, from fruits and vegetables with the occasional dose of honey; double that number for sugar, so 30 g, or an ounce of sugar per day. Prior to World War II, with the nation's candy and soft drink industries expanding, we got up to about 20 g of fructose per day. By 1977, just before the glut of HFCS hit our shores, we were up to 37 g a day, which was 8% of our total caloric intake. By 1994, we were up to 55 g a day or 10% of our total caloric intake. Currently, adolescents consume about 75 g a day on average, and 25% of adolescents consume 100 g of fructose per day. Double those grams for sugar, so 200 g, and then multiply that by 4.1 calories per gram to get 840 calories in sugar alone. Given a normal caloric allotment of 2000 calories per day, adolescents are consuming 40% of their calories or more in sugar alone. Here is the problem. Virtually every naturally occurring foodstuff on the planet has either fat or carbohydrate as its energy source. For instance, coconut, avocado, and olives are all fruits, but they are fatty fruits. They have relatively little carbohydrate. Only sugar -- that is sucrose, or glucose plus fructose -- constitutes both fat and carbohydrate because the glucose is metabolized in the liver as carbohydrate, whereas fructose, because of its unique metabolism in the liver, actually gets turned to fat through the process called de novo lipogenesis. The biggest problem is that of the 600,000 food items sold in the United States today, 80% of them are laced with added sugar." Citation source: http://www.medscape.org/viewarticle/771281_transcript

55. October 19, 2012 - Countyhealthcalculator.org - Quick diabetes and sociodemographic data

    Here is a super cool widget from "Virginia Commonwealth University's Center on Human Needs with support from the Robert Wood Johnson Foundation." A very simple way to start your public health diabetes assessment activities. To get some quick mortality and diabetes stats, type in a state or county in the space provided. To get more detailed stats, click on the button at the bottom, "+ County Health Calculator" which will take you to another page with a US map. Mouse over the map and you will get Education Level, Income Level, Deaths Per Year, Persons with Diabetes and $ spent on Diabetes Care for any state. To get these stats for a county, type in the county at the top. You can even get comparison charts for two counties in the same state. To get some quick stats, just plug in your location and see what comes up. You can find this widget on the Diabetes Resources and Public Health Practice pages.

56. October 18, 2012 - U.S. Diabetes Prevalence, 2009 County-level Data

    Graphic source: http://apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx?mode=OBS

    According to CDC's Division of Diabetes Translation 4/3/2012 release of 2009 county-level estimates of diagnosed diabetes in the United States, "County-level estimates diabetes and selected risk factors can be used to maximize use of existing resources for diabetes management and prevention efforts, including health policy." Source: CDC 4/3/2012 E-mail: CDC releases 2009 county-level estimates of diagnosed diabetes, obesity, and leisure-time physical inactivity in the United States Looking at this map, it is evident that the concentration of diagnosed diabetes is found in the southeastern states of the U.S. Perhaps, community interventions for the prevention of diabetes should be concentrated in these states as well.

57. October 17, 2012 - U.S. Diabetes Statistics, by Race & Ethnicity

    Here is a bar showing the racial and ethnic make-up of those with diabetes. The largest group with the highest percentage is Alaska Natives and American Indians, followed by Blacks and then Hispanics. For more information, see Minority Health and Diabetes

58. October 16, 2012 - How Obesity Leads to Type 2 Diabetes

    Graphic source: http://www.medscape.org/viewarticle/754194_transcript

    Here is a great graphic from Medscape's "The Prevalence of Obesity & Diabetes in Different Populations". Typical of chronic diseases, it is a complex mix of risk factors. While a number of factors can be seen to contribute to the development of type 2 diabetes, it is obesity that creates changes in the body's metabolism that contributes to the the development diabetes. For more information, see Diabetes

59. October 15, 2012 - U.S. Body Weight and Diabetes, by Gender

    Graphic source: http://www.medscape.org/viewarticle/754194_transcript

    In recent weeks I have posted a variety of obesity statistics. For sure, it is the public health scourge of the 21st century that is the harbinger of type 2 diabetes. Here are a couple of line charts to help you think about this issue. The farther left graphic is a line chart showing the concurrent rising prevalences of obesity and type 2 diabetes in the U.S. between 1990 and 2000. The second line graph shows how putting on weight increases the relative risk of developing type 2 diabetes. Note the relative risk only rises when one puts on weight, not when one loses weight. For more information, see Diabetes

60. October 12, 2012 - Mapping Obesity and Associated Health Issues

    Graphic source: http://www.medscape.org/viewarticle/771281_transcript

    Here is a series of maps that pretty much says it all. Notice how obesity and inactivity are clustered in the southeastern U.S. states where there are high prevalences for type 2 diabetes and cardiovascular. No coincidence. Actually, I presented a similar look at this August 19, 2010!! This is just more data to show that unhealthy eating and lack of exercise are behind the growing diabetes epidemic and why we can't seem to conquer heart disease.

61. October 11, 2012 - Assessing Obesity-Related Mortality with the Edmonton Obesity Staging System (EOSS)

    Graphic source: http://www.drsharma.ca/wp-content/uploads/edmonton-obesity-staging-system-staging-tool.pdf The Edmonton Obesity Staging System (or, Edmonton Obesity Scale or Edmonton Score), first introduced in 2009 by Arya M. Sharma, MD, may grow in importance as the obesity epidemic continues because it can better gauge a person's risk for obesity-related mortality. On August 16th, researchers reported the use of the Edmonton Obesity Scale to predict mortality and bariatric surgery urgency, by applying it to NHANES participants with a BMI of 25 or greater: "Traditional measures of obesity focus on excess adiposity and ignore obesity-related comorbid conditions and the effect on functional status. BMI has proven useful for classifying adiposity at the population level, but has limited applicability for assessing individual risk, the investigators wrote. Moreover, BMI cannot distinguish between fat and lean mass, they noted in their introduction. As a result, the amount of adiposity can vary substantially for a given BMI. Neither BMI nor waist circumference captures obesity-related morbidity or the effects of obesity on functional status and quality of life, In contrast to conventional obesity indices, the Edmonton staging system categorizes mortality risk according to adiposity and underlying comorbidities (such as diabetes, hypertension, and dyslipidemia) and functional status. The five-point scoring system ranges from no apparent risk factors (0) to severe and potentially end-stage disabilities, severe psychopathology, and severe impairment of function and well-being. NHANES participants were assigned a score of 3 if they had a self-reported history of angina, heart disease, heart failure, or cerebrovascular disease. In the absence of those comorbid conditions, each participant's Edmonton score was determined on the basis of nine obesity-related comorbidity variables and one variable related to physical function. An Edmonton score of 1 reflects subclinical obesity-related risk factors, mild psychopathology, and mild functional limitation. A score of 2 indicates the presence of established obesity-related chronic disease and moderate limitation of activities. Each risk factor was assessed individually, and the total Edmonton score was determined from the individual scores. Within the NHANES III dataset, an Edmonton score of 2 was associated with a mortality hazard ratio of 1.57 as compared with respondents who had a score of 0 or 1.

    Graphic source: http://www.drsharma.ca/wp-content/uploads/sharma-edmonton-obesity-staging-system.jpg A score of 3 increased the mortality hazard to 2.69 as compared with a score of 0 or 1. The scores were similar after adjustment for metabolic syndrome, BMI, waist circumference, and triglyceride levels. Investigators also examined the Edmonton staging system's ability to predict mortality risk in the 13.8% of patients who met criteria for bariatric surgery (BMI >=40 or BMI >=35 plus at least one underlying comorbid condition). A score of 2 was associated with a mortality hazard of 4 as compared with a score of 0 or 1. A score of 3 boosted the hazard 12- to 13-fold. "We propose that this system be considered adjunctive to current anthropometric classification systems in assessing obesity-related risk," Edmonton score in persons with a BMI of 25 or greater independently predicted increased mortality. Higher scores on an obesity-based health index correlated with higher mortality in an analysis of a large population study. A score of 2 or 3 on the Edmonton obesity staging system was associated with a 57% to 269% greater mortality risk as compared with a score of 0 to 1 in people followed for as long as 18 years. In a separate analysis of individuals eligible for bariatric surgery, a higher score on the obesity index predicted an increased mortality risk, suggesting the index might have a role in prioritizing or assessing the need for bariatric surgery, "This ability [to predict mortality risk] was independent of body mass index (BMI) and the presence of metabolic syndrome or hypertriglyceridemic waist," "Even within strata of BMI categories, there was clear separation of survival curves according to Edmonton obesity staging system scores." "The major incremental contribution of this staging system to anthropometric indices and cardiovascular risk questions is the direct measurement of the presence and severity of underlying obesity-related comorbidities, which enables a more comprehensive and individualized assessment of risk." Citation source: Padwal RS, et al "Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity" CMAJ 2011; DOI: 10.1503/cmaj.110387; Reported http://www.medpagetoday.com/PrimaryCare/Obesity/28062 For more information, see Obesity Information

62. October 10, 2012 - U.S. Obesity and Comorbidities

    Graphic source: http://meps.ahrq.gov/mepsweb/data_files/publications/st364/stat364.shtml

    Here is another chart from AHRQ's March 2012's STATISTICAL BRIEF #364: Obesity in America: Estimates for the U.S. Civilian Noninstitutionalized Population Age 20 and Older, 2009 looking at comorbidities, by weight categories. Here you can see that carrying excess weight increases the risk for these chronic diseases/conditions: heart disease, diabetes, high cholesterol and joint pain. Joint pain and heart disease show the highest percentage for those who are overweight and obese. For more information, see Obesity

63. October 9, 2012 - Global Obesity Projections

    Graphic source: http://www.dietandcancerreport.org/cancer_resource_center/er_graphics_display.php?ID=12

    According to the WCRF/AICR Second Expert Report, global obesity projections are scary. As compared to other countries that were included in the analysis, 60% of American women will be considered obese by 2015, and that's not too far away. This is followed closely by American men, who seem to be way ahead of all the men in other countries in being classified as obese by 2015. For more information, see Obesity Information

64. October 8, 2012 - Adult Obesity, BRFSS 2011 Data

    Graphic source: http://www.cdc.gov/obesity/data/adult.html Graphic source: http://www.rwjf.org/files/images/pr/figures/top10_bottom10_maps_v2-01rev.jpg

    Here is the most recent map of US adult obesity based on Behaviorial Risk Factor Surveillance System data. Perhaps the saddest thing about this map is the inclusion of the 35% and greater category even when no state at this point qualifies. Sadly, no one optimistic that the obesity epidemic will be conquered any time soon. If history repeats itself, my guess is Mississippi will be the first state to reach the 35% and greater category, based on my monitoring the state obesity prevalence rates in recent years. Furthermore, this recent map released by the Robert Wood Johnson Foundation makes it very clear that Mississippi is on top for the race to be #1. For more information, see CDC's Adult Obesity Facts, and Obesity Resources on the Internet

65. October 5, 2012 - U.S. Obesity Statistics, 2009-2010

    Graphic source: http://www.cdc.gov/nchs/data/databriefs/db82.htm

    NCHS Data Brief, Number 82, January 2012's "Prevalence of Obesity in the United States, 2009-2010" shows "In 2009-2010, 35.7% of U.S. adults were obese. More than 35% of U.S. men and women were obese in 2009-2010. There was no significant difference in prevalence between men and women at any age. Overall, adults aged 60 and over were more likely to be obese than younger adults. Among men there was no significant difference in obesity prevalence by age. Among women, however, 42.3% of those aged 60 and over were obese compared with 31.9% of women aged 20-39." Citation source: http://www.cdc.gov/nchs/data/databriefs/db82.htm For more information, see Obesity

66. October 4, 2012 - U.S. Obesity Statistics, 2009 (County-level Data)

    Graphic source: http://apps.nccd.cdc.gov/DDT_STRS2/NationalDiabetesPrevalenceEstimates.aspx?mode=OBS

    Here are county-level data released 4/3/2012 by the CDC's Division of Diabetes Translation. "The county-level estimates help identify counties with high estimated numbers and percentages of people diagnosed with diabetes or at high-risk of diabetes." Source: CDC 4/3/2012 E-mail: CDC releases 2009 county-level estimates of diagnosed diabetes, obesity, and leisure-time physical inactivity in the United States

67. October 3, 2012 - AHRQ's Obesity in America, 2009

    Graphic source: http://meps.ahrq.gov/mepsweb/data_files/publications/st364/stat364.shtml

    Highlights of AHRQ's March 2012's STATISTICAL BRIEF #364: Obesity in America: Estimates for the U.S. Civilian Noninstitutionalized Population Age 20 and Older, 2009 include: "Over one-third of adults 20 and older (35.8 percent) were overweight, 25.1 percent were obese, and another 4.5 percent were extremely obese in 20091 . Men were less likely than women to have a healthy weight (27.4 percent versus 38.6 percent) and more likely to be overweight (42.6 percent versus 29.4 percent, respectively). Non-Hispanic blacks were more likely than other race/ethnic groups to be obese (31.0 percent) or extremely obese (8.0 percent), compared to 24.8 percent and 4.1 percent for non-Hispanic whites, 27.6 percent and 4.3 percent for Hispanics, and 13.4 percent and 2.6 percent for all other races combined (most of which were Asian). Persons (ages 20-64) with public health insurance were more likely to be extremely obese (10.4 percent) than were persons with either private insurance (4.0 percent) or those uninsured (4.7 percent). Adults classified as being obese or extremely obese were more likely to have heart conditions, high cholesterol, diabetes, and joint pain reported. Obese and extremely obese adults were less likely to have regular exercise reported (50.0 percent and 30.9 percent, respectively) compared to healthy weight and overweight adults (66.8 percent and 61.7 percent, respectively)." Citation source: http://meps.ahrq.gov/mepsweb/data_files/publications/st364/stat364.shtml In the above chart, what I found most interesting was those ages 45-64 have more of an issue with weight than those in the 65+ age group. Granted there was a higher percentage of overweight, there was also a higher percentage for normal weight and lower percentage for those obese. For more information, see Obesity

68. October 2, 2012 - International Adult Obesity Statistics (2010)

    Graphic source: http://www.hivehealthmedia.com/world-obesity-stats-2010/

    According to Hive Health Media, the news is not good - obesity is everywhere, "Rates are highest in the United States and Mexico and lowest in Japan and Korea, but have been growing virtually everywhere." But more importantly, here is how obesity is hurting the U.S. on the international stage. According to a UK site, "America is frequently ridiculed for its inhabitant's unwillingness to walk rather than drive. And although the criticism is short sighted, it is at least common with the theme that America is not perceived as a healthy or wise nation by many. Many people consider it a shocking symptom of Western indulgence and neglect that the richest nation has the highest obesity levels and still has problems with illiteracy, homelessness, etc." (Citation source: http://www.vexen.co.uk/USA/hateamerica.html#Obesity) Ouch!

69. October 1, 2012 - Antarctica's Major Calving Event of the Pine Island Glacier

    Creation of new rift in the Pine Island Glacier (Caught on camera 10/26/2011) Graphic source: http://earthobservatory.nasa.gov/IOTD/view.php?id=77266&src=eoa-iotd

70. September 28, 2012 - International Childhood Obesity Statistics (2010)

    Graphic source: http://www.vexen.co.uk/countries/best.html

    Graphic source: http://www.diet-blog.com/07/a_picture_of_obesity_around_the_world.php

71. September 27, 2012 - NCHS Childhood Obesity Statistics

    Graphic source: http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/Figures1.png

    Trends in obesity among children and adolescents aged 2-19 years, by sex: United States, 1971-1974 through 2009-2010 Graphic source: http://www.cdc.gov/nchs/data/hestat/obesity_child_09_10/obesity_child_09_10.html

    Here are National Center for Health Statistics Childhood Obesity Trends, from different time periods. Regardless of which time period, childhood obesity rates are on the rise. Something definitely needs to be done or this current generation of children will suffer earlier onset of chronic diseases associated with obesity, such as Type 2 diabetes which puts those with this disease at increased risk for heart disease.

72. September 26, 2012 - U.S. Childhood Obesity Trends (1963 - 2008)

    Graphic source: http://pharmamkting.blogspot.com/2012/04/type-2-diabetes-in-obese-children.html

73. September 25, 2012 - What is the current state of obesity in America?

    Graphic source: http://www.infographicsinsights.com/2011/03/obesity-in-america-facts-lies-and.html

74. September 24, 2012 - Ngram Viewer: Childhood Obesity

    Graphic source: http://books.google.com/ngrams/graph?content=Childhood+Obesity&year_start=1950&year_end=2012&corpus=0&smoothing=3

    Is childhood obesity just a passing fad? Probably not. But, it is a growing trend. Here is a graph from the Google's Ngram Viewer that looks at the frequency of "childhood obesity" in the books accessed by Google. I decided to look at the time period since 1950. For sure this indicates that childhood obesity is a growing problem since the 1970s. For the next couple of weeks, because it is National Childhood Obesity Awareness Month, I am going to concentrate on exactly what we really know about obesity. I will present whatever obesity statistics I can find online to quantify what we have to deal with. Once we know the numbers we will have a better idea of the magnitude of the problem. For more information, see Childhood Obesity

75. September 21, 2012 - September is National Childhood Obesity Month

    I am glad to see that there is a whole month to raise awareness about childhood obesity. It is a growing problem with no end in sight unless we pool our resources and energies to address this public health issue. If we don't, then we will just have to look forward to the growing numbers of adults suffering from chronic diseases, at earlier ages, that are associated with adult obesity: diabetes, heart disease, cancer, arthritis, etc. Click on the graphic for more information. I have devoted a whole Webpage to obesity, check it out

76. September 20, 2012 - Impact of Education on Health

    According to "Health, United States, 2011" (35th annual report with health data through 2010): "People with higher levels of education and higher income have lower rates of many chronic diseases compared to those with less education and lower income levels, In 2007-2010, higher levels of education among the head of household resulted in lower rates of obesity among boys and girls 2-19 years of age. In households where the head of household had less than a high school education, 24 percent of boys and 22 percent of girls were obese. In households where the head had a bachelor's degree or higher, obesity prevalence was 11 percent for males aged 2-19 years and 7 percent for females. In 2007-2010, women 25 years of age and over with less than a bachelor's degree were more likely to be obese (39 percent-43 percent) than those with a bachelor's degree or higher (25 percent). Obesity prevalence among adult males did not vary consistently with level of education. In 2010, 31 percent of adults 25-64 years of age with a high school diploma or less education were current smokers, compared with 24 percent of adults with some college and 9 percent of adults with a bachelor's degree or higher. Overall, in the same year, 19 percent of U.S. adults age 18 and over were current cigarette smokers, a decline from 21 percent in 2009. Between 1996-2006, the gap in life expectancy at age 25 between those with less than a high school education and those with a bachelor's degree or higher increased by 1.9 years for men and 2.8 years for women. On average in 2006, 25-year-old men without a high school diploma had a life expectancy 9.3 years less than those with a bachelor's degree or higher. Women without a high school diploma had a life expectancy 8.6 years less than those with a bachelor's degree or higher. Citation source: CDC, May 16, 2011 listserv Click on graphic to access the report. For additional data, see Public Health Data

77. September 19, 2012 - Net Worth by Education Level

    Graphic source: http://www.marketingcharts.com/topics/demographics/education-age-mean-steadier-household-net-worth-22412/census-net-worth-education-level-june2012png/

    In a precarious economy, education still counts when it comes to net worth. According to Marketingcharts.com: "US median household net worth (assets minus debts) declined 35% between 2005 and 2010 according to the US Census Bureau (http://www.census.gov/hhes/www/wealth/), which cited both falling stock market prices and a flat housing market. However, advanced education and age continue to be the key determinants in whether a household falls above or below the median. Indeed, despite all educational groups experiencing declines in net worth, between 2005 and 2010, the gap between education levels widened. Per the 2010 figures, median household net worth where the householder holds no high school degree is the lowest, at just $7,270, versus the median of $66,740. Those with a high school diploma are under the median as well, at $42,223. Only at the bachelor's level does the net worth exceed the median, at $142,518. Those with advanced degrees nearly quadruple the median net worth, at $245,763. The correlation between education and net worth did not change for this reporting period, but the gap widened significantly. Those with a high school diploma saw their median net worth fall 39%, versus those with a bachelor's degree, who experienced a 32% decline. Indeed, while in 2000, those with a bachelor's degree had a median net worth nearly 200% those with a high school diploma only, that percentage rose to almost 350% by 2010. Comparing households with a graduate or professional degree versus a high school diploma, the ratio has jumped from 350% to 580%." Citation source: http://www.marketingcharts.com/topics/demographics/education-age-mean-steadier-household-net-worth-22412/census-net-worth-education-level-june2012png/ So, if you are smart, stay in school and learn as much as you can!

78. September 18, 2012 - Stay in school

    Graphic source: http://swampland.time.com/2010/03/09/stay-in-school/

    Here is another way of looking at the importance of a college education - the likelihood of being unemployed. Those with less education are more likely to be unemployed. That is not to say that having a college education doesn't make you totally immune to unemployment, but they make up a lower percentage of those who are out of a job. According the New York Times 7/20/2012 article,"Is It Worth It?" "IN these times of employment uncertainties, a third of adults in the United States have gone back to school in the last five years for additional training, according to a recent poll by The New York Times. And less than a third of them have found a new job or secured a promotion. Still, most consider the experience a good investment of time and money. About 80 percent who have returned for more training are already employed; 10 percent are looking for work. Most of the adults continuing their education are under age 45 (32 percent are 30 to 44 years old; 44 percent under 30). Two-thirds are without a four-year degree. Citation source: http://www.nytimes.com/2012/07/20/education/edlife/returning-to-school-for-additional-training.html?_r=1&emc=tnt&tntemail1=y

79. September 17, 2012 - Education Requirements for Jobs

    Graphic source: http://www.highschooleducationcoach.com/education-news/governing-to-win/ Being an educator, of course, I think education is very important for quality of life. One needs a good education to provide a foundation with which to deal with Life, but most of all, to be able to make a living and support ourselves, and to also do the things we want to do that make life worth living.

    Up until the early 1900s, Americans can pretty much get by without a high school education. That was because the country was mostly agrarian, and in order to grow crops what was really important was having a green thumb and cooperative weather conditions. One can really get by with a sixth grade education, if one was lucky enough to get it. But with a couple of world wars and the change in economic conditions, more education meant more opportunities off the farms. Post-WW II saw the baby-boom generation take hold, and by the 1960s, a college education meant opportunities to become part of the middle class. (Okay, this is just a brief overview, but you should have learned about this high school U.S. history) Today a high school diploma is an absolute necessity and it is quickly becoming replaced with a college education, beginning with an associate degree. To really assess the value of an education one only need to ask employers what they are looking for in education attainment. Here is a pie chart of 2010 data which shows that only 10% of jobs are available to those with no high school diploma, and only 28% are available to those with at least a high school diploma. That means that almost 2/3s of the jobs out there require at least some college education. Given the sad shape of the current economy, having a high school diploma is the barest minimum to survive, but to compete for whatever jobs are out there, you really need a minimum of a 2-year college degree, and getting a 4-year college degree would be optimal. And, that's just to compete for a decent paying job. That is the reality today.

80. September 14, 2012 - Greetings from Times Square, New York City!
    
    Photo: Betty
81. September 13, 2012 - U.S. High School Graduates, by Race and Ethnicity

    Graphic source: http://winginstitute.org/Graphs/Student/High-School-Graduation-Rates/

    Here is a line chart from the Wing Institute that looked at 2008 Census data. It concluded: "1940 to 1990 shows a dramatic increase in percent of U.S. residents 25 years or more year olds with four or more years of high school. In 1940 about 26% of Whites and 7% of Blacks had 4 or more years of high school. By 1990 about 79% of Whites and 66% of Blacks had four or more years of high school. No data is available for Hispanics until 1974 and for Asians until 2003. By 2006 about 87% of Asians, 86% of Whites, 81% of Blacks, and 59% of Hispanics had four or more years of high school. From about 1974 to 2002, Blacks with four or more years of high school has improved dramatically from nearly the same as Hispanics (40%) to nearly the same as Whites (83%). Hispanic graduation rates have not improved nearly as much as that of Whites and Blacks. In the late '90s and early '00s the improvement in graduation rates of all groups slowed." Data source: Source: 2008 United States Census http://www.census.gov/population/socdemo/education/cps2008/tabA-2.xls Citation source: http://winginstitute.org/Graphs/Student/High-School-Graduation-Rates/

82. September 12, 2012 - Global Warming Trends

    Map source: http://earthobservatory.nasa.gov/IOTD/view.php?id=78869&src=eoa-iotd According to the National Climatic Data Center (NCDC) of the National Oceanic and Atmospheric Administration (NOAA): "July 2012 was the hottest month on record for the contiguous (lower 48) United States. It turns out that the month was pretty warm globally as well, lining up as the fourth warmest July since modern record-keeping began in 1880. ...as analyzed by the NASA Goddard Institute for Space Studies (GISS), the map shows how much warmer or cooler each area was in July 2012 compared with the average for the month from 1951-1980.

    Note that the map does not depict absolute temperatures; it shows changes from the long-term average. The darkest reds are as much as 4 Celsius (7 Fahrenheit) above the norm for the month; white is normal; the darkest blues are 4 C below normal. In addition to extreme warming over the United States, the Antarctic Peninsula and much of eastern Europe and North Africa were especially hot in July 2012. According to NCDC: The average combined global land and ocean surface temperature for July 2012 was 0.62 C (1.12 F) above the 20th century average of 15.8 C (60.4 F)...The Northern Hemisphere land surface temperature for July 2012 was the all-time warmest July on record, at 1.19 C (2.14 F) above average...the fourth month in a row that the Northern Hemisphere has set a new monthly land temperature record. ....extreme summer heat waves have become much more common in the temperature record as a result of global warming. During the 1951 to 1980 base period used in the analysis, 33 percent of Earth's land surface experienced statistically hot summers. In the past decade, the number of hot summers has risen to 75 percent of land area. Moreover, extreme heat events in statistical terms, three standard deviations from the norm that used to affect 1 percent of the land area in the past have been affecting as much as 10 percent of land area in the years since 2006. Climate dice, describing the chance of unusually warm or cool seasons, have become more and more loaded in the past 30 years, coincident with rapid global warming, ...extreme anomalies such as those in Texas and Oklahoma in 2011 and Moscow in 2010 were a consequence of global warming because their likelihood in the absence of global warming was exceedingly small. Citation source: http://earthobservatory.nasa.gov/IOTD/view.php?id=78869&src=eoa-iotd

83. September 11, 2012 - Eleventh Anniversary of 9/11/2001

    Let us never forget all the innocent lives that were lost on that fateful day, and once again thank all the brave civil servants who died in the line duty. Many thanks to Suzanvitti.org for these wonderful graphics.

    See 9/11 Eleventh Anniversary

84. September 10, 2012 - Global Warming Trends

    1970-1979

    2000-2009

    
    Graphic source: http://www.good.is/post/real-heat-maps-watch-as-the-world-burns/

    For more information about what is currently known about global warming, see Global Change & Warming

85. September 7, 2012 - Greetings from Terracotta Warriors Exhibit at Discovery Theater, New York City!
    
    Photo: Betty
86. September 6, 2012 - November, 2011, 11th Hottest November on Record

    Graphic source: Enlarged graphic from source

    According to the National Oceanic and Atmospheric Administration, the average global land and ocean temperatures for November 2011 was the 11th warmest November on record, since 1880! This graphic summarizes all the various anomalies recorded across the world for that month. For sure, something is going on with the climate. See http://www.stonehearthnewsletters.com/global-temperatures-12th-warmest-on-record-for-november/climate/ for additional information.

87. September 5, 2012 - The Hottest Places on Earth

    Graphic source: http://earthobservatory.nasa.gov/Features/HottestSpot/?src=eoa-features

    So, it was a really hot summer that resulted in a drought that is being compared to the early 1900s dustbowl. But even as hot as it was, how does it compare to what's going on with the rest of the world? According to NASA's April 5th report,"Where Is the Hottest Place on Earth? It Lies Somewhere Between Folklore and Science, the Desert and the City," here is a map of the hottest places on Earth. At present, it is an inexact science, but they range from 134 to 175 degrees! The highest temperature recorded was at the Flaming Mountain, a ridge of dark red sandstone on the edge of the Taklimakan Desert and the Tian Shan range in China. (Citation source: http://earthobservatory.nasa.gov/Features/HottestSpot/?src=eoa-features)

88. September 4, 2012 - U.S. Drought Map, Summer of 2012

    Graphic source: NASA Earth Observatory image by Jesse Allen, Earth Observatory,using data provided by Inbal Reshef, Global Agricultural Monitoring Project. Caption by Adam Voiland. Now that summer is over, we should look back at what this summer really means, within the larger scheme of things. Was it hot or what? "On July 11, the United States Department of Agriculture announced that more than 1,000 counties in 26 states qualified as natural disaster areas�the largest total area ever declared a disaster zone by the agency." Citation source: http://www.satnews.com/cgi-bin/story.cgi?number=817249146

89. August 31, 2012 - Greetings from Terracotta Warriors Exhibit at Discovery Theater, New York City!
    
    Photo: Betty
90. August 30, 2012 - Stopping HIV

    Graphic source:http://www.cdc.gov/VitalSigns/HIVTesting/

    According to the CDC, "Too many people don't know they have HIV (human immunodeficiency virus). About 1.2 million people are living with HIV in the US but about 240,000 don't know they are infected. Each year, about 50,000 people get infected with HIV in the US. Getting an HIV test is the first step to finding out if you have HIV and getting medical care. Without medical care, HIV leads to AIDS (acquired immunodeficiency syndrome) and early death." Once a person becomes infected with HIV, it is for life. So the best strategy for stopping HIV is to not get infected in the first place. This means practicing safe sex, if you are sexually active, avoiding risky sexual behaviors, avoiding contaminated needles, etc. However, if a person is infected, treatment is available. It is therefore essential that people get tested, and if positive, treatment can be started right away. Find an HIV testing site near you! For information regarding treatment, see federally approved HIV/AIDS medical practice guidelines are available at Clinical Guidelines Portal Additional information can be found at: AIDS/HIV

    Find HIV/AIDS Prevention & Service Providers GO Enter your location, such as: "Washington, DC", or "20002". For more information on this widget, please visit AIDS.gov. Please contact contact@aids.gov with any comments or concerns.

91. August 29, 2012 - CDC's NCHHSTP Atlas

    "The NCHHSTP Atlas was created to provide an interactive platform for accessing HIV, viral hepatitis, sexually transmitted disease (STD), and tuberculosis (TB) data." Citation source: http://www.cdc.gov/nchhstp/atlas/SocialMedia.htm Also, see AIDS/HIV, AIDS/HIV statistics, and Sexual Activity Statistics

92. August 28, 2012 - Healthy People 2020 and AIDS

    Goal: Prevent human immunodeficiency virus (HIV) infection and its related illness and death. Overview: The HIV epidemic in the United States continues to be a major public health crisis. An estimated 1.1 million Americans are living with HIV, and 1 out of 5 people with HIV do not know they have it.1 HIV continues to spread, leading to about 56,000 new HIV infections each year. In 2010, the White House released a National HIV/AIDS Strategy. The strategy includes 3 primary goals: Reducing the number of people who become infected with HIV. Increasing access to care and improving health outcomes for people living with HIV. Reducing HIV-related health disparities. Why Is HIV Important? HIV is a preventable disease. Effective HIV prevention interventions have been proven to reduce HIV transmission. People who get tested for HIV and learn that they are infected can make significant behavior changes to improve their health and reduce the risk of transmitting HIV to their sex or drug-using partners. More than 50 percent of new HIV infections3 occur as a result of the 21 percent of people who have HIV but do not know it. Citation source: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=22 Click on title to access the Healthy People 2020 page on HIV.

93. August 27, 2012 - AIDS 2012 International Conference

    During July 22-27, 2012, AIDS 2012, the first International AIDS Conference was held in the United States in more than 20 years. This conference raised awareness that this infectious disease continues to affect millions. Click on graphic to learn more about what was covered at this conference.

94. August 25, 2012 - www.bettycjung.net is now 13 Years Old!
    

    It is hard to believe that it has been 13 years since I published the first webpages that turned into this Web site. Many thanks to the thousands of visitors who contributed millions of hits during the past 13 years, and for all the nice comments along the way. I will continue to strive to make this Web site a worthwhile place to spend your time and find credible public health and health information.

95. August 24, 2012 - Greetings from Times Square, New York City!
    
    Photo: Betty
96. August 23, 2012 - National HIV/AIDS Strategy (NHAS)Progress Report

    Here is the recently released report about the progress that the U.S. is making in addressing AIDS. Just click on the graphic to access the report.

97. August 22, 2012 - National HIV/AIDS Strategy (NHAS)

    For the next few days I will focus on HIV/AIDS and provide you with an update about what's going on with this global epidemic. The National 2011-2012 HIV/AIDS Strategy seeks to refocus national efforts to address AIDS. Watch a brief intro about the Strategy's mission. To learn more, see AIDS.gov Also, see National HIV/AIDS Stragety Update of 2011-2012 Federal Efforts to Implement the National HIV/AIDS Strategy

98. August 20, 2012 - HIV Interventions: Targeting Those At Greatest Risk

    Graphic source: http://www.medscape.org/viewarticle/768042_transcript

    The epidemiological picture of HIV infection show those at greatest risk are young Black men having sex with men. Because transmission is behavioral, interventions should also have a behavioral focus. Here are examples of HIV interventions developed especially for this population. According to Medscape's "HIV Prevention: Successful Approaches for Young Men Who Have Sex With Men": "Very few in the CDC's compendium of effective behavioral interventions have been specifically developed by, for, and directed toward black MSM. "Many Men, Many Voices (3MV)" is one of the most popular interventions out there. It is a group-level intervention that has been tested and has had some success but it was really an intervention that was developed for older black MSMs. "Young Men, Young Voices (YMYV)" has very similar structure to 3MV. It talks about ways to empower the community to reduce their levels of unprotected receptive anal intercourse, increase condom use, and increase self-efficacy. YMYV also involves teaching these men about the risk for HIV and other STIs. "d-up: Defend Yourself!" -- is geared to black MSM and promotes condom use. Finally, there is the Popular Opinion Leader (POL) intervention which targets men that frequent gay bars and targets elimination of sexual HIV risk." Citation source: http://www.medscape.org/viewarticle/768042_transcript

99. August 17, 2012 - Greetings from Pike Place Market, Seattle, WA
    
    Photo: Lee Jung
100. August 16, 2012 - Epidemiology of AIDS - New HIV Infections

     Graphic source: http://www.medscape.org/viewarticle/768042_transcript

     According to Medscape's "HIV Prevention: Successful Approaches for Young Men Who Have Sex With Men": "When we look at the national statistics, there are a comparable number of new infections among black MSM (men having sex with men) compared to white MSM, and when you consider that black MSM constitute a much smaller percentage of the general population, this means that there is a disproportionate impact among black MSM. When we look at the national statistics, there are a comparable number of new infections among black MSM compared to white MSM, and when you consider that black MSM constitute a much smaller percentage of the general population, this means that there is a disproportionate impact among black MSM." When you put race, poverty, homophobia, and a lack of education together, what you get is higher HIV rates; there is no population in the United States that is more impacted by those factors than black MSM. As we talk about the evolution of HIV prevention and HIV treatment, it is important for us to embrace new technology [eg, biomedical HIV prevention], but we should never lose track of the fact that, at the end of the day, HIV is still primarily driven by behavior and the solutions are going to be driven by behavior too. Among young black MSM, at 16, 17, or 18 years of age they are having their sexual debut with men that are 19, 20, or 21 years of age. Those men have already been out in the community, are already sexually active and have a higher likelihood to be HIV-positive already. You combine that with a lack of self-sufficiency or ability to advocate for themselves in an intimate encounter and you end up with an environment where they are more likely to be infected. Citation source: http://www.medscape.org/viewarticle/768042

101. August 15, 2012 - Epidemiology of AIDS - Route of Transmission, by Gender

     Graphic source: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/general/index.htm

     CDC HIV infection surveillance data show that 77% of men were infected by the AIDS virus through male-to-male sexual contact. This was followed by 12% through heterosexual contact, 7% by injection drug use and 4% by male-to-male sexual contact and injection drug use. This is very different from how women became infected. For women, 86% of women were infected through heterosexual contact, and 14% through injection drug use.

102. August 14, 2012 - Epidemiology of AIDS - Route of Transmission, By Type of Contact, Over Time

     Graphic source: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/general/index.htm

     In my August 9th posting, I mentioned that male-to-male sexual contact was the most common form of transmission for the HIV infection. Looking at transmission mode another way, male-to-male sexual contact comprises 2/3s of the HIV infection diagnoses made, between 2007 - 2010.

103. August 13, 2012 - New CDC Guidelines for the Treatment of Gonorrhea

     According to an August 9th CDC E-mail: "The most significant change to the new guidelines is that CDC no longer recommends an exclusively oral treatment regimen for gonorrhea. CDC now recommends a dual therapy of injectable ceftriaxone in combination with a second antibiotic. Ceftriaxone is more potent against gonorrhea than the once recommended oral antibiotic cefixime and, when paired with the additional oral antibiotic, might slow the emergence of drug resistance by ensuring that gonorrhea infections are quickly cured." Click on graphic to get to the CDC page. Also, see Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral Cephalosporins No Longer a Recommended Treatment for Gonococcal Infections released 8/10/12. For more information, see Gonorrhea

104. August 10, 2012 - Greetings from Stevens Pass (Cascade Mountains, located at the border of King County and Chelan County) WA
     
     Photo: Lee Jung
105. August 9, 2012 - Epidemiology of AIDS - Who Gets Diagnosed, by Transmission Category

     Graphic source: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/general/index.htm

     CDC HIV Infection Surveillance 1985 to 2010 trend data show that male-to-male sexual contact is the main, or most common, route of transmission. This is followed by injection drug use (IDU) as the 2nd most common route of transmission. While male-to-male sexual activity as a mode of transmission peaked in the early 1990s, with ~ 40,000 annual diagnoses, data trends indicate such sexual contact for transmitting HIV has been decreasing. However, male-to-male sexual contact remains the main route of transmission, when compared to other modes of transmission between 1985 - 2010. Note that transmission through heterosexual contact has been slowly increasing over time.

106. August 8, 2012 - Epidemiology of AIDS - Who Gets Diagnosed?

     Graphic source: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/general/index.htm

     This map of CDC HIV Infection Surveillance data shows the rates for diagnoses of HIV infection varies across the U.S. Those states with the highest rates for diagnosis of an HIV infection include: Florida, Georgia, Louisiana, New Jersey and New York

107. August 7, 2012 - Epidemiology of AIDS - Who is Affected, by Gender, Race & Ethnicity

     Graphic source: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/general/index.htm

     Recent CDC HIV Infection Surveillance data show men and women are affected by AIDS in a different way. While African-Americans males make up 41% of 2010 HIV infection diagnoses for men, African-American females make 62% of 2010 HIV infection diagnoses for women!

108. August 6, 2012 - The Natural History of HIV Infection

     Graphic source: http://fohn.net/history-of-aids/history-of-aids-3.html

     Here is a graphic of the natural history of an HIV infection. It is the course that the immunodeficiency virus (HIV) virus takes inside the infected person, regardless of how the infection was contracted (e.g., unprotected sex, contaminated needles or blood transfusions, etc.) Initial flu-like symptoms can be very mild and may be overlooked. So, it is important to get tested if you recently have had unprotected sex. Find a test site near you!

109. August 3, 2012 - Greetings from Grand Coulee Dam, WA (North America's largest masonary structure)
     
     Photo: Lee Jung
110. August 2, 2012 - US AIDS Timelines

     Graphic source: http://www.boston.com/news/specials/aids_at_25/audio/aids_timeline2/

     Other US Timelines Angels in America UPS.edu Photographic History of the AIDS Epidemic Washingtonpost.com The AIDS Epidemic NY Times Timeline: AIDS Epidemic Infoplease.com

111. August 1, 2012 - Global Timeline of AIDS

     Global Timelines

112. Global HIV/AIDS Timelines
113. History of HIV & AIDS Avert.org
114. July 31, 2012 - AIDS as a Pandemic

     Graphic source: http://dailyinfographic.com/outbreak-historys-deadliest-pandemics-infographic Enlarged Graphic

     While millions have died from AIDS since 1981 in the U.S., when it was finally identified as such, it still pales in comparison to other pandemics that have killed millions, like smallpox. However, given time, AIDS will probably catch up to the recorded major infectious disease killers.

115. July 30, 2012 - Global AIDS Statistics

     Graphic by Betty C. Jung, Data source: http://www.avert.org/worldstats.htm

     The 2012 International AIDS Conference held in Washington, DC has generated a lot of interest in AIDS. For the next several weeks I will give AIDS the "Betty Treatment," which means I will compile the most current information about what we know and what we are doing about AIDS and present it in this blog. I will provide a brief perspective on global AIDS statistics, but will be concentrating on what's going on in the U.S. about AIDS. To start, here is the most current global statistics about AIDS. Daunting. Sub-Saharan Africa currently bears the brunt of the scourge of AIDS. More current global AIDS statistics can be found on The Global HIV/AIDS Epidemic by the U.S. Global Health Policy Fact Sheet from Kaiser Family Foundation. See also AIDS/HIV statistics

116. July 27, 2012 - Greetings from Newport, RI's Cliff Walk
     
     Photo: Lee Jung

117. July 26, 2012 - 5 Foods That Can Trigger a Stroke (Part 2)

     Graphic source: http://cutthefatpodcast.com/799/cut-the-fat-blog/diet-soda-and-weight-loss-do-artificial-sweeteners-cause-weight-loss-or-weight-gain

     Here are the additional 3 foods that you probably should avoid, not just for the sake of avoiding strokes, but cardiovascular disease as well. 3. Diet soda Why it's bad. People who drink a diet soda a day may up their stroke risk by 48 percent. A Columbia University study presented at the American Stroke Association's 2011 International Stroke Conference followed 2,500 people ages 40 and older and found that daily diet soda drinkers had 60 percent more strokes, heart attacks, and coronary artery disease than those who didn't drink diet soda. Researchers don't know exactly how diet soda ups stroke risk -- and are following up with further studies -- but nutritionists are cautioning anyone concerned about stroke to cut out diet soda pop. 4. Red meat Why it's bad. This winter, when the respected journal Stroke published a study showing that women who consumed a large portion of red meat each day had a 42-percent higher incidence of stroke, it got nutrition experts talking. The information that red meat, with its high saturated fat content, isn't healthy for those looking to prevent heart disease and stroke wasn't exactly news. But the percentage increase (almost 50 percent!) was both startling and solid; the researchers arrived at their finding after following 35,000 Swedish women for ten years. Researchers have long known that the saturated fat in red meat raises the risk of stroke and heart disease by gradually clogging arteries with a buildup of protein plaques. Now it turns out that hemoglobin, the ingredient that gives red meat its high iron content, may pose a specific danger when it comes to stroke. Researchers are investigating whether blood becomes thicker and more viscous as a result of the consumption of so-called heme iron, specifically upping the chance of strokes. 5. Canned soup and prepared foods Why it's bad. Salt, or sodium as it's called on food labels, directly affects stroke risk. In one recent study, people who consumed more than 4,000 mg of sodium daily had more than double the risk of stroke compared to those who ate 2,000 mg or less. Yet the Centers for Disease Control estimate that most Americans eat close to 3,500 mg of sodium per day. Studies show that sodium raises blood pressure, the primary causative factor for stroke. And be warned: Sodium wears many tricky disguises, which allow it to hide in all sorts of foods that we don't necessarily think of as salty. Source: http://health.yahoo.net/caring/5-foods-that-can-trigger-a-stroke For more information, see Stroke Information, Sodas

118. July 25, 2012 - 5 Foods That Can Trigger a Stroke (Part 1)

     Graphic source: http://talkofthetown411.blogspot.com/2011/09/5-everyday-foods-that-could-trigger.html

     Can food trigger strokes? Possibly, here are 5 foods that you probably should avoid, not just for the sake of avoiding strokes, but cardiovascular disease as well. 1. Crackers, chips, and store-bought pastries and baked goods Why it's bad. For years scientists have known trans fats are dangerous artery-blockers, upping the concentrations of lipids and bad cholesterol in the blood and lowering good cholesterol. This year researchers at the University of North Carolina found that women who ate 7 grams of trans fat each day -- about the amount in two doughnuts or half a serving of French fries -- had 30 percent more strokes (the ischemic type, caused by blocked blood flow to the brain) than women who ate just 1 gram a day. Another recent study, also in women, found that trans fats promoted inflammation and higher levels of C-reactive protein, which have been linked to an increased risk of diabetes, heart disease, and stroke. 2. Smoked and processed meats Why it's bad. Smoked and processed meats are nasty contributors to stroke risk in two ways: The preserving processes leave them packed with sodium, but even worse are the preservatives used to keep processed meats from going bad. Sodium nitrate and nitrite have been shown by researchers to directly damage blood vessels, causing arteries to harden and narrow. And of course damaged, overly narrow blood vessels are exactly what you don't want if you fear stroke. Many studies have linked processed meats to coronary artery disease (CAD); one meta-analysis in the journal Circulation calculated a 42-percent increase in coronary heart disease for those who eat one serving of processed meat a day. Stroke is not the only concern for salami fans; cancer journals have reported numerous studies in the past few years showing that consumption of cured and smoked meats is linked with increased risk of diabetes and higher incidences of numerous types of cancer, including leukemia. For more information, see Stroke Information and Nutrition

119. July 24, 2012 - Prevalence of Stroke, US, 2006-2010

     Age-adjusted prevalence of stroke* among noninstitutionalized adults aged ≥18 years, by state Behavioral Risk Factor Surveillance System, United States, 2010 Graphic source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6120a5.htm

     The May 2012 MMWR report on the prevalence of stroke reports, "age-adjusted prevalence of stroke among noninstitutionalized adults aged ≥18 years, by state, in the United States during 2010, based on data from the Behavioral Risk Factor Surveillance System. In 2010, the states with higher stroke prevalence generally were states in the southeastern United States and Nevada." Citation source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6120a5.htm For more information, see Cerebrovascular Disease

120. July 23, 2012 - Shrinking Your Brain with Smoking, Hypertension, Diabetes & Obesity

     Graphic source: http://www.immortalhumans.com/how-to-stop-your-aging-brain-from-mental-deterioration-and-shrinkage/

     HealthDay reported on data from the Framingham Offspring Study published August 2nd, in "Neurology" that indicates good living can preserve your mental faculties: "...smoking, high blood pressure, diabetes and being overweight were each linked to potentially dangerous vascular changes in the brain. "People should stop smoking, control their blood pressure, avoid diabetes and lose weight. Those with high blood pressure experienced...a faster rate of growth of small areas of vascular brain damage than those with normal blood pressure. Those with diabetes in middle age experienced brain shrinkage in an area known as the hippocampus faster than those without, and smokers lost brain volume overall and in the hippocampus faster than nonsmokers, with a more rapid increase of small areas of vascular brain damage. ...participants who were obese at middle age were more likely to be in the top 25 percent of those with faster declines in tests of executive function, Those with a high waist-to-hip ratio were more likely to be among the 25 percent with a faster drop in brain volume. Citation source: Charles DeCarli, M.D., Raj Shah, M.D., Catherine M. Roe, Ph.D., Aug. 2, 2011, Neurology; as reported in HealthDay For more information, see Cardiovascular & Chronic Disease Main Page

121. July 20, 2011 - Greetings from Newport, RI
     
122. July 19, 2012 - Million Hearts National Initiative

     Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over the next five years. For more information, see Million Hearts Web site

123. July 18, 2012 - The Value of the Framingham Heart Study

     Graphic source: http://www.nhlbi.nih.gov/news/spotlight/success/conquering-cardiovascular-disease.html

     Observational studies have always taken a back seat to more rigorous methods, such as randomized controlled trials. But each type of study is valuable in their own way. Randomized controlled trials are appropriate if you are looking at the effectiveness of interventions. But, if you just want to understand how phenomena changes over time, then observational studies are be very effective. Perhaps, the most well-known observational study is the Framingham Heart Study that has been going on for over 60 years. According to the National Institutes of Health (NIH), which funds this study, "NIH researchers launched the study in the late 1940s to determine the causes of cardiovascular disease by carefully examining over 5,000 healthy people in Framingham, Massachusetts, beginning in mid-life and following them for many years to see who developed cardiovascular disease and how they differed from those who did not." (Source: http://www.nhlbi.nih.gov/new/stories/cardiovascular.htm) And, we have learned so much! The NIH's National Heart, Lung, and Blood Institute "Conquering Cardiovascular Disease" in August 2011 released this graph which clearly shows that by identifying the risk factors for heart disease, mortality has been drastically reduced. So, don't discount observational studies. If they are conducted systematically over long periods of time they can yield new knowledge that can improve our quality of life. For more information, see Cardiovascular Disease and Research Resources

124. July 17, 2012 - U.S. Prevalence of Coronary Heart Disease

     Graphic source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a1.htm

     According the October 14's MMWR, " age-adjusted prevalence of coronary heart disease among adults in the United States during 2010, according to the Behavioral Risk Factor Surveillance System. By state, age-adjusted CHD prevalence in 2010 ranged from 3.7% in Hawaii and 3.8% in DC to 8.0% in West Virginia and 8.2% in Kentucky, with the greatest regional prevalences generally observed in the South." Citation source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6040a1.htm For more information, see Cardiovascular Disease

125. July 16, 2012 - Heart disease and cancer remained the 1st and 2nd leading causes of death, respectively, over the 75-year period.

     NOTE: 2010 data are preliminary. SOURCE: CDC/NCHS, National Vital Statistics System, Mortality. Graphic source: http://www.cdc.gov/nchs/data/databriefs/db88.htm

     The NCHS Data Brief,"75 Years of Mortality in the United States, 1935-2010" (Number 88, March 2012) reports that heart disease and cancer have been part of the top five causes of death for Americans for the 75 years that data were analysed. "A 75-year perspective points to both stability and change in the leading causes of death: stability because three causes (heart disease, cancer, and stroke) remained among the five leading causes each year between 1935 and 2010; and change because other causes moved into or dropped out of the five leading causes at different points over the past 75 years (Figure 2). There were also changes in the proportion of all deaths that were due to each of the leading causes. For example, heart disease and cancer were the leading causes of death from 1935 to 2010, but it was in 1983 that these two conditions accounted for the highest percent (60 percent) of all deaths. In 2010, they constituted 47 percent of all deaths." Citation source: http://www.cdc.gov/nchs/data/databriefs/db88.htm For more information, see Morbidity and Mortality Statistics

126. July 14, 2012 - Manhattanhenge

     Though this time-lapsed video captured 2011's NYC Manhattanhenge, it is a twice-yearly event that features "one of the world's greatest urban phenomena, when the sun aligns itself with Manhattan's 201-year-old street grid." (1) Basically, "when the setting Sun aligns precisely with the Manhattan street grid, creating a radiant glow of light across Manhattan's brick and steel canyons, simultaneously illuminating both the north and south sides of every cross street of the borough's grid." (2) This year it occurred July 11th and July 12th.

     Thus, the urban landscape can be a wonder to behold when city planners of yesteryear created the city street grid that were laid out precisely north-south and east-west, and perfectly aligned with true north as opposed to magnetic north. A similar phenomena occurs with the sunrise around the winter solstice.

     For more information, see Everything You Ever Wanted to Know About...

     Citation sources: (1)http://www.huffingtonpost.com/2012/07/12/manhattanhenge-2012-a-full-sun-aligns-itself-new-york-city-grid-july-11th-photos_n_1667643.html (2) http://www.haydenplanetarium.org/resources/starstruck/manhattanhenge/

127. July 13, 2012 - The Most Scenic Ride to Take Before You Die!

     A couple of weeks ago on vacation, we took the "long way home." And, what a trip it was! After visiting the Grand Coulee Dam we were returning to the Seattle area. Instead of taking the highway we took the alternate, and that really made all the difference. From Waterville, WA go west on Route 2. You will go downhill for more than 6 miles through the most gorgeous terrain ever. You will be driving through a canyon that will take your breath away. It is simply the best ride I have ever taken. It is one ride you have to take before you die.

128. July 12, 2012 - NCI's "Crunching Numbers: What Cancer Screening Statistics Really Tell Us."

     Graphic source: http://www.cancer.gov/ncicancerbulletin/050112/page5

     Disease screening is important because it can lead to a disease diagnosis and early treatment. However, inappropriate screening can compromise health care quality. The National Cancer Institute's "Crunching Numbers: What Cancer Screening Statistics Really Tell Us" sheds light on factors we need to consider with disease screening. This graphic explains the lead-time bias problem. "Lead-time bias occurs when screening finds a cancer earlier than that cancer would have been diagnosed because of symptoms, but the earlier diagnosis does nothing to change the course of the disease. Lead-time bias is inherent in any analysis comparing survival after detection. It makes 5-year survival after screen detection and, by extension, earlier cancer diagnosis an inherently inaccurate measure of whether screening saves lives." Citation source: http://www.cancer.gov/ncicancerbulletin/050112/page5 Click on the graphic to learn about other screening issues as length-biased sampling (or length bias) and how to measure lives saved. For additional information, see Cancer Resources and Research Resources

129. July 11, 2012 - CDC's Atlas of United States Mortality

     Graphic source: http://www.cdc.gov/nchs/products/other/atlas/atlas.htm

     I just love maps! I love them even more when they show more than geography! CDC's Atlas of United States Mortality is a prime example of what you can do when you map health data. From this site you can get disease-specific mortality maps. Really, a great Public Health resource! For more information, see U.S. Federal Government Statistics and Public Health Data Index Page

130. July 10, 2012 - Current State of Autopsies

     Graphic source: http://www.cdc.gov/nchs/data/databriefs/db67.htm

     "An autopsy, the medical examination of a deceased person, may confirm clinical findings, provide more complete information to describe cause of death, or uncover conditions not recognized clinically prior to death. Two types are performed in the United States: a) hospital or clinical autopsies, which family or physicians request to clarify cause of death or assess care, and b) medicolegal autopsies, which legal officials order to further investigate the circumstances surrounding a death."* Autopsies are an important part of understanding disease processes. After all, an autopsy provides the final evidence as to whether or not a proper diagnosis has been made. Such knowledge does improve the quality of medical care. Unfortunately, autopsies are not viewed this way by most people because of the way we commonly view death, something to be ignored and avoided. When a person dies, the last thing surviving members of the person's family want to think about is advancing the practice of Medicine. Perhaps, if more of us can think of donating our bodies for an autopsy (as in donating your body to science), we can contribute something to improving medical care. In the NCHS Data Brief (Number 67, August 2011),"The Changing Profile of Autopsied Deaths in the United States, 1972-2007" The percentage of deaths for which an autopsy was performed declined more than 50 percent from 1972 through 2007, from 19.3 percent to 8.5 percent. External causes accounted for 9 of the 10 most frequently autopsied causes of death. The percentage autopsied declined with age after ages 15-24: from 60 percent at 15-24, to 11 percent at 55-64, to less than 5 percent at 65-74. In 1972, 79 percent of autopsies were performed for deaths due to disease conditions and 19 percent for deaths due to external causes. By 2007, the respective percentages were 46 percent and 50 percent. While the age distribution of deaths shifted to older ages from 1972 through 2007, autopsied deaths were increasingly concentrated in the age groups 1-34 and 35-64. Citation source(& also for *)http://www.cdc.gov/nchs/data/databriefs/db67.htm

131. July 9, 2012 - Disease Classification 101

     When it comes to studying patterns of disease, epidemiologists will you tell how important it is to agree upon the definition of the disease being studied. Without a commonly-agreed upon definition, the statistics would be totally useless, and comparisons would be impossible, or, even worse, inaccurate. Of course, when you talk of definitions, then you need to be as precise as possible. Here is a cool graphic of how disease classification helps us to understand the causes of mortality, in this case, 2009 causes of death for England/Wales: Enlarged Graphic Graphic source: http://www.guardian.co.uk/news/datablog/2011/jan/14/mortality-statistics-causes-death-england-wales-2009 Disease classification has become somewhat of a science that has developed over the course of many years, and has become codified in what is now known as the International Classification of Diseases (ICD). Besides just defining what a particular disease is, it has been adopted by Medicine to study the treatment of disease, and it is being used by health insurers for the reimbursement of health services. The 10th edition is on its way.

     While the new edition promises to be more precise, as we continue to develop a better understanding of disease processes, a new classification paradigm will always cause much disruption for those who use the ICD as part of their work. Just think of the cost of upgrading all the computer systems that use the ICD for billing! But, more importantly, from an epidemiological perspective, changes in disease classification will impact disease trending. Changing how a particular disease is classified can either include or exclude individuals that may have been previously included or excluded in an earlier definition. This is always a challenge - to accurate trend the course of a disease over time. Accuracy in disease trends is really dependent upon an appreciation of how changes in case defintion can skew morbidity and mortality statistics. When fewer people are dying from a disease, does it always mean treatment modalities are better, or, could it be that the case definition has changed? Such is the practice of Epidemiology! A prime example is what happened to AIDS statistics when the CDC changed its case definition for AIDS in 1993: Graphic source: http://rethinkingaids.com/GalloRebuttal/Farber-Gallo-14-Figures/Figure%201%201993%20consequences.jpg Enlarged Graphic If you interested in learning more about the ICD, the CDC just recently released an excellent document covering the history of the ICD, in History of the Statistical Classification of Diseases and Causes of Death For additional information, see Public Health Surveillance and Health Data Standards

132. July 7, 2012 - You Gotta Love Those Baby Pandas!

133. July 6, 2012 - World Map of Social Networks

     Graphic source: http://vincos.it/world-map-of-social-networks/

     Graphic source: http://vincos.it/world-map-of-social-networks/

     The Vincos Blog has been maintaining a log of Social Network Maps. The number of networks continue to change, with Facebook holding dominance across the world. But it is not the only social network around. Here is the latest table of the concentration of the most popular social networks in various countries. To see early maps and tables of social networks, see Vincos Blog For more info, see Technology Resources

134. July 5, 2012 - The Silver Surfers and Technology

     Graphic source:http://www.marketingcharts.com/direct/majority-of-us-seniors-now-online-22327/pew-internet-use-by-age-june2012png/

     I once read that older people on the Net are referred to as Silver Surfers. I like that, especially since the Silver Surfer is one of my favorite comic-book inspired creations. According to telephone interviews conducted by Princeton Survey Research Associates International from March 15 to April 3, 2012: "Majority of US Seniors Now Online. The proportion of American adults aged over 65 who use the internet or email has passed the 50% threshold for the first time, reaching 53% in April 2012, per survey results released in June by the Pew Internet & American Life Project. This represents a significant uptick in growth: in August 2011 just 41% of seniors were using the internet or email,... Although online access by seniors remains well behind the 82% average for American adults aged over 18, seniors frequency of use is much closer to their younger counterparts. Indeed, 70% of internet users aged over 65 say they use the internet on a typical day...(vs.) 87% of internet users aged 18-29 (the highest of all age groups). 7 in 10 Seniors Own a Cell Phone. 69% reported ownership of a cell phone, representing a 21% increase from 57% in May 2010. Although this is again behind other age groups, which hover around the 90% mark, it is the only gadget for which a majority of seniors report ownership. 1 in 3 Internet-Enabled Seniors Use Social Networks. ...as of February 2012, 34% of internet users aged 65 and older used social networking sites, with slightly more than half of those doing so on a typical day. Among all internet users, two-thirds use social networking sites, and 48% do so on a typical day, with the highest overall (86%) and daily (70%) use by 18-29-year-olds. Other Findings: Internet usage is much less widespread among Americans aged over 75. As of April 2012, internet use by these Americans had only reached 34%. 56% of Americans over the age of 75 own a cell phone of some kind. Among adults 65 and older, 39% have a broadband connection at home, up from 8% in 2005. Citation source: http://www.marketingcharts.com/direct/majority-of-us-seniors-now-online-22327/pew-internet-use-by-age-june2012png/

135. July 4, 2012 - Happy Birthday, America!!

     Graphic source: http://www.crazywebsite.com/Pg-Free-Clipart-Graphics/pg_4th_of_July_Clipart/4th_of_July_Pictures_Photos-1.htm

136. July 3, 2012 - 90+ Demographics

     Graphics source: http://www.seniorjournal.com/NEWS/SeniorStats/2011/20111117-Is90thenew85.htm

     In November, 2011, the U.S. released,"90+ in the United States: 2006-2008," one of its American Community Survey Reports. It is somewhat incredible to even think that 10% of the the U.S. population in 2050 will be people who are 90 years and older! Other interesting facts include: An average person who has lived to 90 years of age has a life expectancy today of 4.6 more years (versus 3.2 years in 1929-1931), while those who pass the century mark are projected to live another 2.3 years. The majority (84.7 percent) of those 90 years and older reported having one or more limitations in physical function. Some 66 percent had difficulty in mobility-related activities such as walking or climbing stairs. An older person's likelihood of living in a nursing home increases sharply with age. About 1 percent of what are called the young elderly (aged 65-69) live in a nursing home. The proportion rises to 3 percent for ages 75-79, 11.2 percent for ages 85-89, 19.8 percent at ages 90-94, 31.0 percent at ages 95-99 and up to 38.2 percent among centenarians. Women aged 90 years and older outnumber men nearly 3 to 1; 74.1 percent of the total population aged 90 and older in 2006-2008 were women. Whites represent 88.1 percent of the total 90-and-older population. Blacks make up 7.6 percent, Hispanics 4 percent and Asians 2.2 percent. The annual median income for people 90 and older was $14,760. Men had a higher income than women: $20,133 vs. $13,580. Social Security represents 47.9 percent of total personal income. Citation source: http://www.seniorjournal.com/NEWS/SeniorStats/ 2011/20111117-Is90thenew85.htm Click on the top graphic to access the U.S. Census report. For more information, see Senior Health

137. July 2, 2012 - Growing Older in America: The Health and Retirement Study - Health Behaviors

     NIH's Health and Retirement Study (HRS)looks at the lives of those 50 and older. In looking at health behavior issues, HRS reports: SMOKING."heavy smokers significantly underestimated their risk of premature mortality linked with smoking. People who had quit smoking in the 15 years preceding the survey were as likely as those who had never smoked to report good health. Further analysis indicated that males ages 50 to 54 years who are heavy smokers lose approximately 2 years of healthy life, and females in the same age group who are heavy smokers lose about 1.5 years of healthy life, relative to former smokers." ALCOHOL CONSUMPTION."Men who were heavy drinkers (five or more drinks per day) but not functionally impaired in the initial survey year had a four-fold risk of developing at least one functional impairment (including memory problems) during the 6-year follow-up period. This finding held true even when controlling for the effects of smoking and other factors. Retirement was associated with increased drinking; hospitalization and the onset of a chronic condition were associated with decreased drinking; and widowhood was associated with increased drinking, but only for a short time. OBESITY. "being overweight or obese (using conventional body mass index measures) makes an older person more likely to become functionally impaired in the future. While this relationship is often complex, obesity appears to have an independent effect on the onset of impairment in strength, lower body mobility, and activities of daily living." in 1992 the individual net worth of moderately to severely obese women ages 51 to 61 was 40 percent lower than that of normal-weight peers, controlling statistically for health status, education, marital status, and other demographic factors." Citation Source: http://www.nia.nih.gov/health/publication/growing-older-america-health-and-retirement-study/chapter-1-health For more information, see Senior Health

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Published on the Web: August 3, 2011
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