This is a blog for the Mental Health Policy Class at the George Warren Brown School of Social Work.

March 2, 2007

Washington Times 4 Part Series on India's Inbalance of Sexes

"In most places in the world, a mother can find out the sex of her unborn child, but in India, it's illegal to do so. That is because if she's a female, there is a good chance she will never be born.
Roughly 6.7 million abortions occur yearly in India, but aborted girls outnumber boys by 500,000 -- or 10 million over the past two decades -- creating a huge imbalance between males and females in the world's largest democracy. Ratios of men to women are being altered at an unprecedented rate in India and neighboring China, two countries which account for 40 percent of the world's population.

February 28, 2007

The Stigma of Mental Illness

Five times he called her a "loon" or "lunatic." Each time, the peace activist reacted to Bill O'Reilly's name-calling with a shrug or smirk. But this encounter on "The O'Reilly Factor" raised the question: Who was more outrageous? Was it O'Reilly for using words that some might interpret as slurs? Or was it the activist for not taking him to task?

A Compelling Argument for Universal Health Insurance

For Want of a Dentist
Boy Dies After Bacteria From Tooth Spread to Brain
By Mary OttoWashington Post Staff WriterWednesday, February 28, 2007; Page B01
Twelve-year-old Deamonte Driver died of a toothache Sunday.
A routine, $80 tooth extraction might have saved him.
If his mother had been insured.
If his family had not lost its Medicaid.
If Medicaid dentists weren't so hard to find.

February 21, 2007

Can People with Mental Illness Receive Adequate Treatment in Prisons?

Mentally Ill Inmate Dies Alone (60 Minutes Episode). Scott Pelley looks at the case of Timothy Souders. The inmate's death was recorded on camera while he was in solitary confinement and has instigated a look at the prison's mental health care.

America's Children: Key National Indicators of Well-Being

Presents statistics about children’s economic security, health, behavior, social environment, and education. This biennial report to the Nation on the condition of children in America provides nine contextual measures describing the changing population, family, and environmental context in which children are living, and 25 indicators depict the well-being of children in the areas of economic security, health, behavior and social environment, and education. The 2005 report has special features on children with asthma, children with specified blood lead levels, and parental reports of children’s emotional and behavioral difficulties. In addition, the report includes a special section on family structure and the well-being of children. The Federal Interagency Forum on Child and Family Statistics produces this annual report, which offers the most recent available data from official sources in a nontechnical, user-friendly format.

February 20, 2007

How Do We Solve the Problem of Doctor Shortages in Rural America?

The Wall Street Journal takes a close look at physician shortages in rural areas, noting that the problem is getting worse because of "an unusual tale of two visa programs." The J-1 visa waiver program since 1994 has allowed foreign physicians to become eligible for green cards, so long as they agree to work for three years in medically underserved areas. The program "has provided more than 1,000 doctors annually to underserved areas, outperforming scholarship and loan programs designed to attract young U.S. doctors to these same places," the Journal reports. Health centers like Yakima Neighborhood Health Services, which is featured in the WSJ story, rely on the J-1 visa program for their work force. But because of an expansion of the H1-B visa waiver program enacted in 2000 to provide U.S. companies with more foreign high-tech workers, hundreds of foreign physicians "are bypassing the J-1" and "are securing an H1-B, which doesn't require the rural stint," says WSJ. Now the number of foreign physicians with J-1 visas has dropped from 11,000 in 1995-1996 to 6,000 in 2005-2006. You can read the full story here. Download wall_street_journal_article_yakima_doctors.pdf

A Local Example of Advocacy (Post Dispatch Story)

"What's really disturbing is it's the one form of mental retardation birth defect that is 100 percent preventable," says Melinda M. Ohlemiller, director of prevention and advocacy for St. Louis Arc, an agency that advocates for people with birth defects. So the fight against fetal alcohol syndrome can be won without compromise, Ohlemiller says. That's why health experts have increased their warnings about drinking while pregnant. Even that one glass of red wine at night or a couple of beers on the weekend can have consequences for your unborn child, says Dr. Mark Mengel, professor of family and community medicine at St. Louis University School of Medicine.

February 16, 2007

Drugs, Brains, and Behavior: The Science of Addiction

The National Institute on Drug Abuse (NIDA) has released a layman's guide to alcohol and other drug addiction to complement the new HBO documentary series "Addiction," which premieres in Washington, D.C., this week.
"Drugs, Brains, and Behavior: The Science of Addiction" is a 30-page booklet that provides an overview of the science supporting the concept of addiction as a brain disease. Information on prevention and treatment also is included.

February 15, 2007

What is the Prevalence of Autism in the United States?

U.S. health officials say autism rate about 1 in 150, higher than previous estimates WASHINGTON — About one in every 150 children in the United States has autism or a closely related disorder — a figure higher than most recent estimates — according to a federal survey released Thursday, the most thorough ever conducted. The new data do not mean that autism is on the rise, because the criteria and definitions used were not the same as those used in the past. But the number of children apparently affected — 560,000 nationwide if the new statistics are extrapolated to all 50 states — makes autism an "urgent public health issue" and a "major public health concern," said Marshalyn Yeargin-Allsopp, chief of the developmental disabilities branch of the Centers for Disease Control and Prevention, which conducted the survey.
Missouri democrats push for mental health program
JEFFERSON CITY — House Democrats proposed on Monday to expand funding for a mental health program that provides intensive care for the homeless, people with substance abuse problems and those who are unaware that they are ill. Supporters say the program is designed for patients who have struggled with the traditional model, which assigns patients a case worker who helps them secure a variety of health services. Jackie Lukitesch, executive director of the St. Louis office of the National Alliance on Mental Illness, said the biggest difference between the more intense treatment and traditional models is that patients who miss treatments and appointments are not automatically removed from the program. "They go out and seek out why, if they don't come in, and do not discharge them," she said.
The stepped-up care, called "assertive community treatment," has been used in several states. The Department of Mental Health asked for $5 million to fund the program in its budget requests for the next fiscal year, but Gov. Matt Blunt did not include it in his budget recommendations. A spokeswoman for Blunt said the governor had not included funding for the program "because of funding constraints."

February 14, 2007

Why Do I Need to Learn How to Set Up a Blog?

Blogging clicks with educators Chicago Tribune: "Mundelein High School social worker Julie Wheeler wanted to reach students and parents in a non-threatening way, so she took a lesson from the kids and started her own blog."

The Prescription Project Lauched

Community Catalyst and the Institute on Medicine as a Profession launched The Prescription Project on Feb 12, 2007, calling on academic medical centers, professional medical societies and public and private payers to end conflicts of interest resulting from the $12 billion spent annually on pharmaceutical marketing. Building on a series of reforms recommended last year in an article in the Journal of the American Medical Association (JAMA), the project will conduct and publicize research on conflicts of interest, advocate for policy reforms that will eliminate such conflicts, and promote prescription practices that are based on scientific evidence...

February 12, 2007

How Would Mental Health be Afffected by the President's Proposed Budget?

Significant cuts to the budgets of the Center for Substance Abuse Treatment (CSAT) and the Center for Substance Abuse Prevention (CSAP) were some of the lowlights of the Bush administration's budget for the Substance Abuse and Mental Health Services Administration (SAMHSA) -- part of an FY2008 spending plan that trims or eliminates a number of prominent federal discretionary programs.
"Bush's proposal would provide a big increase in military spending to fight the war in Iraq while squeezing federal health-care programs and cutting most domestic agencies to below fiscal 2006 levels to meet his goal of eliminating the deficit in five years," noted the
American Counseling Association.

Evolutionary Psychopathology

Evolutionary psychology sees the mind as a set of evolved mechanisms, or adaptations, that have promoted survival and reproduction. Evolutionary psychopathology — abnormal psychology through an evolutionary lens — looks at what has gone wrong. The discipline is so new that "some people would say it hasn't started yet," jokes Randolph M. Nesse, a professor of psychiatry at the University of Michigan, and one of its pioneers. No one paradigm has won universal acceptance. Evolution-based therapies rely on an eclectic mix of techniques, and their effectiveness is still being tested.

The VA, Iraq and PTSD

The Department of Veterans Affairs is facing a wave of returning veterans who are struggling with memories of a war where it's hard to distinguish innocent civilians from enemy fighters -- and where the threat of suicide attacks and roadside bombs haunts the most routine mission.
Since 2001, about 1.4 million Americans have served in Iraq, Afghanistan or other locations in the global war on terror. The VA counts post-traumatic stress disorder, or PTSD, as the most prevalent mental-health disorder -- and one of the top illnesses overall -- to emerge from the wars.

Providing Mental Health Services for Prisoners in New York

Spitzer plan aids mentally ill inmates: Governor proposes adding $60 million for improved, more humane services

ALBANY -- In response to long-standing calls for better treatment for the most vulnerable segment of the prison population, Gov. Eliot Spitzer proposes to increase state spending by $60 million over three years on services for mentally ill inmates. The proposal was praised by advocacy groups that say it signals a heightened commitment toward humane care of prisoners with severe psychiatric needs.

The Power of Advocacy

The latest Super Bowl score: Advocacy Groups 2, Advertisers 0.
In the second capitulation by a corporate behemoth in less than a week, General Motors yesterday agreed to modify a TV commercial it aired during Sunday's Super Bowl to address complaints from interest groups.
Mental health organizations had peppered GM with protests about the ad, contending that it trivialized suicide. In the commercial set to the strains of Eric Carmen's "All by Myself," a clumsy auto factory robot throws itself off a bridge in despair after being drummed off an assembly line. GM said it would edit the ad to eliminate the bridge sequence.

February 6, 2007

Is It Appropriate to Lie to Get Services for Your Clients?

In 1977, Randy Revelle says, he almost killed his two young children with a fireplace poker during a psychotic hallucination brought on by untreated bipolar disorder. But at the time, his health insurer didn't cover psychiatric treatments and his family couldn't get him hospitalized. . . . "In order to get admitted, we had to threaten the doctor with jail and lie about the diagnosis," said Revelle. He responded quickly to lithium, which he still takes today, and went on to become King County executive from 1981 to 1985.

Kids' Suicides Rise, CDC Report Finds

New government figures show a surprising increase in youth suicides after a decade of decline, and some mental health experts think a drop in use of antidepressant drugs may be to blame.
The suicide rate climbed 18 percent from 2003 to 2004 for Americans under age 20, from 1,737 deaths to 1,985. Most suicides occurred in older teens, according to the data _ the most current to date from the federal Centers for Disease Control and Prevention. By contrast, the suicide rate among 15- to 19-year-olds fell in previous years, from about 11 per 100,000 in 1990 to 7.3 per 100,000 in 2003.
Suicides were the only cause of death that increased for children through age 19 from 2003-04, according to a CDC report released Monday. "This is very disturbing news," said Dr. David Fassler, a University of Vermont psychiatry professor. He noted that the increase coincided with regulatory action by the U.S. Food and Drug Administration that led to a black box warning on prescription packages cautioning that antidepressants could cause suicidal behavior in children. Fassler testified at FDA hearings on antidepressants during 2003 and 2004 and urged caution about implementing black box warnings. The agency ordered the warnings in October 2004 and they began to appear on drug labels about six months later.

February 2, 2007

Was this Sentence Appropriate?

Okla. Woman Guilty of Harming Daughter - New York Times: "A woman who experts said has a rare mental disorder has been sentenced to more than 15 years in prison after admitting she injected fecal matter into her infant daughter. Sarena Sherrard, 31, pleaded guilty Tuesday to child abuse charges. Two mental health care providers, who have cared for Sherrard since her arrest, testified she could not resist the urge to harm her daughter. They blamed a disorder known as Munchausen syndrome by proxy, in which parents create or exaggerate injury to a child to bring attention to themselves. The cause is unknown. Sherrard was arrested in August 2005 after surveillance video showed her injecting a foreign substance into her daughter's catheter at Children's Hospital in Oklahoma City. Police had put the girl's room under surveillance because doctors suspected someone was harming her, according to court papers."

January 25, 2007

Do You Have Time to Sign a Petition?

Take Action: First Things First: Make Missouri Health Care a Priority!: "Nearly 700,000 Missourians have no health insurance, including 106,000 children. In 2005, Missouri politicians continued to give away millions of dollars in tax breaks for insurance companies and corporations, while eliminating health coverage for 100,000 Missourians and cutting health services for over 300,000 more! Nobody in Missouri voted for that. We need to set this right and ensure that health care for children and families becomes a priority this year!"

January 22, 2007

U.S.-born Children of Immigrants May Have Higher Risk for Mental Disorders Than Parents

NIMH: U.S.-born Children of Immigrants May Have Higher Risk for Mental Disorders Than Parents: "In the first studies to examine the effects of immigration and years of residence on the mental health of Caribbean Black, Latino, and Asian populations in the United States, NIMH-funded researchers found that immigrants in general appear to have lower rates of mental disorders than their U.S.-born counterparts. A special section of the American Journal of Public Health published in January 2007 provides early findings from the National Survey of American Life (NSAL) and the National Latino and Asian American Study (NLAAS) on the prevalence of mental disorders and patterns of mental health service use among minority immigrants and later generations born in the U.S."

Depression Screening Saves Money for Employers

Clinical Psychiatry News: "For employers, the savings generated by a low-intensity depression screening and management program for workers more than offset the costs, according to Dr. Philip S. Wang of Brigham and Women's Hospital, Boston, and his associates.
The researchers examined the economic costs and benefits of a workplace depression intervention from the perspectives of society as a whole and of employers. They devised a statistical model comparing usual care—that is, care-seeking and treatment patterns that typically occur in the absence of a workplace program—with a program comprising a one-time workplace quick screen for depression followed by telephone “care management” by master's-level clinicians."

January 19, 2007

Universal Access in California?

Health care and the states The federalist prescription Economist.com: "Arnold Schwarzenegger, California's governor, this week announced a plan that could change the terms of America's health-care debate. The Republican in charge of the country's most populous state, where 6.5m people, almost one resident in five, lack medical insurance, said he wants to introduce universal health-care coverage.
His recipe is a combination of insurance-market reform, government subsidies and—most important—compulsion. “Everyone in California must have insurance,” Mr Schwarzenegger argued. “If you can't afford it, the state will help you buy it, but you must be insured.”"

January 7, 2007

Has the War on Drugs Been Lost?

This Is Your Brain on Drugs, Dad - New York Times: "Today, after 20 years, hundreds of billions of dollars, and millions of arrests and imprisonments in the war on drugs, America’s rate of drug-related deaths, hospital emergencies, crime and social ills stand at record highs. . . . . Why are so few Americans aware of these troubling trends? One reason is that today’s drug abusers are simply the “wrong” group. As David Musto, a psychiatry professor at Yale and historian of drug abuse, points out, wars on drugs have traditionally depended on “linkage between a drug and a feared or rejected group within society.” Today, however, the fastest-growing population of drug abusers is white, middle-aged Americans. This is a powerful mainstream constituency, and unlike with teenagers or urban minorities, it is hard for the government or the news media to present these drug users as a grave threat to the nation. "

A Surprising Secret to a Long Life

A Surprising Secret to a Long Life: Stay in School - New York Times: "The one social factor that researchers agree is consistently linked to longer lives in every country where it has been studied is education. It is more important than race; it obliterates any effects of income. "

India Prosperity Creates Paradox

India Prosperity Creates Paradox; Many Children Are Fat, Even More Are Famished - New York Times: "Presenting a confounding portrait of child health in India, new research commissioned by the government finds that despite the economic advances of recent years India’s share of malnourished children remains among the worst in the world. Paradox being pervasive in this country, the new data on child malnutrition comes even as public health officials confront what they call alarming levels of childhood obesity. "

January 1, 2007

FDA Approves Plan B's Over-the-Counter Sale

FDA Approves Plan B's Over-the-Counter Sale: "By the end of the year, American women will be able to walk into any pharmacy and buy emergency contraceptive pills without a prescription as a result of a Food and Drug Administration decision announced yesterday. The decision means women will not have to go to a doctor first as long as they can prove they are 18 or older to a pharmacist, who will keep the drugs behind a counter. Younger teenagers will still need a prescription, and the pills will not be sold at gas stations, convenience stores or other outlets that do not have pharmacists."

U.S. Urges HIV Tests for Adults and Teenagers

U.S. Urges HIV Tests for Adults and Teenagers - New York Times: "In a major shift of policy, the federal government recommended yesterday that all teenagers and most adults have H.I.V. tests as part of routine medical care because too many Americans infected with the AIDS virus don’t know it."

The Challenge of Global Health

Foreign Affairs - The Challenge of Global Health - Laurie Garrett: "The fact that the world is now short well over four million health-care workers, moreover, is all too often ignored. As the populations of the developed countries are aging and coming to require ever more medical attention, they are sucking away local health talent from developing countries. Already, one out of five practicing physicians in the United States is foreign-trained, and a study recently published in JAMA: The Journal of the American Medical Association estimated that if current trends continue, by 2020 the United States could face a shortage of up to 800,000 nurses and 200,000 doctors. Unless it and other wealthy nations radically increase salaries and domestic training programs for physicians and nurses, it is likely that within 15 years the majority of workers staffing their hospitals will have been born and trained in poor and middle-income countries. As such workers flood to the West, the developing world will grow even more desperate."

Mitt Romney on Health Care for Everyone

Featured Article: "Every uninsured citizen in Massachusetts will soon have affordable health insurance and the costs of health care will be reduced. And we will need no new taxes, no employer mandate and no government takeover to make this happen."

Calorie Shock at the Counter - New York Times

Calorie Shock at the Counter: "New York City's first-in-the-nation order to ban trans fats from all city restaurants has received wide attention. But the most important health dividends might well come from a less prominent measure that was also approved by the city's Board of Health yesterday: a requirement that fast-food restaurants post the calories in their offerings in large type and in readily visible positions. The likely shock when patrons realize just how many calories they are imbibing with their oversized burgers and fries or richly sweetened coffees may provide just the right impetus to propel overweight customers toward a healthier diet. "

Psychiatry: An Industry of Death?

Psychiatry: An Industry of Death - Wikipedia, the free encyclopedia: "Psychiatry: An Industry of Death is a museum in Hollywood, California, USA. It is owned and operated by the Citizens Commission on Human Rights, an anti-psychiatry organization founded by the Church of Scientology."

December 30, 2006

Sobering Thoughts

Sobering Thoughts: Town Hall Meetings on Fetal Alcohol Spectrum Disorders: "Prenatal exposure to alcohol is one of the leading causes of preventable birth defects and developmental disabilities. During the past 30 years, fetal alcohol spectrum disorders (FASD), including fetal alcohol syndrome, have gradually begun to attract attention. However, awareness and understanding of the disorders remain low, and people who are affected are seriously underserved. The FASD Center for Excellence held a series of town hall meetings in 2002 and 2003 to gauge the issues surrounding FASD nationwide. On the basis of its findings, the center proposed a series of recommendations to begin to remedy some of the deficiencies that were identified."

December 28, 2006

Health insurance companies help block mental health parity bill

Wellstone Action - Wellstone Action Network: "Health insurance companies help block mental health parity bill' by Frederic J. Frommer, Associated Press
WASHINGTON - Aided by House Speaker Dennis Hastert, insurance companies successfully have blocked legislation to make them provide equal coverage for mental and physical illnesses if their policies include both. President Bush endorsed the concept two years ago. Today, supporters of the bill are willing to settle for a scaled-back version they hope Congress will pass in 2004. "

Health insurance companies help block mental health parity bill

Wellstone Action - Wellstone Action Network: "Health insurance companies help block mental health parity bill' by Frederic J. Frommer, Associated Press
WASHINGTON - Aided by House Speaker Dennis Hastert, insurance companies successfully have blocked legislation to make them provide equal coverage for mental and physical illnesses if their policies include both. President Bush endorsed the concept two years ago. Today, supporters of the bill are willing to settle for a scaled-back version they hope Congress will pass in 2004. "

Malnutrition Is Cheating Its Survivors, and Africa’s Future

Malnutrition Is Cheating Its Survivors, and Africa’s Future - New York Times: "Yet almost half of Ethiopia’s children are malnourished, and most do not die. Some suffer a different fate. Robbed of vital nutrients as children, they grow up stunted and sickly, weaklings in a land that still runs on manual labor. Some become intellectually stunted adults, shorn of as many as 15 I.Q. points, unable to learn or even to concentrate, inclined to drop out of school early."

December 16, 2006

Governor Blunt's Medicaid Transformation Report

Missouri Dept. Social Services - Programs & Services for Health Care: "The Medicaid Transformation Report describes Governor Blunts plans to replace Missouri Medicaid with a new program called Missouri Health Net in which every Missouri citizen would have a 'health care home.'"

December 14, 2006

Senator Gibbons (R-Kirkwood) on Mental Health in Missouri

STLtoday - News - Editorial / Commentary: "The Department of Mental Health recently received a $14 million, five-year transformation grant from the federal government. The funds will help support the strategic planning, workforce development and technological enhancements required to transform Missouri's public mental health delivery system into one that is more patient-oriented, efficient and cost-effective."

December 10, 2006

New Poll Finds Broad Support for Health Care Reform

New Poll Finds Broad Support Among Democrats, Independents, and Republicans for Drug Price Negotiation, Reimportation, and Prioritizing Children for Coverage of the Uninsured...Views on Stem Cells More Mixed - Kaiser Family Foundation: "While there is debate in Washington about whether and how to do it, substantial majorities of Democrats (92%), Independents (85%), and Republicans (74%) support allowing the government to negotiate drug prices under Medicare (85% overall, including 65% strongly and 20% somewhat favoring it). There is also widespread support for permitting Americans to buy lower-priced prescription drugs from Canada (79%, including 55% strongly and 24% somewhat). Eight in 10 people believe drug price negotiation will make medications more affordable, while 31% believe it will result in less research and development by U.S. drug companies."

Poor Scores for U.S. Health and Mental Health Care

Poor Scores for U.S. Health and Mental Health Care Systems on New National Scorecard: "A new report on U.S. health care shows that the system falls far short of what it could achieve. On a national scorecard of 37 indicators, the overall score was 66 out of 100, with wide gaps between the best and worst states. The findings indicate that improved performance in key areas would save an estimated 100,000 to 150,000 lives annually and $50 to $100 billion in health care spending. "

December 6, 2006

Sample Letter to the Editor

STLtoday - News - Editorial / Commentary: "The members of the Midwest Regional Fetal Alcohol Syndrome Training Center were shocked by 'Some say it's OK to drink when pregnant' (Nov. 29), which implied that it is safe for pregnant women to drink small amounts of alcohol. The article contained little credible research and tried to obfuscate the issue by claiming that the research was confusing and controversial. The article relied on the voices of women and obstetricians who are not in the vanguard of American medicine. In fact, numerous studies document the deleterious effects of alcohol during pregnancy. "

Doctors aren't chaplains

Doctors aren't chaplains - Los Angeles Times: "A concerted effort is underway to make religious practices part of clinical medicine. About two-thirds of U.S. medical schools now offer some form of training on the role of religion and spirituality in medicine, according to Dr. Harold Koenig of Duke University."

November 16, 2006

When Blind Faith in a Medical Fix Is Broken

When Blind Faith in a Medical Fix Is Broken - New York Times: "A blocked artery is not a good thing. Public health campaigns have drilled that message into the national psyche. Surely, then, whenever doctors find a closed artery, especially in the heart, they should open it. Maybe not. A major study, presented Tuesday at a medical conference in Chicago, challenged the widespread use of tiny balloons and metal stents in people who had suffered heart attacks days or weeks before. Although such treatment can be lifesaving in the early stages of a heart attack, the study found that opening the artery later did no good at all. It merely exposed patients to the discomfort, risk and $10,000 expense of an invasive procedure. "

November 9, 2006

Insurer Sued for Refusing to Pay Costs of Anorexia - New York Times

Insurer Sued for Refusing to Pay Costs of Anorexia - New York Times: "A New Jersey couple filed suit against Aetna Inc., the Hartford-based insurance company, on Wednesday, claiming that it refused to fully cover their daughter’s treatment for anorexia."

October 22, 2006

Living With Love, Chaos and Haley

Living With Love, Chaos and Haley - New York Times: "PLYMOUTH, Mass. — When Haley Abaspour started seeing things that were not there — bugs and mice crawling on her parents’ bed, imaginary friends sitting next to her on the couch, dead people at a church that housed her preschool — her parents were unsure what to think. After all, she was a little girl."

October 20, 2006

Time to Go! Inside the Worst Congress Ever

Rolling Stone : COVER STORY: Time to Go! Inside the Worst Congress Ever: "There is very little that sums up the record of the U.S. Congress in the Bush years better than a half-mad boy-addict put in charge of a federal commission on child exploitation. After all, if a hairy-necked, raincoat-clad freak like Rep. Mark Foley can get himself named co-chairman of the House Caucus on Missing and Exploited Children, one can only wonder: What the hell else is going on in the corridors of Capitol Hill these days?"

August 3, 2006

Poverty

The Mismeasure of Poverty. America’s official quest to describe the circumstances of the disadvantaged in quantitative terms began in the 1870s and the 1880s, with the Massachusetts Bureau of Statistics of Labor and the U.S. Bureau of Labor Statistics, and the initial efforts to compile systematic information on cost-of-living, wages, and employment conditions for urban working households in the United States.1 U.S. statistical capabilities for describing the material well-being of the nation’s population through numbers have developed greatly since then.

April 20, 2006

Medicaid Hurdle for Immigrants May Hurt Others

"More than 50 million Medicaid recipients will soon have to produce birth certificates, passports or other documents to prove that they are United States citizens, and everyone who applies for coverage after June 30 will have to show similar documents under a new federal law. The requirement is meant to stop the 'theft of Medicaid benefits by illegal aliens,' in the words of Representative Charlie Norwood, Republican of Georgia, a principal author of the provision, which was signed into law by President Bush on Feb. 8."

A Physician Speaks Out on Health Care Reform

"[I]ncreasingly I've come to believe that if done right, health care in America could be dramatically better with true single-payer coverage; not just another layer -- a part D on top of a part B on top of a part A, but a simplified, single payer that would cover all Americans, including those who could afford the best right now. Representatives and senators in Washington should have to use the same system my patients and I do were they to vote it in."

Obstacles to Generic Drugs Criticized

"The brand-name drug industry is aggressively working to keep blockbuster drugs widely used by the elderly from being sold in cheaper generic versions when their patents expire, the organization that represents pharmacy benefit managers said yesterday. With an unprecedented number of top-selling drugs scheduled to go off patent within five years, the organization said, branded drug companies are constructing roadblocks to potential savings of $23 billion to seniors and the Medicare system."Free Registration Required for the Washington Post

China Has Too Many Men

"The gender imbalance grew out of communist China's draconian social engineering policies, where a woman, after having one child, was forced to make a choice: sterilization or insertion of an IUD (intrauterine device). To make sure the women kept their birth control devices in, the government � starting in 1982 � sent portable ultrasound machines all over the country. They are compact and lightweight and even some small villages got as many as two or three. But in a classic case of unintended consequences, pregnant women realized that the machines could also identify whether they were having a boy or a girl. And, as a result, by conservative estimates, more than 8 million girls were aborted in the first 20 years of the one-child policy."

Struggle Against Pricey Prescription Pills (Multimedia)

Why it's getting harder every day to find ways to save on prescription drugs.

April 13, 2006

Detox for the Botox Set?

"Brown, now 44, paid almost $15,000 for a controversial medical method known as 'rapid,' or 'anesthesia-assisted,' detoxification. Dubbed 'detox for the Botox set' by Elle Magazine, the procedure involves placing patients under anesthesia before giving them medicines that block opiate cravings."

The Economist on the Massachusetts Plan for Universal Access

"As was discovered by Hillary Clinton a decade ago, it is politically impossible to fix America's health-care system all at once. Congress is too angrily divided, and the federal government lacks the muscle to impose a grand vision on unwilling states. The riddle of how to provide health insurance for the 46m Americans who lack it will have to be solved by trial and error in the states. This week, Massachusetts offered an intriguing proposal. The state legislature passed a bill that would make health insurance compulsory. Just as everyone who drives a car must insure it, so everyone with a body must insure that, too. "

Universal Access in Massachusetts

"Governor Mitt Romney signed most of a sweeping new healthcare bill into law yesterday at a festive Faneuil Hall ceremony hailed as a hallmark of bipartisan achievement, even as healthcare specialists expressed concern that the plan could start losing money in three years. The bill will require all state residents to have health insurance by July 1, 2007, and require businesses with 11 or more workers to pay $295 per employee annually if the companies do not provide insurance. Romney vetoed the fee, but the Legislature is expected to override the veto."

Prophylactic Measures

"An informal survey found that almost half -- 22 of 50 -- of the District's CVS pharmacies lock up their condoms -- this in a city where one in 20 residents is HIV-positive. Most of those stores are in less affluent areas where the incidence of HIV/AIDS, other sexually transmitted diseases and unwanted pregnancy -- all preventable with condoms -- are highest."

Sally Satel on SAMHSA and Mental-Health Politics

"Recently, the federal Substance Abuse and Mental Health Services Administration (SAMHSA), part of the Dept. of Health and Human Services, has released its Consensus Statement of Mental Health Recovery. It is a travesty of psychiatric care. In fact, if a psychiatrist treating patients with severe mental illness followed most of the ten "fundamental" principles of recovery elaborated in the statement, he would be at risk of committing malpractice."

April 6, 2006

Lower Income Linked with Poorer Care Experiences

"There is a health care gap not only separating the U.S. from the other four countries, but also one standing between lower-income and higher-income Americans. Among the countries surveyed, the U.S. stands out for income-based disparities in patient experiences, with below-average-income U.S. adults reporting the worst experiences�compared with their counterparts in the other four countries�on most measures of primary care access, coordination, and doctor-patient relationships. Although a lack of health insurance intensified the disparities, with uninsured U.S. adults often forgoing needed care, insurance coverage does not level the playing field. Even when insured, below-average-income Americans under the age of 65 were more likely to report access problems and delays than insured, above-average-income adults."

U.S. Ranks Poorly on Many Measures in Cross-National Patient Surveys

"U.S. health care leaders often say that American health care is the best in the world. However, recent studies of medical outcomes and mortality and morbidity statistics suggest that, despite spending more per capita on health care and devoting to it a greater percentage of its national income than any other country, the United States is not getting commensurate value for its money. The Commonwealth Fund's cross-national surveys of patients' views and experiences of their health care systems offer opportunities to assess U.S. performance relative to other countries through the patients' perspective�a dimension often missing from international comparisons."

Appearance and Success

"Marie Curie may have discovered radium, but judging from her pictures, she never figured out how to control her frizzies. Eleanor Roosevelt, looking back on a singularly accomplished career, wished she'd been prettier. Madeleine Albright's memoir records her long losing battle to lose weight along with her triumphs as secretary of state. And so on ..."

Effects of Student Debt on Careers

"At a time when the government estimates that two million new teachers will be needed in the next decade, the large student-loan debt that college graduates face may deter students from entering public-service careers like teaching and social work, according to a report released on Wednesday by the State Public Interest Research Groups' Higher Education Project."

March 27, 2006

Woman With Perfect Memory Baffles Scientists

"James McGaugh is one of the world's leading experts on how the human memory system works. But these days, he admits he's stumped.
McGaugh's journey through an intellectual purgatory began six years ago when a woman now known only as AJ wrote him a letter detailing her astonishing ability to remember with remarkable clarity even trivial events that happened decades ago.
Give her any date, she said, and she could recall the day of the week, usually what the weather was like on that day, personal details of her life at that time, and major news events that occurred on that date."

Personality and Politics

"Remember the whiny, insecure kid in nursery school, the one who always thought everyone was out to get him, and was always running to the teacher with complaints? Chances are he grew up to be a conservative."

WHO | mental health Global Action Programme (mhGAP)

"Mental health has become a major international public health concern and WHO has placed high profile focus on the importance of mental health. During 2001 the World Health Day (7 April 2001) was devoted to mental health and 155 countries celebrated the event.":

Depression (Unipolar) - After SSRI Fails, Switching Antidepressants May Help

"A proportion of patients with major depression who are unresponsive to the selective serotonin-reuptake inhibitor citalopram may benefit from taking an alternate antidepressant, according to two studies reporting results from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial in the March 23 issue of the New England Journal of Medicine."

Shock therapy seen to improve quality of life

"Most severely depressed patients who are given electroconvulsive therapy (ECT) -- commonly known is electroshock therapy -- experience improved health-related quality of life that lasts for at least 6 months, a new study shows."

March 16, 2006

A Warning From South Dakota - New York Times

"When President Bush's Supreme Court nominees were asked about abortion and Roe v. Wade, their answers ranged from vague to opaque. But the state legislature in South Dakota felt it heard the underlying message loud and clear. Now, South Dakota has thrown down the gauntlet. It adopted a law last week that makes every abortion that is not necessary to save the life of the mother a crime. The law is clearly unconstitutional under existing Supreme Court rulings. But its backers are hoping that the addition of John Roberts and Samuel Alito to the court will be enough to change things."

Stem Cell Proposal Divides Missouri Republicans - Yahoo! News

"A ballot proposal promoting embryonic stem cell research is turning conservatives against each other and threatening to tear apart Missouri's Republican Party at the very height of its modern-day influence. The measure -- sponsored by a coalition of medical groups, researchers, businesses and patient advocates -- would make Missouri the only state besides California to enshrine the right to stem cell research in its state constitution."

Pharmacy refusals to fill prescriptions sets debate

"The Washington State Board of Pharmacy is considering a policy that would outline if and when pharmacists could refuse to fill prescriptions due to moral, religious or ethical objections.
The discussion is clearly aimed at clarifying whether pharmacists can turn away prescriptions for Plan B, the emergency contraceptive that has caused controversy nationwide, although such a conscience clause could pertain to other areas as well."

A Wrongful Birth? - New York Times

"As in many other realms, from marriage and its definition to end-of-life issues, those ethics and standards are being hashed out in the courts, in one lawsuit after another. And what those cases are exposing is the relatively new belief that we should have a right to choose which babies come into the world. This belief is built upon two assumptions, both of which have emerged in the past 40 years. The first is the assumption that if we choose to take advantage of contemporary technology, major flaws in our fetus's health will be detected before birth. The second assumption, more controversial, is that we will be able to do something � namely, end the pregnancy � if those flaws suggest a parenting project we would rather not undertake." [Free Registration Required]

Study: Drugs Better for Elderly Depression - Yahoo! News

"For elderly people who suffer bouts of depression, drugs work surprisingly better than psychotherapy at keeping these black spells from returning, suggests the longest study ever in patients so old. The findings from the two-year study may encourage some doctors to prescribe antidepressants for longer periods, perhaps even for life, in patients who have been depressed."

Use of Implanted Patient-Data Chips Stirs Debate on Medicine vs. Privacy

"When Daniel Hickey's doctor suggested he have a microchip implanted under his skin to provide instant access to his computerized medical record, the 77-year-old retired naval officer immediately agreed. 'If you're unconscious and end up in the emergency room, they won't know anything about you,' Hickey said. 'With this, they can find out everything they need to know right away and treat you better.'" [Free Registration Required]

Sex and Safety - Los Angeles Times

"Los Angeles County's 11 known sex clubs and bathhouses have long been popular places where gay men (and to a lesser extent heterosexual couples) go to have casual or public sex. Although perfectly legal as long as money doesn't change hands between partners, the steamy meeting points are also a major concern for public health officials because they can be breeding grounds for HIV and other sexually transmitted diseases."

March 13, 2006

Campaign for Mental Health Reform

"The Campaign for Mental Health Reform is a collaboration of 16 national health organizations, representing millions of Americans, to make health a national priority and early access, recovery and quality in mental health services the hallmarks of our nation�s mental health system."

Medicare Rights Center Part D Monitoring Project

"The frustration levels of my clients have been unimaginable! I have actually had clients burst into tears trying to understand the Part D program. As difficult as that process was, it was nothing compared to trying to explain to my clients after they had done everything they were supposed to do, they couldn't get their medications on January 1, 2006."

Racial Disparities & Prescription Surveillance

"Health policies designed to curb inappropriate medication prescribing can have the unintended effect of increasing racial disparities in access to appropriate care, reports a study by the Department of Ambulatory Care and Prevention (of Harvard Medical School and Harvard Pilgrim Health Care). . . 'This is the first well-controlled study to show that health policies designed to reduce drug costs and abuse can increase racial disparities in access to effective care for those with chronic illnesses, like schizophrenia,' said Pearson."

Kweisi Mfume: We Must Do More to Address Crime at its Roots Before a Generation's Lost

"For years, criminal justice policies have reflected the conservative view of lock them up and throw away the key without reflecting on the fact that many reactionary policies have caused more harm than good. Such policies have helped to increase -- not decrease -- the number of felons and the number of victims. Some of the once hailed and triumphed criminal justice policies such as 'three strikes - you're out' have proven to be -- as we knew they would -- a nightmare for criminal justice administrators and policy makers across the nation."

GWU Suit Prompts Questions Of Liability

"About 2 a.m. one sleepless night, sophomore Jordan Nott checked himself into George Washington University Hospital. He was depressed, he said, and thinking about suicide."