Tag Archives: health

Wyoming Is Thinking About Accepting Medicaid Expansion After All

Mother Jones

Michael Hiltzik passes along the news that Wyoming’s governor is the latest traitor to the cause of denying health care to poor people no matter what the cost:

The reason for Wyoming’s wavering is clear: It’s money.

The Health Department says Medicaid expansion could save the state $50 million or more if it expands the program, for which the federal government will pay at least 90%. Meanwhile, Wyoming hospitals say they’re losing more than $200 million a year in uncompensated care for people without insurance.

The state Legislature has rejected the expansion, but Republican Gov. Matt Mead has been saying it’s time to pack up. He’s entering negotiations with the feds for a way to expand Medicaid next year, covering as many as 17,600 low-income residents.

I imagine that before very much longer, most of the other Midwest holdouts will go ahead and accept Medicaid expansion too. That will leave only the hard-core holdouts of the Old South, where the poor are apparently especially undeserving. I guess there must be some kind of difference between poor people in the Midwest and poor people in the South. I wonder what it could be?

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Wyoming Is Thinking About Accepting Medicaid Expansion After All

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A Quarter of Americans Think They or Their Families Will Get Ebola

Mother Jones

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No one has contracted Ebola in the United States, or is very likely to. And no one should be surprised that Donald Trump is tweeting this anyway:

What’s more surprising is that many Americans share fears like those that underlie Trump’s tweet. According to a Harvard School of Public Health/SSRS poll, 68 percent of the US population believes Ebola spreads “easily.” Four in 10 are worried there will be a large outbreak in the United States. And a quarter of Americans are afraid the virus will infect them or someone in their families.

That’s partly a consequence of media distortion, says Gillian SteelFisher, a member of the Harvard research team that conducted the poll. “Ebola’s a terrible disease, and the impact it’s having on West Africa is horrible to observe,” she says. “And the news here is going to capture parts of that but not all of it.” When news reports focus on the gruesome effects of Ebola without explaining why it’s been able to spread so fast in countries like Liberia and Sierra Leone, it’s easy for Americans to believe they’re in danger too. “They’re feeling a very personal and direct threat,” SteelFisher says.

SteelFisher wants the public to hear from health officials who can explain what disease containment resources the United States has and how they differ from West Africa’s. Simple factors like the availability of rubber gloves, which are scarce in Liberia, would make Ebola much easier to control here.

SteelFisher also thinks people might be confused about how Ebola is transmitted. Those who are more familiar with diseases like the flu, or who’ve seen virus disaster films like 2011’s Contagion, might assume Ebola can spread through the air. But in the case of this virus, you can’t get sick without exposure to an infected person’s bodily fluids.

Though some Americans may be overestimating the risk of an Ebola outbreak, more than a few also have a mistakenly rosy view of the treatment plan for people who are infected. A third of those polled said there was “an effective medicine to treat people who have gotten sick with Ebola.” In fact, no such drug has been approved for humans. The drug Zmapp, which was used to treat a pair of American missionaries who caught Ebola in West Africa, is still being tested.

“You don’t want them to be glib,” says SteelFisher. “At the same time, you don’t want people to be panicking here.”

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A Quarter of Americans Think They or Their Families Will Get Ebola

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Why BMI Is a Big Fat Scam

Mother Jones

Sam Island

It wasn’t so long ago that fat people were considered healthy. Doctors were far more worried about underweight Americans, many of whom were too poor to afford enough calories. But as farms industrialized and food became cheaper, the tables began to turn. Shortly after World War II, it became clear that eating too much food led to just as many problems as not eating enough. Insurance companies noticed that their fattest policyholders were significantly more likely to die early than those of average weight. They searched for a way to measure excess fat and hit upon a simple formula developed in 1832 by a Belgian statistician, mathematician, and astronomer named Adolphe Quetelet: Simply divide a person’s weight by the square of his height. This formula, known as body mass index (BMI), spread from insurers to health researchers and finally, in the 1980s, entered the clinical realm.

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Why BMI Is a Big Fat Scam

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Should Pregnant Women Eat Zero Tuna?

Mother Jones

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Food-safety experts at Consumer Reports crunched the numbers on mercury levels in seafood—and they have a new recommendation for pregnant women: Don’t eat tuna at all.

The FDA recommends that pregnant and nursing women consume between 8 and 12 ounces of fish per week to provide proper nutrition for a baby’s brain development and overall health. But some fish are very high in mercury, a neurotoxin that can lead to serious cognitive problems and birth defects in children and babies. And the mercury levels in oceans are rising—humans have tripled the mercury content in oceans since the Industrial Revolution—leading to further mercury absorption by predators like tuna.

Consumer Reports provides charts to help curb mercury levels during fish consumption. Courtesy of Consumer Reports

A team at the Consumer Reports National Research Center analyzed data from the Food and Drug Administration’s chart on mercury levels in seafood and determined that consuming 6 ounces of albacore tuna in a week—the level recommended as safe by the FDA for pregnant women—would put a 125-pound woman over the Environmental Protection Agency’s “safe” mercury threshold by more than two ounces.

Canned light tuna is thought to offer a lower mercury tuna option, but 20 percent of the FDA’s samples of it contained almost double the average level of mercury that it’s supposed to. Some samples had more mercury than the king mackerel—one of the FDA’s top four high-in-mercury fish—which the agency advises pregnant women and children to avoid. Canned tuna constitutes the second most frequently consumed seafood product in the United States.

Some experts like Deborah Rice, a former senior risk assessor for the EPA, think that research since 2001 suggests that there is “no question” that the FDA and EPA’s current limit for mercury consumption is “too high,” she told Consumer Reports. The magazine is urging the FDA and EPA to recommend that pregnant women avoid eating any tuna—and to provide more safety information concerning tuna for pregnant women, children and people who eat a lot of fish (24 ounces of fish, around seven servings, or more per week).

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Should Pregnant Women Eat Zero Tuna?

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The Crisis in Clean Drinking Water

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The Crisis in Clean Drinking Water

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New Drugs and Vaccines Can’t Stop This Ebola Outbreak

Mother Jones

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With the death toll in the worst Ebola outbreak in history exceeding 1,000, pharmaceutical companies and health authorities are sprinting to develop new drugs and vaccines. On Monday, drug maker GlaxoSmithKline announced that it would start clinical trials of an Ebola vaccine ahead of schedule. And on Tuesday, the World Health Organization ruled that the use of experimental drugs to treat Ebola patients is ethical so long as the patients give their consent. But for now, there are no proven drugs to treat Ebola, and experts doubt that any new drug or vaccine could beat back the current outbreak in Sierra Leone, Liberia, and Guinea.

“The drugs are not going to stop the outbreak, period,” says Robert Garry, a virology researcher at Tulane University. One problem, he says, is the meager supply of drugs and vaccines. ZMapp, an experimental drug, has already begun human trials. But Mapp Biopharmaceutical, the company developing ZMapp with the help of the US Army, did not expect to start human tests this early, and it has only about a dozen doses. It has already sent two of those doses to Liberia.

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New Drugs and Vaccines Can’t Stop This Ebola Outbreak

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Humans Have Tripled Mercury in the Oceans

Mother Jones

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On Thursday, researchers released the first comprehensive study of mercury in the world’s oceans over time according to depth. Their finding: Since the Industrial Revolution, the burning of fossil fuels and some mining activities have resulted in a more than three times increase in mercury in the upper 100 meters (about 330 feet) of the ocean. There, it builds up in carnivorous species like tuna—a food staple in the US that health experts have been concerned about for years because of its high mercury levels. Much of the 290 million moles (a unit of measure for chemical substances) of mercury in the ocean right now is concentrated in the North Atlantic.

A neurotoxin, mercury is especially dangerous for children and babies: The American Academy of Pediatrics warns that exposure to it can lead to “poor mental development, cerebral palsy, deafness and blindness.” In adults, mercury poising can lead to problems with blood pressure regulation, memory, vision, and sensation in fingers and toes, according to the Natural Resources Defense Council. And if that wasn’t scary enough, it’s invisible, odorless, and hiding in fish meat.

The researchers say that the increase in mercury levels is starting to overcome the natural ocean circulation patterns. Typically, the coldest, saltiest water in the world’s oceans naturally sinks and brings much of the mercury along with it, offering shelter to marine life from the chemicals. But now, because of the sheer volume of the stuff, the circulation of water can no longer keep mercury out of shallower depths. According to co-author Carl Lamborg, humans are “starting to overwhelm the ability of deep water formation to hide some of that mercury from us.” According to David Krebbenhoft, a geochemist working for the US Geological Survey, these shifts are directly correlated to the increase in mercury outputs over time.

The good news: If we can curb power plant mercury emissions and buy more products with reduced mercury, we can expect to see ocean mercury levels drop in the future. Says Krebbenhoft, “It’s cause for optimism and should make us excited to do something about it because we may actually have an impact.”

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Humans Have Tripled Mercury in the Oceans

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Vibrant Health Green Vibrance Family Size Power – 60 Day Supply, 25.61-Ounce

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Dear New York, Don’t Freak Out About Ebola. You’re Going to Be Fine.

Mother Jones

A man who was recently in West Africa is being tested for the deadly Ebola virus at Mount Sinai hospital in Manhattan, hospital officials confirmed on Monday, after he arrived overnight with symptoms that may be consistent with the virus.

“All necessary steps are being taken to ensure the safety of all patients, visitors and staff,” Mount Sinai officials said in a statement.

But that didn’t stop the inevitable rush of panic on Twitter from New Yorkers and others around the country worried about a potential spread of the disease, which has claimed 887 lives, mainly in West Africa. But, unlike African countries already suffering the misery of the biggest outbreak ever recorded, the American public has little to fear, says Dr. Jonathan Epstein, an Ebola expert and a veterinary epidemiologist with EcoHealth Alliance, an international organization of scientists that studies biodiversity and conservation.

Here is an edited transcript of our conversation about how New Yorkers, and the rest of the country, should think about this news. In short: Don’t freak out. They’ve totally got this.

Mother Jones: What happens now? Should we be worried?

Jonathan Epstein: We certainly shouldn’t be overly surprised if additional cases inadvertently make their way to the United States from Africa. We know that there are direct travel routes from countries in West Africa to the United States. So it’s certainly well within the realm of reason that people who have been exposed to Ebola would board a plane to get to the United States, even without knowing that they are infected.

Dr. Jonathan Epstein, Associate Vice President of Conservation Medicine at EcoHealth Alliance EcoHealth Alliance

Now, once they are detected and hospitalized, our public health systems here are really good. We have exactly what’s needed to control Ebola, and that is to rapidly identify a case with confirmatory diagnostic testing. Those tests are truly available here, whether it’s through the Centers for Disease Control and Prevention in Atlanta, or state health agencies, or the hospitals themselves.

Isolation is critically important with Ebola, and infectious disease wards in major hospitals have the ability to isolate patients. So, provided that the patient is isolated, and the doctors and nurses take appropriate precautions in terms of their own personal protective equipment—”barrier nursing”, wearing gloves, protective clothing, that sort of thing—all of the things are in place at hospitals in the United States to really limit the ability of Ebola to be spread from person to person. I really do have a high confidence that if cases do make it to the United States that they’ll be identified, and traced back, and addressed.

MJ: The mind instantly goes to the situation before a patient reaches the emergency room, or even in the emergency room itself, or those that may have shared a subway stop. How do we assess the level of risk on that front?

JE: The fortunate thing about Ebola virus, as opposed to other viral infections which are easily transmitted through respiratory routes and are airborne like influenza, is that it doesn’t become transmissible until a person is symptomatic, and feeling pretty sick. That’s not to say they still might not go out into the public or have interactions with people, but at the point at which they do get identified by a health care provider, their contacts, their history since they became symptomatic in the past few days or so, will then be traced back by public health authorities.

We’re paying very careful attention to flights coming in from West Africa, and people who are already symptomatic who might arrive at the airport would be detected by public health screens there. There’s high confidence that we’d identify people.

MJ: Tell me more specially about New York City. It’s obviously prepared for big things. Is the city prepared for infectious diseases?

JE: We’ve experienced an infectious disease outbreak. If you remember the influenza H1N1 outbreak of 2009, there were cases in New York City. Public health systems were in place, and very well-equipped to diagnose them rapidly, and a lot of education and outreach campaigns were set in motion to limit the possibility of people getting infected with influenza. There was a lot of activity with respect to prevention. New York City specifically is prepared for infectious disease outbreaks of this nature.

MJ: What should people be aware of if this case escalates in such a big city like New York?

JE: What people need to realize is that even though Ebola is a virus that can have scary symptoms, and has this scary reputation, it’s not extremely transmissible. You need very close contact with a sick, clinically symptomatic patient, so it’s very unlikely that a person arriving with Ebola would set off a huge chain-reaction and cause a massive outbreak, that’s just not a likely scenario. We have very good people conducting surveillance both in New York and nationally to make sure that something like that doesn’t happen. So the conditions here are entirely different than they are in rural Africa, or Central or West Africa where Ebola outbreaks have occurred.

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Dear New York, Don’t Freak Out About Ebola. You’re Going to Be Fine.

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The Case Against Chlorinated Tap Water

Mother Jones

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The chlorination of municipal tap water is considered one of the 20th century’s best public health ideas. The American Water Works Association credits the practice with increasing life expectancy by 50 percent over the past century by virtually eliminating water-borne diseases such as typhoid fever and cholera. But chlorine in drinking water can cause health risks of its own. And while some of the of those risks, such as reactions with organic compounds that can yield toxic byproducts, are relatively well understood and managed, at least one has been largely overlooked: The effect of chlorinated drinking water on the beneficial bacteria in our guts.

The notion that our bodies’ 100 trillion bacteria act as a crucial internal ecosystem, a sort of sixth human organ, has only recently gained currency among mainstream scientists. Researchers now believe a lack of beneficial bacteria in the gut can trigger certain autoimmune diseases, among them diabetes, asthma, and even neurological conditions such as autism. Those conditions have spread in step with Western society’s war on germs, which has scorched our good bacteria along with the bad, throwing our bodies’ microbiomes off balance in the same way that a slashed and burned rainforest becomes susceptible to invasive weeds.

Jeff Leach is a leading microbiome researcher and founder of the American Gut Project, which aims to sequence the microbiomes of tens of thousands of Americans. Leach suspects that several factors may impede bacterial diversity in Americans, among them the profligate use of antibiotics, over-consumption of processed foods, and, at least to some extent, consumption of chlorine in tap water. “It’s something I’ve discussed with a number of other microbiologists,” he replied when I asked about the possibility. “In short, nobody has done the research, but we are certain that there is an impact.”

Based on studies of chlorine’s effects on human cells, the Environmental Protection Agency sets the safe level in drinking water at no more than four parts per million. Even that dilute level can wipe out lots other life forms, however, as anyone knows who has filled a goldfish bowl from the tap.

There’s no debate that chlorinating our water kills off a wide array of malignant bacteria—just try drinking the tap water in countries that don’t fully disinfect it. Much less is known, however, about chlorine’s effect on good bacteria that help preserve healthy digestive systems. We simply don’t know enough about the microbial ecosystem in the human gut to identify every type of bacteria that’s important, much less how well those bacteria survive when we guzzle mildly chlorinated tap water.

Still, some tangential research suggests cause for concern. A 1987 Toxicology study found that consumption of water with even fairly low levels of monochloramine, a commonly used disinfectant that persists in drinking water longer than chlorine, disrupted the immune systems of rats—a finding that’s notable given the strong link between the human immune system and gut microbes.

Chlorine in tap water is also known to kill microbes in soil—watch out, home gardeners!—though it doesn’t penetrate deep into the ground, and microbial populations typically bounce back quickly after watering.

Though the risks of chlorine in tap water might justify purchasing a low-cost home water filter that can remove it, it’s definitely premature to back off of requirements to chlorinate or otherwise disinfect municipal drinking water, as some Wisconsin state legislators proposed a few years ago.

“Chlorination has done tremendous good, so the default is to continue as is,” Martin Blaser, the director of the Human Microbiome Project, told me, “but whether or not there are subtler effects needs to be studied.”

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The Case Against Chlorinated Tap Water

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