“It is time to sound the alarm,” said Dr. Judy Wasserheit, vice chair of the Department of Global Health at the University of Washington, who wrote the article with Dr. Gail Bolan of the U.S. Centers for Disease Control and Prevention and Dr. P. Frederick Sparling of the University of North Carolina School of Medicine, Chapel Hill.

Gonorrhea bacteria - Photo CDC

Gonorrhea is a sexually transmitted disease that can infect the genital tract, throat and anus.

There are more than 600,000 cases of gonorrhea a year in the U.S., making it one of the most common reportable infections in the country.

Untreated, gonorrhea can cause a number of serous complications, including infertility, a chronic painful pelvic condition in women called pelvic inflammatory disease, and ectopic pregnancy, a serious complication in which the fetus develops in the fallopian tube instead of the uterus.

In rare cases, the bacteria can travel through the bloodstream and infect joints, heart valves and the brain.

The bacteria that causes gonorrhea, Neisseria gonorrhoeae, has a history of quickly acquiring the ability to resist antibiotics. In the 1940s it became resistant to sulfa drugs, in the 1980s to penicillins and tetracyclines, and by 2007 to flouroquinolones.

Today, treatment with a class of antibiotics called cephalosporins is considered the most reliable option, but resistance to this class of drugs is on the rise both abroad and in the U.S., raising concerns that doctors here will soon begin seeing cases they cannot cure.

Untreatable cases have not yet been reported in the U.S., but they have appeared in Asia and Europe and a worrying number of strains in the U.S. are showing signs of resistance to cephalosporins.

Resistance to one of the cephalosporins has risen 17-fold in the U.S. over the past few years, Dr. Wasserheit and her colleagues write, increasing from just 0.1 percent of cases in 2006 to 1.7 percent in the first part of last year.

Resistance has been increasing even faster in the western U.S., reaching 3.6 percent of all cases last year and 4.7 percent of cases among men who have sex with men.

Although higher doses may overcome the ability of these strains to resist cephalosporins for a time, Dr. Wasserheit and her colleagues write, urgent action is needed now to prevent the spread of these strains and to develop new treatments.

“There is much to do, and the threat of untreatable gonorrhea is emerging rapidly,” they conclude.

 To learn more:

• Visit the National Library of Medicine’s Medline Plus information page on gonorrhea.

• Visit the Public Health – Seattle & King County’s page on Sexually Transmitted Infections.

Photo: Sigurd Decroos

The good news: Teen pregnancies are at their lowest rate in nearly 40 years, resulting in fewer abortions and births, according to data from the Guttmacher Institute, a research organization focused on sexual and reproductive health.

The report shows that about 7 percent of U.S. teen girls between the ages of 15 to 19 were pregnant in 2008 — a decline from the high of more than 11 percent in 1990.

Abortions among teen girls fell from a peak of more than 4 percent in 1988 to about 1.8 percent in 2008, the lastest year for which data is available.

The bad news: While overall rates have dropped, there is still a major gap among white, Hispanic and black teenagers. Non-Hispanic white teen pregnancy rates fell by 50 percent from their peak; Hispanic teen pregnancy rates, 37 percent; black teen pregnancy rates, 48 percent.

Yet, according to the report, “the abortion rate among black teenagers was four times the rate for non-Hispanic whites, while the rate among Hispanic teenagers was twice the rate for non-Hispanic white teenagers.”

“The disparity has pretty much been unchanged,” said Kathryn Kost, co-author of the report. “If you think of these rates as lines on a graph, they are all going down, but the distance between them is pretty much unchanged.”

Kost said the increase in contraceptive marketing has helped to reduce pregnancies, but Heather Boonstra, a senior public policy associate at Guttmacher said the cost of contraceptives continues to be a factor. Boonstra said increasing the age limit for dependent health care coverage to 26 will increase access to birth control for many teens.

“There’s plenty of evidence that shows that if you take away cost in the equation,there is going to be better contraceptive use, fewer unintended pregnancies, fewer abortions, better birth outcomes,” she said. “The health care reform law was not designed with teens in mind, but … the more parents that are insured, the more teens or their dependents are insured, so certainly that will help.”

Bill Albert, the chief program officer of The National Campaign to Prevent Teen and Unplanned Pregnancy, said the decreased rates are a sign of progress, but more remains to be done. He noted that three out of 10 girls are pregnant by the age of 20.  Among the campaign’s initiatives is one focused on the Latino community and a new website geared to educating young women about birth control.

“In a way the message is let’s celebrate today, and then get back to work this afternoon,” Albert said. “I think this underscores the need to continue to invest as the current admin has in proven efforts to prevent teen pregnancy.”

Photo by Sigurd Decroos of CobraSoft.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Supporters of the initiatives say these new services allow students to get good information about sex anonymously. But there are also those who oppose these initiatives, writes Hoffman.

…proponents of abstinence-based sexual education argue that these digital services presume that sexual activity among teenagers is the norm, and do not spend enough time on alternatives.

“They are only focusing on the risk-reduction model,” said Valerie Huber, executive director of the National Abstinence Education Association, which hopes to kick off its online service for teenagers next year.

Those who run digital programs say they simply want teens to have accurate information, to help them make good decisions. Even though popular culture is saturated with sex, facts and advice can be hard to find.

To learn more:

• Read Hoffman’s article Sex Education Gets Directly to Youths, via Text.

Some of the services discussed:

• ICYC – In Case You’re Curious

• Chicago’s The Sex-Ed Loop

• California’s The Hookup.

• SexEtc: www.sexetc.org

• National Abstinence Education Association: www.abstinenceassociation.org

Photo: Jean Scheijen

This story is part of a reporting partnership that includes WHYY,  and Kaiser Health News.

It’s not news that Americans are dealing with an obesity epidemic. But the problem is particularly acute among African-American women.

Four in five African-American women are obese or overweight, according to the U.S. Office of Minority Health, and carrying those excess pounds can spike the risk for several conditions including heart disease, Type 2 diabetes, high blood pressure and stroke.

Members of the Anderson Monarchs soccer team practice as their coach looks on. The team, which was started at Philadelphia's Marian Anderson Recreation Center, gives game time to girls who have little chance to play another sport (Photo by Todd Vachon/WHYY).

About half of African-American women in the U.S. are obese, compared to 30 percent of white women. Black women not only carry more weight, but they start adding extra pounds years before their white counterparts.

So when does it begin, this excess and unhealthy weight? Research suggests the problem starts early, and it may have a lot to do with when girls give up regular exercise.

Experts want kids to exercise at least 60 minutes every day, but among all children, black girls are most likely to report they got no physical activity in the past week.

A lack of access to exercise opportunities may be one big reason why, says Shiriki Kumanyika, an epidemiologist and public health professor at the University of Pennsylvania.

Research shows that opportunities for recess, sports, physical education — or just to go outside — aren’t spread evenly among children.

“If you kind of add up those situations in urban, inner-city neighborhoods — where most African-Americans live — they are not as available. That’s been documented,” says Kumanyika, who studies patterns of illness and health behavior.

But research suggests that even those girls who do engage in sports and other forms of regular physical activity tend to abandon it in their teen years — and that’s true not just for urban girls or black girls, but all girls.

A National Institutes of Health study that followed girls for 10 years, beginning at age 8 or 9, found that, over time, leisure-time physical activity declined dramatically. That drop off was steepest for African-Americans girls.

“What they found was that by the age of 17 — so that’s the junior, senior year of high school — more than half of black girls, and nearly a third of white girls were reporting no leisure time physical activity at all,” says Temple University researcher Clare Lenhart.

There are lots of reasons why teen girls drop exercise from their lives, says Lenhart: “They have found changes in enjoyment of activities, in peer support or social support for physical activity. They found a lot of competing interests — be it part-time jobs or caring for younger siblings or other family members.”

Walter Stewart says he’s witnessed the phenomenon first-hand. He’s the longtime coach of the Anderson Monarchs, a soccer team of mostly African-American girls from inner-city Philadelphia.

Members of the Anderson Monarchs soccer team gather as their coach Walter Stewart talks to them. The team, which was started at Philadelphia's Marian Anderson Recreation Center, gives game time to girls who have little chance to play another sport (Photo by Todd Vachon/WHYY).

Members of the Anderson Monarchs soccer team gather as their coach Walter Stewart talks to them.

The team, which was started at Philadelphia’s Marian Anderson Recreation Center, gives game time to girls who have little chance to play another sport (Photo by Todd Vachon/WHYY).

“Eighth grade — that’s where it gets to be difficult,” he says. “They are making the transition from young kids to more teenagers, and they are more interested in boys and what boys think.”

Jennifer Johnson was determined not to let that happen to her daughter, Alexandria. Johnson discovered the Monarchs when she was looking for an affordable way to keep Alexandria active.

Alexandria is now 15 and an assistant coach with the team, but her interest in soccer dipped in middle school, around age 12, says Johnson.

“In come the friends, and in come the extracurricular activities at school, and as a parent you really have to press on. I said to her, ‘If it’s not this, you will be involved in something,’” Johnson says.
So Alexandria stuck with soccer, and so did her mother — Johnson is on the sidelines at games and during most practices.

That’s an approach that obesity researchers would approve of. Researchers say that family support — especially mom’s presence — may motivate girls to keep playing.

Researchers are beginning to count up the cost of obesity, and say women can pay a hefty price in dollars– and health.

A sedentary lifestyle and obesity may account for 25 to 30 percent of some major cancers, including colon, kidney and breast cancer in postmenopausal women, according to the National Cancer Institute. Avoiding weight gain, by contrast, can cut cancer risk.

In September 2011, researchers at Boston University reported that overweight and obesity in African-American women increases their risk of death, particularly from heart disease.

The investigators reviewed body mass index–a measure of body fat–and death rates for participants in the ongoing Black Women’s Health Study. A BMI of 25 is considered overweight. The study found a significant increased death risk at a BMI of 27.5–that’s the BMI for a 5-foot-4-inch tall woman who weighs 160 pounds.

Nearly 10 percent of all health care spending in the United States, $147 billion a year, is related to the obesity epidemic. Individually, obese people cost nearly $1,500 more a year in medical expenses compared to healthy-weight people, according to estimates from researchers at George Washington University. Some of that extra expense is paid by individuals, some is passed along to their employers.

Photo of soccer ball courtesy of Jean Scheijen

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Photo by Sue_r_b

America seems to be detrimental to the health of Hispanic immigrant populations — and the longer they are here the worse it is.

New data show that as they settle into American lifestyles, Hispanic immigrants are diagnosed with hypertension, diabetes and obesity at almost the same rate as those born in the U.S.

Hispanic immigrants who have been in the U.S. for 20 years or more are 98 percent more likely to become obese, 68 percent more likely to develop hypertension and about two and a half times more likely to become diabetic than those who have been in the U.S. for less than a decade.

Leslie Cofie, a first-year doctoral student at the University of North Carolina, and the lead researcher on this study, used data from the Centers for Disease Control and Prevention’sNational Health and Nutrition Examination Survey — a group of national studies that combines interviews and physical exams to get the numbers on health outcomes.

“A lot of the studies that have been done before on immigrants have been based on self-reported data sources,” Cofie said. But, he says, self-reported data is more error-prone since it is relying on a person’s recollection. The NHANES studies, however, provide a more comprehensive look since they use medical examination records collected by trained professionals.

At the annual American Public Health Association meeting Cofie discussed findings about Hispanic immigrants who have been in the U.S. up to 20 years and said those who were in the U.S. longer had a significantly higher percentage of hypertension, diabetes and obesity than the Hispanic immigrants who have been here for 10 or fewer years.

Female Hispanic immigrants who have lived in the U.S. for 20 or more years are more prone to obesity and hypertension, while the male Hispanic immigrants living in the U.S. for 20 or more years are more prone to diabetes.

Cofie said that his analysis shows that variables such as access to health care, social economic status or even documentation have no real effect on the number of Hispanic immigrants diagnosed with these chronic conditions. “Even after we control for all those factors, we still see higher prevalence in poor health outcomes of these immigrants.”

Dr. Emilio Carrillo, the vice president of Community Health Development at New York-Presbyterian Hospital said this data is an unfortunate, but inherent part of the Hispanic immigrant experience in the U.S.

“It’s well known that the first generation that came here had a healthier experience,” he said. “But then the next generation comes along and they tend to adapt to the American lifestyle …” which includes poor eating and exercise habits.

Jennifer Ng’andu, the deputy director of the Health Policy Project at the National Council of La Raza in Washington said Hispanic immigrants “are severely disconnected from the health care system.” Ng’andu adds that the more Hispanic immigrants are detached from the health care system, the more costly it will be to support their health care needs. “It’s going to cost us more to keep immigrants outside of the health care system.”

Photo by Sue_r_b

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.