About half of the difference in life expectancy between the U.S. and other high-income countries like Austria and the U.K. is due to injuries sustained from guns, drug poisonings and motor vehicle crashes, according to a new study.
As of 2012, U.S. life expectancy at birth was 78.7 years, compared to 81.5 years in the U.K. and 82.6 years in France, according to World Bank data.
By Carol Torgan
National Institutes of Health
At a Glance
- Exposing babies delivered by C-section to fluids from the mother’s birth canal enriched the babies’ microbes to levels more typical of babies born vaginally.
- Larger studies with further follow-up will be needed to determine the long-term health consequences of the microbial transfer procedure.
Trillions of microbes—including bacteria, fungi, and viruses—live in and on the human body. Some of these microbes cause illnesses, but many are necessary for good health.
Babies delivered via the birth canal acquire a microbial community (microbiota) that resembles that of their mother’s vagina. Babies born by cesarean section tend to acquire a microbial community that more closely resembles that of their mother’s skin.
The microbiota acquired by a newborn are thought to be essential for the development of a healthy immune system and metabolism. Continue reading
By Michael Ollove
A handful of federal lawsuits against states that have denied highly effective but costly hepatitis C drugs to Medicaid patients and prisoners could cost states hundreds of millions of dollars.
The drugs boast cure rates of 95 percent or better, compared to 40 percent for previous treatments. But they cost between $83,000 and $95,000 for a single course of treatment.
The class actions, all filed in the last eight months in federal courts in Indiana, Massachusetts, Minnesota and Pennsylvania, present a series of extremes: a deadly epidemic, a treatment that can stop the disease in its tracks, and an enormous price tag.
At least 3.5 million Americans have hepatitis C, a virus spread through blood-to-blood contact that is usually contracted through the sharing of needles or other equipment to inject drugs.
Left untreated, hepatitis C slowly destroys the liver. Medicaid beneficiaries, a low-income population, have a slightly higher rate of hepatitis C infection than the privately insured, and the rate among prisoners is 30 times higher than in the general population.
The U.S. Food and Drug Administration approved the first of the new drugs, Sovaldi, in 2013. Since then, the FDA has also approved two other drugs, Viekira Pak and Harvoni.
But because the drugs are so expensive, state Medicaid programs and prisons have been restricting them to people in the advanced stages of the disease. Continue reading
The World Health Organization needs urgent reform to boost its ability to respond to crises, and failure to act now could cost thousands of lives, according to an advance copy of a high-level U.N. report.
The report, entitled “Protecting Humanity from Future Health Crises”, is the latest in a series of reviews by global health experts which have been sharply critical of the WHO’s response to the devastating Ebola epidemic in West Africa.
“If the WHO does not successfully reform, the next major pandemic will cause thousands of otherwise preventable deaths,” the report said.
Public Health — Seattle & King County expert weighs in
By Dr. Jeff Duchin, MD
Health Officer and Chief of Communicable Disease Epidemiology & Immunizations
Experts are still learning about Zika virus, and in this time of uncertainty, some some are calling for a quarantine on travelers from areas affected by Zika.
I don’t think it’s a good idea.
Quarantine of travelers exposed to Zika virus is neither appropriate nor feasible, and would likely have no meaningful impact on the spread on the disease – but would result in significant negative unintended consequences on travel, commerce, individuals and families.
Quarantine of returning travelers would be costly and complicated to carry out for no real benefit. Although Zika poses a real threat of continued global spread, continuing measures to protect travelers and control the outbreaks where they are occurring, although imperfect, are more appropriate responses.
This is true for a number of reasons.
- There is no practical way to identify or screen for who is infected with Zika and potentially capable of transmitting infection. Most infections are asymptomatic and there is no rapid diagnostic test.
- In addition, everything we know suggests the threat to the US is not large. Based on experience with other viruses, like dengue and chikungunya, that are transmitted by the same mosquito vectors and have reached the US after large scale epidemics expanded globally, the risk for ongoing transmission or large outbreaks in the US is thought to be low. (In much of the country including the Pacific Northwest, we don’t have the type of mosquitoes that transmit Zika, dengue and chikungunya.) In contrast, the number of persons traveling to and from Zika-affected areas would be extremely large and enter the US at many points, making implementation of quarantine unrealistic even if it was potentially useful.
- And, it’s likely that Zika, as dengue and chickungunya viruses have done, will become established in much of the world, meaning that quarantine would need to be continued on an ongoing basis.
By Barbara Feder Ostrov
Stanford University scientists say they’ve devised a more accurate and comprehensive DNA test to screen newborns for cystic fibrosis, the most common fatal genetic disease in the United States.
Affecting about one in 3,900 babies born in the U.S., cystic fibrosis causes mucus to build up in the lungs, pancreas and other organs, leading to frequent lung infections and often requiring lifetime treatment for patients, whose median lifespan is 37 years.
Every state screens newborns for cystic fibrosis, but the current sequence of tests can miss cases, threatening babies’ lives.
The new method described in a recent article in The Journal of Molecular Diagnostics, promises to be more efficient and cost-effective, researchers said. It may also improve screening for non-white babies, for whom cystic fibrosis is rarer and harder to diagnose.
The new method promises to be more efficient and cost-effective and may also improve screening for non-white babies in whom cystic fibrosis harder to diagnose.
Cystic fibrosis is caused by a defect in the CFTR gene, which regulates the movement of water and salt out of the body’s cells. In California, current genetic screens look for 40 of the most common mutations of the CFTR gene in newborns.
Yet any of the more than 2,000 known mutations in that gene could play a role in the disease, and there are likely others that have not yet been discovered.
The new test uses “next generation” DNA sequencing that can quickly and more cheaply look at the entire CFTR gene, not just selected mutations. It does not require an extra blood sample. Rather, it uses the tiny amount of blood drawn from the common newborn heel stick test that’s already used to screen for a number of diseases, including cystic fibrosis.
The researchers say this advance can enable testing labs to review many newborn samples at a time and reduce costs, allowing a technology previously used only to diagnose individual cases to be applied to a large population. Continue reading
HHS Sec. Burwell says ‘beat goes on’ as agency seeks to expand health law’s influence
By Mary Agnes Carey
Department of Health and Human Services Secretary Sylvia M. Burwell on Friday hailed the health law’s 2016 enrollment gains and said the department was already beginning to gear up for the next enrollment period.
In addition to the health law, Burwell’s agency is juggling many other priorities these days, including coordinating her agency’s response to the emerging threat of the Zika virus, President Barack Obama’s “Moonshot on Cancer” initiative and the growing epidemic of opioid abuse.
“The beat goes on,” she said during a briefing with reporters at HHS headquarters. Continue reading
By Mike Kreidler
Washington State Insurance Commissioner
A growing concern for consumers and health insurers is the cost of prescription drugs and specifically, treatment for debilitating and life-threatening diseases.
Hepatitis C is a good example. New drugs are now used to cure this life-threatening liver ailment with proven success. But the pills are costly, ranging from $55,000 to almost $95,000 per patient for a standard 12-week treatment period.
Two nationwide organizations, the American Association for the Study of Liver Diseases and the Infectious Disease Society of America, now recommend that most patients receive treatment even if they are in the early stage of the disease versus waiting until it has progressed.
Last November, the federal government encouraged states to ensure that health coverage policies are “informed” by the treatment guidelines noted above. Unfortunately we do not have the authority to mandate that insurance companies abide by the guidelines. However, we do expect insurers to be current on all appropriate guidelines that best serve consumers. That is true for all types of treatments.
We recently asked health insurers in Washington if they were aware of the new guidelines and if they were making any changes to how they were treating patients with this disease. The responses were varied, but there were common themes: Continue reading
From the Washington State Department of Health
Recent tests expand the area now known to have the Valley Fever fungus
Recent soil and dust samples from several sites in south-central Washington have tested positive for the fungus that causes Valley Fever and for the first time positive samples were found in Yakima County.
The Washington State Department of Health, Yakima Health District, and Benton-Franklin Health District have been working together to understand where the fungus is present and what soil types will support its growth in Washington state.
A total of nine human cases of Valley Fever have been reported from Yakima (4), Benton (3), Franklin (1), and Walla Walla (1) counties since 2010. Soil sampling was initiated as a result of illness reports; samples from several sites in Benton County previously tested positive for the fungus.
While the risk of becoming infected in Washington is thought to be low, soil testing helps health officials identify where the fungus is located, where ill people might have been exposed, and what environmental conditions the fungus needs to survive. Continue reading
By Phil Galewitz
2016 Obamacare Enrollment Tops Expectations At 12.7 Million
About 12.7 million Americans enrolled in private health insurance through the federal and state marketplaces for 2016, the Obama administration said Thursday.
Sign-ups in the third enrollment period for the Affordable Care Act’s online marketplaces — and the last that will be completed while President Barack Obama is in office — easily topped last year’s amount and also beat the administration’s modest forecast.
The 2016 enrollment period began Nov. 15 and ended Jan. 31. Except for limited exceptions such as job losses, Americans will have to wait until mid-November to enroll again.
About 4 million enrollees on healthcare.gov this year enrolled in the coverage for the first time.
Of the 12.7 million consumers enrolling in marketplace coverage, more than 9.6 million came through the federal healthcare.gov exchange that handles 37 states. The rest, 3.1 million, selected a plan through the 13 state-based marketplaces.
About 4 million enrollees on healthcare.gov this year enrolled in the coverage for the first time, according to the Department of Health and Human Services.
At the end of last year’s enrollment period, 11.7 million people had chosen plans, but that figure dropped to 9.3 million by September because not everyone paid premiums and some found coverage elsewhere, such as through employers.
In October, the White House estimated that 10.1 million Americans would have health care coverage through the exchange at the end of 2016, a figure that counts people who paid and were covered at the end of the entire year.
By Julie Rovner
Nearly six years after its enactment, the Affordable Care Act remains a hot-button issue in the presidential race — in both parties.
“Our health care is a horror show,” said GOP candidate Donald Trump at the Republican debate in South Carolina Dec 15.
Texas Sen. Ted Cruz, winner of the Iowa caucuses, said at the debate in Des Moines Jan. 28 that the health law has been “a disaster. It is the biggest job-killer in our country.”
Democrats largely support the law, but even they can’t agree on how to fix its problems. Hillary Clinton said at the Jan. 25 town hall on CNN that she wants to “build on the ACA. Get costs down, but improve it, get to 100 percent coverage.”
Clinton’s rival for the nomination, Vermont Sen. Bernie Sanders, acknowledged that “the Affordable Care Act has done a lot of good things,” but added that “the United States today is the only major country on earth that doesn’t guarantee health care to all people as a right.” Sanders is pushing a government-run “Medicare for All” plan instead.
In some cases candidates are bending the truth. But in general, both praise and criticisms of the law are accurate. That’s because the health law is so big and sweeping that it has had effects both positive and negative.
Here is a brief guide to some things the health law has — and has not — accomplished since it was signed by President Barack Obama in 2010. Continue reading