Winter 2012 frontlines
[ Winter 2012 ]
Quick updates about the latest public health news from across the School and beyond.
Harvard Public Health Review now on Kindle
Take the Review on the road in your Kindle e-book reader. Visit the Amazon.com Kindle Store and search for “harvard public health” to download. Coming soon on other e-readers.
To Know, or Not to Know? Our Dilemma about Alzheimer’s
Would you want to know? An international survey designed and analyzed by HSPH and Alzheimer Europe found that 85 to 95 percent of respondents from five countries (the U.S., France, Germany, Spain, and Poland) said that if they were experiencing memory loss and confusion, they would go to a doctor to determine if the cause was Alzheimer’s disease. Although currently no single test can reliably diagnose Alzheimer’s, 38 to 59 percent of respondents believe there is such a test. In four of the five countries, Alzheimer’s was the second-biggest health fear after cancer. While fear of getting Alzheimer’s disease was highest among those aged 60 and over (20 to 47 percent), even among 18–34 year-olds, 6 to 22 percent reported that Alzheimer’s was the disease they most feared getting.
7 Billion and Counting…
If you think the world is crowded now, just wait a few years. Between today and 2050, our 2011 global population of roughly 7 billion could expand by another 1.1 to 2.6 billion people. David Bloom, HSPH’s Clarence James Gamble Professor of Economics and Demography, writes that already-strained developing countries will likely face tremendous difficulties supplying food, water, housing, and energy to their growing populations—with worldwide repercussions for health, security, and economic growth.
Rural Health Care is Ailing
In the first national study of care at critical access hospitals* (CAHs) in the rural U.S., HSPH researchers have found that CAHs have fewer clinical capabilities, lower quality of care, and worse patient outcomes than other hospitals. Patients admitted for heart attack, heart failure, or pneumonia were at 30 to 70 percent greater risk of dying within 30 days than those at other hospitals. Karen Joynt, an instructor at both HSPH and Brigham and Women’s Hospital and the study’s lead author, said CAHs “face a unique set of obstacles to providing high-quality care,” which current health policy efforts don’t address. The study recommends partnerships with larger hospitals, greater use of telemedicine, or joining national quality-improvement efforts to help CAHs ensure, in Joynt’s words, “that all Americans receive high-quality care, regardless of where they live.”
*CAHs are geographically isolated facilities with no more than 25 acute care beds.
China and U.S. Health Leaders Convene at HSPH
In China, health care quality in rural areas often lags behind that in cities.
In the United States, lack of communication among health care providers sometimes results in inadvertent harm to patients.
These deficiencies, and how to address them, were just two of many issues discussed during the first annual Harvard America-China Health Summit held at Harvard School of Public Health in September. Keynote speakers included Chen Zhu, China’s Minister of Health, and Sherry Glied, Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services.
The two-day event, sponsored by HSPH’s China Initiative, drew more than 700 health officials and other participants from China, the U.S., and beyond to exchange information on problems and solutions in health care.
Both the United States and China have embarked on ambitious health reform plans. Both share key goals—such as expanding access, improving quality, and lowering costs. And both are striving to achieve these goals amid mounting medical costs, rising rates of chronic disease, technological challenges, and other factors.
Chen listed many recent improvements in Chinese health care, including drops in maternal and infant mortality rates, increases in life expectancy, and reductions in out-of-pocket medical expenses.
Glied likewise outlined progress in the U.S. since the passage of major health care reform legislation last year. She mentioned popular new provisions such as the inclusion of adults up to age 26 on their parents’ health care plans as well as lower medication costs for seniors.
Some 50 speakers discussed topics including traditional Chinese medicine, chronic disease control, information technology in health care, the relationship between doctors and drug companies, and telemedicine.
Dean Frenk Inducted Into the American Academy of Arts and Sciences
HSPH Dean Julio Frenk was among a group of the nation’s most influential artists, scientists, scholars, authors, and institutional leaders who were inducted into the American Academy of Arts and Sciences at an October 2011 ceremony in Cambridge. The Academy, which was founded during the American Revolution, is one of the nation’s oldest and most prestigious societies of scholars and leaders.
Noncommunicable Diseases to Cost $47 trillion
Reports about the growing threat from noncommunicable diseases, or NCDs—such as cancer, heart disease, and diabetes—have appeared prominently in headlines in recent months. At a September 2011 conference convened by the Washington Post, HSPH Dean Julio Frenk described a “moral imperative” to prevent and treat NCDs in poor countries, similar to the international anti-AIDS effort made a decade ago. A report released the same month, jointly authored by the World Economic Forum and an HSPH team led by David Bloom, Clarence James Gamble Professor of Economics and Demography, and Elizabeth Cafiero, a research assistant in the Department of Global Health and Population, noted that the global economic impact of NCDs over the next two decades will total a staggering $47 trillion. And in June, a major international study on worldwide trends in diabetes, published in The Lancet, found that the number of adults with the disease reached 347 million in 2008—more than double the number in 1980. The study was co-led by Goodarz Danaei, HSPH assistant professor of global health. Today, an estimated 63 percent of deaths worldwide are caused by NCDs, making them the world’s leading killer.
Massachusetts Girls Land on Planet Health
Planet Health—an obesity and eating disorders prevention program developed at HSPH and first implemented at five Massachusetts middle schools—saved an estimated $14,000 in total medical expenses for the 254 girls enrolled in the program by averting the costs of treating obesity and eating disorders. The girls, aged 10 to 14, learned about the benefits of healthy eating, less TV, and more physical activity. Girls who went through the program were about half as likely as others to purge or use diet pills to control their weight. Planet Health is now offered at thousands of schools nationwide. Learn more
Energy-Efficient Buildings: Hazardous to Your Health?
Talk about unintended consequences: Energy-efficient building weatherizations, retrofits, and upgrades can cause dampness, poor ventilation, excessive temperatures, and emissions from building materials. These factors can degrade air quality and trigger respiratory problems such as asthma and other health problems. These are the findings of a new Institute of Medicine report requested by the U.S. Environmental Protection Agency (EPA) and prepared by a committee chaired by John Spengler, HSPH Akira Yamaguchi Professor of Environmental Health and Human Habitation. Spengler says that “America is in the midst of a large experiment” with weatherization and energy-efficient retrofits that affect air quality. He recommends that the EPA make “an upfront investment to … avoid problems where they can be anticipated,” and that doing so will “yield benefits in health and in averted costs of medical care, remediation, and lost productivity.”
Off the Cuff
New Chair, Department of Epidemiology
Stephen B. Kay Family Professor of Public Health
Is epidemiology a beautiful science?
“I started to see beauty in science as an undergrad, looking at embryonic development. There is nothing more beautiful than watching a single cell turn into an organism. It contains all the signals needed to dictate which cells become a wing, which a thorax, which an eye. The beauty is the apparent simplicity hiding an enormous complexity.
Epidemiology might seem dry to most people—but it’s just turning the beauty of biology into numbers. When epidemiologists get together, they might look at a table or a graph and say, ‘We’ve distilled this down to its essence.’ One of the most beautiful charts I’ve seen has two graphs, each representing a 50-year time span, overlaying each other. One graph shows the declining number of hours that Americans are sleeping at night—its line is going down. The other shows the percentage of Americans who are overweight or obese—its line has the same slope and curvature as the sleep line, but it’s going up.
The beauty of this chart is its simplicity. It encapsulates two important trends that we can’t deny are occurring. We have to be careful that we’re not oversimplifying their connection, but it begins the conversation. That’s why I think it’s beautiful.”