Tuesday, November 24, 2009

Once again - some links for you

  1. I wrote a few weeks ago about unsexy health threats, and chronic disease could probably fit under that category. Certainly the Global Alliance for Chronic Disease thinks so. This organization, founded in June, is trying to increase awareness of the prevalence of chronic disease around the world, even in developing countries. This article details more about this organization and this issue.
  2. Food safety legislation has been given the next push forward in the Senate. This article says that the full Senate won't take up the legislation until 2010, but Congress is certainly looking to move on food safety legislation of some sort this session. "The Senate bill would expand U.S. Food and Drug Administration (FDA) oversight of the food supply and shift its focus toward preventing, rather than reacting, to foodborne outbreaks. FDA would have the power to order recalls, increase inspection rates and require all facilities to have a food safety plan."
  3. I have briefly mentioned the economy's effect on public health, and this article repeats that message - the economy has affected the public's health and well-being. Respondents to a recent survey indicated that they were more likely to overeat and less likely to exercise due to stress about the economy. Respondents were also less likely to take care of health problems in a timely manner. And, last but certainly not least, emotional health was adversely affected by the economy.
  4. And finally, our favorite topic du jour - the recent change in the U.S. Preventive Services Task Force's recommendations on breast cancer screenings.

    This article provides a good, solid perspective on the recommendation change, explaining a bit about why the public has a hard time accepting the fact that screenings are not always in our best interests: "Statisticians and epidemiologists know this for a fact. The problem is, there's no way to tell which of the tumors are dangerous and need to be treated and which are harmless and would be best left alone. So all of them get treated, often aggressively. The medical establishment calls this overdiagnosis."

    This article's title, "New mammogram guidelines are confusing, but here's why they make sense," says it all. The article notes that the new guidelines are in line with international recommendations and goes through the recommendation in a detailed manner, explaining each point. The potential harms from widespread mammogram screening include radiation exposure, false-positives, and the incorrect notion that early detection is always a good thing. It's a good article.

    This NY Times op-ed piece by Robert Aronowitz has an interesting premise: "Why do we keep coming around to the same advice — but never comfortably follow it?" The column details some of the history of cancer screening and treatment and how increased diagnoses of cancer led to increased pressure to screen earlier and diagnose earlier and more often. He makes a very good point:
    "You need to screen 1,900 women in their 40s for 10 years in order to prevent one death from breast cancer, and in the process you will have generated more than 1,000 false-positive screens and all the overtreatment they entail. This doesn’t make sense. We could do more research and hold more consensus conferences. I suspect it would confirm the data we already have. But history suggests it would never be enough to convince many people that we are screening too much."

    And, finally, "What watching ESPN could teach us about mammograms" - this title immediately caught my eye. Basically, this article says that statistical data are presented in the sports world every day and understood - why can't the same thing be done in public health? Why is the message clouded? Great question! The answer is that we have messaging problems, we public health professionals. It's true. It also gives a link to the National Cancer Institute's breast cancer assessment tool - interesting.

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