Why Do Millions of Children Have to Die?

It is fitting that following my previous post on the growth in the global millionaire community, I decide to reflect on the moral travesty that is child mortality. I say moral because it is a problem that need not still exist to the degree that it does, and that only persists because our global economic system are not sufficiently guided by ethical principles.

Historically, around 43 percent of children died before the age of five; as fairly recently as the 19th century, every second or third child would perish, even in relatively developed Western countries. Although child mortality has declined rapidly over recent decades — down to 4.3 percent globally, compared to 8 percent in 2000 and 18 percent in 1960 — it is still far higher than it should be.

Nowadays, anywhere from 6 to 9 million children die before their fifth birthday, and nearly half of them die within a month of their birth. (This does not include millions more that die before adulthood.) About 42 countries, mostly in sub-Saharan Africa, account for 90 percent of these deaths. Two-thirds of these children die from causes that are easily preventable, namely diarrhea, pneumonia, malnutrition, and malaria. Continue reading

Insects, Food of the Future

As many of you know from previous posts, I am a big advocate of cultivating insects as a major sustainable food source for the world. Already enjoyed as a staple food by around 2 billion people worldwide, bugs of all kinds offer a cheap, accessible, and nutritional form of sustenance in a world of stress resources. Hence why the U.N. Food and Agriculture Organization (FAO) concluded in its report on the idea that “the consumption of insects … contributes positively to the environment and to health and livelihoods.”

As the L.A. Times reports, the message is even getting across to the United States, albeit ever so slowly. The article covers several businesses that are attempting to make bug food mainstream in a culture not accustomed to the idea. For the sake of brevity, I will highlight the general findings and benefits regarding insects as a food source.  Continue reading

The Leading Cause of Death in Each Country

Everyday, an average of 150,000 people die worldwide. What kills them varies wildly from country to country.

Citing the collaborative research of hundreds of researchers from around the world, the following short video from Vox.com shows the number one cause of early death by country. The results clearly demonstrate the influence of geography, culture, and economics on human mortality.

Here is a map of the data pulled from the video.

No.1 Cause of Death Around the World

The video also introduces the idea of measuring “years of life lost”, which compares the age of death to the potential maximum lifespan (presently an average of around 86 years). This method captures the true scope and tragedy of early death. After all, a country can have a high death rate because its aging population is reaching the limit of human longevity; hence why the leading causes of death in richer country are those that tend to strike the old, like stroke and heart disease. This shows that most people in those nations are managing to live long lives at or near (if not beyond) the potential human average.

But if most people in a given country are dying from things that occur well before old age, than it denotes serious socioeconomic and political problems: issues like war, lack of public health infrastructure, rampant poverty, and so on. Hence why poorer countries have more people dying from causes that are otherwise easily cured, treated, or even preempted in richer nations.

As the video points out, as many as 40 percent of the deaths in Sub-Saharan Africa occur to people less than five years old. This is a stunning figure, especially when one looks at the specifics: something as mundane in the developed world as diarrhea can be a death sentence in other parts of the world. And for all our concerns about violent crime, most people in the U.S., Europe, and other developed nations can rest assured that they are unlikely to die at the hands of another person (though for certain communities within these countries, that is a different story).

A country’s leading cause of death can also reveal certain peculiarities in their culture, history, or society. Persian Gulf countries have a strong subculture geared around drag racing and risky driving, leading to their unusually high rate of death by car accidents. This could be linked to high youth unemployment and a repressive social environment, which leads to boredom, angst, and the pursuit of these sorts of thrills. Meanwhile, China’s high rate of stroke deaths portends its rapid development and industrialization, but also spells trouble as it deals with rich-world problems without yet establishing a rich-world public health system.

This data is at once fascinating and disconcerting. It shows the huge level of disparity between certain parts of the world, and reaffirms how our success in life — including our capacity to live full, healthy lives — is largely a product of random chance. We are at the mercy of geography. Had I been born in Bolivia, the Congo, or Pakistan, I could have long died from the banal childhood afflictions I suffered without worry. Then again, if had I been born in North America, Europe, or Australia a century or two earlier, there would be a similar likelihood of dying from infectious disease.

Source: IFLS

The Health Benefits of Watching Fish

IFLS reports on the first known study to research the psychological effect of observing marine life. It might seem like an oddly specific thing to look into, but given the long history of aquarium-keeping across civilizations, it makes sense to consider what value humans derive from the practice

Sure enough, British researchers from Plymouth University and the University of Exeter, in collboration with the National Marine Aquarium, found measurable benefits in physical and mental well being among test subjects following a bit of aquarium-gazing.  Continue reading

Ebola Vaccine Trial Proves 100 Percent Effective

From The Guardian:

The results of the trials involving 4,000 people are remarkable because of the unprecedented speed with which the development of the vaccine and the testing were carried out.

Scientists, doctors, donors and drug companies collaborated to race the vaccine through a process that usually takes more than a decade in just 12 months.

“Having seen the devastating effects of Ebola on communities and even whole countries with my own eyes, I am very encouraged by today’s news”, said Børge Brende, the foreign minister of Norway, which helped fund the trial.

“This new vaccine, if the results hold up, may be the silver bullet against Ebola, helping to bring the current outbreak to zero and to control future outbreaks of this kind. I would like to thank all partners who have contributed to achieve this sensational result, due to an extraordinary and rapid collaborative effort”, he said on Friday.

….

To test how well the vaccine protected people, the cluster outbreaks were randomly assigned either to receive the vaccine immediately or three weeks after Ebola was confirmed. Among the 2,014 people vaccinated immediately, there were no cases of Ebola from 10 days after vaccination — allowing time for immunity to develop — according to the results published online in the Lancet medical journal (pdf). In the clusters with delayed vaccination, there were 16 cases out of 2,380.

In another precedent-breaker, the trial was sponsored by the World Health Organisation because “nobody wanted to step into this role so we took the risk”, said assistant director-general, Dr Marie-Paule Kieny.

Funding came from the Wellcome Trust and other partners including the governments of Norway and Canada. Others involved included Médecins sans Frontières, whose volunteer doctors were on the frontline, and the London School of Hygiene and Tropical Medicine. About 90% of the trial staff were from Guinea, a country where no clinical research had been carried out before. The vaccine is made by Merck.

The data will soon go to regulatory agencies for licensing purposes, after which it can be produced and stockpiled for any future Ebola epidemics. Thus far the plan is to use it only for those most at risk in outbreaks, rather than administered to entire populations. Here is hoping everything pans out.  Continue reading

U.S. Hospitals Charge Patients Three Times Market Rate

Reports of widespread exploitation and inefficiency in the U.S. healthcare system is hardly shocking anymore, not that it is any less disquieting. From accessibility and cost-effectiveness, to health outcomes like life expectancy and maternal health, the U.S. consistently performs mediocre at best in various metric of performance.

Some months back, I shared an article from Slate that pinned much of this problem on greedy hospitals. A recent study reported in The Atlantic only further bolsters this grim assessment:

North Okaloosa [in Florida], along with New Jersey’s Carepoint Health-Bayonne Hospital, tops the list of the U.S. hospitals with the highest markups for their services, according to a new study in Health Affairs. The study found that, on average, the 50 hospitals with the highest markups charged people 10 times more than what it cost them to provide the treatments in 2012.

On average, all U.S. hospitals charged patients (or their insurers) 3.4 times what the federal government thinks these procedures cost. “In other words, when the hospital incurs $100 of Medicare-allowable costs, the hospital charges $340”, explain the authors, Ge Bai of Washington and Lee University and Gerard F. Anderson of the Johns Hopkins Bloomberg School of Public Health. The ratio of hospital charges to costs has only increased over time: In 1984, it was just 1.35, but by 2011, it was 3.3.

In the study, the facilities that marked up their prices the most were more likely to be for-profit (as opposed to not-for-profit), urban hospitals that are affiliated with a larger health system. Community Health Systems operates half of the 50 hospitals with the highest markups. The U.S. Justice Department has investigated the Franklin, Tennessee-based hospital chain for the way it bills Medicare and Medicaid. In February, the company and three New Mexico Hospitals agreed to pay $75 million to settle a case in which Community Health Systems was accused of making illegal donations to county governments, which were then used to obtain matching Medicaid payments.

Overall, three-quarters of the hospitals on the highest-markup list are in the South, and 40 percent of them are in Florida.

Only Maryland and West Virginia restrict how much hospitals can charge. The Affordable Care Act makes not-for-profit hospitals offer discounts to uninsured people, but it doesn’t set limitations on bills sent to patients treated at out-of-network or for-profit hospitals.

Unsurprisingly, the researchers found that the system is especially predatory towards those that are either most vulnerable in terms of their healthcare needs (such as having chronic or potentially fatal ailments) and those with “the least market power” (e.g. the poor, who also tend be medically vulnerable). Equally unsurprising is how these overcharges are found to contribute to “exceptionally high medical bills, which often leads to personal bankruptcy or the avoidance of needed medical services” — little wonder why the U.S. fares poorly in health outcomes.

As expected, the solutions to such an entrenched and widespread problem will not be easy or politically tenable (at least not yet).

In an statement, Jarrod Bernstein, spokesman for Carepoint Health-Bayonne Hospital, said, “These charge prices affect less than 7 percent of our overall encounters system-wide, and without it, or adequate contract reimbursements, our safety net hospitals that serve the most vulnerable among us risk closure. That is why we are calling for a new healthcare reimbursement system that offers equivalent rates for all patient encounters regardless of where they live that will make these charges irrelevant”.

The study authors say one way to fix this might be to require hospitals to post their markups online so patients can price-compare before they go. But that wouldn’t work for emergencies, for people who live far from all but one hospital, or for the many people for whom hospital charging codes are, very understandably, inscrutable.

Alternatively, legislators could say that hospitals can only charge people a certain amount more than what they would charge Medicare, which usually negotiates some of the lowest rates. Or, more states could do what Maryland, Germany, and Switzerland all do and aggressively limit how much all hospitals can charge, period.

But as the authors note, that last solution would be “subject to considerable political challenges”, which is perhaps a polite way of saying, “will make the Obamacare battle of 2010 seem like a casual game of bridge among friends”.

Maybe it won’t be so politically challenging to change the system once push comes to shove. How much longer will people put up with being preyed upon in their most vulnerable circumstances? Profiting off of sickness and vulnerability — whether as an insurer or hospital — is as morally repugnant as it gets. How could this be tolerable? What does it say about our culture?

Music as Medicine

In the broadest sense of the term ‘medicine’, most would agree without question that music can definitely have positive effects to our mental and emotional well-being. (In a sense it also improves our physical health, insofar as most people cannot engage in exercise without it.)

The Atlantic reports on The Sync Project, a recently launched, Boston-based initiative seeking to further our understanding of the neurological and physical effects of music on humans. The goal is to go beyond anecdotes and produce more measurable evidence for how and why music impacts us, and from there look into any possible medical applications.

You can learn more about this interesting endeavor here, but I am interested in sharing what we do know about music:

Current research into how music affects the body and brain shows that there is at least some degree of influence, physically and psychologically.

For instance, research published in 2005 by Theresa Lesiuk at the University of Windsor, Canada, concluded that music helped to improve the quality and timeliness of office work, as well as overall positive attitudes while people were working on those tasks. A review in 2012 by Costas Karageorghis found there was “evidence to suggest that carefully selected music can promote ergogenic and psychological benefits during high-intensity exercise”. Meanwhile, Stefan Koelsch in Berlin has found “music can evoke activity changes in the core brain regions that underlie emotion“, and physically, “happy” music triggers zygomatic muscle activity—that is, smiling—and “sad” music “leads to the activation of the corrugator muscle”—the frowning muscle in the brow.

“Just because music—or anything else—acts upon a part of the brain, does not mean that mental health can be influenced”, Robert Zatorre, a neurologist at McGill University and a scientific advisor for The Sync Project, wrote in an email. “We need far more sophisticated understandings of what is going on in a given disease before we can really answer” the question of if music can definitively affect mental or physical health. “That said, there are a few promising avenues that people are trying with particular disorders, and hopefully that work will accelerate in future”.

Parkinson’s disease is among those specifically cited as being mitigated by the power of music. I can certainly attest to my depression and anxiety being assuaged by music, though of course a variety of other lifestyles changes contributed.

I look forward to seeing what efforts like The Sync Project discover. What are your thoughts and experiences regarding the medical potential of music therapy?

How Screens Negatively Impact Health

Thanks to the boom in mobile technology — particularly smartphones and tablets — screens have become ubiquitous in modern society. It is almost impossible for most people to avoid exposing their eyes to some sort of screen for hours at a time, whether it is texting on your phone, bingeing shows and movies on Netflix, or playing video games.

In fact, the introduction of electricity is what first began the disruption of 3 billion years of cyclical sunlight governing the functions of life. What has been the effect of increasingly undermining this cycle, which humans have long been shaped by?

Wired explores some of the troubling research coming out regarding if and how more and more light exposure is negatively impacting us:

Researchers now know that increased nighttime light exposure tracks with increased rates of breast cancer, obesity and depression. Correlation isn’t causation, of course, and it’s easy to imagine all the ways researchers might mistake those findings. The easy availability of electric lighting almost certainly tracks with various disease-causing factors: bad diets, sedentary lifestyles, exposure to they array of chemicals that come along with modernity. Oil refineries and aluminum smelters, to be hyperbolic, also blaze with light at night.

Yet biology at least supports some of the correlations. The circadian system synchronizes physiological function—from digestion to body temperature, cell repair and immune system activity—with a 24-hour cycle of light and dark. Even photosynthetic bacteria thought to resemble Earth’s earliest life forms have circadian rhythms. Despite its ubiquity, though, scientists discovered only in the last decade what triggers circadian activity in mammals: specialized cells in the retina, the light-sensing part of the eye, rather than conveying visual detail from eye to brain, simply signal the presence or absence of light. Activity in these cells sets off a reaction that calibrates clocks in every cell and tissue in a body. Now, these cells are especially sensitive to blue wavelengths—like those in a daytime sky.

But artificial lights, particularly LCDs, some LEDs, and fluorescent bulbs, also favor the blue side of the spectrum. So even a brief exposure to dim artificial light can trick a night-subdued circadian system into behaving as though day has arrived. Circadian disruption in turn produces a wealth of downstream effects, including dysregulation of key hormones. “Circadian rhythm is being tied to so many important functions”, says Joseph Takahashi, a neurobiologist at the University of Texas Southwestern. “We’re just beginning to discover all the molecular pathways that this gene network regulates. It’s not just the sleep-wake cycle. There are system-wide, drastic changes”. His lab has found that tweaking a key circadian clock gene in mice gives them diabetes. And a tour-de-force 2009 study put human volunteers on a 28-hour day-night cycle, then measured what happened to their endocrine, metabolic and cardiovascular systems.

As the article later notes, it will take a lot more research to confirm the causation between disrupting the circadian rhythm and suffering a range of mental and physical problems. Anecdotal evidence would suggest that in the long-term, for many (though not all) people, too much exposure to screen-light can cause problems. But given the many other features of modern society that are just as culpable — long hours of work, constant overstimulation, sedentary living — identifying which, if not most, aspects of the 21st century lifestyle is responsible can be difficult to do, let alone resolve.

Four Successful Ways Other Countries Are Dealing With Drug Abuse

From Alternet.org.

Let’s start with an easy one – sterile syringe access programs. We know from decades of research and implementation the world over that these programs prevent the spread of HIV/AIDS and hepatitis C among people who inject drugs. And yet our federal government still prohibits the use of federal HIV prevention funding for syringe access programs, citing erroneous drug war rhetoric about “encouraging drug use.” While we could consider all of the data from around the world, in the case of syringe access, we have plenty of evidence from locally funded programs here in the U.S. that have proven this scare-mongering to be untrue. Syringe access programs prevent the spread of HIV/AIDS and do not encourage or increase rates of drug use. Period. This has been proven from Bangkok to Bakersfield – so why is Washington dragging its feet?

Next up is another proven method of preventing HIV and other diseases. Safe injection facilities (SIFs) are places where people who inject drugs can do so under medical supervision. These facilities reduce overdose deaths and the spread of diseases such as HIV/AIDS and hepatitis C, and also to draw hard-to-reach users into treatment and rehabilitation. While the idea of facilitating intravenous drug use might raise eyebrows as syringe access once did, the results are incontrovertible. More than 90 facilities are serving clients — and saving lives — as we speak, in countries including Canada, Australia, the Netherlands, Spain and Switzerland. It’s time we started raising our eyebrows at a government willing to ignore the evidence in favor of drug war rhetoric.

This next innovative idea saves lives and is successfully treating opiate addiction in a number of European countries including Denmark, Germany, Switzerland and the U.K: heroin-assisted treatment. This treatment involves strictly regulated and controlled prescription of pharmaceutical heroin to help severely dependent heroin users who have not succeeded with other treatment options. The programs have been shown to significantly improve participants’ health, their housing and employment situations, and to dramatically decrease criminal behavior. Impressive results like these should have this idea on the tip of every legislator’s tongue.

And, finally, the success story that has dramatic implications for drug policy the world over: decriminalization. Ten years ago Portugal shifted its method of dealing with drug use and misuse from a punitive approach to a health-centered one by rapidly expanding access to treatment and decriminalizing drugs – all of them. Rates of overdose and HIV infection have dropped precipitously and none of the hysterical predictions of Lisbon becoming a drug tourism capital have materialized.  In fact, following the introduction of decriminalization, Portugal has maintained drug use rates well below the European average – and far lower than the United States. Most importantly, youth drug use rates have dropped – a goal we can all agree on. It’s a bold experiment – but didn’t the U.S. used to be a place known for its bold experiments?

In light of forty years of failure, would it hurt to at least try some of these options, perhaps beginning at the local or state level? How much more money and life must be wasted in these fruitless efforts?

Mental Health Clinics Closing Down Across the US

As NPR reports, there’s a countrywide shortage of psychiatric wards, leaving people in desperate need of such assistance to languish in hospitals that can’t properly care for them.

While the US has more prisoners than any other country in the world, it also institutionalizes the fewest number of citizens – suggesting that a lot of people in need of mental health treatment are being locked up or ignored instead. With our already meager mental health system crumbling from austerity, there’s no telling what the consequences will be.