Life spans of the least educated are shrinking; steepest decline among white women, biggest gap among white men

Here's some bad news for states like Kentucky, which are overwhelmingly white and have large shares of the population that did not graduate from high school: A new study "that looks separately at Americans lacking a high school diploma found disturbingly sharp drops in life expectancy for whites," and four previous studies support that case, reports Sabrina Tavernise of The New York Times.

"The reasons for the decline remain unclear," writes Tavernise, "but researchers offered possible explanations, including a spike in prescription-drug overdoses among young whites, higher rates of smoking among less-educated white women, rising obesity, and a steady increase in the number of the least-educated Americans who lack health insurance."

Dr. S. Jay Olshansky

White women without high-school diplomas are at particular risk, said S. Jay Olshansky, a public health professor at the University of Illinois at Chicago and the lead investigator on the study, published last month in Health Affairs. They lost a whopping five years of life expectancy between 1990 and 2008, he said.

That's big. To understand just how big: The average life expectancy for white women without a high-school diploma was 73.5 years, compared with 83.9 years for white women with a college degree or more. For white men, the gap was even bigger: 67.5 years for the least educated white men compared with 80.4 for those with a college degree or better.

The slump is now the subject of an inquiry by the National Academy of Sciences. “There’s this enormous issue of why,” said David Cutler, an economics professor at Harvard University. “It’s very puzzling and we don’t have a great explanation.” And it is yet another sign of distress in one of the country’s most vulnerable groups during a period when major social changes are transforming life for less educated whites. (Read more)

Here's some bad news for states like Kentucky, which are overwhelmingly white and have large shares of the population that did not graduate from high school: A new study "that looks separately at Americans lacking a high school diploma found disturbingly sharp drops in life expectancy for whites," and four previous studies support that case, reports Sabrina Tavernise of The New York Times.

"The reasons for the decline remain unclear," writes Tavernise, "but researchers offered possible explanations, including a spike in prescription-drug overdoses among young whites, higher rates of smoking among less-educated white women, rising obesity, and a steady increase in the number of the least-educated Americans who lack health insurance."

Dr. S. Jay Olshansky

White women without high-school diplomas are at particular risk, said S. Jay Olshansky, a public health professor at the University of Illinois at Chicago and the lead investigator on the study, published last month in Health Affairs. They lost a whopping five years of life expectancy between 1990 and 2008, he said.

That's big. To understand just how big: The average life expectancy for white women without a high-school diploma was 73.5 years, compared with 83.9 years for white women with a college degree or more. For white men, the gap was even bigger: 67.5 years for the least educated white men compared with 80.4 for those with a college degree or better.

The slump is now the subject of an inquiry by the National Academy of Sciences. “There’s this enormous issue of why,” said David Cutler, an economics professor at Harvard University. “It’s very puzzling and we don’t have a great explanation.” And it is yet another sign of distress in one of the country’s most vulnerable groups during a period when major social changes are transforming life for less educated whites. (Read more)

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Government says health-reform law to save average Kentuckian with Medicare coverage $5,000 through 2022

The U.S. Department of Health and Human Services says the Patient Protection and Affordable Care Act will likely save the average person with traditional Medicare coverage $5,000 from 2010 to 2022, and people with Medicare who have high prescription drug costs will save more than $18,000 over the same period, based on the agency's estimates.

The department also announced that seniors and people with disabilities in Kentucky have already saved $85.5 million on prescription drugs since the law was enacted. Nationwide, the report states that over 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

The U.S. Department of Health and Human Services says the Patient Protection and Affordable Care Act will likely save the average person with traditional Medicare coverage $5,000 from 2010 to 2022, and people with Medicare who have high prescription drug costs will save more than $18,000 over the same period, based on the agency's estimates.

The department also announced that seniors and people with disabilities in Kentucky have already saved $85.5 million on prescription drugs since the law was enacted. Nationwide, the report states that over 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted. This includes $195 million in savings on prescriptions for diabetes, over $140 million on drugs to lower cholesterol and blood pressure, and $75 million on cancer drugs so far this year.

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Study estimates that secondhand smoke kills 42,000 Americans a year, and 900 of those are babies

More bad news for smokers and those who love them: A report out this week in the American Journal of Public Health says secondhand smoke is accountable for 42,000 deaths of non-smokers each year in the U.S., including nearly 900 infants. Kentucky likely has more than its share of those deaths because the percentage of Kentuckians who smoke is the nation's highest.

The study at the University of California, San Francisco notes that those annual deaths represent nearly 600,000 years of potential life lost and $6.6 billion in lost productivity, amounting to $158,000 per death.

The study by Wendy Max a professor of health economics at the UCSF School of Nursing, involved the first use of a biomarker to gauge the physical and economic impacts of cigarette smoke, and revealed that secondhand smoke exposure disproportionately affects African Americans, especially their infants. 

More bad news for smokers and those who love them: A report out this week in the American Journal of Public Health says secondhand smoke is accountable for 42,000 deaths of non-smokers each year in the U.S., including nearly 900 infants. Kentucky likely has more than its share of those deaths because the percentage of Kentuckians who smoke is the nation's highest.

The study at the University of California, San Francisco notes that those annual deaths represent nearly 600,000 years of potential life lost and $6.6 billion in lost productivity, amounting to $158,000 per death.

The study by Wendy Max a professor of health economics at the UCSF School of Nursing, involved the first use of a biomarker to gauge the physical and economic impacts of cigarette smoke, and revealed that secondhand smoke exposure disproportionately affects African Americans, especially their infants. 

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Doctor complaints about bill aimed at reducing prescription drug abuse largely based on misconceptions, health officials say

State health officials say doctors' complaints about House Bill 1, which cracks down on pill mills and doctors who supply the illegal prescription pill trade, result from misunderstandings and misconceptions about the law's language and intent, Mike Wynn of The Courier-Journal reports. Doctors say the bill's regulations are excessive and restrict their ability to write common prescriptions.

Assistant deputy inspector general Stephanie Hold, of the Cabinet for Health and Family Services, said doctors have at least 19 misconceptions about the state's drug tracking system, Kentucky All Schedule Prescription Electronic Reporting, and said checking KASPER before writing prescriptions "should not impede them in any way," Wynn reports. Mike Rodman, director of the Kentucky Board of Medical Licensure, said there's nothing in the law that prevents doctors from prescribing controlled substances. He said many doctors have for years practiced prescription standards similar to those in the bill, but feel uncomfortable with them being written as law.

The co-chair of the state oversight committee, Democratic Rep. John Tilley, said there are some legitimate concerns about the bill "that need discussion after we can distill what is fact and what is myth," but lawmakers could likely address all of them without changing the statute. (Read more)

State health officials say doctors' complaints about House Bill 1, which cracks down on pill mills and doctors who supply the illegal prescription pill trade, result from misunderstandings and misconceptions about the law's language and intent, Mike Wynn of The Courier-Journal reports. Doctors say the bill's regulations are excessive and restrict their ability to write common prescriptions.

Assistant deputy inspector general Stephanie Hold, of the Cabinet for Health and Family Services, said doctors have at least 19 misconceptions about the state's drug tracking system, Kentucky All Schedule Prescription Electronic Reporting, and said checking KASPER before writing prescriptions "should not impede them in any way," Wynn reports. Mike Rodman, director of the Kentucky Board of Medical Licensure, said there's nothing in the law that prevents doctors from prescribing controlled substances. He said many doctors have for years practiced prescription standards similar to those in the bill, but feel uncomfortable with them being written as law.

The co-chair of the state oversight committee, Democratic Rep. John Tilley, said there are some legitimate concerns about the bill "that need discussion after we can distill what is fact and what is myth," but lawmakers could likely address all of them without changing the statute. (Read more)

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Republicans reject governor's executive order creating health benefits exchange; move is only symbolic for now

Republican legislators voted yesterday against Gov. Steve Beshear's executive order creating the Kentucky Health Benefits Exchange, required by federal health reform. Sen. David Givens of Greensburg offered a motion to the legislative Health and Welfare Committee that said Beshear doesn't have authority to create new agencies, but only to rearrange existing agencies with the legislature's approval, Nick Storm of cn|2 Pure Politics reports.

Democrats at the meeting were caught off guard and ultimately walked out after raising objections, Storm reports. They claimed Beshear was following federal law, and said the legislature should consider the matter when it reconvenes in January. Legislators hoped they would get answers from the Cabinet for Health and Family Services about costs and operations of the exchange, which they didn't get at their meeting last month.

The exchange will match up the uninsured with private health insurance companies, and is designed to serve those who make too much to qualify for Medicaid but don't have employer-sponsored insurance. After Democrats left the meeting, Republicans voted to report the committee's findings to the Legislative Research Commission and the governor. The vote remains symbolic unless it is cited in a lawsuit challenging the exchange, which now seems likely. (Read more)

Republican legislators voted yesterday against Gov. Steve Beshear's executive order creating the Kentucky Health Benefits Exchange, required by federal health reform. Sen. David Givens of Greensburg offered a motion to the legislative Health and Welfare Committee that said Beshear doesn't have authority to create new agencies, but only to rearrange existing agencies with the legislature's approval, Nick Storm of cn|2 Pure Politics reports.

Democrats at the meeting were caught off guard and ultimately walked out after raising objections, Storm reports. They claimed Beshear was following federal law, and said the legislature should consider the matter when it reconvenes in January. Legislators hoped they would get answers from the Cabinet for Health and Family Services about costs and operations of the exchange, which they didn't get at their meeting last month.

The exchange will match up the uninsured with private health insurance companies, and is designed to serve those who make too much to qualify for Medicaid but don't have employer-sponsored insurance. After Democrats left the meeting, Republicans voted to report the committee's findings to the Legislative Research Commission and the governor. The vote remains symbolic unless it is cited in a lawsuit challenging the exchange, which now seems likely. (Read more)

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Acromegaly in cats

Greco DS. Feline acromegaly. Top Companion Anim Med. 2012; 27: 31-5.

From Dr. Mark Peterson: endocrinevet.blogspot.com

Acromegaly (or hypersomatotropism) is a disease that derives its name from two Greek words: ‘acro’ (meaning extremity) and ‘megale’ (meaning great). The disease has been known in humans for at least 100 years, and has been identified in cats starting in the 1980s. The disease is caused by a tumor (adenoma) of the pituitary gland in the brain that leads to excessive secretion of growth hormone. The effects of excessive growth hormone include the development of diabetes mellitus and increase in size of certain parts of the body (e.g., jaw, skull, limbs). Internal organs (e.g., heart, liver, kidney) may also be increased in size. 

The typical feline patient is an older male cat with diabetes mellitus that is difficult to manage. The disease is diagnosed by finding increased blood levels of growth hormone and/or insulin-like growth factor as well as demonstration of a pituitary mass using magnetic resonance imaging or computed tomography. Few treatments are available for this disease in cats; to date, the most effective approach has been radiation therapy. Most affected cats eventually die of congestive heart failure, chronic kidney failure, or complications of the growing pituitary tumor. [SL]

See also: 

• Niessen SJM. Feline acromegaly: An essential differential diagnosis for the difficult diabetic. J Feline Med Surg. 2010; 12: 15-23.
• Final report, Winn grant W10-017: Evaluation of a long-acting somatostatin receptor ligand for the treatment of feline acromegaly
• Insights into veterinary endocrinology: Dr. Mark E. Peterson

More on cat health: Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Greco DS. Feline acromegaly. Top Companion Anim Med. 2012; 27: 31-5.

From Dr. Mark Peterson: endocrinevet.blogspot.com

Acromegaly (or hypersomatotropism) is a disease that derives its name from two Greek words: ‘acro’ (meaning extremity) and ‘megale’ (meaning great). The disease has been known in humans for at least 100 years, and has been identified in cats starting in the 1980s. The disease is caused by a tumor (adenoma) of the pituitary gland in the brain that leads to excessive secretion of growth hormone. The effects of excessive growth hormone include the development of diabetes mellitus and increase in size of certain parts of the body (e.g., jaw, skull, limbs). Internal organs (e.g., heart, liver, kidney) may also be increased in size. 

The typical feline patient is an older male cat with diabetes mellitus that is difficult to manage. The disease is diagnosed by finding increased blood levels of growth hormone and/or insulin-like growth factor as well as demonstration of a pituitary mass using magnetic resonance imaging or computed tomography. Few treatments are available for this disease in cats; to date, the most effective approach has been radiation therapy. Most affected cats eventually die of congestive heart failure, chronic kidney failure, or complications of the growing pituitary tumor. [SL]

See also: 

• Niessen SJM. Feline acromegaly: An essential differential diagnosis for the difficult diabetic. J Feline Med Surg. 2010; 12: 15-23.
• Final report, Winn grant W10-017: Evaluation of a long-acting somatostatin receptor ligand for the treatment of feline acromegaly
• Insights into veterinary endocrinology: Dr. Mark E. Peterson

More on cat health: Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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UK study will try to stem high-risk, health-damaging risks in drug-using rural women in Appalachian Kentucky

Researchers at the University of Kentucky have embarked on a five-year study that aims to lower behavioral risks of HIV/AIDS and hepatitis C among disadvantaged, rural women in Appalachian Kentucky. With the help of a $2.7 million grant from the National Institute on Drug Abuse, investigators will examine the effectiveness of a brief intervention in reducing high-risk behaviors, including sexual practices and use of injected drugs.

Michele Staton-Tindall, right, associate professor in the College of Social Work, is the principal investigator. "Our intervention will focus on an individualized plan for enhancing each woman's motivation to reduce risk behaviors and to utilize existing health services," Staton-Tindall said. "The long-term goal of this study is to increase access to health and behavioral-health services in order to improve the quality of health for high-risk rural women."

According to co-investigator Jennifer Havens, HIV is not a high risk for Appalachian drug users, but hepatitis C is. Caused by a virus that attacks the liver, it is the leading cause of liver cancer in the United States. Currently, more Americans die each year from diseases related to hepatitis-C infection than from HIV-related causes, according to data from the Centers for Disease Control and Prevention. Like HIV, hepatitis C is spread through contact with contaminated blood, often through the use of needles shared by intravenous drug users.

Researchers at the University of Kentucky have embarked on a five-year study that aims to lower behavioral risks of HIV/AIDS and hepatitis C among disadvantaged, rural women in Appalachian Kentucky. With the help of a $2.7 million grant from the National Institute on Drug Abuse, investigators will examine the effectiveness of a brief intervention in reducing high-risk behaviors, including sexual practices and use of injected drugs.

Michele Staton-Tindall, right, associate professor in the College of Social Work, is the principal investigator. "Our intervention will focus on an individualized plan for enhancing each woman's motivation to reduce risk behaviors and to utilize existing health services," Staton-Tindall said. "The long-term goal of this study is to increase access to health and behavioral-health services in order to improve the quality of health for high-risk rural women."

According to co-investigator Jennifer Havens, HIV is not a high risk for Appalachian drug users, but hepatitis C is. Caused by a virus that attacks the liver, it is the leading cause of liver cancer in the United States. Currently, more Americans die each year from diseases related to hepatitis-C infection than from HIV-related causes, according to data from the Centers for Disease Control and Prevention. Like HIV, hepatitis C is spread through contact with contaminated blood, often through the use of needles shared by intravenous drug users.

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