According to CDC, there has been a 54 percent increase in the number of pregnant women who’ve had strokes in 1995 to 1996 and in 2005 to 2006. While this may surprise some researchers, it certainly would not surprise clinicians who take care of pregnant women who have risk factors such as obesity, chronic hypertension or a lack of prenatal care. Ten percent of strokes occur in the first trimester, 40 percent during the second trimester and more than fifty percent occur during the post partum period and after the patient has been discharged home. Hypertension was the cause of one-third of stroke victims during pregnancy and fifty percent in the post partum period. Hypertension accounted for one-third of stroke cases during pregnancy and fifty percent in the post partum period. Many stroke cases might be prevented if blood pressure problems were treated appropriately during pregnancy.
Pregnant women who have high blood pressure during the first trimester are treated with medication and are classified as having chronic hypertension. The problem occurs when Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
The National Institute for Healthcare Management Foundation is a nonprofit, nonpartisan organization focused on healthcare. The foundation just published an excellent report on the distribution of healthcare costs in the population.
The results indicate that reducing healthcare cost is all about reducing and managing chronic diseases.
U.S. healthcare spending has sharply increased between 2005 and 2009 by 23 percent from $2 trillion to $2.5 trillion per year.
This is a result of a combination of factors. Chief among them is the increasing incidence of obesity.
Who spends the money? Read more »
*This blog post was originally published at Repairing the Healthcare System*
Q. What is the difference between a public health expert and Il Duce?
A. Mussolini was not nearly as arrogant as a public health expert.
In prior posts, DrRich related how two major publc health efforts over the past few decades – the effort to put all of us on low-fat diets, and the effort to reduce everyone’s cholesterol levels – have amounted to massive experiments, based upon insufficiently-tested assumptions and surmises and hypotheses which the experts arrogantly (and incorrectly) determined to be fact, and which were conducted upon the entire American population without its knowledge or consent.
These public health experiments cost billions of dollars, needlessly transformed large swatches of American industry, and (at least in the case of low-fat diets) likely produced significant harm to the citizenry. Furthermore, despite such results, these misbegotten public health efforts have inured Americans to the notion that it is right and proper for government experts to determine for each of us what we must and must not eat.
DrRich now feels obligated to call his readers’ attention to yet another experiment which these same public health experts have launched, an experiment under which each of us – once again – is to become an unwitting research subject, an experiment whose results are unpredictable, but which has a realistic chance of producing harm to many of us. DrRich speaks, of course, of the new US dietary guidelines, published earlier this year, regarding sodium. Read more »
*This blog post was originally published at The Covert Rationing Blog*
You probably see your primary care physician once a year, and your dentist twice a year. But how often do you see your eye doctor? Vision is the most valued of the 5 senses, and yet Americans don’t seem to be making regular eye exams a priority. A recent CDC survey suggests that as many as 34.6% of adults over the age of 40 (with moderate to severe visual impairment) believe that they don’t need regular eye exams. About 39.8% of the respondents said that they didn’t get regular exams because they were too costly, or because their health insurance didn’t cover the expense.
Although cost may play a role in peoples’ thinking, a comprehensive eye exam costs as little as $45-50 at retail outlets. I suspect that the real reason why people don’t get regular eye exams is because they incorrectly believe that if their vision is stable, their eyes are healthy.
A comprehensive eye exam is a type of medical check up – it is not just a vision assessment. Eye care professionals can diagnose everything from glaucoma and cataracts to high cholesterol, diabetes, high blood pressure, and even neurologic conditions such as brain tumors and multiple sclerosis. The eyes are more than a “window to the soul” but a window to general physical health. And the good news is that exams are relatively inexpensive and painless – so please consider making them part of your yearly health maintenance routine.
And to my primary care friends – don’t forget to encourage your patients to get annual eye exams. As the CDC notes:
Recommendations from primary-care providers can influence patients to receive eye-care services; persons who had visual screening during routine physical examinations had better eye health because of reminders to visit eye specialists. Public health interventions aimed at heightening awareness among both adults aged ≥65 years and health-care providers might increase utilization rates among persons with age-related eye diseases or chronic diseases that affect vision such as diabetes.
I myself have had an unexpected diagnosis during an eye exam, and feel passionate about the importance of preventive screening. In fact, I’ll be the upcoming host of a new eye health education initiative – a radio show called, “Healthy Vision with Dr. Val Jones” supported by ACUVUE brand contact lenses. The first show will be released here today, and it’s also available at Blog Talk Radio.
Reasons for Not Seeking Eye Care Among Adults Aged ≥40 Years with Moderate-to-Severe Visual Impairment — 21 States, 2006–2009. Morbidity & Mortality Weekly Report, May 20, 2011. 60(19);610-613
Alexander RL Jr., Miller NA, Cotch MF, Janiszewski R. Factors that influence the receipt of eye care. Am J Health Behav 2008;32:547–56
Strahlman E, Ford D, Whelton P, Sommer A. Vision screening in a primary care setting. A missed opportunity? Arch Intern Med 1990;150:2159–64
Disclosure: Dr. Val Jones is a paid consultant for VISTAKON®, Division of Johnson & Johnson Vision Care, Inc.
When we hear about maternal death, we immediately think of a third world country but in reality, 2 to 3 women die every day in the U.S. from pregnancy and childbirth. Unfortunately, African American women are affected disproportionately and are four times more likely to die than anyone else. The tragedy is that at least half of these deaths are preventable.
In her article, Special Report: Black Women Die Nearly Four Times the Rate of White Women From Pregnancy Complications, Rita Henley Jensen, describes the dilemma of the acting chief of the maternal and infant unit of CDC, Dr. William Callaghan. Callaghan can’t sleep at night because he wants to know why pregnancy is more dangerous for U.S. African American women.
During my residency training, I witnessed a maternal death. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*