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by Brian T. Lynch, MSW
Let’s say you really want to know if Obamacare has had a positive effects on keeping people healthy. Partisan politics makes it difficult to get any concrete or objective answers to this or any questions regarding the Affordable Care Act (ACA). So how would you go about finding the answer?
You could find out by designing your own study. You might start by looking at diseases that are silent killers because these have permanently damaging effects long before there are physical symptoms.
Diabetes is just such a disease. According to medical sources, as many as one person in four have diabetes and don’t know it. The longer it goes undetected the more it damages your internal organs, yet a simple blood test and doctors visit is all it takes to uncover and control this disease.
Now imagine that you have results of 400,000 diabetes blood tests nationwide from which you could pull out all the newly diagnosed cases. First you sort the new case in 2013, before any Medicaid expansion, from the 2014 cases after the expansion. Next you sort the new diabetes cases from each period by the 26 states that expanded Medicaid from the 24 states that refused. A concrete measure of an improved healthcare outcome would be finding that there was an increased rate of diabetes detection in the expansion states over the non-expansion states.
Just such a study was done and published this week (March 21, 2015) by Qwest Diagnostics, a national medical laboratory. What their analysis discovered was a 23% increase of newly diagnosed cases of diabetes in the states that expanded Medicaid in 2014. There was only a 0.4% increase in new diabetes cases from states that did not expand Medicaid. What’s more, they were able to see a trend towards earlier detection of diabetes in the expansion states. Earlier detection means fewer heart attacks, strokes, kidney transplants, amputations, blindness and premature deaths. This, in turn, means a healthier population and lower health care costs over time.
Thousands of people will now lead healthier lives and live to their full potent in those 26 states that expanded Medicaid under the ACA. The number of people who could have been covered by the expansion roughly equals the number who got coverage in 2014. This means an almost equal number of people will likely experience needlessly declining health due to undiagnosed diabetes. The states that don’t expand Medicaid will have higher healthcare costs in the future resulting from a less healthy population.
The news isn’t all bleak for the poor or elderly in states that didn’t expand Medicaid. A report by the Avalere Health organization recently found that there are 550,000 new enrollees in standard Medicaid in 15 states that have not expanded Medicaid. They attribute this rise in enrollment to the “woodwork effect,” caused by increased public awareness and publicity surrounding Obamacare. These are individuals who were eligible for standard Medicaid but hadn’t applied. It is safe to presume that some of them will benefit from the early detection of diabetes.
From this one Quest diagnostics study alone the answer is clear. The Affordable Care Act is having a positive effect on the health and well-being of citizens in those states that expanded Medicaid. There are other silent killers that can easily be detected early while treatments and cures are still possible, such as high blood pressure and many types of cancer. If earlier detection of these diseases are also resulting from Medicaid expansion, this would be overwhelming evidence that the ACA is improving health outcomes.
Expanding Medicaid doesn’t cost the states any additional revenue for the first few years. After that there is significant reimbursements from the Federal Government. Refusing Medicaid expansion actually costs states millions of dollars in uncompensated care right now. Doing this on ideological grounds is not a principled position, not when it clearly results in a less healthy population and increased medical expenses for the foreseeable future.
I close with a quote from the actual Quest Diagnostics study findings:
Actual Study Findings:
“We identified 215,398 and 218,890 patients who met our definition of newly diagnosed diabetes within the first 6 months of 2013 (control period) and 2014 (study period), respectively (a 1.6% increase). We identified 26,237 Medicaid enrolled patients with new diabetes in the control period vs. 29,673 in the study period: an increase of 13%. The number of Medicaid-enrolled patients with newly identified diabetes increased by 23% (14,625 vs. 18,020 patients) in the 26 states (and District of Columbia) that expanded Medicaid compared with an increase of 0.4% (11,612 vs. 11,653 patients) in the 24 states that did not expand Medicaid during this period. Similar differences were observed in younger and older adults and for both men and women.”
Quest Diagnostics Diabetes Study: http://care.diabetesjournals.org/content/early/2015/03/19/dc14-2334.full.pdf+html
by Brian T. Lynch, MSW
More and more people are looking to purchase organic foods in the belief that organically grown food is healthier. There has been growing concern about possible health impacts from the agrochemicals used in traditional crop production. These chemicals have included pesticides growth regulators and various petrochemical fertilizers. Many of these synthetic chemicals are not permitted in organically grown food. This often requires organic farmers to adopt different methods of crop production including mechanical weeding and different schedules of crop rotation. The question has been whether the absence of agrochemicals and the differing methods of food production actually produce safer or more nutritious crops.
A recent meta-analysis of 343 peer reviewed studies was published in the British Journal of Nutrition. This analysis uncovered that there are indeed significant differences between organically grown and traditionally grown crops. It was found that organically grown crops have higher antioxidants and lower concentrations of trace metals such as cadmium. I higher intake of antioxidants, such as those found in organic foods in this study, have been found to reduce the risk of cardiovascular disease and certain types of cancer such as colon cancer. Antioxidants have also been linked to a lower risk of certain degenerative neurological conditions. Low dose, long-term exposure to cadmium can be damaging to the kidneys and can lead to the formation of kidney stones.[http://www.epa.gov/osw/hazard/wastemin/minimize/factshts/cadmium.pdf]
For more detailed information on this study the abstract has been appended below along with a link to the original study.
News that organically grown food is richer in antioxidants is especially encouraging news since there continues to be little evidence that antioxidant supplements have a beneficial effect on health. it appears that not all substances with antioxidant properties have beneficial effects, and in some cases the effects of certain anti-oxidant chemicals can be harmful. What seems to be important for receiving health benefits from antioxidant substances is to obtain them through fresh fruits and vegetables rather than through supplements.
The school of Public health at Harvard has published a good review of the benefits of antioxidants, the just of which reads:
Free radicals contribute to chronic diseases from cancer to heart disease and Alzheimer’s disease to vision loss. This doesn’t automatically mean that substances with antioxidant properties will fix the problem, especially not when they are taken out of their natural context. The studies so far are inconclusive, but generally don’t provide strong evidence that antioxidant supplements have a substantial impact on disease. But keep in mind that most of the trials conducted up to now have had fundamental limitations due to their relatively short duration and having been conducted in persons with existing disease. That a benefit of beta-carotene on cognitive function was seen in the Physicians’ Health Follow-up Study only after 18 years of follow-up is sobering, since no other trial has continued for so long. At the same time, abundant evidence suggests that eating whole fruits, vegetables, and whole grains—all rich in networks of antioxidants and their helper molecules—provides protection against many of these scourges of aging. [ http://www.hsph.harvard.edu/nutritionsource/antioxidants/ ]
Demand for organic foods is partially driven by consumers’ perceptions that they are more nutritious. However, scientific opinion is divided on whether there are significant nutritional differences between organic and non-organic foods, and two recent reviews have concluded that there are no differences.
In the present study, we carried out meta-analyses based on 343 peer-reviewed publications that indicate statistically significant and meaningful differences in composition between organic and non-organic crops/crop-based foods.
Most importantly, the concentrations of a range of antioxidants such as polyphenolics were found to be substantially higher in organic crops/crop-based foods, with those of phenolic acids, flavanones, stilbenes, flavones, flavonols and anthocyanins being an estimated 19 (95 % CI 5, 33) %, 69 (95 % CI 13, 125) %, 28 (95 % CI 12, 44) %, 26 (95 % CI 3, 48) %, 50 (95 % CI 28, 72) % and 51 (95 % CI 17, 86) % higher, respectively.
Many of these compounds have previously been linked to a reduced risk of chronic diseases, including CVD and neurodegenerative diseases and certain cancers, in dietary intervention and epidemiological studies. Additionally, the frequency of occurrence of pesticide residues was found to be four times higher in conventional crops, which also contained significantly higher concentrations of the toxic metal Cd.
Significant differences were also detected for some other (e.g. minerals and vitamins) compounds. There is evidence that higher antioxidant concentrations and lower Cd concentrations are linked to specific agronomic practices (e.g. non-use of mineral N and P fertilisers, respectively) prescribed in organic farming systems. In conclusion, organic crops, on average, have higher concentrations of antioxidants, lower concentrations of Cd and a lower incidence of pesticide residues than the non-organic comparators across regions and production seasons.
[ http://csanr.wsu.edu/m2m/papers/organic_meta_analysis/bjn_2014_full_paper.pdf ]
The Authors 2014. The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution licence http://creativecommons.org/licenses/by/3.0/
Image credit: http://upload.wikimedia.org/wikipedia/commons/2/2f/Culinary_fruits_front_view.jpg
Changing brains: why neuroscience is ending the Prozac era
The big money has moved from developing psychiatric drugs to manipulating our brain networks
Daniel Lieberman: ‘Dieting is a disaster for everyone’
The big one is obesity. We evolved to put on fat wherever necessary, and that was a good thing in human history. Most people until recently had to work hard and they lived just at the margin of energy balance, and a little bit more energy stored in fat meant that you could have more babies, and your babies were more likely to survive. That was pretty powerful stuff, right? Now we’re in this bizarre situation that for the first time in billions of years of evolution we have an organism that is not energy limited any more.
The final point is that our instinct when we are sick is to try to treat each other – which is right and proper. But when we have a mismatch disease caused by this poor fit between our bodies and our environments we treat the symptoms only. On the one hand people are living longer and are healthier than probably ever in human history, but also suffering in new ways that are draining the economy. The US is the worst example but the UK isn’t far behind, in terms of how much you are spending in treating chronic non-infectious diseases that are preventable. We can prevent heart disease, we can prevent flat feet and myopia, but we can only do so if we consider our evolution.
The big one is obesity. We evolved to put on fat wherever necessary, and that was a good thing in human history. [snip] Dieting really is a disaster for everybody, it takes superhuman effort to lose weight, it can be done but it isn’t easy. And that’s because we’re evolved not only to gain weight but to hold onto it. So if that overweight person starts dieting that’s just as hard as if an underweight person starts dieting, you go into a negative energy balance and all kinds of mechanisms kick in that cause us to become less active, to reshuffle energy around our bodies to defeat that effort to lose weight. So of course obesity is our number one problem.[Stop]
America has a growing obesity epidemic. This we know for certain. We also know that obesity is far more prevalent among poor Americans and that more and more Americans are slipping into poverty. Real, inflation adjusted wages have been stagnant for over 30 years. Current wages are in decline and the number of people below the poverty line is near an all time high.
What is the link between poverty and obesity? It is a fact that the five states with the greatest obesity levels are also among the ten poorest states. They are also among the states with the lowest life expectancy. One theory as to why the poor are more likely to be obese is that they don’t have access to healthy foods in poor neighborhoods.
In April of this year the New York Times published an article highlighting two recent studies that looked at whether people in poor communities had access to stores and supermarkets that sold fresh, healthy foods. These two studies found that the poor have as much, or more access to stores selling healthy foods. One study found that poor neighborhoods have twice as many fast food restaurants and corner stores, but almost twice as many supermarkets as well. So the “food desert” theory of why poor American are more obese appears to be false.
A second theory on the connection between obesity and the poor is that they can’t afford to eat healthy. This is the “calories are cheap, nutrition is expensive” theory. Supporting this notion a recent American Journal of Clinical Nutrition study that found $1 could buy 1,200 calories of potato chips but just 250 calories of vegetables and 170 calories of fresh fruit. An excellent CNN article recently reported that:
“Ground beef that is 80/20 is fattier but cheaper than 90/10. Ground turkey breast is leaner than the other two but is usually the more expensive. And many of us can’t even begin to think about free-range chicken and organic produce — food without pesticides and antibiotics that’ll cost you a second mortgage in no time at all.”
And the cost of groceries is rising. The U.S. Department of Agriculture estimated the weekly grocery bill for a family of four was about at $134.50 in 2010 and $141.20 in 2011. An extra $7.00 per week is a lot for families living below the poverty line, especial when family incomes are in decline.
Other recent research also suggests a strong link between poverty, obesity and US food policy. While genetics may play a role in obesity, socioeconomic class may be a better predictor of obesity.
AcademicEarth.org has posted a brief video on their Website explaining this link that also relates it to current U.S. food policies. They report that Americans today eat 25% more calories than they did in the 1970’s (the same time period when hourly wages stopped rising with hourly productivity). The additional calorie intake is skewed towards lower income families. This important video federal food subsidies and other U.S. policies may be directly contributing to the current obesity crisis. Please view the video here: http://academicearth.org/electives/the-economic-cost-of-obesity/.
Created by AcademicEarth.org
Sometimes the big news stories can only be seen by the shadows they cast. You would think that it would be easy to find detailed updates on the Fukushima disaster’s impact on the fishing industry, milk production, global radiation distribution patterns, etc. You would be mistaken. The massive media coverage the initial disaster has fallen nearly silent. Some frustrated environmental advocates have suggested that there may be a media blackout. Maybe not, but media follow-up stories are few and far between these days.
In July of last year there were major stories about Fukushima and the plum of radiation reaching across the Pacific Ocean towards North America. On July 16, 2012, Deborah Dupre of the Examiner reported the following:
“As hair falls out of a Fukushima victim’s head, a new German study reports that North America’s West Coast will be the area most contaminated by Fukushima cesium of all regions in Pacific in 10 years, an “order-of-magnitude higher” than waters off Japan, according to a new German study followed by a former New York Times journalist going inside the no-entry zone and reporting radiation levels over 10 times higher than Tepco’s data.”
The article was accompanied by this scary graphic:
The article went on to say: “”After 10 years, the concentrations become nearly homogeneous over the whole Pacific, with higher values in the east, extending along the North American coast with a maximum (~1 × 10−4) off Baja California,” a new research report states.”
Then, on August 22, 2012, NHK News reported that the Fukushima Daiichi nuclear plant says it has detected radiation 380 times the government safety limit in a fish caught off Fukushima Prefecture.
Since then not much else has been reported on the spread of radiation to North America. It has been reported that tons of debris from the tsunami continues to wash up on the Pacific coast, but very little, especially in the main stream press, about how we are being effected. http://www.gizmodo.co.uk/2012/12/fukushima-debris-to-keep-hitting-the-pacific-coast-this-winter/
Perhaps my internet search skill are not the best, but the fact that I have to search for follow-up information is a warning sign. Journalists and the media should paying more attention to to this topic. The one recent article related to radiation fallout from Fukushima I found was a scientific study published in November, 2012. It focuses primarily on how tracing the travel of radionuclides gives insight into atmospheric air circulation in the Northern Hemisphere.
I think we all deserve to know more about what the US, Canadian and Mexican governments are doing to monitor radiation levels, track distribution rates and study how it may be impacting our food supply.
Below is a reference to the recently published study.
1 November 2012, Pages 80–85
Tracking the complete revolution of surface westerlies over Northern Hemisphere using radionuclides emitted from Fukushima
Massive amounts of anthropogenic radionuclides were released from the nuclear reactors located in Fukushima (northeastern Japan) between 12 and 16 March 2011 following the earthquake and tsunami. Ground level air radioactivity was monitored around the globe immediately after the Fukushima accident. This global effort provided a unique opportunity to trace the surface air mass movement at different sites in the Northern Hemisphere. Based on surface air radioactivity measurements around the globe and the air mass backward trajectory analysis of the Fukushima radioactive plume at various places in the Northern Hemisphere by employing the Hybrid Single-Particle Lagrangian Integrated Trajectory model, we show for the first time, that the uninterrupted complete revolution of the mid-latitude Surface Westerlies took place in less than 21 days, with an average zonal velocity of > 60 km/h. The position and circulation time scale of Surface Westerlies are of wide interest to a large number of global researchers including meteorologists, atmospheric researchers and global climate modellers.
DATA DRIVEN VIEWPOINT: I am posting this story because I have never heard of food product counterfeiting before and wondered if other people in other parts of the country have heard of similar instances of this sort of deception. Most stories about counterfeit foods involve food imports. This is a case where a brand name product is purchased and repackaged here in the US. It raises lots of question about how something like this can happen, where a product is purchased in such bulk quantities for repackaging in an obviously disreputably operation without the knowledge of the brand name manufacturer. Note also that there was no local law enforcement investigation. If anyone knows of any similar situations please contact me in the comment section below. Thank you.
Counterfeit ketchup caper: Exploding bottles leave major mess in Dover
on October 18, 2012 at 7:22 AM, updated October 18, 2012 at 4:38 PM
DOVER — It looks like a grisly murder scene. Red splotches pooling on a warehouse floor. A rotten smell. Insects swarming. Crates knocked to the ground.
But no one died here.
This wasn’t carnage. This was condiment.
Inside a privately owned Dover warehouse are the remnants of an abandoned Heinz Tomato Ketchup counterfeiting scheme. The ketchup appears to be real but the labels on the plastic bottles are a fraud, according to a Heinz spokesman.
Company officials, who visited Dover last week, believe someone purchased traditional Heinz Ketchup and transferred it from large bladders into individual bottles labeled “Simply Heinz,” a premium variety made with sugar instead of high fructose corn sweetener.
The 7,000 square feet of space on Richboynton Avenue in Dover had hundreds of crates holding thousands of bottles of ketchup. Of course, without any quality control, it is impossible to know what, if anything, else was put in those bottles.
Heinz does not believe the scheme got too far.
“The site of this operation was abandoned and had produced only a small quantity of bottles, much of which was still on site,” said Michael Mullen, vice president of corporate & government affairs in an e-mail.
The thing is, you can’t just walk away from something like this. Tomatoes and vinegar, both acidic, combined with sugars, which ferment when left unattended in the heat, build up pressure inside the bottle and then … explode.
That leads to a pretty big mess and a feast for flies, which is what caught the attention of other tenants who rent space in the warehouse, Dover Public Safety Director Richard Rosell said. If this all sounds a bit unusual, it is.
“These incidences are rare for Heinz,” Mullen said. “As the world’s leading manufacturer of ketchup, Heinz has stringent manufacturing and packaging practices in place to ensure the safety of consumers.”
Dover police are not yet involved. They are aware of the situation, Rosell said, but nothing has been reported stolen.
Heinz is working with the U.S. Food and Drug Administration’s Office of Criminal Investigation, Mullen said.
“As a company dedicated to food safety and quality, Heinz will not tolerate illegal repackaging of our products and we will prosecute to the fullest extent of the law anyone who engages in such illicit behavior,” Mullen said.
The space is leased by Wholesome Foods, LLC, which is registered to Joseph Carrera, according to state records. A man answering Carrera’s cell phone repeatedly hung up when he learned a reporter was on the on the line. Voice messages were not returned.
Rutgers University food science professor Don Schaffner said counterfeit food operations in the U.S. are rare, though scams have popped up with greater frequency internationally in recent years.
In 2008, a chemical used to make concrete, fertilizer and plastics called melamine sickened 300,000 children in China and killed at least six infants when it was used as filler in Chinese milk and formula products.
Schaffner said it’s impossible to know what health consequences the counterfeit ketchup could have caused without knowing what kind of filler might have been added, but said it’s unlikely someone making counterfeit food would follow even basic food safety regulations that govern food products in the U.S.
“If you’re opening ketchup containers and pouring ketchup into other bottles, God knows what you’re diluting it with,” Schaffner said. “Ketchup is thick, so it’s possible you would not use a food-grade ingredient to replicate that texture. I can’t begin to imagine how bad it could be.”
Star-Ledger staff writer Jessica Calefati contributed to this report.
This article has been changed to reflect the following correction: It was incorrectly reported that acids ferment, causing ketchup bottles to explode if left in the heat. Sugars ferment, not acids.
Counterfeit food becoming a bigger problem
The most recent case involved vodka laced with methanol which left some college students in England with permanent vision damage.
Something that just popped up recently. Garden-variety tomato being marketed as the more expensive heirloom ones.