Health & Fitness (141)
Sound like a sales pitch? Get ready for a lot more. As President Barack Obama's health care law moves from theory to reality in the coming months, its success may hinge on whether the best minds in advertising can reach one of the hardest-to-find parts of the population: people without health coverage.
The campaign won't come cheap: The total amount to be spent nationally on publicity, marketing and advertising will be at least $684 million, according to data compiled The Associated Press from federal and state sources.
About 16 percent of Americans are uninsured, but despite years of political debate and media attention, more than three-quarters of them still know little about the law known as "Obamacare," according to recent surveys.
"It's not sugar cereal, beer and detergent," said Brooke Foley, chief executive officer of the Chicago-based Jayne Agency, one of the advertising firms crafting messages to reach the uninsured.
The Obama administration and many states are launching campaigns this summer to get the word out before enrollment for new benefits begins in October.
The targets are mostly the working poor, young people who are disengaged, or those who gave up their insurance because of the cost. Three-quarters are white. Eighty-six percent have a high school education or less. Together they make up a blind spot in the nation's health care system.
"They've been shut out. It's too expensive and it's incredibly confusing," said David Smith of the advertising agency GMMB, pitching the health law's benefits in Washington and Vermont.
Their confusion might only have been magnified by the administration's surprise announcement recently postponing part of the system that affects businesses. But that change should not affect many individuals. A bigger complication is that in about half the states, Republican governors are declining to cooperate, which will limit the marketing.
The states that have been more receptive to the health care overhaul and are further ahead in their planning will receive proportionally more federal money for outreach, advertising and marketing than Republican-led states that have been hostile to the law.
AP research from all 50 states shows the amount of government spending will range from a low of 46 cents per capita in Wisconsin, which has ceded responsibility for its health insurance exchange to the federal government, to $9.23 per capita in West Virginia, which opted for a state-federal partnership.
About $4.8 million in public money will be spent trying to sign up New Jersey's 1.3 million uninsured, for example, compared to the nearly $28 million spent reaching out to Washington state's much smaller 960,000.
Texas has the highest percentage of uninsured people in the nation, three times more than Illinois. But only a fourth as much public money will be spent on getting people enrolled in Texas.
Austin resident Caryl Mauk, 46, remains confused about the Affordable Care Act even though Texas' federally run exchange is just two months away from opening for enrollment.
She has not had insurance since she had to quit her nursing job in 2011 because of a heart condition. She's been struggling with chest pains, arthritis and fatigue but doesn't know what to make of the new program.
"Sometimes I just get overwhelmed," Mauk said. "I don't want to get bad news again, and that slows me down in making calls."
In the GOP states, community groups with federal grants will lead the effort. Private companies from Walgreens to Cosmopolitan magazine have launched their own educational campaigns.
Ads based on research about the uninsured will soon start popping up on radio, TV and social media. Grassroots organizers are recruiting their pastors, barbers and mothers and arming them with carefully worded messages. In some neighborhoods, volunteers will go door-to-door.
The pitch: If you don't make much money, the government can pick up some of the cost of your health insurance. If you can afford a policy, by law you have to get one. People will be directed to healthcare.gov, a government site, for more information.
The political stakes for the Obama administration in a big response are high. If only the sickest people sign up, the cost of their medical care could overburden insurance carriers and sink the new marketplaces. The new system depends on a balanced pool.
The ad campaign already underway in Colorado demonstrates the search for an effective message.
There, TV commercials show people being magically transformed into champions. One minute they're shopping for health insurance on a computer, the next they're winning at a horse race, in a casino or at the World Series with champagne corks flying. The slogan: "When health insurance companies compete, the only winner is you."
That's because market research shows Coloradans like competition, said Tom Leydon, CEO of Denver-based advertising and digital marketing agency Pilgrim.
The celebratory scenes "remind people of the good feeling they get when they win," he said.
Despite the focus on winning and champions, there may be little if any cooperation for the publicity blitz from the professional sports leagues, which would have the potential to reach tens of millions of people. Two Republican Senate leaders warned the leagues about getting involved in "a highly polarized public debate."
In states where there will be no official cooperation, Enroll America, a coalition of health companies and advocates, has deployed volunteers to hand out brochures at a farmers market in Austin and hold house parties in Cincinnati, and plans a seven-figure ad buy across the nation.
"There has to be an echo chamber," said John Gilbert, national field director for the Enroll America media campaign. "If I'm uninsured and it's October, I won't be able to go anywhere without (hearing) the message of enrollment."
Chicago resident Martin Upshaw, whose fast food job doesn't provide health benefits, said the cost has kept him uninsured.
"The bottom line is the dollar sign," said Upshaw, 27, who survived a shooting three years ago. "I would love to be able to go in and see a doctor and make sure I'm OK."
In Chicago, the Jayne Agency's staff talked to more than 50 patients at an emergency room to hone the best message. The slogan they chose: "Don't Just Get By." The ad campaign features real people and their health stories.
On a recent Sunday in southwest Houston, volunteers recruited by Blue Cross Blue Shield set up information tables at a community center where three Methodist church services are held.
"I'm looking to get where I can go to the doctor and have a $25 to $30 co-pay," said churchgoer Yolanda Boykin, 60, whose current job through a temp agency does not provide health insurance.
Another part of the campaign nationwide, focused on young men, is refining messages for their mothers.
Market research has shown that young adults say it's often a parent, a girlfriend or a sibling who will push them to sign up for something like health insurance, said Julie Bataille, helping lead the outreach for the Obama administration, so the campaign will "make sure moms are aware."
--- AP writer Juan A. Lozano contributed to this report from Houston.
--- AP Medical Writer Carla K. Johnson can be reached at HTTP://WWW.TWITTER.COM/CARLAKJOHNSON
Doctors initially attributed the donor's death to other causes. But during an investigation prompted by the kidney recipient's death in February, lab testing found evidence of rabies in the donor's brain tissue and also detected encephalitis, a brain inflammation that can be caused by rabies.
The virus was consistent with raccoon rabies and was nearly identical to a virus found in the transplanted kidney and other tissue from the recipient, an Army veteran from Maryland, said the report, compiled by researchers from the federal Centers for Disease Control and Prevention and others and published Tuesday in the Journal of the American Medical Association.
Investigators don't know if organs given to three other patients - the North Carolina donor's heart, liver and second kidney-were infected with the rabies virus, but all three were considered at risk. Their recipients received anti-rabies treatment "and to date remain well," said CDC researcher Dr. Neil Vora, the lead author.
While the case is rare, it underscores the need to improve screening for would-be organ donors with suspected encephalitis, the report's authors say. They say a uniform donor questionnaire could help better identify risk factors for the virus and that rabies should be considered in donors with unexplained encephalitis.
The United Network for Organ Sharing issued guidance last year to help organ procurement organizations screen for encephalitis and other central nervous system infections in potential donors. It urged caution in accepting organs from donors with an untreated central nervous system infection.
The researchers want to improve awareness that rabies can be the cause of encephalitis, said co-author Dr. Sridhar Basavaraju, another CDC researcher. But he added, "We wouldn't want to mandate any screening that would potentially exclude transplantable organs."
The study is based on a review of laboratory tests and medical records, and interviews with relatives of the organ donor and recipient. It provides the most detailed account of the chain of events that led to the two deaths and the investigation that followed, which prompted health authorities to recommend vaccines for dozens of people who were in contact with the donor or recipients.
The case attracted public attention because of the rare circumstances, including the long time between infection and death of the transplant recipient - about a year and a half.
It was just the third documented transmission of rabies through a solid organ transplant, the report says.
Also, there are only roughly two human rabies deaths in the United States each year, and all but two domestic cases between 2000 and 2010 were linked to bats, according to the report. The authors say raccoons pose an under-recognized risk for infection and their spread into urban areas raises concern.
The patient who received the North Carolina donor's kidney at the Walter Reed National Military Medical Center in Bethesda, Md. in September 2011 has not been publicly identified.
The donor was 20-year-old William Edward Small, an avid outdoorsman from North Carolina who got sick after a fishing trip in Florida, where he was undergoing Air Force training.
Small's initial symptoms included nausea, vomiting and fever - which could indicate rabies but also other less serious conditions that are much more common. Doctors thought Small had eaten tainted fish.
Questioned during the organ procurement process, relatives said they didn't know of any recent risk of rabies exposure, and doctors did not test him.
Investigators say they learned during subsequent interviews that Small trapped raccoons for use as bait during hunting-dog training exercises, and had been bitten at least twice by the animals, 18 months and seven months before developing symptoms. He was not treated for those bites.
"If you don't ask specific questions, you don't get specific answers," said Dr. Michael Green, chairman of an advisory committee on disease transmission for the United Network for Organ Sharing.
"At the time these questions are being asked initially, families are often traumatized, in shock," Green said. "They're losing a loved one. They may not be thinking normally or straight or remember all those details."
---- JAMA: HTTP://WWW.JAMA.COM
Follow Eric Tucker on Twitter: HTTP://WWW.TWITTER.COM/ETUCKERAP
The manufacturer of the Plan B One Step morning-after contraceptive has been granted exclusive rights by the FDA to market their drug over-the-counter without age restrictions. The decision was released earlier this week.
The Food and Drug Administration approved Teva Pharmaceuticals' Plan B One Step for over the counter sale...no prescription or proof of age required. In its decision, the FDA granted a three year period during which Teva can sell its' single tablet product exclusively on pharmacy shelves, while generic drugs will still require a prescription for young women 16 and younger.
Most metro St. Louis pharmacies carry Teva's Plan B, which is a two-pill dosage and some already have the Plan B One Step in the pharmacy. The FDA decision will now move that product on to the store shelves.
A study of older men found those who regularly skipped breakfast had a 27 percent higher risk of a heart attack than those who ate a morning meal. There's no reason why the results wouldn't apply to other people, too, the Harvard researchers said.
Other studies have suggested a link between breakfast and obesity, high blood pressure, diabetes and other health problems seen as precursors to heart problems.
"But no studies looked at long-term risk of heart attack," said Eric Rimm, one of the study authors at the Harvard School of Public Health.
Why would skipping breakfast be a heart attack risk?
Experts aren't certain, but here's what they think: People who don't eat breakfast are more likely to be hungrier later in the day and eat larger meals. Those meals mean the body must process a larger amount of calories in a shorter amount of time. That can spike sugar levels in the blood and perhaps lead to clogged arteries.
But is a stack of syrupy pancakes, greasy eggs and lots of bacon really better than eating nothing?
The researchers did not ask what the study participants ate for breakfast, and were not prepared to pass judgment on whether a fatty, sugary breakfast is better than no breakfast at all.
Other experts agreed that it's hard to say.
"We don't know whether it's the timing or content of breakfast that's important. It's probably both," said Andrew Odegaard, a University of Minnesota researcher who has studied a link between skipping breakfast and health problems like obesity and high blood pressure.
"Generally, people who eat breakfast tend to eat a healthier diet," he added.
The new research was released Monday by the journal Circulation. It was an observational study, so it's not designed to prove a cause and effect. But when done well, such studies can reveal important health risks.
The researchers surveyed nearly 27,000 men about their eating habits in 1992. About 13 percent of them said they regularly skipped breakfast. They all were educated health professionals - like dentists and veterinarians - and were at least 45.
Over the next 16 years, 1,527 suffered fatal or non-fatal heart attacks, including 171 who had said they regularly skipped breakfast.
In other words, over 7 percent of the men who skipped breakfast had heart attacks, compared to nearly 6 percent of those who ate breakfast.
The researchers calculated the increased risk at 27 percent, taking into account other factors like smoking, drinking, diet and health problems like high blood pressure and obesity.
As many as 18 percent of U.S. adults regularly skip breakfast, according to federal estimates. So the study could be important news for many, Rimm said.
"It's a really simple message," he said. "Breakfast is an important meal."
Hawaii tops the charts in the government's first state-by-state look at how long Americans age 65 can expect to live, on average, and how many of those remaining years will be healthy ones.
Retirement-age Mississippians fared worst, with only about 17 1/2 more years remaining and nearly seven of them in poorer health.
U.S. life expectancy has been growing steadily for decades, and is now nearly 79 for newborns. The figures released Thursday by the Centers for Disease Control and Prevention estimate life expectancy for people 65 years old, and what portion will be free of the illnesses and disabilities suffered late in life.
"What ultimately matters is not just the length of life but the quality of life," said Matt Stiefel, who oversees population health research for Kaiser Permanente.
The World Health Organization keeps "healthy life expectancy" statistics on nearly 200 countries, and the numbers are used to determine the most sensible ages to set retirement and retirement benefits. But the measure is still catching on in the United States; the CDC study is the first to make estimates for all 50 states.
Overall, Americans who make it to 65 have about 19 years of life ahead of them, including nearly 14 in relatively good health, the CDC estimated.
But the South and parts of the Midwest clearly had lower numbers. That's not a surprise, experts said.
Southern states tend to have higher rates of smoking, obesity, diabetes, heart disease, and a range of other illnesses. They also have problems that affect health, like less education and more poverty.
These are issues that build up over a lifetime, so it's doubtful that moving to Hawaii after a lifetime in the South will suddenly give you more healthy years, they said.
After Mississippi, Kentucky, West Virginia and Alabama had the lowest numbers for both life expectancy and healthy life expectancy. States with the best numbers included Florida - a magnet for healthy retirees - as well as Connecticut and Minnesota.
The estimates were made using 2007 through 2009 data from the census, death certificates and telephone surveys that asked people to describe their health. The CDC's Paula Yoon cautioned not to make too much of the differences between states. Results could have been swayed, for example, by how people in different states interpreted and answered the survey questions.
- Nationally, women at 65 can expect nearly 15 more years of healthy life. Men that age can expect about 13 years.
- Blacks fared much worse than whites. They could expect 11 years of healthy life, compared to more than 14 for whites.
The CDC report makes "painfully clear" the disparities in the health of whites and blacks in their final years, said Ellen Meara, a health economist at Dartmouth College.
CHICAGO (AP) - A pair of new Illinois laws will fund diabetes research and track economic costs of the disease.
Gov. Pat Quinn signed the bills Thursday at a conference organized by the University of Chicago Medicine's Kovler Diabetes Center.
One measure creates a special license plate. Just over half of the $40 cost of the plate will go to the Diabetes Research Checkoff Fund.
House minority leader Tom Cross sponsored the bill. He hopes the license plate will serve as a "moving billboard" for diabetes awareness.
The second bill requires the Illinois State Diabetes Commission to report regularly on the economic and social costs of diabetes and efforts to prevent the disease.
The laws take effect Jan. 1.
The Illinois Department of Public Health says about 800,000 state residents have diabetes.
An experimental surgical knife can help surgeons make sure they've removed all the cancerous tissue, doctors reported Wednesday. Surgeons typically use knives that heat tissue as they cut, producing a sharp-smelling smoke. The new knife analyzes the smoke and can instantly signal whether the tissue is cancerous or healthy.
Now surgeons have to send the tissue to a lab and wait for the results.
Dr. Zoltan Takats of Imperial College London suspected the smoke produced during cancer surgery might contain some important cancer clues. So he designed a "smart" knife hooked up to a refrigerator-sized mass spectrometry device on wheels that analyzes the smoke from cauterizing tissue.
The smoke picked up by the smart knife is compared to a library of smoke "signatures" from cancerous and non-cancerous tissues. Information appears on a monitor: green means the tissue is healthy, red means cancerous and yellow means unidentifiable.
To make sure they've removed the tumor, surgeons now send samples to a laboratory while the patient remains on the operating table. It can take about 30 minutes to get an answer in the best hospitals, but even then doctors cannot be entirely sure, so they often remove a bit more tissue than they think is strictly necessary.
If some cancerous cells remain, patients may need to have another surgery or undergo chemotherapy or radiation treatment.
"(The new knife) looks fabulous," said Dr. Emma King, a head and neck cancer surgeon at Cancer Research U.K., who was not connected to the project. The smoke contains broken-up bits of tumor tissue and "it makes sense to look at it more carefully," she said.
The new knife and its accompanying machines were made for about >250,000 ($380,000) but scientists said the price tag would likely drop if the technology is commercialized.
The most common treatment for cancers involving solid tumors is removing them in surgery. In the U.K., one in five breast cancer patients who have surgery will need further operations to get rid of the tumor entirely.
Scientists tested the new knife at three hospitals between 2010 and 2012. Tissue samples were taken from 302 patients to create a database of which kinds of smoke contained cancers, including those of the brain, breast, colon, liver, lung and stomach.
That was then used to analyze tumors from 91 patients; the smart knife correctly spotted cancer in every case. The study was published Wednesday in the journal Science Translational Medicine. The research was paid for by groups including Imperial College London and the Hungarian government.
At a demonstration in London on Wednesday, doctors used the new knife - which resembles a fat white pen - to slice into slabs of pig's liver. Within minutes, the room was filled with an acrid-smelling smoke comparable to the fumes that would be produced during surgery on a human patient.
Takats said the knife would eventually be submitted for regulatory approval but that more studies were planned. He added the knife could also be used for other things like identifying tissues with bad blood supply and identifying the types of bacteria present.
Some experts said the technology could help eliminate the guesswork for doctors operating on cancer patients. "Brain cancers are notorious for infiltrating into healthy brain tissue beyond what's visible to the surgeon," said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society. "If this can definitively tell doctors whether they've removed all the cancerous tissue, it would be very valuable," he said.
Still, Lichtenfeld said more trials were needed to prove the new knife would actually make a significant difference to patients. Early enthusiasm for new technologies hasn't always panned out, he said, citing the recent popularity of robotic surgery as an example.
"It expanded very rapidly but is now hitting some bumps along the road," he said.
Lichtenfeld said it's unclear whether more widespread use of the smart knife will actually help patients live longer and said studies should also look into whether the tool cuts down on patient's surgery times, their blood loss and rate of wound infections.
"This is a fascinating science and we need to adopt any technology that works to save patients," Lichtenfeld said. "But first we have to be sure that it works."