Would you like a side of Dioxin with your Burger?

The Environmental Protection Agency is holding public hearings beginning today to review a proposed safe exposure limit for dioxin, a known carcinogen and endocrine disruptor produced as a common industrial byproduct. It's all but impossible to avoid exposure to dioxin. Women exposed to it pass it on to fetuses in the womb, and both breast milk and formula have been shown to contain the stuff. Research done by the Environmental Working Group has shown that a nursing infant ingests an amount 77 times higher than what the EPA has proposed as safe exposure. Adults are exposed to 1,200 times more dioxin than the EPA suggests is safe, mostly through eating meat, dairy, and shellfish.

What's a diabetic to do?

A growing number of health plans are trying a number of programs to encourage diabetics to take better care of themselves. One such program offers to reduce a or eliminate a plan member's diabetes drug co-pays as an incentive to take their medications regularly. Sounds like a good idea, unless that medication is Avandia. A recent story by Gardner Harris in the New York Times (read it here) tells the sad tale about how its manufacturer, SmithKline Beecham, waged a decade long campaign to cover up study results that clearly showed Avandia to not only be no better than a competing pill, but also showed clear signs that it was riskier to the heart.

The company knew about the heart risks associated with the drug as early as 1999. But it wasn't until 2007 when a cardiologist at the Cleveland Clinic filed a lawsuit to force the company (now known as GSK) to publish the test results on its website. Even then, the company would only admit to knowing about the heart risks back to 2005.

How can we expect people who suffer from chronic ailments like diabetes to embrace plans that encourage healthy behavior, when a drug they are being encouraged to take puts their health at greater risk?

Email helps improve health of patients with diabetes and hypertension

A recent study by Kaiser Permanente researchers found that patients suffering from diabetes and hypertension who emailed their doctors had higher quality of care scores than those who do not use such technology.

The study specifically focused on 35,423 patients with diabetes or hypertension in Kaiser's Southern California region. Those that used Kaiser's electronic health records system--dubbed My Health Manager--had better cholesterol and blood pressure levels after two months than those who did not.

The study provides new evidence that making secure email available to patients can improve their clinical outcomes. Unfortunately, a Harris Interactive/HealthDay poll determined that less than 10 percent of American adults even use electronic health records or exchange emails with their doctors,

Are we being treated, and overtreated, to death?

Hope springs eternal. But that American tendency to fight death to the bitter end might not be the best way to depart this mortal coil.

Doctors can't tell you how long a patient will live, but they usually know when an illness is incurable, according to the Associated Press.

Yet doctors persist in practicing "exhaustion medicine"--treating until there are no more options left to try--Dr. Martha Twaddle, chief medical officer of Midwest Palliative & Hospice Care Center in suburban Chicago, told the AP.

More than 80 percent of patients with progressive chronic illnesses such as cancer, heart failure or Alzheimer's disease, say they want to avoid hospitalization and intensive care when they are dying, according to the Dartmouth Atlas Project, which monitors healthcare trends.

Yet hospitalizations during the last six months of life have risen for Medicare recipients between 1996 and 2005. Nearly one in three Medicare dollars goes toward treating chronic illness in the last two years of life.

Meanwhile, the average amount of time spend in hospice and palliative care, which stresses comfort and quality of life after an illness becomes incurable, is dropping because people start too late. In 2008, one-third of people had it for a week or less, according to the National Hospice and Palliative Care Organization.

"People are actually now sicker as they die," Dr. Ira Byock, director of palliative care at Dartmouth-Hitchcock Medical Center told the AP. Often families push for treatment, choosing needless medicine that prolongs suffering over comfort care. But "there are worse things than having someone you love die," he said.

See Marilynn Marchione's Associated Press article on the subject for a closer look.

F is for Fat (or should I say Fatter)

The Trust for America's Health has just released its seventh annual report on obesity and the results are depressing. Here are the highlights of the report:

Adult obesity rates rose in 28 states over the past year. Only the District of Columbia experienced a decline in adult obesity rates.

More than two-thirds of states (38) now have adult obesity rates above 25 percent.

Eight states have rates above 30 percent: Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Tennessee and West Virginia.

In 1991, no state had an obesity rate above 20 percent.

Adult obesity rates rose for a second consecutive year in 15 states and rose for a third consecutive year in 11 states.

Mississippi had the highest rate of obese adults at 33.8 percent. Colorado had the lowest rate at 19.1 percent and is the only state with a rate below 20 percent.


The news about childhood obesity is equally depressing.

Highlights from the report:

State-specific obesity rates ranged from a low of 9.6 percent in Oregon to a high of 21.9 percent in Mississippi.

Eight states, plus the District of Columbia, have childhood obesity rates greater than 20 percent: Arkansas, Georgia, Illinois, Kentucky, Louisiana, Mississippi, Tennessee and Texas.

Nine of the 10 states with the highest rates of obese children are in the South, as are nine out of the 10 states with the highest rates of poverty.

Go here to read the full report.

It's Healthrageous!

A Boston-based start up may have a powerful tool to help individuals overcome their unhealthy behavior. The company, Healthrageous, a is a spinout of Partners Center for Connected Health. The startup’s software is designed to automatically give people personalized advice to help them reach health goals such as losing weight, lowering blood pressure, or controlling their diabetes. However, unlike a lot of personal health record products which depend on a user to conscientiously update the information about their health status, Healthrageous says they will automate the gathering of essential biometric data. They will do this by linking wireless monitoring devices such as glucose meters directly to a users online personal health record. The company's software will then be able to provide feedback to the user,offering advise and motivation to help the user achieve desired health goals. The feedback can be delivered to an internet-connected computer, mobile phone, or even via snail mail. For a closer look at this company's new offering check out this article by Ryan McBride at XConomy Boston