Type 2 diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call. Unfortunately, few people ever hear the alarm. A new report from the Centers for Disease Control and Prevention shows that among Americans age 20 and older, only 10% of those with prediabetes know they have it. Given that as many as 73 million Americans have prediabetes, that’s a lot of missed opportunities to prevent the ravages of diabetes. One reason many people don’t know that they may be headed toward diabetes is they’ve never had their blood sugar tested. This simple test isn’t part of routine preventive care, but perhaps it should be.
To get or stay healthy, many people focus on exercising more, eating better, or quitting smoking. Getting recommended vaccinations is another relatively simple strategy for health that an alarming number of Americans overlook. Vaccination isn’t just for kids. Adults should get immunized against infectious agents that cause the flu, pneumonia, whooping cough (pertussis), shingles (herpes zoster), and more. The latest schedule for adult immunization has been published in the Annals of Internal Medicine. It now recommends adding a second anti-pneumonia vaccine for people with compromised immune systems. It also says that all adults age 65 and older should get the tetanus, diphtheria, and pertussis (Tdap) vaccine, as should pregnant women with each pregnancy. When it comes to adult immunization, Americans aren’t doing very well. One-third of older Americans don’t get the pneumococcal vaccine, 84% don’t get the shingles vaccine, and 87% don’t get the tetanus, diphtheria, and pertussis vaccine. In addition to protecting yourself from an infectious disease, immunization also protects others.
As a huge, snowy Nor’easter barrels into New England, I’m thinking about all the shoveling I’ll be doing over the next couple days. Luckily I have three teenagers to help. But now that I’m of an AARP age, I have to be more mindful of the cardiovascular effects of shoveling. Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases during significant snow storms. What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. Pushing a heavy snow blower can do the same thing. Cold weather also contributes. Tips for protecting the heart include shoveling many light loads instead of fewer heavy ones, taking frequent breaks, and hiring a teenager.
The gun control proposals that President Barack Obama unveiled yesterday highlight the intensely personal nature of this issue. What often gets lost in the debate is the public health dimension of firearm possession. In 2011, the last year for which we have complete statistics, 32,163 American men, women, and children were killed by firearms. Since 2000, the running total is more than 400,000. That’s a staggering loss of life. A few are accidents, some are suicides, and about one-third are homicides. One way to sidestep the contentious debate over gun control would be to focus more effort on preventing gun violence. In a compelling article, three Harvard-affiliated researchers make the case for approaching gun violence as we have tackled other serious public health issues. Writing in JAMA, Drs. Dariush Mozaffarian, David Hemenway, and David Ludwig summarize lessons learned from successful efforts at reducing deaths from smoking, motor vehicle accidents, and poisoning and suggest ways to apply similar approaches to stemming gun violence. By talking about gun violence as a public health issue, and treating it that way, we may be able to save thousands of lives that are now needlessly lost each year.
If you like numbers and statistics, especially those about health, two reports released this week should keep you occupied for days: the massive Global Burden of Disease study was published in The Lancet, and the American Heart Association released its annual “Heart and stroke statistics” report. The Global Burden of Disease project found that average life expectancy continues to rise in most countries. It also found that infection and other communicable causes of disease no longer dominate deaths and disability. Today, so-called non-communicable causes like traffic accidents, violence and war, heart disease, cancer, and other chronic conditions account for two-thirds of world deaths and the majority of years lost to disability and death. According to the American Heart Association’s annual report, the percentage of deaths due to heart attack, stroke, and other cardiovascular diseases has fallen by nearly one-third since 1999, but don’t expect that to continue. Increases in high blood pressure, high cholesterol, diabetes, overweight, and inactivity threaten to reverse these gains.
For all too many people, using a tablet computer is a pain in the neck, shoulders, and back. Why? Widely popular tablets like the iPad, Nook, Kindle Fire, and Xoom are so light and easy to handle that you can hold one on your lap or in your hand. That can put you in a position that’s bad for your neck, shoulders, and back. In a study of 15 experienced tablet users, Harvard School of Public Health researchers found that working with a tablet held on the lap or placed flat on a table makes the neck bend much more than does working with a desktop or notebook computer. Neck-wise, the best tablet orientation was having it propped up on a table. Next time you expect to be working with a tablet computer for more than a few minutes, place it on a table and use a case that holds it at a comfortable viewing angle. Shift your hands, your weight, or even stand up when you can. And take a break every 15 minutes.
A report in this week’s Journal of the American Medical Association describes an outbreak of tattoo-related infections in four states: New York, Washington, Iowa, and Colorado. All involved Mycobacterium bacteria. Infection with these fast-growing bugs can cause problems ranging from a mild rash around the tattoo site to severe abscesses that require surgery and several months of antibiotic therapy. This isn’t the first such report. An outbreak in Ohio, Kentucky, and Vermont involved methicillin-resistant Staphylococcus aureus (sometimes known as MRSA), a hard-to-treat bug that can cause substantial damage to the skin and the rest of the body. Tattoo-related infections have three main sources: unsterile practices by the tattoo artist and his or shop, the ink used for tattooing, and poor after-care. Don’t hesitate to ask a tattoo artist directly what the shop’s sterilization processes are. And follow instructions afterward for caring for the tattoo.
Based on data presented this week at the Union for International Cancer Control meeting in Montreal, a startling 40% of cancers may stem from modifiable causes, such as diet, exercise, tobacco and alcohol exposure, and appropriate screening. Although adapting a healthy lifestyle isn’t an ironclad guarantee against cancer, it can help lower a person’s individual risk.
Why is it so incredibly hard to quit smoking—even when you are desperate to do so? For some people, the answer may be in their genes. In a report published online in the American Journal of Psychiatry, a team led by Dr Li-Shiun Chen of the Washington University School of Medicine identified a “high risk” version of a nicotine receptor gene that is more common in heavy smokers. Those with the high-risk gene took two years longer to quit smoking. But there was a silver lining: smokers with the high-risk gene were three times more likely to respond to smoking cessation therapies. The study provides hope for even hardcore smokers. However long it takes, quitting is beneficial. In a study published in the Archives of Internal Medicine, quitting smoking reduced the risk of dying—even in people in their 80s. “Even older people who smoked for a lifetime without negative health consequences should be encouraged and supported to quit,” the researchers wrote.
As Benjamin Franklin once wrote, “nothing is certain but death and taxes.” A new study suggests that death and taxes are more than just unrelated “certainties,” and that one (paying taxes) could lead to the other. Over the last 30 years, an average of 226 Americans died in motor vehicle accidents on the day taxes were due (usually April 15th), compared to 213 on other days. The authors speculated that the increase may be due to distracted driving because of the added stress of tax day, more alcohol drinking, or less sleep. If the JAMA findings are real, staying off the road on tax day could ever so slightly reduce your chances of getting into an accident on the road. But there are other, better ways to keep yourself and others safe while driving every day of the year.