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Center for Working-Class Studies Youngstown State University
Job Loss and Health Problems
Deindustrialization and job cuts often lead to long periods of unemployment, intermittent employment and increased underemployment, and the effects transcend simply the loss of pay, medical benefits and purchasing power. Financial strain creates stress, depression and family tensions, which can manifest in a variety of ways, from increased use of drugs and alcohol to suicide and domestic violence. At the same time, unemployment correlates with increased physical health problems. Reduced access to health care makes it less likely that displaced workers and their families will receive appropriate care. The mental and physical health costs of deindustrialization do not harm only patients; increased demand for health care combined with decreased economic resources leads to health care workers and systems that are overburdened and ultimately unable to meet the community's needs.
Displaced workers, especially primary breadwinners, are likely to feel significant pressure and anxiety about providing for their families. But job loss causes more than just financial distress; work plays a key role in shaping individual identity and social relations. The loss of work can disrupt an individual's sense of self and his or her value and competence. As Al Gini writes, "To work is to be and not to work is not to be."42
Even when clear external reasons exist for layoffs, individuals may internalize the loss, blaming and doubting themselves. Given that job loss undermines both financial and personal security, it's not surprising that many studies have shown that unemployment correlates with higher levels of anxiety and depression.43 A 1988 study showed that workers displaced by the closing of an Indiana RCA plant reported significantly higher levels of symptoms of depression. While 5 percent of employed workers indicated on a survey that they "very often" felt "hopeless about the future," 38.2 percent of the displaced workers gave the same response.44 More than half of physicians surveyed in the southsuburban area of Chicago indicated that they were seeing higher rates of alcoholism after a series of plant closings.45
While it might be expected that men struggle more than women with the loss of work - given their traditional role as breadwinners and the image of masculinity associated with some industrial jobs (such as steel making) - studies show that women, especially single mothers, display more symptoms of depression and anxiety after being laid off.46
Plant closings limit workers' economic opportunities, and "anxiety, depression, and other forms of anguish may be the normal result of rational calculation of these life chances," according to Hamilton.47 Finding a new job does not entirely alleviate these fears, because the experience of being laid off can generate persistent fear about losing the next job. The security that workers once felt, especially those who worked for local companies that seemed to be dependable employers, disappears.
These problems are exacerbated by the loss of social networks that come with deindustrialization. Workplaces provide connections for most people that are built on shared experience and daily interaction. Many workers describe their coworkers as being "like family." For many, the workplace becomes a site of their most intimate relationships. When plants close, workers lose this easy daytoday interaction. Feelings of shame, anger and sadness may make it difficult for coworkers to maintain close ties once their shared work disappears. To lose such networks during a time of personal crisis is doubly hard. Displaced workers without good social support networks show higher rates of both physical and mental illness.48 For a significant number of individuals in a single community to lose a major support system at one time is devastating.
Job loss also correlates with increases in family violence. Perrucci found that almost onethird of displaced workers (31.7 percent) indicated that the financial strains of unemployment were undermining marital relationships. Job loss also undermines men's feelings of selfsufficiency and disrupts household structures. Such tensions related to gender roles increase the probability of domestic violence.49 A 2002 study found that the risk of domestic violence increased 30 percent when a man's contributions to household income declined and increased 50 percent for every period of unemployment.50 This probability is increased even further when economic distress exists throughout a community.51 Increases in interpersonal violence may not be limited to the family. According to Steve May and Laura Morrison, "observers have begun to note the relationship between deindustrialization and workplace (and domestic) violence, workplace litigation and workplace stress and injury."52
Laidoff workers also experience declines in physical health. Studies consistently report that physical health problems, such as headache, high blood pressure, cardiovascular disease and digestive problems, as well as mortality rates, increase when people lose their jobs. Increased death rates result from disease as well as from suicide and accidents.53
As M.H. Brenner has shown, in crosscultural studies conducted over the last 25 years, unemployment contributes to elevated mortality rates.54 These effects can appear quite quickly: within a year after a major mine closing in Lewis County, Wash., the county public health office reported that it was already seeing increased rates of death due to heart disease as well as an increase in the death rate for people between ages 25 and 44.55
When unemployment is combined with other problems associated with economicallystruggling communities, such as poor housing, increased levels of drug use and higher crime rates, the result is what the Executive Intelligence Review terms "death zones" - areas where the death rate for various age groups exceeds the national average.56
Health problems caused by deindustrialization also affect local clinics and hospitals, and this may reduce access to health care for everyone in the community. Public hospitals, which provide care for patients in financial need, including the poor and unemployed, feel the strain when demand from such patients increases. These hospitals already struggle to provide care as they face cuts in Medicare reimbursements and increased demand as the percentage of Americans without health insurance rises. Add increased demand from a significant number of laidoff workers and their families, and they face a serious crisis.
Hospitals have attempted to address the financial strains by cutting services and staffing, including emergency rooms, which further reduces both access and quality of care, but sometimes even these cuts are not enough. A 2005 report shows that public hospitals in cities and the surrounding suburbs, especially lowerincome suburbs, are already closing at significant rates.57 While these closings may not be traced directly to deindustrialization, they illustrate the connection between economics and public health.
A recent report by the Urban Institute suggests that the problem will only worsen, as rising unemployment could add hundreds of thousands of children and adults to state and federal health programs, requiring an increase of $3.4 billion for Medicaid and the State Children's Health Insurance Program. Of the additional money needed, $1.4 billion would come from the states.58
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Jul 15, 2012 | Bloomberg
Simple exercise, such as walking and resistance training, improved thinking and memory in older adults in several new studies that suggest physical activity offers a key strategy in slowing mental decline.
One trial found that walking may boost brain volume in the region for memory. Another showed that weight training helped the mental function of older women with mild cognitive impairment. The research was presented today at the Alzheimer's Association International Conference in Vancouver.
Current Alzheimer's drugs offer only temporary improvement in symptoms of the disease, which slowly destroys brain cells and robs patients of memory, thinking, concentration and function. Findings that even moderate amounts of exercise might benefit the brain may offer patients a simple, non- pharmaceutical tool to help to stave off mental decline, said Kirk Erickson, an author of one of the studies.
"People want to find a magic cure for Alzheimer's disease, but for memory function, a pair of sneakers might be just as important," Erickson, an assistant professor of psychology at the University of Pittsburgh in Pennsylvania, said in a July 13 telephone interview.
"Physical activity appears to be an incredibly promising and effective approach and a non-pharmacological approach to improve brain function and hinder the progression of potential disease states like dementia and Alzheimer's disease. We have a lot more research to go before we can sell this as a prescription."
About 5.4 million Americans have Alzheimer's and, by 2050, that number is expected to grow to as many as 16 million, according to the Alzheimer's Association. The number of people worldwide with the condition is expected to swell to 115 million by 2050.
Brain Growth
In the trial led by Erickson, researchers looked at 120 adults without dementia who engaged in moderate walking three times a week for 30 minutes to 45 minutes for a year or stretching and toning for the same periods of time. The researchers used magnetic resonance imaging, or MRI, to assess the areas of the brain responsible for memory that usually shrink with age.
They found a 2 percent growth in the area of the brain called the anterior hippocampus in those who exercised compared with those who engaged in stretching and toning.
"This is like essentially rolling back the clock by one to two years," Erickson said. More research is needed to determine if growth in that area continues with repeated exercise or levels off and what happens when someone stops exercising, he said.
Weight Training
A separate study led by researchers from the University of British Columbia in Vancouver found that twice-weekly weight lifting, or resistance training, may help alter the rate of mental decline in older women with mild cognitive impairment.
The trial followed 86 women ages 70 to 80 for six months who did resistance training, walking or balance and toning twice a week. Researchers found that the resistance-training group improved significantly on tests of mental functioning and memory over those in the balance and toning group. No memory benefit was seen among the walkers versus the balance and toning group.
Teresa Liu-Ambrose, the study's senior author and an assistant professor of physical therapy at the Vancouver Coastal Health Research Institute and the University of British Columbia, said strength training, which may be easier than aerobic activity such as walking for some older adults, requires people to think and learn new exercises, which may be why it worked better than walking in this study. Also, aerobic exercise may have to be done more frequently than twice a week to yield benefit in people already at risk for developing dementia, she said.
New Focus
"Physical activity, whatever shape and form, is beneficial," she said in a July 13 telephone interview. What researchers now need to focus on is refining who benefits from which type of exercise program.
A step in that direction comes with the results from a third trial today, which Liu-Ambrose was also the principal investigator. That trial found that weight lifting is more effective than balance and toning in improving or maintaining selective attention and conflict resolution only among those with less cognitive impairment. The exercises yielded similar results in those who had more cognitive impairment.
A fourth study from Japan included 50 older adults with mild dementia who were assigned to exercise that included aerobic exercise, muscle strength training and postural balance retraining for 90 minutes a day twice a week for a year, or to an education group that attended three classes about health over 12 months. The researchers found that those in the exercise group performed better on memory tests than those in the education group.
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Robert Reich is pleased to see the Justice Department crackdown on "Big Pharma," but doesn't think think the government is doing anywhere near enough to solve the problem:
How Not to Get Big Pharma to Change Its Ways, by Robert Reich: Earlier this week the Justice Department announced a $3 billion settlement of criminal and civil charges against pharma giant GlaxoSmithKline - the largest pharmaceutical settlement in history - for improper marketing prescription drugs in the late 1990s to the mid-2000s.The charges are deadly serious. Among other things, Glaxo was charged with promoting to kids under 18 an antidepressant approved only for adults; pushing two other antidepressants for unapproved purposes,... and, to further boost sales of prescription drugs, showering doctors with gifts, consulting contracts, speaking fees, even tickets to sporting events.$3 billion may sound like a lot of money, but during these years Glaxo made $27.5 billion on these three antidepressants alone,... so the penalty could almost be considered a cost of doing business.Besides, to the extent the penalty affects Glaxo's profits and its share price, the wrong people will be feeling the financial pain. ... Not a single executive has been charged - even though some charges against the company are criminal. ...The Glaxo case is the latest and biggest in a series of Justice Department prosecutions of Big Pharma for illegal marketing prescription drugs. ... The Department says the prosecutions are well worth the effort. By one estimate it's recovered more than $15 for every $1 it's spent.But what's the point if the fines are small relative to the profits, if the wrong people are feeling the financial pinch, and if no executive is held accountable?The only way to get big companies like these to change their behavior is to make the individuals responsible feel the heat.An even more basic issue is why the advertising and marketing of prescription drugs is allowed at all, when consumers can't buy them and shouldn't be influencing doctor's decisions anyway. Before 1997, the Food and Drug Administration banned such advertising on TV and radio. That ban should be resurrected.Finally, there's no good reason why doctors should be allowed to accept any perks at all from [drug] companies... It's an inherent conflict of interest. Codes of ethics that are supposed to limit such gifts obviously don't work. All perks should be banned, and doctors that accept them should be subject to potential loss of their license to practice.Simon Johnson, summarizing Dennis Kelleher of the blog Better Markets, says banks have the same problem:
... Global megabanks have an incentive to deceive customers, including both individuals and nonfinancial corporations. Their size confers both market power and the political power needed to conceal the extent to which they engage in economic fraud. The lack of transparency in derivatives markets provides them with an opportunity to cheat, but the abuses are much wider – as the Libor scandal demonstrates. The ripoff is not just of retail investors. ...This has motivated Samuel Brittan of the Financial Times to rethink his view of competitive markets. Sort of:
As one of the few commentators to have always favored competitive market capitalism I have had to ask myself a few questions. Apart from scandals such as the Libor rate fixing, we have had the behavior of banks before the great recession; a trend to much greater concentration of income and wealth, squeezing the living standards of ordinary citizens; and one could go on.So, after asking himself these questions, what does he propose?:
Yet if anyone expects me to issue a clarion call for more state ownership and control, they will be disappointed. ... What then has gone wrong? ... Few of us like competition; and the tendency to form closely knit groups to keep outsiders at bay is probably as old as the human race. For pre-capitalist examples one has only to think of the medieval guilds, whether of craftsmen or Master Singers. More subtle are the practices of bankers, as they come disguised as services for customers. In summary, success has depended more on whom you know than what you know. Hence the catchphrase "crony capitalism". ...The biggest obstacle to reform is that insiders can devote time and energy to maintaining their position. For ordinary citizens, political reform is a sideshow that hardly repays such efforts. The protests in financial canters are a well-meant but ill-focused attempt to offset this bias.Yet nil desperandum. The UK corn laws were repealed and the US antitrust acts were passed; and in time both the financiers and the Eurocrats will be brought down.So, no cause for despair? Not so sure about that (the changes he describes did not come easily). It feels a bit like the Libor scandal has produced a turning point, but the power hold on politicians is still as strong as ever. We've seen how some Democrats react if Obama so much as points a finger in the direction of the financial industry, and if Romney is elected does anyone think the government will get tougher with big banks, big pharma, or big anything else?
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Economist's View
Lane Kenworthy:
Why the surge in obesity?, by Lane Kenworthy: The Weight of the Nation is a four-part series on obesity in America by HBO Films and the Institute of Medicine, with assistance from the Centers for Disease Control (CDC) and the National Institutes of Health (NIH). It's been showing on HBO and can be viewed online. Each of the four parts is well done and informative.Obesity is defined as having a body mass index (BMI) of 30 or more. For a person 6 feet tall, that means a weight of more than 220 pounds. For someone 5'6″, the threshold is 185 pounds. People who are obese tend to earn less and are more likely to be depressed. They are at greater risk of diabetes, heart disease, stroke, and some types of cancer, and they tend to die younger. The CDC estimates the direct and indirect medical care costs of obesity to be $150 billion a year, about 1% of our GDP.The chart below, which appears several times in The Weight of the Nation, shows the trend in obesity among American adults since 1960, the first year for which we have good data. The data are from the National Health and Nutrition Examination Survey (NHANES). They are collected from actual measurements of people's height and weight, rather than from phone interviews, so they're quite reliable. After holding constant at about 15% in the 1960s and 1970s, the adult obesity rate shot up beginning in the 1980s, reaching 35% in the mid-2000s.What caused the surge in obesity? The standard explanation is too much eating and too little physical activity, and The Weight of the Nation sticks with this story. But it shouldn't, because the evidence suggests one of these two hypothesized culprits has been far more important than the other.Here is the trend in eating, measured as average calories in the food supply (adjusted for loss and spoilage) according to data from the Department of Agriculture. This chart too is from The Weight of the Nation. The timing of change matches that for obesity; the level is flat through the 1970s and then rises sharply beginning in the 1980s. An alternative series, measuring energy consumption per capita, goes back to 1950 (see figure 6, chart F here); it too shows little or no change until 1980, and then a sharp jump. The rise in food consumption correlates closely with the rise in obesity.That isn't true of physical activity. We're less active now than we were half a century ago, but the timing of the decline in activity doesn't match up with the shift in obesity.We don't have good historical data for a comprehensive measure of activity, such as calories expended, so we have to look instead at individual components. We can begin with the most-often-cited culprit: television. Here too The Weight of the Nation presents data, shown below, with the suggestion that TV watching is a significant cause of rising obesity. But the trend doesn't support that inference. Time spent watching television has increased steadily since 1950. There was no sudden rise in the 1980s.What about video games, the internet, and smartphones? The internet and smartphones arrived on the scene too late to account for the rise in obesity in the 1980s and most of the 1990s. The timing doesn't work for video games either; they're played mostly by the young, beginning in the 1980s, but obesity rates rose sharply in the 1980s and 1990s among adults of all ages, even among the elderly (see table 2 here).
More Americans now have sedentary jobs and drive to work. Yet as David Cutler, Edward Glaeser, and Jesse Shapiro noted in a paper published nearly a decade ago, these shifts have been going on for a long time, with no acceleration in the 1980s.
"Between 1910 and 1970, the share of people employed in jobs that are highly active like farm workers and laborers fell from 68 to 49 percent. Since then, the change has been more modest. Between 1980 and 1990, the share of the population in highly active jobs declined by a mere 3 percentage points, from 45 to 42 percent. Occupation changes are not a major cause of the recent increase in obesity.
"Changes in transportation to work are another possible source of reduced energy expenditure - driving a car instead of walking or using public transportation. Over the longer time period, cars have replaced walking and public transportation as a means of commuting. But this change had largely run its course by 1980. In 1980, 84 percent of people drove to work, 6 percent walked, and 6 percent used public transportation. In 2000, 87 percent drove to work, 3 percent walked, and 5 percent used public transportation. Changes of this minor magnitude are much too small to explain the trend in obesity."
Another reason to doubt the importance of declining physical activity is that the elderly probably have become more active over time, rather than less, and yet we observe a rise in obesity among the elderly too, similar in timing and magnitude to that of younger adults (again see table 2 here).
In short, the evidence suggests that reduced physical activity has not been a key cause of the surge in obesity in America (more here, here, here, here, here).
This doesn't mean physical activity plays no role in determining which persons become obese. And it doesn't mean an increase in activity won't help reduce obesity's prevalence. But it does suggest that a strategy focused on increasing activity - and The Weight of the Nation leans in this direction - may not get us as far as we'd like. To make serious progress in reducing obesity, we need to significantly reduce the number of calories many of us consume.
[Lane has a follow-up post here: Is rising obesity a product of income inequality and economic insecurity?]
Fred C. Dobbs:
(Why? IMO, *corn syrup*.)
The World Is Fat (Especially America) http://nyti.ms/NNLA2P
NYT - June 19, 2012 - CATHERINE RAMPELL - EconomixThe world could stand to shed a few pounds. Fifteen million metric tons, in fact, according to a new study.
In the study (*), published in the open-access journal BMC Public Health, researchers used country-specific data on body mass index and heights to estimate the biomass of the world's entire adult population.
They concluded that in 2005, the global adult human biomass was about 287 million metric tons. (A metric ton is 1,000 kilograms, or about 2,200 pounds.) About 15 million metric tons of that biomass were the extra pounds of people who were overweight (here defined as having a body mass index value above 25). About 3.5 million metric tons of that total biomass were because of obesity (having a B.M.I. above 30).
The United States is to blame for a lot of those spare tires. While America holds about 5 percent of the world's adult population, it accounts for about a third of the excess weight because of obesity.
Japan and the United States in particular demonstrate the extreme variations in weight. Both are rich countries, but the American population is one of the most overweight in the world and Japan's is one of the leanest. The average B.M.I. in Japan in 2005 was 22.9, and in the United States it was 28.7.
If all countries had the same B.M.I. distribution as Japan, the world's total biomass would fall by 14.6 million metric tons, or 5%. ...
*- http://www.biomedcentral.com/1471-2458/12/439/abstract
Alex Blaze:
I thought Weight of the Nation made it clear at several points that diet was more important than exercise in the increase of obesity. There was one expert who said it was a confluence of various trends, which doesn't negate the fact that food is more significant than exercise.
I don't get how it could just be # of calories in the food supply, though. The US has been getting more efficient in terms of productivity per acre over the last couple decades, and we've also switched to higher calorie crops (soy and corn), moving away from vegetables and fruit (Weight of the Nation finally mentioned something I knew was true: if every decided to eat the daily recommended amount of fruits and vegetables tomorrow, there wouldn't be enough to go around).
But grains are traded on a global market, and other wealthy nations have food prices that are generally as low as the US (I've lived between the US and France since 2005 and food costs about the same in both countries. I've never had to reduce my caloric intake in France to mind my budget). But the US still has a higher obesity rate than Europe or East Asia.
So international comparisons would be useful in testing the correlation between "number of calories available" and "obesity rate."
EMIchael:
I wonder if the increase in caloric intake correlates with the increase of the working hours of American families? The time period seems to match.
" Families earning the median income now work about 3500 hours, on average, compared to 2800 hours in 1975. The 26 percent increase in hours worked mainly reflects increases in work outside of the home among women. In fact, among two-parent families with median earnings, the hours of men were relatively constant over time, while hours worked by women more than doubled from 1975 to 2009."http://www.brookings.edu/up-front/posts/2011/07/08-jobs-greenstone-looney
As more and more families had both parents working, time for shopping and preparation decreased. And the "easy way" to prepare meals contains a lot of calories. And those eating habits developed while young are now moving up the age ladder.
If you look at the chart in the Brookings link of hours worked per family it almost mirrors the calorie and obesity charts in Kenworthy's article.
Cynthia:
You can't measure nutrients by calories. A calorie is no different than a BTU, just an energy index.
100 calories of pure fat is different nutrient-wise than 100 calorie of Broccoli.
The major problem with our food is that it is "hollow". It lacks nutrients, especially trace minerals. Corporate farms pump the soil with isolated N,P,K and do not rotate the crops.
Over a few short yrs, the soil is depleted of trace minerals (compare a garden tomato to store bought).
If your food is hollow, your still hungry after a meal, and over indulge.
Another issue is our eating habits. We eat too fast, (the French have it right, as Lafayette will tell you) slow and with a glass of wine.
Food is dissolved in your stomach with HCL acid. If you throw a ton of stuff in there, you overwhelm the acid (raising Ph) and it sits there bloated until the stomach gets the Ph down.
ken melvin said...
Pizza and soda.
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April 26, 2012
Since direct-to-consumer drug advertising debuted in the late 1990s, the number of people on prescription drugs for life has ballooned.
Why has Big Pharma failed to produce new antibiotics for deadly infections like MRSA (methicillin-resistant Staphylococcus aureus), VRE (vancomycin-resistant enterococci), C. Difficile and Acinetobacter baumannii even as they leap from hospital to community settings? Because there is no money in it.
Pharma executives "have shown less interest in medicines like antibiotics that actually cure disease than in those that only treat symptoms," writes Melody Petersen, author of Our Daily Meds. "Most blockbusters are pills for conditions such as anxiety, high cholesterol or constipation that must be taken daily, often for months or years. They are designed for rich Americans who can afford to buy them." Nor are medicines for tropical diseases like malaria, which kills a child every 30 seconds, a priority, notes Petersen. They also lack ka-ching.
Since direct-to-consumer drug advertising debuted in the late 1990s, the number of people on prescription drugs -- especially prescription drugs for life -- has ballooned. Between 2001 to 2007 the percentage of adults and children on one or more prescriptions for chronic conditions rose by more than 12 million, reports the Associated Press and 25 percent of US children now take a medication for a chronic condition. Seven percent of kids take two or more daily drugs. Who says advertising doesn't work?
Of the top-selling drugs in 2011, led by Lipitor, Nexium, Plavix, Advair Diskus, Abilify, Seroquel, Singulair and Crestor, none is taken occasionally, or "as needed" and the treatment goal is never to get off the drug, like an antibiotic. Why would Pharma deal itself out of the game?
There are two ways Pharma hooks the US public on prescriptions for life. First, prescriptions that used to be taken as needed for pain, anxiety, GERD (gastroesophageal reflux), asthma, mood problems, migraines and even erectile dysfunction, gout and retroviruses (in some cases) are now full-time medicines. Instead of having a bad day or heartburn, you have a disease like anxiety or GERD which calls for full pharmaceutical artillery. Instead of having body pain to be treated transiently, you are put on an antidepressant like Cymbalta or seizure drug like Lyrica or Neurontin indefinitely.
Secondly, many of the top-selling drugs today are to prevent chronic conditions like high cholesterol, high blood pressure and osteoporosis that people are said to be "at risk" for. Needless to say, in both cases, people never know if the drugs are working or whether they would have had symptoms without them. This creates a loyal customer who is afraid to quit a prescription because it might be working. And why should they quit anyway when a third party is probably paying?
Here are some drugs -- not all -- that are marketed for perpetuity.
1. ADHD and Drugs for Pediatric 'Psychopathologies'
Thanks to Pharma's "diagnose early" and screening campaigns, millions of children are treated with stimulants for ADHD and antipsychotics for bipolar disorder and assorted conduct, oppositional defiant, development disorders and "spectrums" today. No wonder Michael Bandick, brand manager for Eli Lilly's popular antipsychotic Zyprexa, called it "the molecule that keeps on giving" at a national sales meeting.
But giving kids daily drugs creates two problems. First, parents will never know if their kids would have outgrown their conditions, and second, it's unlikely they'll ever get "clean." In fact, Pharma marketers worry about the revenue threat of kids going off their meds when they leave home and even run an ad campaigns in college newspapers to keep them on. One ad shows the lead singer of Maroon 5, declaring, "I remember being the kid with ADHD. Truth is, I still have it." The ad's tag line reads, "It's Your ADHD. Own It."
2. Hormone Replacement Therapy
When the popular HRT pill Prempro was launched by Wyeth, now Pfizer, in the 1980s, then-CEO Bob Essner told sales associates, "We can make real the full promise of HRT to create in the near future a world where the majority of women will start HRT at menopause and continue on it for the rest of their lives," reports Philadelphia magazine. The scheme of treating estrogen "deficiency" for 30 or 40 years worked until 2002 when HRT was found to cause breast cancer, heart attacks, strokes, blood clots and dementia. They were some of the conditions it was supposed to prevent. Oops. But Pharma has not abandoned the billion-dollar franchise and news about estrogen benefits is creeping back into the news, predicated on the public's short memory. People don't lose hormones because they age; they age because they lose hormones, say Pharma hormone sellers. Even men now "suffer from" testosterone deficiencies or Low T.
3. Happy Pills
Pharma's success in convincing people with anxiety or the "blues" that they need an antidepressant was a Wall Street coup. Instead of taking the occasional Xanax, people agreed to alter their entire body chemistry with a drug they took for months, years or decades.
But as antidepressants fall in popularity, because of their many side effects, including alarming "discontinuation symptoms" when people try to stop, WebMD is conducting damage control to keep people on them. Don't believe that antidepressants turn "you into a zombie," make you gain weight, ruin your sex life, make you "forget your problems rather than dealing with them" or cost too much, says the huge pro-pill Web site in one article. Depression is linked to heart disease, obesity, diabetes, Alzheimer's and cancer says a second WebMD article. Stay on your meds.
4. Proton Pump Inhibitors (PPIs)
Some say gastroesophageal reflux disease (GERD) is just lowly "heartburn" whipped up by Pharma into a profitable disease. But over 110 million prescriptions were written for proton pump inhibitors (PPIs) like Nexium and Prevacid in 2009, making it the third most prescribed class of drugs. Long-term use of PPIs increases the risk of hip, wrist and spine fractures, the FDA warns and the drugs can cause potentially lethal C. difficile-caused diarrhea and community-acquired pneumonia says national health advocacy group, Public Citizen. But Pharma has a different message. GERD can lead to esophageal inflammation, scar tissue and cancer, if untreated, it tells patients and symptoms won't go away on their own. No wonder doctors call PPIs "Purple Crack."
5. Statins
The best-selling statin drugs like Lipitor and Crestor that lower their cholesterol risks are pretty much the definition of "lifer medications," taken in perpetuity. Who would dare to go off of them and risk cardiovascular events?
One patient on a cholesterol drug site writes that despite feeling "miserable" on statins, "What do you do? Go off the statins and let your arteries clog up?" But medical professionals say it is not safe to stay on statins indefinitely. Patients are at risk of liver dysfunction, acute kidney failure, cataracts and muscle damage known as myopathy, reports British Medical Journal. And statins can also cause memory loss and increase the risk of developing of Type 2 diabetes and muscle damage, FDA warns.
Still the appeal of a drug that lowers the risk of cardiovascular events without a change in diet or lifestyle made Lipitor the top-selling drug in the world, until recently, when its patent expired. Statins are now prescribed for kids, for the same reason.
6. Asthma-Control Medicines
Like ADHD and "pediatric psychopathology" drugs, Pharma conducts aggressive early treatment campaigns for asthma drugs, recommending that children as young as one year be treated when "symptoms" first emerge. ("Before they go away," says one cynical doctor.)
It has also marketed daily asthma "control" medicines like Advair and Symbicort so aggressively (prescription drugs added onto patients' regular asthma medicine -- ka-ching) that nearly two-thirds of the nation's millions of asthma sufferers take them. Despite the expense of adding an additional drug to rescue inhalers or inhaled corticosteroids when asthma is a lifelong disease, there are no clinical benefits to the upsell, says the research institute of Medco, the nation's largest pharmacy benefit manager. Neither trips to the ER or hospitalizations are reduced with control drugs. And there's another mark against the daily drugs that don't work: they may make asthma worse says some published reports.
Martha Rosenberg frequently writes about the impact of the pharmaceutical, food and gun industries on public health. Her work has appeared in the Boston Globe, San Francisco Chronicle, Chicago Tribune and other outlets.
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Sep 6, 2012 | Science Daily
Obesity is a known risk factor for developing type 2 diabetes. But it hasn't been clear whether the "dose" of obesity -- how much excess weight a person has, and for how long -- affects the risk of diabetes.
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A new University of Michigan Health System study of about 8,000 adolescents and young adults shows the degree and duration of carrying extra pounds are important risk factors for developing type 2 diabetes in adulthood.
"Our study finds that the relationship between weight and type 2 diabetes is similar to the relationship between smoking and the risk of lung cancer," says study lead author Joyce Lee, M.D., M.P.H., a pediatric endocrinologist at U-M's C.S. Mott Children's Hospital. "The amount of excess weight that you carry, and the number of years for which you carry it, dramatically increase your risk of diabetes."
The study appears online ahead of print in the September issue of the Archives of Pediatric Adolescent Medicine.
"We know that, due to the childhood obesity epidemic, younger generations of Americans are becoming heavier much earlier in life, and are carrying the extra weight for longer periods over their lifetimes," says Lee. "When you add the findings from this study, rates of diabetes in the United States may rise even higher than previously predicted."
Researchers found that a measure of degree and duration of excess weight (based on the number of years body mass index, a calculation of weight and height, of 25 or higher) was a better predictor of diabetes risk than a single measurement of excess weight. A BMI over 25 is considered overweight and over 30 is considered obese.
Lee and colleagues also found that black and Hispanic compared with white individuals had a higher risk for diabetes, for a same amount of excess weight over time.
For example, individuals with a BMI of 35 (10 points higher than healthy weight) for 10 years would be considered to have 100 years of excess BMI. Hispanics in this group were twice as likely to develop diabetes compared to whites, while blacks in this group had one-and-a-half-times greater risk than whites.
Based on the latest findings, Lee suggests obesity prevention and treatment efforts should focus on adolescents and young adults, especially racial minorities.
In addition, she believes that measuring and following BMI and the cumulative "dose" of excess BMI may be helpful for clinicians and patients in understanding risk of diabetes in the future.
Evidence from other research indicates that BMI increases with age, and children who are obese are more likely to become obese adults.
Obesity is a well-known contributor to type 2 diabetes, cardiovascular disease, disability and premature death.
Funding: National Institute of Diabetes and Digestive and Kidney Diseases and the Clinical Sciences Scholars Program at the University of Michigan.
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October 12, 2009 | Robert Reich's Blog
The health-insurance industry has finally revealed itself for what it is.
Background: The industry hates the idea that's emerged from the Senate Finance Committee of lowering penalties on younger and healthier people who don't buy insurance. Relying on an analysis by PricewaterhouseCoopers, insurers say this means new enrollees will be older and less healthy -- which will drive up costs. And, says the industry, these costs will be passed on to consumers in the form of higher premiums. Proposed taxes on high-priced "Cadillac" policies will also be passed on to consumers. As a result, premiums will rise faster and higher than the government projects.
It's an eleventh-hour bombshell.
But the bomb went off under the insurers. The only reason these costs can be passed on to consumers in the form of higher premiums is because there's not enough competition among private insurers to force them to absorb the costs by becoming more efficient. Get it? Health insurers have just made the best argument yet about why a public insurance option is necessary.
Right now they run their markets and set their prices, and pass on any increased costs directly to consumers. That's what they're threatening to do if the legislation attempts to squeeze, even slightly, the colossal profits they plan to make off of thirty million new paying customers.
They want every penny of those profits. They demand every cent. And if the government dares raise their costs a tad higher than they expected when they first signed on to support the bill, they'll pass those costs on to consumers in the form of higher premiums. They can carry out their threat only because they have unaccountable, untrammeled market power.
But they've now hoisted themselves on their own insured petard. They've exposed themselves. If they had to compete with a public insurance plan, they couldn't get away with this threat. They couldn't pass on the extra costs. They'd have to compete with a public insurance option that forced them to give consumers the best deals possible.
Now's the time for Congress and the White House to say to the insurance industry: You want to play hardball? Okay. We'll play it, too. You didn't want a public insurance option. That was one of your conditions for supporting the bill. You wanted gigantic profits from having thirty million new paying customers and the market to yourself. The Senate Finance Committee and the White House agreed because they wanted your support and were afraid of the negative ads and hurricane of opposition you could finance. But you're even greedier than we imagined. And now you've demonstrated that greed to the American people. They don't want to turn over even more of their hard-earned money to you. So, insurance companies, we've got news for you. We're going to make sure Americans have the freedom to choose a public insurance option that's cheaper and better, and you're going to have to work hard to keep them your customers.
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Firemane wrote:
There's also a disconnect in health care. Further away from big city, crappier is the health care. Not exactly a master plan for an extended, pleasant retirement.
Thats a trend that's likely to change going forward. Yet another bubble is health care but this won't last forever. Along with people likely relocalizing the medical profession will find itself out of money.
Obviously I expect pension plans to be blowing up big time over the next several years along with retirement plans. They are not going to get squat for returns for decades. Big business will be forced to play hardball on medical insurance. Likely they will drop a lot of employee coverage. Same for public employees eventually.
This will force Doctors to accept living as a small town physician again. Things will change and yes very likely we won't get the "quality" of medical care that some of us have enjoyed. Now what I have seen is people in their 80's and 90's blowing hundreds of thousands of dollars on medical care with a dubious return. Perhaps living a few more years with most of it spent in a hospital. I'm not convinced this is quality medical care. When its my time to go I'll weigh the cost of medical care vs quality of life etc and decide for myself. I'm not gonna live in a hospital.
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