February 7, 2012
Category: Healthcare
I wrote last month about the role of chronic diseases in healthcare-cost growth, so I was excited to see a new report from the Institute of Medicine called Living Well with Chronic Illness: A Call for Public Health Action.
When I think of chronic illness, diabetes and heart disease are what leap to my mind -- in part because they're so tied to the lifestyle factors of smoking, inadequate exercise, and poor nutrition, and in part because they cost our health system so much money. The IOM report notes that chronic illness represents 75% of the $2 trillion the US spends each year on healthcare, but it also emphasizes that the goal of addressing chronic diseases conditions isn't just to slow the growth of healthcare costs, but to improve quality of life. The report is a response to a request by CDC and the Arthritis Foundation to "help identify ways to reduce disability and improve the function and quality of life for people living with chronic illness."
Another refreshing aspect of this report is that it doesn't just focus on the usual suspects of chronic disease (diabetes, heart disease, kidney disease, etc.). While the authors seek to assist health officials in prioritizing the use of limited healthcare dollars, they're also careful to avoid ranking diseases by a single metric. The report highlights nine "clinical clusters" that together "encompass and flesh out the range of key issues that affect the quality of life of patients with the full spectrum of chronic illnesses." Here's my quick summary of the nine conditions, which I hope will encourage some of you check out the full report. (The diseases are described in Section 2 of the report, and the uncorrected proof is currently available for free downloading.)
Read on »
Posted by Liz Borkowski at 6:54 PM • 3 Comments • 0 TrackBacks
February 6, 2012
Category: OSHA • Occupational Health & Safety • Regulation • Safety
The federal Occupational Safety and Health Administration (OSHA) issued citations last week to Zaloudek Grain Co. in Kremlin, Oklahoma for safety violations identified in its investigation of the August 4, 2011 incident in which two young workers each lost a leg. The citations listed six serious violations and a proposed penalty of $21,500. Two of the violations were assessed the OSHA maximum $7,000 penalty amount, one for inadequate guarding around the auger (1910.212(a)(2)) and the other for failing to train the young men (1910.272(e)(2)). The other safety regulations violated by the employer included rules related to adequate exit routes and a safe means of egress (1910.36(e)(2), 1910.37(a)(3), and 1910.37(b)(2)). The citation noted that one exit was blocked with wheat.
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Posted by Celeste Monforton at 2:00 PM • 0 Comments • 0 TrackBacks
February 3, 2012
Category:
A few of the recent pieces I've liked:
Ruth Marcus in the Washington Post: Why the poor should concern Romney
Scott Carlson in The Chronicle of Higher Education: America's Health Threat: Poor Urban Design
Maia Szalavitz at Healthland: The Wet House: Homeless People with Alcoholism Drink Less When Booze Is Allowed (Also see Matt Stroud at The Atlantic Cities: Why More Homeless Shelters Should Allow Alcohol)
Matthew Yglesias at Slate: Dirty Money: The astonishing new data showing that simply eliminating inefficient fossil fuel subsidies could achieve half the world's carbon reduction goals
Rafaela von Bredow in Der Spiegel: The Controversial Release of Suicide Mosquitoes
Posted by Liz Borkowski at 11:55 AM • 1 Comments • 0 TrackBacks
February 2, 2012
Category: Cancer • Environmental Health • Environmental Protection Agency • Mining • Public Health - General • Water
Communities affected by contaminated air, water and soil, workers retaliated for complaining about safety issues, and vulnerable groups abused by organizations charged with protecting them, are topics at the heart of public health. This week they are especially recognized by the Joan Shorenstein Center on the Press, Politics and Public Policy at Harvard University's Kennedy School of Government as finalists for its Goldman Prize for Investigative Reporting. Four of the six teams of journalists dug deep and reported on issues intrinsically linked to public health.
The Center for Public Integrity's Jim Morris, Chris Hamby and others, joined forces with Howard Berkes, Elizabeth Shogren and others to produce "Poisoned Places: Toxic Air, Neglected Communities" a series of articles based on a previously undisclosed EPA internal "watch list." The reporters took us into the homes, yards, and town squares of Muscatine, Iowa; Hayden, Arizona; Ponca City, Oklahoma; Chanute, Kansas, and other places to explain how much is known about the serious health hazards in these locales but how little has been done to address them. Our own Lizzie Grossman followed-up on their work to examine how "Chronic polluters are also chronic workplace safety violators."
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Posted by Celeste Monforton at 2:00 PM • 0 Comments • 0 TrackBacks
February 1, 2012
Category: Confined Space @ TPH • Occupational Health & Safety
Celeste wrote last week about the letter from scientists and public health experts urging President Obama to direct the Office of Management and Budget to finish reviewing the Department of Labor's proposed health standard on crystalline silica. Respirable crystalline silica has been known for several centuries as an occupational hazard -- it can cause irreversible fibrotic lung disease and is also associated with lung cancer. An estimated 1.7 million US workers are exposed to this hazard, and could benefit from the rule. But OMB has been reviewing the rule for more than 11 months.
The Huffington Post and EHS Today both picked up on the story right away, and this morning NPR's Morning Edition aired a story on it. NPR's Nell Greenfieldboyce reports:
[Occupational health physician Tee Guidotti] was pleased when, last Valentine's Day, the Department of Labor sent the OMB a new proposal for regulating silica. That office has to review the proposal before it is made public, and that review was supposed to take only 90 days.
As the one-year anniversary approaches, many safety advocates wonder what's holding things up. Records show that officials have held nine private meetings on the issue.
Guidotti went to one, which was requested by a medical group, the American Thoracic Society. He says officials didn't ask too many questions. "But you could tell from what they did ask that they were very well-briefed," Guidotti says. "So they know about this. They know it well."
Most of the other meetings were with industry groups, like the American Chemistry Council's Crystalline Silica Panel.
... A Labor Department spokesman said that OSHA was working with the White House office "to address complex issues related to the costs, benefits and economic impact analyses." This has required "extensive new analyses by OSHA" and additional review, he said, but OSHA would "continue to complete the required steps in the rule-making process as quickly as possible."
The National Council for Occupational Safety and Health has launched a Deadly Dust tumblr with news, information, and video clips on this issue.
In other news:
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Posted by Liz Borkowski at 3:42 PM • 0 Comments • 0 TrackBacks
January 31, 2012
Category: Healthcare
by Kim Krisberg
Joy Jay has the sweetest Southern accent you'll ever hear. It's the kind of accent that makes her news about the state of mental health services in South Carolina harder to hear than usual.
"Mental health has taken some of the biggest (funding) cuts of any agency in the state," said Jay, executive director of Mental Health America of South Carolina. "It's really affected the number of people who can be served -- the door is very narrow now for people with chronic, persistent (mental) illness. And for people with temporary problems, they can't even get into the system; there's no money for them to be served. It's a major, major problem."
From fiscal year 2009 to 2012, South Carolina decision-makers enacted some of the largest reductions to mental health services in the nation, cutting funds by nearly 40 percent, according to a November 2011 report from the National Alliance on Mental Illness (NAMI). In 2009, more than 95,000 South Carolina residents seeking mental health services were served; in 2011, that number dropped to about 90,000 -- and not because demand went down, Jay said. Jay noted that her organization is now busy building a 14-unit housing project for adults living with mental illness, and 46 people are already on the waiting list. It's the biggest waiting list they've ever had for their housing services, Jay told me.
"I believe we have an obligation to serve our elderly, our children and our disabled and when we don't do that well, we end up with lots of problems," she said. "If we don't spend money on one end, we'll spend it on the other."
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Posted by The Pump Handle at 12:30 PM • 4 Comments • 0 TrackBacks
January 30, 2012
Category: Cancer • Chemicals Policy • Combustible Dust • OSHA • Occupational Health & Safety • Regulation • Safety
The Labor Department provided an update on January 20, 2012 to its regulatory agenda, including revised target dates for improved workplace safety and health standards. Several of the rules OSHA now expects to publish in 2012 are regulations the agency previously said would be issued one or two years ago. Missed deadlines, however, are nothing new for OSHA---an agency that has only issued two new major health or safety standards in the last 10 years.
To put these new projections from OSHA in perspective, I'll refer to forecasts made previously by the Obama/Solis Administration in 2009 and 2010.
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Posted by Celeste Monforton at 3:00 PM • 0 Comments • 0 TrackBacks
January 27, 2012
Category: Education • Healthcare
During his State of the Union address, President Obama spent more time talking about education than about healthcare, which he mentioned only passing. The two are connected, though, as a response from Dean Dad at Confessions of a Community College Dean reminds us:
In reference to yesterday's post about cost (among other things), a commenter asked how I could assert ever-rising costs for colleges in the face of flat salaries for faculty.
That's an easy one. Costs include much more than salaries.
The elephant in the room for any discussion of labor costs is health insurance. When the cost of employer-provided insurance goes up, then labor costs go up, even if salaries remain flat. The employee might not feel it, but the employer absolutely does. From the employer's perspective, an increase in the cost of benefits is no different than a raise.
This is why I pull out what little hair I still have whenever I read the New Faculty Majority's advocacy of the "Vancouver model" for paying adjuncts. Vancouver is in Canada. In Canada, health insurance is not attached to employment. If you don't account for that, then you miss the point. Establish single-payer health insurance in America, and we can get a handle on the adjunct compensation issues. Until then, we use adjunct compensation to get a handle on health insurance.
Dean Dad's earlier post reported, "President Obama has put higher education "on notice" that if we keep raising tuition, we'll get our public funding cut." (The post is also well worth a read if you're at all interested in education costs and funding.) But, he goes on to point out, the cost of college is influenced by the cost of healthcare, which has been increasing far more quickly than GDP or inflation.
The Affordable Care Act primarily addresses health insurance coverage. It does have some provisions aimed at reducing costs, but as I wrote earlier this week, we still have a long way to go in figuring out how to reduce costs while maintaining or improving the quality of care.
The fact that rising healthcare costs contribute to cost growth in education -- and, really, in any sector that requires work from a lot of people who get health benefits -- is just one more reminder that failing to address healthcare-cost growth will affect our entire economy.
Posted by Liz Borkowski at 11:22 AM • 0 Comments • 0 TrackBacks
Category: Chemicals Policy • Environmental Health • Environmental Protection Agency • MSHA • OSHA • Regulation
The Republicans' mantra about the burden of regulations seems to have cast a spell on the Obama Administration's attitude about promoting new regulatory initiatives. My observations about this were reinforced this week when I read the Administration's statement accompanying its Fall 2011 regulatory plan. The message is clear: new regulations and an election year don't mix.
The tone of this new Obama Administration regulatory statement oozes caution. Let's set aside the fact that this "Fall 2011" regulatory plan was not released at all in the autumn, but on January 20, 2012. It seems the Obama White House wants to steal ammunition from those who claim there are too many new regulations in the pipeline, and also dampen the expectations of those who expected this Administration to aggressively implement more robust public protection rules.
Read on »
Posted by Celeste Monforton at 8:00 AM • 0 Comments • 0 TrackBacks
Liz Borkowski is a Research Associate at the George Washington University School of Public Health's Department of Environmental and Occupational Health. She lives in Washington, DC and loves public transportation and pumpkin empanadas.
Celeste Monforton, DrPH, MPH is a Professorial Lecturer at the George Washington University School of Public Health's Department of Environmental and Occupational Health. She also spent a decade working for the US Department of Labor, and has served on the teams investigating the 2006 Sago mine disaster and 2010 Upper Big Branch mine disaster for the state of West Virginia.
