Dr. Evans Leads Charge Against Disparities in Healthcare

As the founder and CEO/President of Community Wellness Centers of America LLC (CWCOA) and Equinox Electronic Medical Records (EMR), Dr. Robert Evans is working towards organizing and delivering required healthcare services in under-served communities that otherwise would be neglected.

As a medical physician and long time community activist, Dr. Evans understands the resources and programs required to address chronic illnesses through preventive programs, which are often absent from minority communities.

Dr. Evans has developed his companies with a primary mission to deliver state-of-the-art health programs and services, improve healthcare outcomes in underserved communities, and collaborate with hospital systems, physicians, and ancillary healthcare services. All of these steps will help to create a coordinated healthcare delivery system to provide equality in healthcare for residents through increased emphasis on prevention.

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Bring On the Exercise, Hold the Painkillers

Phys Ed

Taking ibuprofen and related over-the-counter painkillers could have unintended and worrisome consequences for people who vigorously exercise. These popular medicines, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, work by suppressing inflammation. But according to two new studies, in the process they potentially may also overtax the kidneys during prolonged exercise and reduce muscles’ ability to recover afterward.

Anyone who spends time around people who exercise knows that painkiller use is common among them. Some athletes joke about taking “vitamin I,” or ibuprofen, to blunt the pain of strenuous training and competitions. Others rely on naproxen or other NSAIDs to make hard exercise more tolerable.

NSAID use is especially widespread among athletes in strenuous endurance sports like marathon and ultramarathon running. By some estimates, as many as 75 percent of long-distance runners take ibuprofen or other NSAIDs before, during or after training and races.

But in recent years, there have been hints that NSAIDs might not have the effects in athletes that they anticipate. Some studies have found that those who take the painkillers experience just as much muscle soreness as those who do not.

A few case studies also have suggested that NSAIDs might contribute to kidney problems in endurance athletes, and it was this possibility that caught the attention of Dr. Grant S. Lipman, a clinical associate professor of medicine at Stanford University and the medical director for several ultramarathons.

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For Millions, Life Without Medicaid Services Is No Option


TUSCALOOSA, Ala. — Frances Isbell has spinal muscular atrophy, a genetic disorder that has left her unable to walk or even roll over in bed. But Ms. Isbell has a personal care assistant through Medicaid, and the help allowed her to go to law school at the University of Alabama here. She will graduate next month.

She hopes to become a disability rights lawyer — “I’d love to see her on the Supreme Court someday,” her aide, Christy Robertson, said, tearing up with emotion as Ms. Isbell prepared to study for the bar exam in her apartment last week — but staying independent will be crucial to her professional future.

“The point of these programs is to give people options and freedom,” said Ms. Isbell, 24, whose family lives a few hours away in Gadsden.

The care she gets is an optional benefit under federal Medicaid law, which means each state can decide whether to offer it and how much to spend. Optional services that she and millions of other Medicaid beneficiaries receive would be particularly at risk under Republican proposals to scale back Medicaid as part of legislation to repeal and replace the Affordable Care Act.

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$45 Billion to Fight Opioid Abuse? That’s Much Too Little, Experts Say


WASHINGTON — The Senate leadership’s efforts to salvage the Republican health care bill have focused in part on adding $45 billion for states to spend on opioid addiction treatment.

That is a big pot of money. But addiction specialists said it was drastically short of what would be needed to make up for the legislation’s deep cuts to Medicaid, which has provided treatment for hundreds of thousands of people caught up in a national epidemic of opioid abuse.

The new money would most likely flow to states in the form of grants over 10 years, averaging out to $4.5 billion per year. With hundreds of people dying every week from overdoses of heroin, fentanyl and opioid painkillers, some specialists say a fixed amount of grant money is simply inadequate compared with the open-ended funding stream that Medicaid provides to treat all who qualify for the coverage.

“When it comes to other illnesses like breast cancer or heart disease, we’d never rely solely on grants for treatment — because we know that grants are not substitutes for health coverage,” said Linda Rosenberg, president and chief executive of the National Council for Behavioral Health, which represents treatment providers. “Addiction is no different.”

The Affordable Care Act vastly expanded access to addiction treatment by designating those services as “essential benefits.” That means they had to be covered through both an expansion of Medicaid to far more low-income adults and the marketplaces set up under the law for people to buy private plans. Both the House and Senate health bills would effectively end the expansion and cap federal Medicaid spending, resulting in the loss of coverage for millions of people, according to the Congressional Budget Office.

According to the National Household Survey on Drug Use and Health, there were roughly 1.35 million low-income Americans in 2015 with an opioid use disorder. Only 25 percent of those people get treated in a year, although the Affordable Care Act’s expansion of health insurance coverage has provided more resources for closing the treatment gap.

Richard G. Frank, a health economics professor at Harvard Medical School, has estimated that last year, people who enrolled in expanded Medicaid incurred about $4.5 billion in costs for mental health and addiction treatment. But in an updated analysis this month, Mr. Frank, who worked for the Obama administration during the rollout of the Affordable Care Act, calculated it would cost $14 billion in the first year and more than $183 billion over a decade to treat addiction and related illnesses in low-income people who would lose coverage under the Republican plan.

“Medicaid spending contracts and expands based on need as well as new treatment options,” Mr. Frank wrote in his analysis. “That means that funding is there for people and states when they need it the most. For example, the opioid epidemic will likely continue to morph and require different interventions of care should new synthetic drugs cause different health problems.”

Public health experts are concerned that grants aimed at treatment and recovery would not address a multitude of other physical health problems associated with addiction. One glaring example is hepatitis C, a blood-borne virus endemic among people who use needles to inject illicit drugs. Treatment is extremely expensive, but Medicaid has expanded access to it in many states. Many addicts also suffer from diabetes and other chronic conditions, or get endocarditis, a serious heart infection connected to intravenous drug use.

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The U.S. spends more on health care than any other country. Here’s what we’re buying.

December 27, 2016
American health-care spending, measured in trillions of dollars, boggles the mind. Last year, we spent $3.2 trillion on health care — a number so large that it can be difficult to grasp its scale.A new study published in the Journal of the American Medical Association reveals what patients and their insurers are spending that money on, breaking it down by 155 diseases, patient age and category — such as pharmaceuticals or hospitalizations. Among its findings:

  • Chronic — and often preventable — diseases are a huge driver of personal health spending. The three most expensive diseases in 2013: diabetes ($101 billion), the most common form of heart disease ($88 billion) and back and neck pain ($88 billion).
  • Yearly spending increases aren’t uniform: Over a nearly two-decade period, diabetes and low back and neck pain grew at more than 6 percent per year — much faster than overall spending. Meanwhile, heart disease spending grew at 0.2 percent.
  • Medical spending increases with age — with the exception of newborns. About 38 percent of personal health spending in 2013 was for people over age 65. Annual spending for girls between 1 and 4 years old averaged $2,000 per person; older women 70 to 74 years old averaged $16,000.

The analysis provides some insight into what’s driving one particularly large statistic: Within a decade, close to a fifth of the American economy will consist of health care.

“It’s important we have a complete landscape when thinking about ways to make the health care system more efficient,” said Joseph Dieleman, an assistant professor at the Institute for Health Metrics and Evaluation at the University of Washington who led the work.
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Scientists are bewildered by Zika’s path across Latin America

October 25 at 3:24 PM (original post)

Nearly nine months after Zika was declared a global health emergency, the virus has infected at least 650,000 people in Latin America and the Caribbean, including tens of thousands of expectant mothers.

But to the great bewilderment of scientists, the epidemic has not produced the wave of fetal deformities so widely feared when the images of misshapen infants first emerged from Brazil.

Instead, Zika has left a puzzling and distinctly uneven pattern of damage across the Americas. According to the latest U.N. figures, of the 2,175 babies born in the past year with undersize heads or other congenital neurological damage linked to Zika, more than 75 percent have been clustered in a single region: northeastern Brazil.

The pattern is so confounding that health officials and scientists have turned their attention back to northeastern ­Brazil to understand why Zika’s toll has been so much heavier there. They suspect that other, underlying causes may be to blame, such as the presence of another ­mosquito-borne virus like chikungunya or dengue. Or that environmental, genetic or immunological factors combined with Zika to put mothers in the area at greater risk.

“We don’t believe that Zika is the only cause,” Fatima Marinho, director of the noncommunicable disease department at Brazil’s Ministry of Health, said in an interview.

Brazilian officials were bracing for a flood of fetal deformities as Zika spread this year to other regions of the country, Marinho said. However, “we are not seeing a big increase.”

Researchers and health officials remain cautious about the lower-than-expected numbers. The latest studies have found more evidence than ever that the virus can inflict severe damage on the developing infant brain, some of which may not be evident until later in childhood.

How the Zika virus affects an infant’s brain

But researchers so far have learned a lot more about Zika’s potential to do harm than its likelihood of doing so.

Scientists at the U.S. Centers for Disease Control and Prevention are closely watching Puerto Rico, which has reported more than 26,800 cases of Zika. More than 7,000 pregnant women could be infected by the end of the year, according to the CDC.

But although the outbreak has spread this year to more than 50 nations and territories across the Western Hemisphere, U.N. data shows just 142 cases of congenital birth defects linked to Zika so far outside Brazil.
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8 Foods to Eat to Help Prevent Cancer

Here are eight categories of great foods to eat:

  1. Red, yellow and orange peppers, carrots, sweet potatoes and cantaloupe… These are very rich in plant substances called carotenoids. “Research has found that women who have high- er levels of carotenoids are at lower risk for breast cancer,” says Vandana Sheth, registered dietitian nutritionist, spokesperson for the Academy of Nutrition and Dietetics.
  2. Dark green leafy vegetables… Kale, spinach, collard greens and Swiss chard deliver carotenoids that in lab studies inhibited the growth of cer- tain types of breast cancer cells, according to the American Institute for Cancer Research (AICR).
  3. Blueberries… These are packed with antioxidants, Sheth says.
  4. Walnuts… In animal studies, mice that were fed walnuts cut their breast cancer in half, according to the dietitian.
  5. Salmon… Consuming this fatty fish, rich in omega-3 fatty acid, may reduce wom- en’s risk of breast cancer, according to a report from AICR.
  6. High-fiber foods… Black beans, barley, lentils, raspber- ries, skin-on pears and broccoli are good choices. Aim for 30 to 45 grams a day for cancer prevention, says Sheth, Los Angeles area.
  7. Apples… The peel delivers dietary fiber and the flesh contains plant chemicals that act as protective antioxidants.
  8. Garlic and onions… These members of the allium family slowed the development of breast can- cer in animal studies.
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Utah Zika Case Shows Physical Contact Can Spread The Virus

urfinguss via Getty Images
Zika virus was spread through physical contact in Utah case.

Back in July, a 38-year-old Utah man was diagnosed with the Zika virus, even though he hadn’t traveled to a Zika-affected region or had sexual contact with someone who did.

Experts were puzzled.

They knew that Zika virus was transmitted in only one of four ways: from the bite of an infected mosquito, from sexual contact with an infected person, from contact with infected blood, or from pregnant mother to fetus in the womb. They also knew that Salt Lake City, Utah is not a hospitable environment for the Aedes Aegypti mosquito, which transmits the virus easily.

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Voter Registration Deadlines, State by State


Election Day is Nov. 8. But the vast majority of the 50 states do not allow voters to register that day. Here’s a rundown of the deadlines to register by state.

The “mail” dates refer to the day by which an application must be postmarked. States that offer registration on Election Day often have special requirements. On a desktop computer, you may search for your state’s name with keyboard shortcuts: Ctrl F on a PC or Command F on a Mac.

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Take MLK’s name out your mouth: An open letter to Clemson football coach Dabo Swinney

Head coach Dabo Swinney of the Clemson Tigers (Photo by Mike Ehrmann/Getty Images) | American clergyman and civil rights campaigner Martin Luther King (1929 - 1968). (Photo by Keystone/Getty Images)

Head coach Dabo Swinney of the Clemson Tigers (Photo by Mike Ehrmann/Getty Images) | American clergyman and civil rights campaigner Martin Luther King (1929 – 1968). (Photo by Keystone/Getty Images)

Dear Coach Swinney,

I’m a professor at Clemson. We’ve never met, but we work with many of the same students.

I listened to your comments on the issue of athlete protests on the field, and I wanted to share some of my impressions.

I winced when I heard a reporter ask you, a white man who makes somewhere in the area of $5 million a year from the physical labor and bodily risk of unpaid black athletes, if he would “discipline” them for making a political statement. Given that you and I both work on the former plantation of John C. Calhoun, the historical significance of the question is staggering and troubling.

To your credit, you said that you would not discipline a player for not standing during the national anthem, an act of defiance most recently started by 49ers quarterback Colin Kaepernick.

You did acknowledge Kaepernick’s right to protest, and you encouraged other players to exercise those rights if they want to. I was glad to hear all of those things. For a moment, I felt even prouder than I already am to be a professor at Clemson.
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Racial disparity emerges in rare child suicide rates

(CNN)There has been a disturbing increase in suicide rates among elementary school-age black children in recent years in the United States, and yet researchers aren’t quite sure why.

When compared with early adolescents, younger children who die by suicide are more likely to be black boys who hang or suffocate to death, suggests a new paper published in the journal Pediatrics on Monday.

Why are U.S. suicide rates on the rise?

Why are U.S. suicide rates on the rise? 05:36
“I think the biggest finding is that — even though suicide is extremely rare in children — children sometimes can and sometimes will think about suicide and make suicide attempts,” said Jeff Bridge, an epidemiologist and director of the Center for Suicide Prevention and Research at Nationwide Children’s Hospital in Columbus, Ohio, who was a co-author of the paper.
“So that’s why it’s important for parents, pediatricians and teachers to be able to identify the warning sides of suicide in children and take appropriate steps when warning signs are present,” he said.

Children vs. early adolescents

The paper included surveillance data on suicide deaths in 17 states from 2003 to 2012. The data were collected by the Centers for Disease Control and Prevention’s National Violent Death Reporting System.
The researchers obtained the data in the system on children 5 to 14 years old whose cause of death was suicide; this resulted in 693 suicides that researchers then examined and analyzed.
As suicide deaths among children are rare, the researchers noted that the suicide rate among 5- to 11-year-olds is only 0.17 per every 100,000 persons. Among 12- to 17-year-olds, the rate is 5.18 per 100,000.

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