The world health report – Health systems financing: the path to universal coverage
“Good health is essential to human welfare and to sustained economic and social development. WHO’s Member States have set themselves the target of developing their health financing systems to ensure that all people can use health services, while being protected against financial hardship associated with paying for them.
In this report, the World Health Organization maps out what countries can do to modify their financing systems so they can move more quickly towards this goal – universal coverage – and sustain the gains that have been achieved The report builds on new research and lessons learnt from country experience. It provides an action agenda for countries at all stages of development and proposes ways that the international community can better support efforts in low income countries to achieve universal coverage and improve health outcomes.” (From website announcement)
Factors Influencing Rural Residents’ Utilization of Urban Hospitals
By: Margaret Jean Hall, Jill Marsteller, and Maria Owings
Source: National Center for Health Statistics
Objective—To examine, using nationally representative data, which patient, hospital, and county characteristics influence rural residents’ urban hospitalization.
Methods—Rural residents hospitalized in urban hospitals (crossovers) are compared with those hospitalized in rural hospitals (noncrossovers). National Hospital Discharge Survey data were merged with Area Resource File and Centers for Medicare & Medicaid Services data to study rural inpatients’ characteristics; hospital descriptors; and county or state socioeconomic and health service variables. Multivariate logistic regression analysis identified covariates of the likelihood of being a crossover.
Findings—About one-third of the rural resident hospitalizations in 2003 were in urban hospitals. Other factors constant, those requiring greater resources had higher odds of crossing over, as did younger inpatients, those transferred from other hospitals, receiving surgery, and with mental diagnoses or congenital anomalies. Males, emergency admissions, and intervertebral disk disorder inpatients had lower odds of crossing over compared with those who were not in these categories. Crossover patients’ hospitals had higher Medicare case mix indices than hospitals used by noncrossovers. Rural inpatients in government hospitals, rather than proprietary or non-profit hospitals, had greater odds of crossing over, as did rural patients from counties with lower population density, fewer hospital beds, more hospitals, more commuters, and lower per capita income compared with those in other categories.
Conclusions—Rural hospitals continue to be an important source of inpatient care, but rural residents travel to urban hospitals in some specific instances.
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Sharing of Data Leads to Progress on Alzheimer’s
Gina Kolata | New York Times
August 12, 2010
The key to a collaborative Alzheimer’s project was an ambitious agreement to share all the data, making every single finding public immediately.
Vital Signs: State-Specific Obesity Prevalence Among Adults — United States, 2009
Source: Morbidity and Mortality Weekly Early Release
Background: Obesity is a costly condition that can reduce quality of life and increases the risk for many serious chronic diseases and premature death. The U.S. Surgeon General issued the Call to Action to Prevent and Decrease Overweight and Obesity in 2001, and in 2007, no state had met the Healthy People 2010 objective to reduce obesity prevalence among adults to 15%.
Methods: CDC used 2009 Behavioral Risk Factor Surveillance System survey data to update estimates of national and state-specific obesity prevalence. Obesity was calculated based on self-reported weight and height and defined as body mass index (weight [kg] / height [m]2) ≥30.
Results: Overall self-reported obesity prevalence in the United States was 26.7%. Non-Hispanic blacks (36.8%), Hispanics (30.7%), those who did not graduate from high school (32.9%), and persons aged 50–59 years (31.1%) and 60–69 years (30.9%) were disproportionally affected. By state, obesity prevalence ranged from 18.6% in Colorado to 34.4% in Mississippi; only Colorado and the District of Columbia (19.7%) had prevalences of <20%; nine states had prevalences of ≥30%.
Conclusions: In 2009, no state met the Healthy People 2010 obesity target of 15%, and the self-reported overall prevalence of obesity among U.S. adults had increased 1.1 percentage points from 2007.
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Overcoming Rural Health Care Barriers through Innovative Wireless Health Technologies
Darrell M. West testimony in front of the Health Subcommittee of the U.S. House of Representatives Committee on Veterans Affairs
June 24, 2010 —
In testimony before the Health Subcommittee of the U.S. House of Representatives Committee on Veterans Affairs, Darrell West argues that wireless health technologies can provide quality and accessible care to rural veterans.
Genetic Markers of Adult Obesity Risk Are Associated with Greater Early Infancy Weight Gain and Growth
By: Cathy E. Elks, et al.
Source: PLoS Medicine
Genome-wide studies have identified several common genetic variants that are robustly associated with adult obesity risk. Exploration of these genotype associations in children may provide insights into the timing of weight changes leading to adult obesity.
Methods and Findings
Children from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were genotyped for ten genetic variants previously associated with adult BMI. Eight variants that showed individual associations with childhood BMI (in/near: FTO, MC4R, TMEM18, GNPDA2, KCTD15, NEGR1, BDNF, and ETV5) were used to derive an “obesity-risk-allele score” comprising the total number of risk alleles (range: 2–15 alleles) in each child with complete genotype data (n = 7,146). Repeated measurements of weight, length/height, and body mass index from birth to age 11 years were expressed as standard deviation scores (SDS). Early infancy was defined as birth to age 6 weeks, and early infancy failure to thrive was defined as weight gain between below the 5th centile, adjusted for birth weight. The obesity-risk-allele score showed little association with birth weight (regression coefficient: 0.01 SDS per allele; 95% CI 0.00–0.02), but had an apparently much larger positive effect on early infancy weight gain (0.119 SDS/allele/year; 0.023–0.216) than on subsequent childhood weight gain (0.004 SDS/allele/year; 0.004–0.005). The obesity-risk-allele score was also positively associated with early infancy length gain (0.158 SDS/allele/year; 0.032–0.284) and with reduced risk of early infancy failure to thrive (odds ratio = 0.92 per allele; 0.86–0.98; p = 0.009).
The use of robust genetic markers identified greater early infancy gains in weight and length as being on the pathway to adult obesity risk in a contemporary birth cohort.
Health, United States, 2009
Source: Centers for Disease Control and Prevention
From Press Release:
The use of medical technology in the United States increased dramatically between 1996 and 2006, according to “Health, United States, 2009,” the federal government’s 33rd annual report to the President and Congress on the health of all Americans.
The report was prepared by the Centers for Disease Control and Prevention’s National Center for Health Statistics from data gathered by state and federal health agencies and through ongoing national surveys.
This year’s edition features a special section on medical technology, and finds that the rate of magnetic resonance imaging, known as MRI, and computed and positron emission tomography or CT/PET scans, ordered or provided, tripled between 1996 and 2007.
Health, United States, 2009 Home Page. Includes complete report, executive summary, highlights, charts, and trend tables.
How Healthy Is Your County? New County Health Rankings Give First County-by-County Snapshot of Health in Each State
Source: University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation
From the press release:
The County Health Rankings—the first set of reports to rank the overall health of every county in all 50 states—were released today by the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation at a briefing in Washington, D.C and on www.countyhealthrankings.org. The 50 state reports help public health and community leaders, policy-makers, consumers and others to see how healthy their county is, compare it with others within their state and find ways to improve the health of their community.
Each county is ranked within the state on how healthy people are and how long they live. They also are ranked on key factors that affect health such as: smoking, obesity, binge drinking, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates and number of children living in poverty.
County Health Rankings
Trends in Breast Cancer Mortality in the United States
By: Rogelio Saenz
Source: Population Reference Bureau
Recent recommendations from the U.S. government suggesting a relaxation in the age women should begin undergoing regular mammography exams have raised major debate and concerns.
The Department of Health and Human Services’ Preventive Services Task Force recommends that women in their 40s forego routine mammography exams until they turn 50, at which time they should have the procedure done every two years. The report came on the heels of a debate in the medical community initiated months earlier with the publication of an article that suggested the benefits of early mammography screening were exaggerated, with false-positive detections too easily disregarded.
Critics of the report have accused the task force of using cold cost/benefit analyses that could potentially overturn the reductions in breast cancer deaths over the last couple of decades. Many fear that the recommendations represent the rationing of health care and that the health insurance industry will use the new guidelines to block access to mammography exams to women younger than 50.
According to the American Cancer Society, death rates associated with breast cancer have declined since 1990 at about 2 percent per year for women 50 and older and 3.2 percent annually among those younger than 50. Early detection of breast cancer through regular mammograms has been credited as one of the primary reasons behind the declining death rate from breast cancer.
Despite the decline, the disease continues to inflict a heavy toll on women in the United States. In 2009, approximately 40,000 women are expected to die from breast cancer, while roughly 192,000 women are expected to be diagnosed with the disease. There are also substantial race and ethnic gaps in breast cancer mortality rates, which could potentially increase under the newly proposed guidelines.
Death in the United States, 2007
By: Arialdi M. Miniño, Jiaquan Xu, Kenneth D. Kochanek, and Betzaida Tejada-Vera
Source: National Center for Health Statistics
* In 2007, the age-adjusted death rate for the United States reached a record low of 760.3 per 100,000 population. Life expectancy at birth reached a record high of 77.9 years.
* States in the southeast region have higher death rates than those in other regions of the country.
* In 2007, the five leading causes of death were heart disease, cancer, stroke, chronic lower respiratory diseases, and accidents. These accounted for over 64 percent of all deaths in the United States.
* White females have the longest life expectancy (80.7 years), followed by black females (77.0 years).
* The gap in life expectancy between white persons and black persons declined by 35 percent between 1989 and 2007. The race differential was 4.6 years in 2007.
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