Citizen Cartwright

AP: Racial health disparities harming African Americans

"From birth to death, Black Americans fare worse in measures of health compared to their white counterparts. They have higher rates of infant and maternal mortality, higher incidence of asthma during childhood, more difficulty treating mental illness as teens, and higher rates of high blood pressure, Alzheimer’s disease and other illness as adults,” says The Associated Press, which spent a year examining the issue.

 

Key takeaways:

 

— African American women have the highest maternal mortality rate in the United States, almost three times the rate for white women, according to the Centers for Disease Control and Prevention. And African American babies are more likely to die, and far more likely to be born prematurely, setting the stage for health issues that can follow them throughout their lives.

 

Multiple factors contribute to these disparities, according to the CDC and advocacy groups, such as underlying health conditions. But more doctors and experts point to the role of structural racism that's created inequitable access to health care, implicit bias and discriminatory care.

 

— More than 12 percent of African American children nationwide have asthma, compared with 5 percent of white children.

 

With asthma, especially for children, where you live makes all the difference, says AP. And where you live often depends on your race. 

 

Across America, nearly 4 in 10 African American children live in areas with poor environmental and health conditions compared to 1 in 10 white children, AP says.

 

– The United States has a shortage of mental health providers who understand the roles that racial identity and racism play in shaping young African Americans' mental health. Between 1991 and 2019, African American adolescents had the highest increase of any group in suicide attempts, at nearly 80 percent.

 

— About 56 percent of African American adults have high blood pressure, compared to 48 percent of white adults. 

 

Only 32 percent of white adults with high blood pressure have their condition under control with medication, but the level for African Americans is even lower, at 25 percent.

 

Among white people, the prevalence of cardiovascular risk factors and disease is projected to decrease over time, says AP. Yet significant increases are projected among people of color, especially African Americans and Latinos.

 

— About 14 percent of African Americans over the age of 65 have Alzheimer’s, compared with 10 percent of white Americans, according to the CDC. The trauma of experiencing racism is believed to be a contributing factor, AP says.

On Bike to Work Day, celebrating personal, eco health

Friday is Bike to Work Day, a part of National Bike Month promoting the benefits of cycling for our personal health and the global environment.

 

The Associated Press is highlighting what cities are doing to promote cycling.

 

In Washington, D.C., for example, in 2001, cyclists had three miles of (unprotected) bicycle lanes. By 2019, the network exceeded 100 miles, and cycling as a share of all travel in the city increased fivefold. In 2020 and 2021, the city built nearly 20 miles of protected lanes to be safer than merely marked lanes on streets shared with cars.

 

A study of 20 cities that expanded cycling infrastructure in the Americas, Europe and Australia in recent decades shows that ridership surged while cyclist fatalities and serious injuries dropped.

 

In D.C., cycling increased 435 percent between 2000 and 2017, and cyclists’ fatalities and serious injuries dropped 54 percent, according to global urban planning researchers Ralph Buehler of Virginia Tech and John Bucher of Rutgers University.

Drug shortages

Thousands of patients are facing delays in getting treatments for cancer and other life-threatening diseases as drug shortages in the United States approach record levels, says The New York Times.

There are 238 items on the drug shortages list of the American Society of Health-System Pharmacists. 

 

“This is, in my opinion, a public health emergency,” says Dr. Amanda Fader, a professor at the Johns Hopkins School of Medicine and a president-elect of the Society of Gynecologic Oncology, “because of the breadth of the individuals it affects and the number of chemotherapy agents that are in shortage right now.”

White House officials and members of Congress are grappling with an opaque and sometimes interrupted supply chain and quality and financial issues that are leading to manufacturing shutdowns, the Times says. They’re examining the underlying causes of the faltering generic drug market, which accounts for about 90 percent of domestic prescriptions.

 

Some shortages, like those of weight-loss drugs, are the result of high demand, while others have been attributed to overprescribing, including for antibiotics, or a lack of investment in potential alternatives.

The Biden administration has assembled a team to find long-term solutions for shoring up the pharmaceutical supply chain as the United States remains heavily reliant on medicines and drug ingredients from India and China. 

 

Officials have been debating possible measures including tax incentives for generic drugmakers and greater transparency around generic drug quality. The current incentives favor drugmakers with the lowest prices, which includes those that might cut corners — leading to disruptive plant shutdowns if the FDA requires a fix. 

 

The FDA, which employs a team of about 10 people who do the day-to-day work of mitigating and reporting drug shortages, has said it's seeking authority from Congress to get additional information about the drug manufacturing and supply chain.

 

Four Senate bills with bipartisan sponsorship could help get generic drugs to market more quickly by addressing tactics or loopholes causing delays, the Times says.

What’s the status of the coronavirus as the emergency designation ends?

Nearly everybody in the United States has some form of immunity as the emergency designation ends Thursday, whether from vaccines, a previous infection or both, says The New York Times. And medications like Paxlovid have significantly reduced the risk of serious illness.

 

"But we must also remember that there is a substantial group of Americans who are still very worried about contracting Covid, in particular the older and the sicker,” says Dr. Sanjay Gupta of CNN.

 

"The CDC estimates that the risk of hospitalization for those 75 or older is between 9 and 15 times higher than for those who are 18 to 29, and here in the United States, nearly 25 million people are older than 75,” Gupta says.

 

"When it comes to our general health, a study published in the journal Clinical Infectious Diseases found that people with asthma had a 1.4 times higher risk of hospitalization than a healthy person, hypertension bumped up the risk to 2.8 times higher, chronic kidney disease to four times higher and severe obesity to 4.4 times higher,” Gupta says. "Someone with three or more health conditions had a five times higher risk. Forty percent of Americans are obese, and nearly 70 percent of the country has at least one of the conditions that greatly increases their risk.”

 

One of the greatest lessons of the pandemic for the United States, Gupta says, is that “while we had tremendous resources to combat this pandemic, our collective poor health put us at a tremendous disadvantage. We must do all we can to focus on the basics, because no amount of wealth can buy good health.”

 

Dr. Robert Wachter, chair of the department of medicine at the University of California, San Francisco, says he continues to wear a mask in most crowded indoor settings, like on a plane or in a museum but not if he needs to go into a store quickly. He says his main motivation is to avoid long Covid.

 

Gupta says: "During the past three years, I would often speak with public health and other experts to try to work out exactly when we would move out of the pandemic phase and into the endemic stage of this health emergency. There were few hard answers. Instead, many told me that it came down to the number of Covid deaths we could stomach as a society, in exchange for an end to having our lives disrupted.”

 

And, as individuals, it comes down to our own personal risk assessment.

 

Here are 23 pandemic decisions that went right, from The Atlantic.

Good news on global population, health, climate solutions

Let’s end the week with good news from Future Crunch.

— The nonprofit Club of Rome has published a follow-up to its seminal 1972 Limits to Growth study, saying its long-feared "population bomb" may never go off. 

Global population will peak at 8.6 billion in 2050 and decline to 7 billion by 2100 if current trends continue, the group estimates. 

— Tuberculosis deaths in Africa dropped 26 percent between 2015 and 2021, the World Health Organization says. 

“African countries have made remarkable progress against TB. The question is no longer about whether we can end TB, but how fast we must act to reduce the disease burden, save lives and maintain a high momentum towards a TB-free world,” says Dr. Matshidiso Moeti, WHO Regional Director for Africa.

— "Bangladesh isn't just ground zero for climate disaster,” says Future Crunch. "It's also a hotspot for solutions, where a mix of technology and community have resulted in cyclone-related mortality declining more than 1,000-fold in the past 40 years.”

"I tell my American friends, 'You should send your skeptics to Bangladesh! The awareness of climate change here is the highest in the world,'“ says Saleemul Huq, director of the Bangladesh-based International Center for Climate Change and Development. "But we have gone through the doom and gloom phase. That's yesterday's news in Bangladesh."

U.S. is 15th in World Happiness Report 2023

But it ranks 34th in the “happiness gap” between the top and bottom halves of the U.S. population, says this year’s report, from the Sustainable Development Solutions Network, a global initiative for the United Nations.

The top ten countries of the 156 ranked are:
• Finland (for the sixth year in a row)
• Denmark
• Iceland
• Israel
• Netherlands
• Sweden
• Norway
• Switzerland
• Luxembourg
• New Zealand

“The ultimate goal of politics and ethics should be human well-being,” says Jeffrey Sachs, a professor and director of the Center for Sustainable Development at Columbia University and one of the authors of the report. “The happiness movement shows that well-being is not a ‘soft’ and ‘vague’ idea but rather focuses on areas of life of critical importance: material conditions, mental and physical wealth, personal virtues, and good citizenship. We need to turn this wisdom into practical results to achieve more peace, prosperity, trust, civility – and yes, happiness – in our societies.”

Good news, from Future Crunch

You probably recall Future Crunch, the Australia-based group that compiles good-news stories from around the world to balance the ubiquitous negative coverage.

 

Let’s catch up with the positive trends Future Crunch is highlighting.

 

Here are "99 good news stories you probably didn't hear about in 2022," an annual Future Crunch run-down.

 

And here is Future Crunch’s most recent weekly email, including good news on global democracy, teen pregnancy and cancer in the United States, measles in southeast Asia, the healing of the ozone layer, a new way of thinking about urban density, and the restoration of the Jordan River.

How to live to be 100

That’s the topic of an article on The Washington Post website this morning. 

 

Today also is the birthday of my mother-in-law, who died in 2021 three weeks before her 101st birthday. So I’ll honor her on her birthday by noting that she was a poster child for living the way experts say promotes longevity.

 

Jamie Justice, an assistant professor of gerontology at Wake Forest University, says in the Post article that some research has suggested genetics account for around 25 percent of longevity. The other 75 percent relates to your environment — where you live, what you eat, how often you exercise and your support system from friends or family.

 

And, Justice says, a good public health system “can’t be undersold.” If you have a better health-care system, you’re going to have a higher life expectancy, she says.

 

Other experts add that keeping mentally active is key. 

 

My mother-in-law, Audrey Crosby, certainly had good genes. She never showed any signs of dementia. 

 

She also stayed active, volunteering at a hospital, a food bank, a theater. She was a friendly person who chatted with everyone.

 

I won the mother-in-law lottery. I felt closer to Audrey than to my own parents. She was flexible and never once interfered in the relationship of my husband and me. It’s a tribute to her that when her living situation was changing, I invited her to live with us, which she did for several years. 

 

Audrey was intellectually curious, taking Elderhostel (now called Road Scholar) classes. I was surprised to see a study a couple of months ago saying crossword puzzles may slow dementia. Audrey was a crossword puzzle maven as long as I knew her.

 

Audrey also benefited from good health care. Her geriatrician was excellent.

'America is on the right track'

So says conservative columnist and commentator David Brooks in The Atlantic.

 

But we don’t know it, he says, because “negativity is by now so deeply ingrained in American media culture that it’s become the default frame imposed on reality.”

 

"In large part, this is because since the dawn of the internet age, the surest way to build an audience is to write stories that make people terrified or furious,” he says. 

 

"This permanent cloud of negativity has a powerful effect on how Americans see their country,” Brooks says. "When Gallup recently asked Americans if they were satisfied with their personal life, 85 percent said they were, a number that has remained remarkably stable over the past 40 years. But when Gallup asked Americans in January 2022 if they were satisfied with the direction of the country, only 17 percent said they were, down from 69 percent in 2000. In other words, there was a 68-percentage-point gap between the reality people directly experienced in their daily life and the reality they perceived through the media filter.”

 

"The first problem with all this pessimism is that it is ahistorical,” Brooks says. "Every era in American history has faced its own massive challenges, and in every era, the air has been thick with gloomy jeremiads warning of catastrophe and decline. Pick any decade in the history of this country, and you will find roiling turmoil. But in all of those same decades, you will also find, alongside the chaos and the prophecies of doom, energetic dynamism and leaping progress.

 

"The second problem with the decline narrative is that it distorts reality. My basic take is that life in America today is objectively better than it was before but subjectively worse. We have much higher standards of living and many conveniences, but when it comes to how we relate to one another — whether in the realm of politics, across social divides, or in the intimacies of family and community life — distrust is rife, bonds are fraying, and judgments are harsh.

“But that doesn’t mean the future isn’t going to be brighter than the present, or that America is in decline. The pessimists miss an underlying truth — a society can get a lot wrong as long as it gets the big thing right. And that big thing is this: If a society is good at unlocking creativity, at nurturing the abilities of its people, then its ills can be surmounted.”

 

Brooks presents lots of statistics on ways humanity in general and America in particular continue to unleash human creativity: in improved living standards, education, productivity, equality, life expectancy, innovation infrastructure, technology.

 

"I’ve bludgeoned you with statistics in order to make a point: Pessimism about our future is unwarranted,” Brooks says. "You may think that one major American political party has gone crazy, and I will agree with you. You can point to all of the ways in which life in America is infuriating and unjust, and I will agree with you there too. But the story of America is a story of convulsion and reinvention. We go through moments when the established order stops working. People and movements rise up, and things change. The culture is a collective response to the problems of the moment; as new problems become obvious, the culture shifts. We’ve been in the middle of one of those tumultuous transition periods since, I’d say, 2013. But 2022 evinced hopeful signs that we’re coming out of it.

 

"If there is one lesson from the events of the past year, it is that open societies such as ours have an ability to adapt in a way that closed societies simply do not. Russia has turned violent and malevolent. China has grown more authoritarian and inept. Meanwhile, free democratic societies have united around the Ukrainians as they battle to preserve the liberal world order. And American voters seem to finally be adapting to the threat Donald Trump poses to our democracy, forming a robust anti-Trump coalition that will significantly lessen his chances of ever working in the White House again.

 

"America is a wounded giant, and many of its wounds are self-inflicted. But America has always been a wounded giant. And it has always stumbled forward, driven by an inner turbine of ambition and aspiration that knows no rest."

'The world is better off than you think'

The past year "excelled particularly” in technological strides, says opinion columnist Nicholas Kristof in The New York Times.

 

Solar power capacity around the world is on track to about triple over the next five years and overtake coal as the leading source of power globally, he says. Technical improvements are constant — such as MIT researchers’ developing a way to produce thin and flexible solar panels that can turn nearly any outdoor surface into a power source.

 

Batteries are "one of the most exciting frontiers of technology, making remarkable advances crucial to storing green power,” Kristof says.

 

Nuclear fusion as an energy source reached a milestone in 2022, producing more energy than it took to start the reaction.

 

Green hydrogen is also gaining ground and could be useful for shipping and energy storage.

 

The bottom line: “We are in the midst of a revolution of renewables that may soon leave us far better off,” Kristof says. "If things go right, we’ll be able to enjoy cheaper, more reliable and more portable power than ever before. Truly cheap energy, whether from solar or fusion, could be transformational: For example, it could run desalination plants to provide the fresh water that we’re running out of.”

 

Health technology also has made "immense gains,” says Kristof. "Scientists are making significant progress on vaccines for malaria, reflecting what may be a new golden age for vaccine development. Immunotherapy is making progress against cancer (among other feats, it is keeping one of my friends alive). A new gene editing technique may be able to cure sickle cell anemia; Bill Gates argues in his annual letter that the same approach may eventually offer a cure for HIV/AIDS as well.”