TAG: "Public health"

UC Merced researchers delve into valley fever from all angles


Team working toward better treatments and perhaps a vaccine for ‘silent epidemic.’

Before it infects humans who breathe it in, the fungus that causes valley fever changes shapes in the environment. Once infected, some people fight it off while others die.

If scientists can determine how that shape-shift happens, they might be able to stop it, said professor Clarissa Nobile, one of a large, interdisciplinary team at UC Merced working to tackle the valley fever challenge from every imaginable angle.

If researchers can figure out why people react differently to the fungus, it could lead to better treatments, professor David Ojcius said.

Scientists know the fungus is distributed through dust, but if they can monitor levels in real time, they can build a warning system, professor Wei-Chun Chin said.

And if researchers can determine where at-risk groups get information, they can create social marketing campaigns that make sure that what people are hearing is accurate, visiting professor Carol Sipan said.

These four researchers have expertise in microbiology, immunology, bioengineering and public health. They’re part of the UC Merced team working toward better treatments and perhaps a vaccine for what the Centers for Disease Control calls a “silent epidemic.”

“We’re the glue that pulls this whole thing together,” said professor Paul Brown, director of UC Merced’s Health Sciences Research Institute.

The glue began to gel about a year after the institute was established. That’s when faculty members from all three of UC Merced’s schools came together to attack this potentially debilitating, but poorly understood, illness endemic to the San Joaquin Valley.

“We haven’t really had a research university in the region that could do this, that could pull it all together. We do now,” Brown said.

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Many seniors who fall repeatedly don’t seek medical attention


Study finds health care workers also often fail to counsel seniors on preventing future falls.

More than half a million older Californians — 12.6 percent of the state’s senior population — fall more than once a year, but nearly 60 percent of them fail to seek medical attention afterward, according to a new study by the UCLA Center for Health Policy Research.

The study also found that among those who did seek treatment, 40 percent did not receive counseling from a medical provider about how to prevent future falls.

Falls are the leading injury-related cause of death and need for medical care among Californians age 65 and older, according to the study. In 2012, more than 1,800 seniors died after falling and seniors’ fall-related injuries resulted in more than 72,000 hospitalizations.

“There is a cost in terms of both lives and resources when doctors fail to talk to seniors who have already fallen about how to prevent future falls,” said Steven Wallace, associate director of the Center for Health Policy Research and author of the study.

Using data from the 2011–12 California Health Interview Survey, the study found older seniors are twice as likely as younger seniors to have multiple falls: nearly 1 in 5 people 85 and older reported that they fell more than once a year, compared with 1 in 10 of those aged 65 to 74. Nearly a quarter of seniors who have suffered a stroke, and almost 20 percent of those with any disability, had multiple falls. Twenty-six percent of seniors with moderate mental impairment had multiple falls, as did 38 percent with severe mental impairment.

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Expanding palliative care in California could save billions of dollars


Berkeley Forum report highlights three programs that give patients greater choice of care.

Click image to view report

A report released today (Nov. 19) by the Berkeley Forum finds that California hospital spending could be reduced by billions of dollars over the next eight years if patients’ wishes about palliative care were honored.

The Berkeley Forum — a collaborative effort involving executive leadership of major health insurers, health care delivery systems and the state of California with health policy experts from the School of Public Health at UC Berkeley — previously issued a vision of increased choice and better value for patients nearing end of life.

The new report builds on that vision, highlighting three major programs that give patients in California greater choice of care outside the hospital. The programs’ interdisciplinary teams incorporate patient goals and wishes when planning treatment, resulting in patient-centered care that tends to move people out of intensive hospital settings and into care in the community.

“Our review shows that offering more choices to patients can not only increase satisfaction with care and improve outcomes, but also divert spending from expensive and unwanted services,” said Eric Kessell, policy director for the Berkeley Forum and lead author on the report.

The study also found that by expanding access to community-based palliative care to over 100,000 Californians a year through 2022, more than $5.5 billion could be moved from high-cost, unwanted hospital services while honoring patient wishes for care at home and in other community settings.

“The wishes of patients, their families and loved ones should be honored at the end of life,” said Richard Scheffler, co-chair of the Berkeley Forum. “Many of them do not want to die in a hospital. This report gives them other choices.”

In order to achieve this vision, conversations about palliative care will need to be incorporated throughout the health care delivery system, with increased use of nurse practitioners and other health care professionals, and a tripling of physicians certified in hospice and palliative medicine.

Stephen Shortell, chair of the Berkeley Forum, said, “The increased interest in palliative care is part of a larger movement toward greater patient and family engagement in all aspects of their care over the life course.”

“Expanding palliative care in California is the right thing to do on every level. It is what patients want, it improves outcomes, it lowers costs and most importantly provides compassionate relief to those suffering.”

— David Feinberg, president of the UCLA Health System, CEO of the UCLA Hospital System and UC Health’s representative on the Berkeley Forum

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Are children better off than they were 25 years ago?


UCLA publishes comprehensive analysis of children’s rights around the world.

Jody Heymann, UCLA

Twenty-five years ago this month, the countries that compose the United Nations reached a landmark agreement that laid the foundation for much-needed strengthening of children’s rights and protections in nearly every country around the world.

Today, the Convention on the Rights of the Child remains the only formal global effort to improve children’s rights and the most widely ratified human rights treaty in history. Only three U.N. member nations have not ratified the treaty: Somalia, South Sudan and the United States.

“The Convention on the Rights of the Child is a promise from our global community to all children,” said Dr. Jody Heymann, founding director of the World Policy Analysis Center and dean of the UCLA Fielding School of Public Health. “Everyone deserves to know whether their country is fulfilling that promise and how it compares to other countries facing similar opportunities and constraints.”

To mark the 25th anniversary of the CRC on Nov. 20, the center assessed 190 U.N. countries’ progress toward fulfilling the CRC’s commitment to children in critical areas such as the right to education, protection from child labor and child marriage, and discrimination of children with disabilities.

How are the world’s children faring?

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UCLA’s Healthy Campus Initiative helps inspire nationwide college program


Partnership for a Healthier America launches Healthier Campus Initiative.

An “instant recess” at UCLA dovetails with the Healthy Campus Initiative.

By Rebecca Kendall, UCLA

Less than two years after UCLA launched its groundbreaking Healthy Campus Initiative, a prominent organization is introducing a national health and wellness program for colleges and universities.

The Partnership for a Healthier America, which works with the private sector and Michelle Obama to make healthier choices easier, announced its Healthier Campus Initiative today (Nov. 16) in New Orleans at the American Public Health Association’s annual conference. UCLA is one of 20 colleges and universities that are part of the program, which will reach more than 500,000 students and 126,000 faculty and staff. UCLA is the only postsecondary institution in California that is participating.

According to the organization’s CEO, UCLA was one of the important inspirations for the program. “The Healthier Campus Initiative was born out of a collaboration between the Partnership for a Healthier America and the nation’s leading nutrition, physical activity and campus wellness experts, including leaders at UCLA,” said Lawrence Soler.

“Over the past few years, UCLA has become a leader in the movement to create a healthier environment for its students, faculty and staff, and this initiative would not have been possible without UCLA’s early insights, input and support.”

UCLA’s Healthy Campus Initiative is a campuswide effort that draws upon the campus’s world-renowned research and teaching to find new and innovative ways to promote healthy living at UCLA and share that education and research with other communities.

Each of the participating universities has pledged to adopt guidelines for food and nutrition, physical activity and programming over the next three years.

“The PHA agreement gives us an opportunity to help evaluate our progress toward our goals,” said Dr. Wendy Slusser, associate vice provost for the HCI and a clinical professor at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health. “It will also introduce us to other university leaders across the U.S. and enhance our learning of best practices and our ability to leverage resources to promote health and wellness on our campuses and in our communities.”

Slusser attended the announcement joined by UCLA colleagues and philanthropist Jane Semel, who with her husband, Terry Semel, envisioned and supported UCLA’s Healthy Campus Initiative.

PHA’s Healthier Campus Initiative comprises 23 guidelines, many of which UCLA has already implemented as part of its campus mandate. Others were new initiatives prompted by PHA discussions. Among them are offering a minimum of one “wellness meal,” which meets nutritional guidelines set by PHA, at each mealtime; offering a minimum of five types of fruits, five types of vegetables and two 100 percent whole grain products at both lunch and dinner; and implementing a program at dining venues to encourage healthier food consumption.

UCLA has also moved to add more local and sustainable food as part of its commitment to the PHA program. Currently, UCLA serves 17 percent locally sourced food in its dining operations; the campus’s goal is to achieve 20 percent by 2020.

The focus on healthy, sustainable food at UCLA is in line with the University of California Global Food Initiative, which was also shaped in part by leaders of UCLA’s HCI. The systemwide initiative was introduced by UC President Janet Napolitano in July at an event held at UCLA’s student-run community garden.

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UC San Diego names associate dean for public health


Bess Marcus to develop a Public Health Institute.

Bess Marcus, UC San Diego

Bess Marcus, Ph.D., has been appointed senior associate dean for public health with the UC San Diego School of Medicine. This new appointment recognizes the rapidly growing field of public health in academic medicine and its pivotal role in protecting and improving the health of individuals and communities through promotion of healthy lifestyles, research for disease and injury prevention, detection and control of infectious diseases and assessing hazardous environments.

Marcus will develop a Public Health Institute to serve as a home for all public health-oriented efforts at UC San Diego. This strategic role is designed to promote public health research and education activities across the campus, foster interdisciplinary conversations and collaborations, focus the need for resources and oversee public health degree offerings at UC San Diego.

“The ultimate goal of this new role and the institute is to help people achieve healthier, happier lives,” said Marcus who also serves as chair of the Department of Family and Preventive Medicine. “The university wants its passionate and talented public health students to serve in the broader community where, mentored by our top-notch research faculty, they can help to implement evidence-based health promotion and disease prevention programs.”

“The field of public health is central to addressing some of the most pressing health issues we face today, such as rising health care costs and the need for greater prevention of disease and disability across the lifespan,” said David Brenner, M.D., vice chancellor for UC San Diego Health Sciences and dean of the School of Medicine. “We are fortunate to have Dr. Marcus in this leadership role and look forward to developing programs that will impact the health of our local communities.”

Marcus earned her M.S. and PhD. degrees in clinical psychology from Auburn University, with a fellowship in behavioral medicine at Brown University.  She has published more than 200 peer-reviewed articles and three books. Her colleagues have recognized her with numerous awards, including the “Women Who Mean Business” Award from the San Diego Business Journal and the UC San Diego Equal Opportunity/Affirmative Action and Diversity Award.

For more than 25 years, Marcus has had continuous funding from the National Institutes of Health to conduct research aimed at promoting exercise adherence and understanding the acquisition and maintenance of exercise behavior. She developed and validated assessments for understanding the stages and processes of exercise behavior change and has also developed interventions to promote moderate-intensity physical activity in community, workplace and primary care settings. Over the past 10 years her research has focused on increasing physical activity among underserved and vulnerable populations.

She has regularly participated in American Heart Association, American College of Sports Medicine, Centers for Disease Control and Prevention, and National Institutes of Health panels, which have created recommendations and guidelines on the quantity and intensity of physical activity necessary for health benefits. She served on the Executive Committee for the Development of a National Strategic Plan for Physical Activity and she now serves on the Board of Directors for the National Physical Activity Plan Alliance.

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Arsenic in drinking water linked to 50% drop in breast cancer deaths


‘What we found was astonishing.’

One typically does not hear talk of the health benefits of arsenic, but a new study by researchers from UC Berkeley and the Pontifical Catholic University of Chile has linked arsenic to a 50 percent drop in breast cancer deaths.

The study, published this month in the journal EBioMedicine, presents results of breast cancer mortality data from a region in Chile where residents were inadvertently exposed to high levels of arsenic, a naturally occurring element found in many minerals. Instead of an increase in mortality, as with many other cancer sites, the study found that breast cancer deaths were cut in half during the period that coincided with high arsenic exposure. The effect was more pronounced among women under age 60, with mortality in these women reduced by 70 percent.

“What we found was astonishing,” said study lead author Dr. Allan Smith, UC Berkeley professor of epidemiology and director of the Arsenic Health Effects Research Program. “We’ve been studying the long-term effects of arsenic in this population for many years, focusing on increased disease and mortality attributed to the historical exposure to arsenic in this population.”

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Study: Hospital mergers, acquisitions leading to increased patient costs


Counterintuitive findings published in Journal of the American Medical Association.

The trend of hospitals consolidating medical groups and physician practices in an effort to improve the coordination of patient care is backfiring and increasing the cost of patient care, according to a new study led by a UC Berkeley health policy expert.

The counterintuitive findings, published today (Oct. 21) in the Journal of the American Medical Association, come as a growing number of local hospitals and large, multi-hospital systems in this country are acquiring physician groups and medical practices.

“This consolidation is meant to better coordinate care and to have a stronger bargaining position with insurance plans,” said study lead author James Robinson, professor and head of health policy and management at UC Berkeley’s School of Public Health. “The movement also aligns with the goals of the Affordable Care Act, since physicians and hospitals working together in ‘accountable care organizations’ can provide care better than the traditional fee-for-service and solo practice models. The intent of consolidation is to reduce costs and improve quality, but the problem with all this is that hospitals are very expensive and complex organizations, and they are not known for their efficiency and low prices.”

Robinson teamed up with study co-author Kelly Miller, program analyst at Integrated Healthcare Association, a nonprofit organization that promotes health care quality improvement, accountability and affordability in California.

The researchers analyzed four years of data, from 2009 to 2012, on 158 major medical groups and 4.5 million patients in California. Groups were put into three categories: owned by physicians, owned by a local hospital or hospital system, or owned by a large hospital system that spans multiple geographic markets in the state.

The measure of costs included physician visits, inpatient hospital admissions, outpatient surgery and diagnostic procedures, drugs, and all other forms of medical care except for mental health services. (The researchers did not have data on mental health services since they are paid for separately.)

After controlling for such factors as the mix of severely ill patients and geographic differences in cost, the researchers found that per patient expenditures were 19.8 percent higher for physician groups in multi-hospital systems compared with physician-owned organizations. Groups owned by local hospitals were better, but per patient costs still ran 10.3 percent higher compared with physician-owned groups.

Why would consolidation lead to increased costs? It could be that once a medical group has been acquired, physicians in those groups are expected to admit their patients to the high-priced hospital, Robinson said.

“Hospital-owned medical groups usually are expected to conduct ambulatory surgery and diagnostic procedures in the outpatient departments of their parent hospital, but hospital outpatient departments are much more costly and charge much higher prices than freestanding, non-hospital ambulatory centers,” he said.

Robinson said that public policy should not encourage mergers and acquisitions as a means of promoting collaboration. Instead, he said, policymakers should consider supporting the use of bundled payments for hospitals and physicians to improve coordination of care.

“Hospitals are an essential part of the health care system, but they should not be the center of the delivery system,” said Robinson. “Rather, physician-led organizations based in ambulatory and community settings are likely to be more efficient and provide cheaper care.”

The study authors noted that their findings are limited to California, and that further studies should be done using data from other states.

“Nevertheless, these findings are important since California is the nation’s leader in terms of having physicians participate in large medical groups that already perform the functions ascribed to ‘accountable care organizations’ by the Obama administration,” said Robinson.

The Robert Wood Johnson Foundation provided support for this research.

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UC Davis names chair of public health sciences


Distinguished cancer prevention researcher Brad Pollock to lead department.

Brad Pollock

Brad Pollock, a leading researcher on the incidence and control of childhood and adolescent cancer, has become chair of the Department of Public Health Sciences at the UC Davis School of Medicine.

Pollock directs a team of 35 investigators who conduct population-based studies aimed at preventing disease and shaping health policy. Department faculty members have advanced knowledge of cancer, autism, reproductive health and agricultural exposures, and they are among the nation’s leaders in the fields of epidemiology, biostatistics, and environmental and occupational health sciences. Together, they have received nearly $100 million in research funding from the National Institutes of Health, state of California and foundations.

The department also offers a master’s degree program in public health and leads graduate groups in epidemiology and biostatistics.

Pollock came to UC Davis from the University of Texas Health Science Center at San Antonio, where he was the founding chair of the Department of Epidemiology and Biostatistics in the School of Medicine. He is the principal investigator of a $19 million National Cancer Institute grant to engage community physicians in expanding participation in cancer clinical trials as well as research on cancer control and cancer care delivery. The grant includes a focus on underserved populations, including Latinos, adolescents and young adults. He also co-chairs the Clinical Trials Task Force for the Patient-Centered Outcomes Research Institute’s PCORnet national network, and he previously chaired the Biostatistics, Epidemiology, Research Design Key Function Committee of the national Clinical Translational Science Award Program.

While his research focuses on pediatric oncology, Pollock also has extensive experience in multi-institutional studies on adult cancer, HIV, diabetes and obesity. He is known for combining medical informatics with clinical, translational and transdisciplinary approaches in addressing health issues.

“Dr. Pollock’s accomplishments align perfectly with our team’s mission of having a meaningful impact on health and quality of life,” said Julie Freischlag, vice chancellor for Human Health Sciences and dean of the School of Medicine at UC Davis. “His success at linking multiple research methodologies with population science will guide the department to new levels of achievement as a comprehensive program with international influence.”

Pollock earned his bachelor’s degree from UC Irvine and his master’s and doctorate degrees from UCLA’s School of Public Health.

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Drinking sugared soda associated with cell aging


UCSF scientists find shorter telomeres in immune cells of soda drinkers.

Elissa Epel, UC San Frnacisco

Sugar-sweetened soda consumption might promote disease independently from its role in obesity, according to UC San Francisco researchers who found in a new study that drinking sugary drinks was associated with cell aging.

The study revealed that telomeres — the protective units of DNA that cap the ends of chromosomes in cells — were shorter in the white blood cells of survey participants who reported drinking more soda. The findings were reported online today (Oct. 16) in the American Journal of Public Health.

The length of telomeres within white blood cells — where it can most easily be measured — has previously been associated with human lifespan. Short telomeres also have been associated with the development of chronic diseases of aging, including heart disease, diabetes, and some types of cancer.

“Regular consumption of sugar-sweetened sodas might influence disease development, not only by straining the body’s metabolic control of sugars, but also through accelerated cellular aging of tissues,” said Elissa Epel, Ph.D., professor of psychiatry at UCSF and senior author of the study.

“This is the first demonstration that soda is associated with telomere shortness,” Epel said. “This finding held regardless of age, race, income and education level. Telomere shortening starts long before disease onset.  Further, although we only studied adults here, it is possible that soda consumption is associated with telomere shortening in children, as well.”

The authors cautioned that they only compared telomere length and sugar-sweetened soda consumption for each participant at a single time point, and that an association does not demonstrate causation. Epel is co-leading a new study in which participants will be tracked for weeks in real time to look for effects of sugar-sweetened soda consumption on aspects of cellular aging. Telomere shortening has previously been associated with oxidative damage to tissue, to inflammation, and to insulin resistance.

Based on the way telomere length shortens on average with chronological age, the UCSF researchers calculated that daily consumption of a 20-ounce soda was associated with 4.6 years of additional biological aging. This effect on telomere length is comparable to the effect of smoking, or to the effect of regular exercise in the opposite, anti-aging direction, according to UCSF postdoctoral fellow Cindy Leung, Sc.D., from the UCSF Center for Health and Community and the lead author of the newly published study.

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Smoking’s $18B toll on California


Despite declines in numbers of smokers, related diseases account for 1 in 7 deaths in state.

Read the full report (click image to view)

By Carolyn McMillan, UC Newsroom

Fewer Californians smoke today than 10 years ago, yet smoking continues to take an enormous toll on the state and its residents, triggering $18.1 billion in health care costs and lost productivity from illness and premature death.

In the first comprehensive analysis of the financial and health impacts of tobacco in more than a decade, UC San Francisco researchers found that smoking accounted for 1 in 7 deaths in the state — more than from AIDS, influenza, diabetes, or many other causes.

While the number of smokers in California declined from a decade ago, nearly 4 million people still smoke, including an estimated 146,000 adolescents, the UCSF study found.

Far too many smoking deaths

“We found that while the California tobacco control program has led to reductions in tobacco use in the state over the last decade, smoking is still far too prevalent and results in far too many deaths and high health care costs,” said principal investigator Wendy Max, Ph.D., professor of health economics at the UCSF School of Nursing and director of the UCSF Institute for Health & Aging.

The research was conducted at the institute, with grant funding from the Tobacco-Related Disease Research Program of the University of California’s Office of the President.

The findings offer a snapshot of tobacco use throughout the state drawn from 2009 data, the most recent available when the study began.

UCSF researchers profiled each of the state’s 58 counties with total costs, costs per resident and per smoker, expenditures for each type of health care, smoking prevalence and mortality measures. The same investigators conducted similar statewide studies in 1999 and 1989.

The report found that smoking prevalence was higher in some parts of the state than others, and that males — whether teens or adults — were far more likely to smoke than females.

“This kind of detailed data helps us target our limited smoking cessation resources where they are needed most,” said Dr. Michael Ong, chair of the California Tobacco Education and Research Oversight Committee and a UCLA physician. “We also see clearly from this report that tobacco — despite declines in its prevalence — remains a major threat to public health and a drain on health care resources.”

An extraordinary economic burden

The cost to California, its counties and its residents from smoke-related diseases remains significant. In Los Angeles County, for example, smoking carried a $4.4 billion price tag in 2009 — the highest of any county in the state. That total included $2.3 billion in direct health care costs and $2.1 billion for indirect costs, of which $1.7 billion was due to premature deaths.

“Smoking exacts an extraordinary economic burden on our county,” said Dr. Paul Simon, director of the LA County Public Health’s division of Chronic Disease and Injury Prevention. “The dollar amount is staggering, and it does not take into account the untold emotional costs on family members and friends.”

UC President Janet Napolitano said the study exemplifies the ways in which university research informs the work of public health offices around the state. UC campuses conduct a wide range of research each year aimed at improving the lives of Californians and people around the world — often in partnership with state and federal agencies looking to understand and address important health issues.

“In partnership with the state, we’ve made great strides in educating people about the risks of smoking, but as this important study shows, there is much more to do,” Napolitano said.

As the former Arizona attorney general, Napolitano was heavily involved in implementing the Master Settlement Agreement and represented the nation’s attorneys general on the Board of the Legacy Foundation, the largest national nonprofit public health organization devoted to tobacco control.

Statewide, smoking represented $6.8 billion in lost productivity and about 587,000 years of potential life lost from 34,363 deaths, or 17.1 years per death, the researchers found.

More deaths than AIDS, diabetes or Alzheimer’s

Smoking also was found to be a leading cause of death in 2009. The 34,363 total deaths from smoking were 17 times the number from AIDS; five times the deaths from diabetes, influenza and pneumonia; and three times the number of deaths from Alzheimer’s disease and unintentional injuries.

Cancer was the primary cause of smoking-attributable death, accounting for 13,514 deaths, followed by cardiovascular disease with 10,490 deaths, and respiratory diseases with 10,331. Pediatric disease accounted for 27 deaths, and secondhand smoke exposure was attributed to 794 adult deaths.

The direct health care costs of smoking accounted for 54.4 percent of the total $18.1 billion cost of smoking, or $9.8 billion. Lost productivity due to illness comprised 7.9 percent ($1.4 billion), and lost productivity from premature death comprised 37.6 percent ($6.8 billion).

Hospital care of current and former smokers cost $4.3 billion of the $9.8 billion total health care costs of smoking. Ambulatory care services were $2.1 billion; nursing home care, $1.5 billion; prescription drugs, $1.1 billion; and home health care, $794 million.

The report found that the state’s tobacco control efforts have been effective in reducing smoking-attributable deaths, reducing the prevalence of smoking and cutting the real costs of smoking, as compared to a decade ago.

Nonetheless, costs remain high and the wide variation in smoking costs across the counties suggests that many geographic areas would benefit from targeted efforts to reduce smoking.

“County-level estimates of the costs of smoking help to identify geographic disparities in the economic burden of tobacco use. These data are useful for local governments and policy makers to develop more effective tobacco control policies at the local level,” said co-author Hai-Yen Sung, Ph.D., professor of health economics at the UCSF School of Nursing and the UCSF Institute for Health & Aging.

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Sesame Street helps teach physicians a lesson


Incarceration plays major role in health disparities in U.S., says UC Riverside professor.

UC Riverside’s Scott Allen (left) is seen here with Sesame Street’s Alex, a blue-haired, green-nosed Muppet who has a father in jail, and Brown University’s Josiah Rich (right). (Photo courtesy of Pam Hacker, Sesame Street)

More than two million people are incarcerated in the United States, the highest incarceration rate in the world. So perhaps it comes as no surprise that last year the popular children’s television series Sesame Street introduced a character that has an incarcerated father.

With incarceration having found a home even on Sesame Street, public health practitioners, policymakers and health care providers ought to pay closer attention to incarceration’s impact on health inequality in the country, argue a team of two physicians and a medical researcher in an article published today (Oct. 6) in Annals of Internal Medicine.

Scott A. Allen, M.D., a professor of medicine in the School of Medicine at the University of California, Riverside, and his colleagues report that while many people need to be in prison for the safety of society, a majority are incarcerated due to behaviors linked to treatable diseases such as mental illness and addiction.

“In such cases, incarceration will improve neither the imprisoned person nor the social problem without medical intervention,” Allen writes, along with co-authors Dora M. Dumont, Ph.D., M.P.H., at the Rhode Island Department of Health and Josiah D. Rich, M.D., M.P.H., at Brown University.

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