Live streaming right now: “How does where you live affect your health.”#BUSPH40 #BUSPHSymposia #environment #public health

Lots of health news in Boston this week, but at the moment, check out the live stream of this event.capture

Can the physical and social aspects of your neighborhood influence your health? The symposium will explore the roles of the built environment and housing and will evaluate the science on how interventions can improve the health of vulnerable populations.

 

Agenda

8:30–9 a.m.
Breakfast and Informal Greetings

9–9:15 a.m.
Welcome and Opening Remarks

Sandro Galea, Dean and Robert A. Knox Professor, Boston University School of Public Health

Jonathan Levy, Professor, Environmental Health, Boston University School of Public Health


BUILT ENVIRONMENT AND HEALTH
9:15–10 a.m.

Howard Frumkin, Professor of Environmental and Occupational Health Sciences, School of Public Health, University of Washington


10–11:30 a.m.

Panel Discussion: Separating Neighborhood-Level from Individual-Level Risk Factors

Mariana Arcaya, Assistant Professor, Urban Studies, Massachusetts Institute of Technology

Yvette Cozier, Assistant Dean for Diversity and Inclusion and Assistant Professor, Epidemiology, Boston University School of Public Health

Theresa Osypuk, Associate Professor, Epidemiology and Community Health, University of Minnesota School of Public Health

Shakira Suglia, Associate Professor, Epidemiology, Emory University Rollins School of Public Health

Monica L. Wang (Moderator), Assistant Professor, Community Health Sciences, Boston University School of Public Health


HOUSING AND HEALTH
11:30 a.m.–12:30 p.m

Ron Sims, Former Deputy Secretary of the United States Department of Housing and Urban Development


12:30–2 p.m.

Panel Discussion:  The Influence of Housing on Health

Carlos Dora, Coordinator, Public Health and the Environment Department, World Health Organization

Patricia Fabian, Research Assistant Professor, Environmental Health, Boston University School of Public Health

David Jacobs, Chief Scientist, National Center for Healthy Housing

Megan Sandel, Associate Professor, Pediatrics, Boston University School of Medicine

John Spengler (Moderator), Akira Yamaguchi Professor of Environmental Health and Human Habitation, Harvard T.H. Chan School of Public Health


2–2:10 p.m.

Break


2:10–3:40 p.m

Panel Discussion: High-Risk Populations and Strategies to Improve Health

Kalila Barnett, Executive Director, Alternatives for Community and Environment

JoHanna Flacks, Legal Director, Medical-Legal Partnership | Boston (MLPB)

Hector Olvera, Associate Professor and Director of Research, University of Texas at El Paso School of Nursing

Madeleine Scammell, Assistant Professor, Environmental Health, Boston University School of Public Health

Carey Goldberg (Moderator),  Health and Science Reporter, WBUR


3:40–3:45 p.m.

Closing Remarks

Jonathan Levy, Professor, Environmental Health, Boston University School of Public Health

Don’t take your #vitamins, says doctor from the Cambridge Health Alliance

fruit-photoEven though it is affiliated with Beth Israel Deaconess Medical Center, the Cambridge Health Alliance is often overlooked in this land of huge, lauded teaching hospitals. But Dr. Pieter A. Cohen’s editorial about supplements in JAMA gets a mention in  a story in this Tuesday’s Well column  in The New York Times.

Americans spend more than $30 billion a year on dietary supplementsvitamins, minerals and herbal products, among others — many of which are unnecessary or of doubtful benefit to those taking them. That comes to about $100 a year for every man, woman and child for substances that are often of questionable value…

In an editorial entitled “The Supplement Paradox: Negligible Benefits, Robust Consumption” accompanying the new report, Dr. Pieter A. Cohen, of Cambridge Health Alliance and Somerville Hospital Primary Care in Massachusetts, pointed out that “supplements are essential to treat vitamin and mineral deficiencies” and that certain combinations of nutrients can help some medical conditions, like age-related macular degeneration. He added, however, “for the majority of adults, supplements likely provide little, if any, benefit.”

Among the changes found in the new study: multivitamin/mineral use declined to 31 percent from 37 percent, “and the rates of vitamin C, vitamin E and selenium use decreased, perhaps in response to research findings showing no benefit,” Dr. Cohen wrote. Sometimes people do act sensibly when faced with solid evidence.

Boston Globe: Sachs, Angell, weigh in on health care reform

Jeffrey  Sachs of  Columbia University is not a health care guy; he’s a big picture guy. One in  a series of lengthy columns in The Boston Globe offered this:

captureOBAMACARE INCREASED health care coverage but did not solve the crisis of sky-high prices, and may well have exacerbated it by adding government subsidies into a system marked by pervasive market power and lack of competition.

I therefore recommend the following policies to address America’s urgent health care crisis.

First, as I’ve suggested in previous articles in this series, America should adopt policies to reduce income inequalities, end the over-incarceration of the poor, empower workers, clean and green the environment, and raise the social status of working-class families. Over time, such measures would help to reverse the epidemics of drug abuse, mental illness, obesity, and other diseases exacerbated by poverty and low social status.

Second, America should move toward universal health care coverage through public financing, as in Canada and Europe, with health providers (both private and not-for-profit) supplying coverage on the basis of capitation rather than fee-for-service. Capitation would encourage and enable health providers to offer supportive services (nutrition counseling, social support, health advising) that help to prevent, treat, and manage chronic conditions such as cardiovascular disease and adult-onset diabetes.

Third, the government should move to a system of price ceilings for medicines under patent through rational guidelines that balance the incentives for R&D with drug affordability and access. Economists have long argued that today’s patent law does not do an adequate job of balancing the needed incentives for innovation with the assurance of access to affordable medicines. The situation became intolerable after the advent of Medicare Part D, with the government now spending vast sums for drugs and drug companies grossly abusing the system by setting outrageous markups on the cost of production.

None of this is a dream or a utopian vision. These reforms would simply put the United States on the path toward improved health care coverage, affordability, and outcomes already enjoyed by the citizens of Canada, Japan, and many countries in Europe.

To which Dr. Marcia Angell, a former NEJM editor vocal critic of health care profiteering, had this to say:

JEFFREY D. SACHS has written an excellent overview of what makes the American health system so inadequate, inequitable, and expensive, compared with other advanced countries, and he recommends some important reforms. But one of them — paying providers a set yearly amount for each patient covered (capitation), instead of paying on a fee-for-service basis — would not work in this country, because, unlike other countries, our providers are largely for-profit (or behave that way).

Should Boston Children’s Hospital expansion go forward? Opponents cite higher costs, smaller garden.

Planned to write a post linking to the wave of endorsements and opposition to the proposed expansion at Boston’s Children’s Hospital, but the Globe columnist Joan Vennochi did it for me. Her opinion piece  links to the various supporters -Gov. Charlie longwood map Globe’s staff editorial endorsing the plan.  BHN is in the reporting, not the endorsing, business. So, FYI.

The need for Children’s to renovate old quarters is not in dispute. But its expansion needs are open to question. Children’s says it will fill beds from national and international referral sources. But it has been working to expand its referral network in Massachusetts. In the past 24 months, Children’s has filed numerous notices of material change about new arrangements to either acquire physicians or become the preferred provider. That suggests the hospital expects to take volume from the current marketplace. At the same time, it will drive up costs, since the hospital has also said it expects to get commercial insurance and Medicaid rate increases every year.

As the Children’s plan moves forward, Massachusetts is under pressure to reduce state health care costs, with spending on Medicaid — the health program for the poor and disabled — already flagged as a trouble spot.

Competitors like Tufts Medical Center and Massachusetts General Hospital — which is part of the Partners network — are also worried that a larger Children’s will dominate the pediatric hospital landscape. To add to the intrigue, Jack Connors, who was chairman of the Partners board from 1996 to 2012, is backing Children’s and essentially undercutting the concerns of MGH doctors. “If you’re successful in business, you grow,” Connors told the Globe.

Ah, business. In the end, is that what this is all about?

Health Leaders: #Lacks family members now have a say in #Henrietta’s immortal scientific legacy

My report from Health Leaders on a recent talk by members of Henrietta Lacks’ famfile_000-4ily.

The ongoing story of the late Henrietta Lacks, the African-American
woman who unwittingly provided cells for years of medical research, has much to offer those battling disparities
in healthcare, according to family members who spoke in Boston last week.

That message, delivered at a panel discussion, came from Lacks’ grandson David Lacks, Jr. and her great granddaughter Victoria Baptiste, RN, as well as Joseph Betancourt, MD, director of the Disparities Solutions Center at Massachusetts General Hospital.

Two Boston meetings look at the role of patient advocates. They offer two very different perspectives.

patient-advocacy-summit-e4fb

Pharmaceutical manufacturers often  look to patient advocates for help winning approval for new drugs. Their most recent success in this area was the FDA’s approval of a new drug for Duchenne muscular dystrophy. That decision came despite recommendations against approval from FDA staff.

In an editorial, the Boston Globe questioned the FDA’s move while noting that eteplirsen’s “entry into the marketplace represents a major victory for the patient advocacy movement, and is bound to encourage more such engagement in the drug-approval process. Based on the infighting that went on over the Duchenne treatment, that’s going to be challenging for the FDA. It has to find a balance between public opinion and what’s truly in the public interest.” (The Globe also featured a story this week about one of those patient advocates.)

Today, drug makers in Boston are hosting a conference for patient advocates. The “Patient Advocacy Summit 2016 – Sharing Our Stories: Building a Patient-Centered Ecosystem” is underway at Novartis facility near MIT.

This event brings industry leaders together with patient advocates and other stakeholders to examine ways in which life sciences companies can more fully incorporate the patient voice into the work they do— not just approaching regulatory applications or at commercialization, but throughout the drug development cycle.

The day-long event will include panel discussions, case study presentations (spotlighting industry/patient partnerships), a keynote address, and awards ceremony, as well as a networking breakfast, lunch and cocktail reception. Expected attendance is 180 patient advocacy professionals, patient organizations and other stakeholders.

Worth noting that the same topic was the subject of  yesterday’s  panel at HUBweek, a  science/tech/arts series ongoing in Boston. The title: “The FDA and the Drug Approval Process: Is it Really Broken?”  Some made the point —  we should listen to the parents of sick children.  Others offered a different perspective: Patients might be better off in clinical trials with informed consent and free drugs,  rather paying  $300,000 per year for that same, unproven medication with unknown side effects.

Contacted after the panel, Zuckerman, president of the National Center for Health Research in DC,  offered these thoughts:

  1. Patient perspectives are crucial in helping us understand what scientific data mean, what the benefits and risks both mean to patients.  So patients should be part of the process – what should the outcome measures be and how can they be measured?
  2. The FDA is listening to patients who desperately want treatments but they are not listening well to patients who are harmed by ineffective or unsafe treatments.  That’s partly because the former are funded by Pharma to attend FDA meetings and to lobby Congress, but the latter are on their own, often don’t have the money to attend FDA public meetings, and wouldn’t even know about them if they don’t read the Federal Register, which is the only place they are announced in advance.

 A few more tweets worth noting.

 

Can #Massachusetts tame #health #spending with transparency and oversight?

Stuart Altman, the Brandeis University healthcare economist who has advised presidents from Nixon to Obama, talked to Health Leaders last week. He is capturenow  the head of the Massachusetts Health Policy Commission, which tracks total health spending statewide.  

HLM: How is Massachusetts trying to address high costs?

Altman: First of all, it is the only state that has recognized that it should be involved in total state spending. Some other states that are closer are Vermont and Maryland. But the Massachusetts state government is really acknowledging that it has responsibility for not only what it spends on Medicaid, but that it should be concerned with total spending.

Full story at Health Leaders. 

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