Health Headlines - March 23

U.S. Doctors Providing Less Charity Care

Over the past decade, the percentage of U.S. doctors who provide free care to the poor has declined from about 75 percent to about 66 percent, according to a study released Thursday by the Center for Studying Health System Change.

The researchers said this trend, which indicates a growing problem for people without health insurance, is likely the result of stagnant government reimbursement rates and lower fees negotiated by insurers on behalf of their customers.

"In the past, a lot of physicians were able to afford (to provide free care) because they could charge paying patients higher rates," Dr. Peter Cunningham, lead researcher for the center, told the Associated Press.

Another factor is that more doctors are leaving solo practices and joining large group practices. "This means that they have less control over the types of patients they see," Cunningham said.

Rates of free care have declined across all major medical specialties since the mid-1990s, the report said. Currently, surgeons provide the highest rate of charity care (78.8 percent), perhaps because many of them treat uninsured patients in hospital emergency departments, the AP said.

TB Rates at All-Time Low in U.S.

Tuberculosis rates reached an all-time low in the United States in 2005, but there's been an increase in the incidence of drug-resistant TB, the U.S. Centers for Disease Control and Prevention said Thursday.

The agency's Morbidity and Mortality Weekly Report said there were 14,093 TB cases reported in 2005, compared with 14,516 cases in 2004. The TB case rate in 2005 was 4.8 cases per 100,000 people, the lowest since reporting began in 1953.

However, the 3.8 percent decline in TB cases from 2004 to 2005 was one of the smallest decreases in more than a decade, the report noted.

It also said that the number of people with multi-drug resistant (MDR) tuberculosis increased 13.3 percent from 2003 to 2004, the most recent year for which data was available. MDR tuberculosis, which refers to disease that is resistant to at least two front-line therapies (isoniazid and rifampin), is difficult and costly to treat and can be fatal.

MDR tuberculosis now accounts for 1.2 percent of all TB cases for which drug-susceptibility data is available, the report said. It will be critical to monitor MDR tuberculosis trends in the coming years to determine whether the 2005 increase represents a nationwide trend and to help experts understand the implications of resistance for TB treatment and control.

In other TB-related news, the World Health Organization (WHO) said Thursday that providing the entire population of East Asia and the Pacific with access to TB treatment has led to a sharp reduction in TB-related infections and deaths.

The number of people infected with TB in 2005 was estimated to be about 500,000 less than the number infected in 2000. The annual number of TB deaths in 2004 was 40,000 less than in 2000, after the WHO introduced the DOTS (directly observed treatment, short-course) program, Agence France Presse reported.

Preliminary reports indicate that 70 percent of estimated TB cases in the region were now being detected and about 85 percent of detected cases were being treated.

California and New York Have Dirtiest Air: EPA

California and New York have the dirtiest air in the United States and residents in those states have a higher air pollution-related cancer risk than people in the rest of the nation, says a U.S. Environmental Protection Agency report.

The National-Scale Air Toxics Assessment is based on emissions of 177 chemicals in 1999, the most recent year for which data was available, the Associated Press reported.

The report said that New York residents' estimated risk of developing cancer from airborne toxins is 68 residents per million. It's 66 residents per million in California. The U.S. national average is 41.5 per million.

Oregon, Washington, D.C., and New Jersey rounded out the top five in terms of poor air quality. Rural areas of Wyoming, South Dakota and Montana had the cleanest air, the AP reported.

Omega-3 May Control Prostate Cancer

Men with prostate cancer who eat a diet rich in omega-3 fish fats may gain some protection from developing a more aggressive form of the cancer, suggests a U.K. study in the British Journal of Cancer.

The study found that omega-3 fats could prevent prostate tumor cells from migrating and invading other areas of the body, including bone marrow, BBC News reported.

Researchers tested two types of dietary fat -- omega-3 and omega-6 -- on prostate cancer cells in a lab. Omega-6 fats are found in vegetable oils, nuts and seeds and are part of a healthy diet.

Omega-6 actually increased the spread of prostate cancer cells into bone marrow, while omega-3 prevented it. The researchers said the cancer cells may use omega-6 as a high energy source for growth and migration while omega-3 appears to interfere with that process, BBC News reported.

Schools, Hospitals Need to Ready for Potential Pandemic: Experts

Hospitals and schools in the United States are being urged to prepare for the possibility of a human bird flu pandemic.

It's not alarmist or premature for school boards and superintendents to make such preparations, say federal health officials, who noted that school officials already do emergency planning for severe weather, terrorism, and student violence, the Associated Press reported.

There are a number of problems that school leaders would have to cope with in the event of a pandemic. These include: Closing schools or quarantining students; making sure children keep learning at home if schools are closed; easing parents' fears; providing food to children who rely on school meals.

"Those are the kinds of issues that I don't think people have spent a lot of time talking about yet," Stephen Bounds, director of legal and policy services for the Maryland Association of School Boards, told the AP.

"But if New Orleans and Katrina taught us nothing else, it taught us you need to be thinking about things ahead of time -- and preparing for the worst," Bounds said.

As for hospitals, many are still in the planning stages for a pandemic. The topic was discussed Tuesday at a meeting of epidemiologists in Chicago.

"Awful" decisions will need to be made by hospitals, noted Dr. Andrew Pavia, an infectious-disease specialist from Salt Lake City. For example, does a hospital deny a 65-year-old patient a ventilator in favor of a 25-year-old patient who has a better chance of survival?

One simple way to lessen the impact of a pandemic would be to increase low flu-vaccination rates among U.S. hospital staff, said Mayo Clinic vaccine specialist Dr. Gregory Poland.

Food Fact:
Now "ear" this.

It's a fact -- you don't need butter to make fresh corn taste great. For best flavor, cook corn on the cob the same day it's picked. Frozen corn has all the nutritive benefits of fresh corn because it's processed soon after it's picked -- one-half cup of corn kernels contains about 3 grams of fiber. Yellow corn contains lutein, a plant pigment that helps protect your eyes.

Fitness Tip of the day:
Chocolate on a diet!

Yes, you can find 25-calorie treats! The trick for dieters who get tripped up by feelings of deprivation is learning to indulge in favorites wisely rather than swearing them off entirely. If you love chocolate, a kiss has only 25 calories, compared to 270 in a chocolate bar. For many, such substitutions make them more likely to stick to a healthier eating plan. But everyone is different: If you find that "just a little" leads to a lot, stay away from temptation, at least for awhile.

FAQ of the day:
What's so bad about accelerated weight loss?

Try to lose weight too fast and your body will perceive the calorie deficit as a state of semi-starvation. To conserve energy, it will slow down the rate at which it burns calories. Crash diets may take weight off fast, but they also make it more likely the pounds will come right back when you resume your normal eating patterns.