Health Headlines - May 9

U.S. Has Poor Newborn Survival Rate: Report

The United States has the second highest death rate for newborns among industrialized nations, according to a new global report.

The death rate for U.S. newborns is 5 per 1,000 live births, the same as Hungary, Malta, Poland and Slovakia, the Save the Children report released Monday showed. Latvia had the worst rate -- 6 per 1,000 -- among industrialized countries, the Associated Press reported.

Japan had the lowest newborn death rate -- 1.8 per 1,000 -- among the 33 industrialized nations. The Czech Republic, Finland, Iceland and Norway tied for second place with 2 per 1,000.

Racial and income disparities are factors in the poor U.S. ranking. Among black Americans, the newborn death rate is 9 per 1,000, which is closer to rates in developing nations than rates in industrialized countries, the AP reported.

A lack of national health insurance and short maternity leaves in the United States may also be factors, the report authors said.

"Every time I see these kinds of statistics, I'm always amazed to see where the United States is, because we are a country that prides itself on having such advanced medical care and developing new technology ... and new approaches to treating illness. But at the same time not everybody has access to those new technologies," Dr. Mark Schuster, a Rand Co. researcher and pediatrician with the University of California, Los Angeles, told the AP.

Liberia had the highest newborn death rate among all nations -- 65 deaths per 1,000 live births.

U.S. Employees at Smaller Firms Pay More in Health Insurance

Workers at the smallest U.S. businesses (1 to 9 employees) pay an average of 18 percent more in health insurance than people who work at the largest companies (1,000 + employees) when the percentage of total medical expenses paid by the health plan (actuarial value) is taken into account, says a Commonwealth Fund-supported study released Tuesday.

The type of health plan is a major factor in determining actuarial value and adjusted cost. Adjusted premiums are 25 percent higher for indemnity plans and 18 percent higher for preferred provider organization (PPO) plans than HMOs, the study said.

Factors that contribute to the differences in premiums include: higher administrative costs from marketing; medical underwriting (the process of assessing medical risk), and greater risks.

The study also found that workers in states with large urban populations -- such as California, Massachusetts, New York and Pennsylvania -- tend to get more value for their premium dollar than workers in rural states like Maine, West Virginia, Wyoming and Wisconsin.

The findings appear in the May/June issue of the journal Health Affairs.

The study also found:

* Fifty-two percent of workers in small firms (1 to 49 employees) have deductibles, compared with 44 percent of workers in firms with 50 or more employees, and 40 percent of workers in firms with 1,000 or more employees.
* For workers in small firms who have deductibles, the average amount is $599, compared with $386 for workers in large firms.

FDA Argues to Restore Ephedra Ban

As part of its legal fight to restore a ban on dietary supplements that contain low doses of the weight-loss aid ephedra, the U.S. Food and Drug Administration said Monday that the federal judge who lifted the ban misunderstood the law.

The ban was successfully challenged last year by Utah-based Nutraceutical Corp. when U.S. District Judge Tena Campbell in Salt Lake City ruled that the ban couldn't be enforced against supplements that contained up to 10 milligrams of ephedra, the Associated Press reported.

But Campbell didn't understand the law or the FDA's duties in regulating dietary supplements, a lawyer for the FDA told a three-judge panel of the 10th U.S. Circuit Court of Appeals Monday.

Lawyer Christine Kohl also argued that Campbell ignored scientific information on ephedra's effects on the body, the AP reported.

The FDA banned ephedra two years ago. It has been linked to dozens of deaths and thousands of reports of health problems, including increased blood pressure and heart attacks.

In court Monday, an attorney for Neutraceutical Corp. argued that Campbell was correct in ruling that the FDA should have researched the effects of various doses of ephedra and, instead of a blanket ban, should have developed specific, dose-based regulations for ephedra, the AP reported.

Get Morning-After Pill in Advance, Ob-Gyn Group Urges U.S. Women

Women in the United States should get an advance prescription for the morning-after pill so they'll have it on hand if they need it, the American College of Obstetricians and Gynecologists (ACOG) advises in a new "Ask me" campaign.

The effort is meant to increase access to the emergency birth control after the Bush administration refused to allow over-the-counter (OTC) sales of the contraceptive, the Associated Press reported.

Last year, senior Food and Drug Administration officials overruled their own scientists' decision that OTC sales of the morning-after pill would be safe. The FDA indefinitely postponed a decision on the issue.

The "Ask me" campaign includes distribution of waiting-room posters to the ACOG's 49,000 members. The posters urge women of childbearing age to ask about getting a prescription for the morning-after pill that they could keep on hand in case they need it, the AP reported.

The morning-after pill reduces the risk of pregnancy by up to 89 percent if it's used within 72 hours of sex. However, it can be difficult -- especially on weekends or holidays -- to find a doctor to write a prescription in time.

The morning-after pill is sold without a prescription in Britain, Canada and in a few U.S. states, the AP reported.

Despite Laws, Many Pregnant Women Not Tested for HIV

Despite state laws requiring that all pregnant women be offered HIV testing multiple times during pregnancy, about 20 percent of Florida women reach their third trimester without being tested for HIV, according to a review of Florida women conducted from 2004-04.

The findings were presented Monday at the annual meeting of the American College of Obstetricians and Gynecologists.

Rapid HIV testing of more than 1,300 women who lacked proof of HIV testing when they reached the delivery room identified one HIV-positive mother. Doctors were able to preventively reduce the baby's risk of infection, said Dr. Andrew W. Helfgott, chief of the section of maternal-fetal medicine at the Medical College of Georgia who previously worked in a high-risk pregnancy program in Pensacola, Fla.

"The problem we found in Pensacola is the women either didn't get offered testing in the third trimester or -- and this will remain a problem all over the country until we go totally to electronic medical records -- we had trouble getting prenatal care records while women were in labor and delivery," Helfgott said in a prepared statement.