Prevention Matters

The Pan American Health Organization (PAHO) is encouraging nations to require graphic images on all tobacco products depicting the sickness and suffering caused by tobacco use. They urged countries to follow the lead of Brazil, Canada, Chile, Panama, Uruguay and Venezuela

Smoke-related health risks are notable among all smokers, but one group of people - infants - has an exceptionally high risk for smoking-related health issues despite the fact they can't even smoke. The CDC says 174,000 deaths each year, including 776 infant deaths, are attributed to women’s smoking habits.

“Smoking during pregnancy is one behavior known to result in infant morbidity and mortality and for which effective cessation interventions exist,” the CDC says. One in five women smoke for three months before becoming pregnant and may attempt to quit, but many start smoking shortly after the baby has been delivered. In 2005, the lowest prevalence was in New York City with 5.2% and the highest in West Virginia with 35.7%. The Healthy People 2010 goal is to reduce prenatal smoking to less than 1%.

Many of the dangers infants face associated with maternal smoking include low birth weight, preterm infants, and complications during pregnancy. And, the risks don’t end after pregnancy. Instead, secondhand smoke can cause respiratory infections, ear infections, and an increased likelihood of SIDS, Sudden Infant Death Syndrome. Smoking before conception can delay pregnancy and reduce fertility, but maternal smoking also costs the mother much more than the price of cigarettes. The CDC cites serious economic concerns when both the mother and child inevitably suffer the consequences of the mother’s smoking habits.

Amy Himmelstein
Tobacco Policy and Program Intern
Partnership for Prevention

H.L. Mencken famously wrote: "For every problem, there is a solution that is simple, neat, and wrong." It's still true. A recent case in point: an item on Insureblog that expressed exasperation that more people aren’t practicing wellness.

“...wellness and health care include what we can do for ourselves, to keep ourselves . . . healthy,” the author posits. “We can exercise (free). We can get adequate sleep (free). We can steer clear of substance abuse of all kinds (free). We can keep a reasonable diet (free). We can always wash our hands (free). We can hold it down to 85 on the Interstate (free). We can stop smoking or never start (better than free). To a great extent we already have free health care in the U.S.

“Why, I wonder, aren’t more people taking advantage of free health care? Free is affordable. What's the problem?”

Gosh, where do we start? Let’s just take them one-by-one.

• It’s not so easy to exercise in a high-crime neighborhood where there’s no safe, convenient place to be physically active. And when there are no sidewalks in a neighborhood, more people will drive instead of walk and fewer kids can safely walk to school.
• Adequate sleep can be hampered by inadequately regulated neighborhood noise, or by chronic diseases that are increasing in incidence across the country and which more people cannot afford to have treated.
• A reasonable diet isn’t so easy in a neighborhood where there’s a fast food restaurant on every corner but purchasing fresh fruit and vegetables requires a one-hour bus ride.
• We can always wash our hands only when facilities to do so are easily accessible.
• Where enforcement isn’t present, some people simply aren’t going to “hold it to 85 on the interstate,” whether I choose to do so or not.
• Most people have to try numerous times before they successfully quit smoking. But many of them can’t afford or aren’t aware of the drugs, patches and other tools that could help them succeed, or they aren’t covered by their health insurance. And stopping smoking isn’t so easy when the tobacco industry is allowed to manipulate the nicotine content in their products to make them even more addictive. Even if they succeed, they are often subjected to second-hand smoke from other smokers. Meanwhile, keeping people from starting smoking is made more difficult when tobacco companies can engage in sophisticated marketing efforts targeting our most vulnerable populations.

A healthy lifestyle does indeed require personal responsibility. But a community has a responsibility to provide an environment that doesn’t make doing the right thing more difficult or more expensive.

The number of US adults following a healthy lifestyle has fallen in the last two decades despite health campaigns, a study shows. Levels of exercise also fell, as did consumption of fruit and vegetables. The American Journal of Medicine study found the number of people exercising three times a week or more fell from 53% to 43%, while the number of people eating five portions of fruit and vegetables a day fell by nearly 40%. Overall, researchers found, the number of people adhering to five "healthy habits" - including maintaining a healthy weight and stopping smoking - decreased from 15% to 8%.

The governor of the nation's largest tobacco-producing state has signed into law a statewide ban on smoking in bars and restaurants. The North Carolina ban doesn’t take effect until Jan. 2, 2010. The bill's chief backer in the legislature left open the possibility that he would try in the future to broaden the new smoking ban in order to cover businesses beyond restaurants and bars.

Unmet contraceptive needs and unsafe sex both figure in the top 20 risk factors for mortality and burden of disease, says an editorial in PLoS Medicine.

The editors, whose publication is produced by Public Library of Science, call for political and religious leaders to redouble their efforts to realign research and policy making to promote better sexual health for all, and provide the support that is necessary to enable medical research to fulfill its role in promoting sexual health. The editors said these matters have been included in PLoS Medicine's recently announced priority areas for publication.

'There are 19 million new cases of STDs each year in the United States, at an estimated cost of US$15.9 billion annually to the US health care system," the editors write.

Private well water should be tested yearly, and in some cases more often, according to new guidance offered by the American Academy of Pediatrics (AAP). The recommendations call for annual well testing, especially for nitrate and microorganisms such as coliform bacteria, which can indicate that sewage has contaminated the well. The recommendations point out circumstances when additional testing should occur, including testing when there is a new infant in the house or if the well is subjected to structural damage.