To mark the end of the year, I asked several of Minnesota’s medical and public-health experts to describe the most significant event (“good” or “bad”) in their field of expertise in 2011. Here’s what they chose:
From Dr. Steven Miles, professor of medicine and bioethics at the University of Minnesota Medical School:
Perennial issues gave medical ethics its share of media attention in 2011. There were more scandals about how pharmaceutical and medical device companies sell products by overstating benefits, concealing harms, or using clinician payola to build markets. Fines in the hundreds of millions of dollars have no effect. Criminal action is contemplated. Congress holds hearings: zzzzzzzz.
The abortion debate had its ripple effects. The Obama administration refused to allow the morning-after pill to go over-the-counter to women under 17, who must make a decision, find a clinic, and get a prescription in less than 72 hours from the time of unprotected sex.
Congress continues to insist on a pro-life military even though at least one in three of women is sexually assaulted. Mississippi rejected a bill saying “life begins at conception” that would have made much in-vitro-fertilization and research on some stem cells illegal.
The much-maligned ObamaCare has made it illegal for health insurers to play “Tag! You’re out!” with pre-existing conditions. Two and a half million more 19- to 25-year-olds have insurance. The health insurance industry is struggling under the onerous new rule that they must pay out 80-85 percent of insurance premiums for health care. (Casinos pay out 96 percent.)
And who can forget Minnesota’s own Michele Bachmann’s wide-eyed lie that she met a mom who had a child who got “mental retardation” from the cancer preventing HPV vaccine.
From Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy:
It’s back; H5N1 influenza, or as most know it, bird flu. This is an influenza virus that continues to cause serious illness in poultry and wild birds in Asia, Africa and Europe. Occasionally humans become infected from close contact with sick birds. Over the past 8 years, 336 of 573 reported human H5N1 infection cases have died. The major concern among public health officials is that the H5N1 virus will change genetically to allow it to be readily transmitted to and by humans. With the high mortality rate for current human cases, even a “milder form” of H5N1 infection could cause a catastrophic influenza pandemic that would be much worse than even the 1918 swine flu pandemic. In the 1918 pandemic it is estimated that up to 2% of the population died.
Now researchers in the Netherlands and University of Wisconsin have reported altering genetic components of the H5N1 virus such that it can be readily transmitted between ferrets (an animal model highly predictive of how influenza viruses will act in humans) and it kills 60 to 80 percent of the ferrets. The National Science Advisory Board for Biosecurity (of which I am a member) has recommended the manuscripts describing this work not be published with full details so as to not allow individuals or groups who would use this virus as bioweapon a road map for how to make it. The news of this seminal event in life sciences is unfolding this very week. Stay tuned as this situation will play out over the months ahead. At the very least we know Mother Nature could make these same genetic changes to the H5N1 virus. This could be the cause of our next influenza pandemic; a daunting thought.
This year brought big news on bisphenol A (BPA), a hormone-disrupting chemical linked to adverse health effects like cancer, infertility, diabetes, obesity and ADHD. While use of BPA has largely been phased out of water bottles and baby bottles, exposure to BPA in the epoxy resin that lines food cans is still widespread. A new study found BPA in foods consumed by children, like SpaghettiOs. Another study detected BPA in canned foods commonly consumed at Thanksgiving, like pumpkin, green beans and gravy. A Harvard study found that volunteers who consumed canned soup daily for five days had a 1,000 percent increase in urinary BPA.
Another study illustrates the power of prevention: Families that ate a fresh-food, packaging-free diet for three days reduced their urinary levels of BPA by 66 percent. A key question is how do we translate this new science into public health policy to prevent exposures to BPA?
Women’s Reproductive Health
From Sarah Stoesz, president and CEO of Planned Parenthood Minnesota, North Dakota, South Dakota:
The federal government nearly shut down in early April — not over job creation, not over the economy — but over continuing to allow low-income women access to basic health care. Majority lawmakers in the U.S. House of Representatives not only attempted to zero out the federal Title X program, but specifically targeted Planned Parenthood in an unprecedented attempt to ban federal funding for patients of the nation’s largest provider of preventive health care — the women and families who are among the nation’s most vulnerable people. In the end, we were able to hold the line, preserve funding for Planned Parenthood’s patients and save the nation’s family planning program.
Title X has helped millions of women nationwide plan their families since its inception more than 40 years ago. Women rely on Planned Parenthood’s Title X supported clinics for basic preventive care such a life-saving cancer screenings, birth control, pap tests and health education. Planned Parenthood’s 20 clinics throughout metropolitan, suburban and rural Minnesota served 52,482 patients with Title X funding in 2010, the vast majority of them women over age 18 at or below federal poverty level.
Title X clinics are part of the fabric of the communities they serve and are some women’s only access to health care. Saving Title X meant saving women’s health and lives — in Minnesota and across the country.
The most significant development in sleep medicine in 2011 involves Superintendent Valeria Silva of St. Paul Public Schools with her initiative entitled “Strong Schools, Strong Communities.” In this initiative, Superintendent Silva continues her onslaught to erode the health of thousands of St. Paul’s school children by promoting her program to advance school start times with its subsequent early busing routes. In doing so, she continues to neglect years, if not decades, of absolutely compelling clinical and scientific evidence that directly link the effects of acute and chronic sleep deprivation to decrements in daytime performance, memory consolidation, alertness, and mood, as well as its association with a growing litany of negative health consequences such as obesity, childhood diabetes and depression.
Furthermore, by pushing her own agenda, Superintendent Silva neglects that advancing school start times is not associated with an advance in a child’s sleep onset time but is only associated with less sleep. This, in turn, is associated with aggressive and delinquent behavior, as well as social problems. Thus, this direct assault on the health and development of our society’s most valuable asset, our children, is in direct opposition to both commonly accepted scientific knowledge — and common sense.