British Columbia bans mandatory high heels at work

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I’m sure there will be mixed comments on this, but it makes sense for several reasons:

  • Safety
  • Comfort
  • Productivity
  • Gender equity

As noted in a previous blog, US emergency rooms treated an average of more than 12,000 injuries each year between 2002 and 2012, and the trend is increasing. (1)

Health insurance costs being what they are, how does requiring employees to wear heels make any sense?

So, one Canadian province has taken action. (2) The government of British Columbia has stipulated that employers can no longer require high heels as part of a work dress code.

Very intelligent.  No wonder people live longer in Canada.

This discussion calls to mind a classic issue that has arisen in relation to motor cycle helmets, seat belts, physical fitness, impaired driving, and vaccines — an individual’s actions affect others.

What do you do when one person’s choice can raise health insurance costs for everyone else? Each person who pursues a risky behavior adds a small increment to the costs borne by health insurers, and the little pieces add up. Of course, the health insurer response is to raise rates to cover these costs. Everyone who has insurance pays more. 

US public policy in this area is at best erratic. Some rules support individual liberty; some what is best for the majority. Very inconsistent.


Sources:

  1. Mary Elizabeth Dallas, “Injuries from high heels on the rise,” Spectrum Health Healthbeat, 13 JUne, 2015. http://healthbeat.spectrumhealth.org/injuries-from-high-heels-on-the-rise/
  2. Jamie Feldman, “New Canadian Law Bans Mandatory High Heels At Work,” Huffington Post, 10 April 2017. http://www.huffingtonpost.com/entry/high-heels-at-work_us_58eba4b9e4b0c89f9120220c?arq&utm_medium=email&utm_campaign=Lifestyle%20041017&utm_content=Lifestyle%20041017+Version+A+CID_8acfd2db7513e868287551b794356c32&utm_source=Email%20marketing%20software&utm_term=Read%20more&%20041017

Low dose aspirin and pregnancy

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The National Institutes of Health reported on a study regarding the benefit of low dose aspirin to pregnant mothers.

Low dose aspirin has been recognized as a course for reducing the risk of heart attack.

This study has an entirely different focus.  Featured Image -- 5334

C-reactive protein (CRP) can be found in the blood, and indicates the presence of inflammation in the body.

In pregnant women, CRP level is an indicator for premature uterine contractions, premature delivery and miscarriage.  As reported in one study . . .

(93) out of (100) women with premature uterine contractions had elevated level of C-Reactive protein and 91% delivered prematurely while in the control group only (9) out of (100) women had elevated level of C-reactive protein and only 8% of them delivered preterm. Differences were statistically highly significant. [Nakishbandy]

Aspirin treats inflammation. Pregnant women with inflammation who take low dose aspirin improve their chances for a successful delivery.

The CRP screen is a low-cost test, and is included in “most” standard tests during pregnancy.    Aspirin is, of course, cheap.

What to know:

The doctor needs to pay attention to CRP level.  Since the finding about low dose aspirin is new, the doctor may not be aware of it.

Standard caveat:  I’m a researcher, not a doctor.  Patients need to take an active role in healthcare in order to assure good results.  I’m trying to help by making people aware of useful information as it becomes available.  Better information should mean better conversations with your medical professionals.


Sources:

Women’s Healthcare Under Attack

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The Affordable Care Act is a complex law which addressed a number of serious omissions in American healthcare.

  • While the Act is flawed, calls for simple repeal are at best naive and will hurt a great many people.  Unfortunately, “Congress” seems to be a synonym for “ignorance”.

The Kaiser Family Foundation weighed in on one of these issues today — universal access to contraception.  I’m not going to repeat their entire article here.  You can find it at

http://kff.org/womens-health-policy/issue-brief/the-future-of-contraceptive-coverage/?utm_campaign=KFF-2017-January-Future-of-Contraceptive-Coverage&utm_medium=email&_hsenc=p2ANqtz-8GDcQq7tdmeq63OmhJQp_6O8mXB7t-8g_0PPXr_7xS_Nb6uM4sKhgU560QDQgTEPH20tlmp0Z0_RVIZKs4aN0jL-0136q6GE1-LECbE6U2AE7VM2E&_hsmi=40279577&utm_content=40279577&utm_source=hs_email&hsCtaTracking=3b5a083c-444e-49d7-b9ed-786e93b8471a%7Cb988136a-71ce-466e-9021-3684f879937e

The Act eliminated out of pocket costs for contraception for most women and made access independent of workplace or insurer.  (Remember the lawsuits involving church employees from before the law?)

When coupled with the attack on Planned Parenthood, which provides breast cancer screening for low income women as well as access to contraceptives, it seems like there is an agenda to reduce healthcare for women.

  • One interesting finding in the Kaiser data is that men are less supportive of contraceptive services for women than are women.  Most members of Congress or male.  While only a minority of men feel this way, the reasons for this are unclear. 

One theme to which I keep returning is the promise of “Life, Liberty and the Pursuit of Happiness” made by the Founding Fathers in the Declaration of Independence.  These rights are meaningless without good health.  In modern terms, that means universal access to quality healthcare.

Another Thought about Choosing a Doctor

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Seriously, you need to think about this.  We all do.  Patients of female doctors have better survival rates.

“There was ample evidence that male and female physicians practice medicine differently,” said Ashish Jha, MD, professor of health policy and director of the Harvard Global Health Institute. “Our findings suggest that those differences matter and are important to patient health. We need to understand why female physicians have lower mortality so that all patients can have the best possible outcomes, irrespective of the gender of their physician.” Dr. Jha was a senior author of a landmark 2016 study published in JAMA Internal Medicine that examined how differences in the way male and female physicians practice affect clinical outcomes. In the study, better patient outcomes were linked to care from female physicians.

[Source: Becker’s Hospital Review; JAMA is the acronym for the Journal of the American Medical Association]

Older Men and the Women Who Love Them, More

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Cleaning out my mailbox, there was an article on this in Science Daily from earlier this year that’s important for oltestosteroneder men and the women who love them to know.

Low testosterone levels complicate recovery from hospital stays, according to a study from the University of Texas.

Testosterone levels fall in men after age 40 as part of the aging process.  However, some see sharper declines than others.  I know of cases in which men in their 30s have been diagnosed with this condition.

Testosterone is a hormone produced by the pituitary gland and affects a large array of body functions.  Levels are measured by an inexpensive blood test.  This test is not part the normal lab work with a physical exam and has to be requested separately.

Other symptoms of low testosterone include

  • Fatique
  • Depression and mood changes
  • Loss of sex drive and erectile dysfunction
  • Weight gain and fat distribution
  • Loss of bone density
  • Lower production of red blood cells
  • Lower sperm production
  • Loss of muscle mass and strength
  • Hair loss

Put simply, low testosterone is a big deal.  The other problem is that men may be under treatment for other issues when testosterone is the real issue.  That includes men who are taking antidepressants and products like Viagra.

If someone is taking these other medications and  not getting the desired results, that may be a sign that a testosterone check needs to be run.  Treating the wrong problem is a waste of both money and time.  That’s how I found out.

You need involvement by a competent doctor.  There may be risks associated with testosterone therapy among men who have a history of heart disease.  The therapy is by prescription and some health plans do cover the costs of medication.  (There are non-prescription products advertised on TV, but there is no indication that they work.  My guess is that people reporting success with them were people who really didn’t need testosterone therapy.)

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Sources

STD ISN’T A GAS ADDITIVE, BUT THE US IS HIGH ON IT

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chancre-oral-1-200There are times when I’m actually grateful for being an old fart.  Not often, but it happens.

One thing for which I’m not grateful is the length of time the Federal Government takes to gather, validate and publish health data.  They’re better than they used to be, but even a 10-month delay in reporting to the public is unacceptable.

The US may not know how to create jobs, but it knows how to spread sexually transmitted disease (the STD of the title of this post).  2015 was the second year in a row for increases in all three major categories of these diseases (Chlamydia, Gonorrhea and Syphilis).  In fact, the 1.5 million new cases of Chlamydia reported to the CDC in 2015 is the highest number of new cases for any disease ever reported in the US.  These diseases also accounted for an estimated $16 billion in healthcare spending in the US.

Almost 2/3 of new Chlamydia cases are among people who are less than 25 years of age.  An estimated 20,000 women each year become sterile from the disease.

STDs are also a problem in the gay community.  There’s an odd pattern of infection linking Syphilis and HIV: have of gay and bisexual men with Syphilis also have HIV.  The pattern is known, the reason for the pattern is speculative.

Very little of this affects us old people for any of a variety of reasons.  For which I’m grateful.


Sources:

  1. “Sexually Transmitted Diseases (STDs)”, The Centers for Disease Control and Prevention.  https://www.cdc.gov/std/stats/
  2. CDC FACT SHEET, “Reported STDs in the United States,” October 2016.