If we want more evidence-based practice, we need more practice-based evidence.*

If we want more evidence-based practice, we need more practice-based evidence.*


Chapter 7
- Archives of Headlines
Adult Health

U.S. sees growing racial gap in heart deaths.
ATLANTA (Reuters, Nov. 13,1998) - Deaths from coronary heart disease, the number one killer in the United States, declined between 1981 and 1995 but the decreases were greater for whites than for blacks, federal health officials said Thursday. The Centers for Disease Control and Prevention said death rates from coronary heart disease declined for virtually all age groups above age 35, but less so for blacks. Black women aged 35 to 54 were more than twice as likely to die of coronary heart disease than white women of the same age, the CDC said.

Study says 1st heart attacks deadlier for women.
CHICAGO (Reuters, Oct. 28,1998) - First heart attacks are deadlier for women than men, with women 72% more likely to die than men within the following month, according to a Spanish study published Tuesday. "Women experienced more lethal and severe first acute myocardial infarction than men, regardless of (other risk factors for heart disease), age or previous angina (chest pain)," said the study from the Institut Municipal d'Investigacio Medica in Barcelona. Researchers said the death rate for women during the first 28 days after a first attack was 18.5% compared to 8.3% for men - a 72% greater risk for the women.

New margarine spread can lower cholesterol.
WASHINGTON (Reuters) - A new margarine made with a fat-blocking derivative from pine trees can lower blood cholesterol by up to 14% in people who eat it, U.S. researchers reported Wednesday. They said men and women with borderline-high cholesterol who ate the spread regularly lowered both their total cholesterol and their so-called "bad" LDL cholesterol, which clogs up
arteries. The spread, sold under the name Benecol in Finland, will be launched in the United States later this year. Johnson & Johnson unit McNeil Consumer Products will sell the spread in the U.S. and plans to set up a manufacturing plant next year. It also plans a line of salad dressings.


More information on the report below may be found at: http://nt.excite.com/news/r/980926/10/news-clinton

President Bill Clinton announced Saturday, Sept. 26, 1998 that he is initiating new steps to fight cancer.

As marchers gathered in Washington to push for greater emphasis on fighting cancer, the President announced in his weekly radio address that cancer patients would be given greater voice in determining Federal cancer research priorities. He is also asking the National Cancer Institute to speed development of a system making it easier for patients to participate in clinical trials of new cancer treatments.

A White House fact sheet was released that said that the National Cancer Institute would implement a system by next year to let cancer patients participate in reviewing research grant proposals and planning policies.

It also announced a $48 million program to fund research into how technologies developed in areas such as computer science, engineering, defense and astronomy could be used against cancer.

Also announced by the White House was a new program to fund research to on the impact of the disease on patients and their families.

In his radio address, Clinton urged Congress to pass a number of health and research measures he has proposed, including a five-year, 65% increase in cancer research funding.

NUMBER OF AMERICANS WITHOUT HEALTH INSURANCE JUMPS TO 43.2 MILLION: Despite Booming Economy, Number Uninsured Rises 1.5 Million. (Physicians for a National Health Program, Cambridge, MA, Sept. 25, 1998) -- The number of Americans without health insurance climbed to 43.2 million last year, nearly one in every six persons. The number of uninsured was up 1.5 million from 41.7 million in 1996, equivalent to 125,000 people losing coverage every month, according to an analysis of raw data posted on the internet by the Census Bureau yesterday.    

The 1998 Current Population Survey (CPS) data was analyzed by researchers at Harvard Medical School and Columbia University College of Physicians and Surgeons last night, and reported by Physicians for a National Health Program today.

"Sixteen percent of Americans are without insurance, a higher proportion than at any time since the passage of Medicare of Medicaid," according to Dr. Steffie Woolhandler, Associate Professor of Medicine at Harvard and a co- founder of Physicians for a National Health Program. "What's startling is the magnitude of the increase when the economy was booming."

California experienced the largest jump in uninsured, up 575,000 to 7.1 million people without coverage. Other states with large increases in the number of uninsured include Michigan (up 276,000 to 1.1 million), Illinois (up 169,000 to 1.5 million), Alabama (up 108,000 to 660,000), Florida (up 96,000 to 2.8 million), Maryland (up 96,000 to 680,000), and Pennsylvania (up 76,000 to 1.2 million).

In six states, more than one out of every five persons is uninsured: Texas (24.5%), Arkansas (24.4%), Arizona (23.8%), California (21.5%), New Mexico (20.2%), and Mississippi (20.1%). The number of states with less than 10% of the population uninsured dwindled from eight in 1996 to just five in 1997. Hawaii (7.5%) and Wisconsin (7.9%) had the lowest percentages of uninsured in 1997.

"We see the terrible consequences of patients lacking insurance in my clinic every day," said Dr. Bob LeBow, Medical Director of the Terry Reilly Health Center in Nampa Idaho and President of Physicians for a National Health Program.

"Hispanic Americans had the highest rates of uninsurance," noted Dr. Olveen Carrasquillo of Columbia University. "Millions of middle and upper income families also were uninsured."
Nearly 11 million people in families with incomes between $30,000 and $60,000 were uninsured in 1997, as well as 5.8 million in families with incomes over $60,000. The uninsurance rate for Hispanics climbed from 33.6% to 34.2%.

Uninsurance rates increased both for men (from 17.1% to 17.5%) and for women (from 14.2% to 14.7%). While the number of uninsured children was stable at 10.6 million, there were increases for young and middle-aged adults; 23.8% of people 18-39 were uninsured in 1997 (up from 22.7% in 1996), as were 14.6% of those between 40 and 65 (up from 14.4%).
Medicaid enrollment fell by approximately 1.8 million, apparently as a result of welfare cutbacks. Meanwhile, despite rising employment, the proportion of Americans with private coverage actually fell slightly from 70.2% to 70.0%. Medicare coverage rose slightly.

"These may be the best of times for the economy, but they are the worst of times for health care," noted Dr. David Himmelstein of Harvard. "Uninsurance is rising, even people with coverage often can't get the care they need, and costs will double in the next decade. It's time to reopen debate over national health insurance."

Physicians for a National Health Program is a nationwide organization based in Chicago with over 8,000 members that supports universal access to health care. PNHP was founded in 1987.

Additional Chart and Tables with State-based data  available upon request: (312) 554-0382

Non-smokers tackle tobacco firm MONTREAL (17 Sept 1998) (CP) -- A non-smokers group alleged Tuesday that Imperial Tobacco destroyed scientific studies in 1992 on the links between smoking and cancer. The charge, levelled by Garfield Mahood of the Non-Smokers' Rights Association, brought a quick denial as the firm insisted the only papers destroyed were copies. "We're not talking about originals," said Imperial Tobacco spokesman Michel Descoteaux. "No original version of any study was destroyed." Descoteaux said the originals are still on file in England, where Imperial Tobacco's corporate parent is based. He said the health hazards of smoking have been known since the last century but he denied there is any proven cause-and-effect between tobacco and cancer. Mahood called a news conference to discuss letters sent by a lawyer to B.A.T. Industries, the British parent firm of Canada's Imasco Ltd. and Imperial Tobacco. He said the 1992 letters from Simon Potter of Montreal, marked Confidential and Privileged, concerned the deliberate destruction of a long list of studies.
The list names 60 destroyed documents by their internal reference numbers -- RD828, RD95JR, etc. -- but gives no titles or other clues to what the papers were about. Mahood said not all copies were wiped out -- some later surfaced in the United States. He argued they contained material that incriminates the tobacco industry. Mahood's group maintained that the destruction of the documents raised serious legal and ethical questions that could possibly only be answered by a royal commission.

No heart attack risk for contraceptive pill - study. WASHINGTON (Reuters, Sept. 13, 1998) - Women who take the new versions of the contraceptive pill do not have an increased risk of heart attack, U.S. researchers said in a study, published in the American Heart Association journal Circulation. The study is the largest U.S. study to look at the question of the pill and heart attacks in recent years. Dr. Stephen Sidney and colleagues at Kaiser Permanente Medical Care in Oakland, Calif. pooled data from two studies of 1,200 women aged 18 to 44. About 270 of the women had suffered heart attacks and 990 had not. About 85% of the women had used oral contraceptives at some time in their lives. They said women who do suffer heart attacks are more likely to be obese, or to smoke.

Tamoxifen reduces breast cancer risk - FDA panel
. BETHESDA, Md. (Reuters, Sept. 3, 1998) - The first ever drug considered for the prevention of cancer reduces risk, but does not fully prevent disease, a panel of federal advisers said Wednesday. The drug, known generically as Tamoxifen, was recommended for U.S. Food and Drug Administration approval as a preventive drug by a committee of scientific experts and cancer doctors. But they said Tamoxifen could only reduce the risk of breast cancer in the short term in women who might be especially predisposed to getting the disease.

Statistics on cancer in 1998
(1 September 1998)  Health Canada has just released figures on the estimated number of cases of cancer in Canada in 1998, as well as the estimated number of deaths caused by the different forms of the disease. The statistics are issued by the Cancer Bureau, which conducts and is developing cancer surveillance programs and risk assessment networks.  
For more information, visit http://www.hc-sc.gc.ca/hpb/lcdc/bc/facts_e.html

Experts say fat rivals smoking as health threat. Aug. 31, 1998. PARIS (Reuters) - Medical experts warned that obesity was rapidly becoming a problem in the developing world as well as industrialized nations and could one day rival smoking in its impact on public health. "This is a pandemic, probably one of the top five public health problems in the world. Scientists are already beginning to wonder whether it will be worse than smoking," Dr. Philip James told reporters at the start of the Eighth International Congress on Obesity, which began Monday in Paris. James, who heads a task force for the International Association for the Study of Obesity, and other scientists said there was considerable hope that new drugs would soon be coming on line to help fat people lose weight and stay fit.

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