Showing posts with label childhood. Show all posts
Showing posts with label childhood. Show all posts
Addressing Low Childhood Vaccination Rates A Population Health Management Perspective
Tuesday, March 18, 2014
Whats the one issue that drives the most doctors crazy? The Disease Management Care Blog suspects its persons who use basic vaccinations. Thats because physicians are inculcated from the first day of their education with triumphant stories of how basic science and public health joined forces to banish many common and fatal infectious diseases. Not getting your shots is crazy.
DMCB readers are probably aware of how childhood U.S. vaccination rates are dropping. While we continue to wonder just how any parent or guardian could let that happen, heres a handy summary on the story behind the story: the New England Journal has an article on Improving Childhood Vaccination Rates:
Total U.S. rates of vaccination remain greater than 90%, but there are some pockets of the country with rates just over 50%. Thats where there have been outbreaks of disease leading to some pointless deaths.
Parents (or guardians) opposed to vaccination are unlikely to change their minds. Thats why high vaccination rates among the remainder of children are important to create herd immunity.
There are four approaches to achieving high vaccination rates:
1. Make shots free and think about paying parents to have their children immunized.
The DMCB likes the idea but wishes the authors had pointed out that in the context of value-based insurance, this is hardly a radical idea.
2. Make it really difficult to attend school without proof of vaccination. Getting an exemption should demonstrate that the parents are serious and not shuffling by on lax enforcement.
The DMCB grew up in New York City and recalls being immunized against polio in the schools cafeteria. Is it time to bring this back as a first-line strategy?
3. Confront the anti-vaccine community with counter-education campaigns that rely on more than facts and figures. Anecdotes and trusted public figures should also be used.
Whither social media? And, at a traditional marketing level, the DMCB thinks that maybe its time to partner with the pharma companies that do such a good job of convincing TV viewers to take lipid-lowering agents and anti-depressants. Nothing against the colleagues in public health, but theyre not known for their marketing savvy.
4. Physicians need to step up one patient at a time and, while theyre at it, make sure theyre up to date with their shots.
The DMCB did a literature search on "shared decision making" and "vaccination" and found no useful information. Given the success of aids and engagement strategies that enable truly informed decision-making, the DMCB thinks its time for the population health management community to step up and offer their services.
(One last thought: Newts been lampooned for his moon-base wackiness, but as the DMCB understands it, his recommendation is really based on an X-Prize approach, which he contrasts with the discontinued Shuttle program. The DMCB wonders if such an approach couldnt work in those areas of the country with critically low childhood vaccination rates: a 5 figure prize to any outfit that can move it to 90%. Why not?)
Image from Wikipedia
Excess Childhood Weight Doubles Adult Obesity Rate
Thursday, March 6, 2014
(Article first published as Childhood Obesity Doubles Adult Risk – Early Weight Loss Intervention Required on Technorati.)
Children and teens naturally need additional calories and nutrition to fuel their fast paced metabolism and accelerated growth. Researchers are beginning to understand that many diseases including heart disease and cancer begin to develop decades before clinical symptoms are detected. Excess body weight in youth provides the fuel for disease progression in later life. Small changes in diet at an early age can have a significant impact on overall health and longevity.
Study Confirms Childhood Overweight Results in Adult Obesity
The results of a study published in The Journal of the American Medical Association shows that nearly 40% of obese adolescents can be expected to become severely obese by the age of 30. This is compared to only 2.5% of healthy weight and slightly overweight teenagers. The study found that gender did play a role in progression to adult obesity, as 37% of males and 51% of females in the study became severely obese in adulthood.
Understanding the Cause of Childhood Obesity
The Effects of Super Sizing and Fructose
Ending the Obesity Cycle
The latest research shows that the obesity trend will continue through 2050, peaking at 42% of all men, women and children. While these numbers are devastating, they can be reversed with a plan to prevent overweight and obesity in adolescents. Studies show that eliminating the dietary and environmental factors that lead to excess weight can prevent the onset of health conditions that will plaque children into adult life.
A study published in the American Journal of Clinical Nutrition shows that a plant-based diet seems to be a sensible approach for the prevention of obesity in children. While a strict vegetarian diet may not be the answer for all children, lowering caloric intake from fast food restaurants and limiting fructose from sweetened beverages and processed foods will provide immediate results. Children can make dietary and lifestyle changes easier than adults, and just need a little parental encouragement to alter the obesity cycle, lower disease risk in later life and improve longevity.
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