Weekly this and that - Jan. 4, 2007

There was a nice range of health stories in the news in the past week; here are a few that piqued my interest.

Dieting articles and disordered eating

The Associated Press reported this week that girls who read magazine stories on dieting demonstrate unhealthy weight-loss measures, such as fasting and cigarette smoking, five years later. I am concerned about this, and I'm not saying it isn't true, but much as I would like to say "See? I told you the media had an impact," I don't think this observational study rises to the level of cause and effect. Although the study took into account whether girls were concerned about their weight to begin with or not, there are just too many other factors that could contribute to disordered weight loss strategies to make this study believable. Other factors I would've considered: What else did girls read? what did they take away from the articles? what about physical activity?

I'd be interested to hear more thoughts.

In the "too much medicine" department...

Gil Welch, Lisa Schwartz, and Steve Woloshin had an essay in this Tuesday's New York Times health section on the epidemic of diagnoses.

They conclude:

As more of us are being told we are sick, fewer of us are being told we are well. People need to think hard about the benefits and risks of increased diagnosis: the fundamental question they face is whether or not to become a patient. And doctors need to remember the value of reassuring people that they are not sick. Perhaps someone should start monitoring a new health metric: the proportion of the population not requiring medical care. And the National Institutes of Health could propose a new goal for medical researchers: reduce the need for medical services, not increase it.

Or as my former boss used to say, "The definition of a well person is someone who hasn't been worked up sufficiently."

Also in this department is a new study from the University of Michigan showing that a third of implanted cardioverter defibrillators - devices that restore heart rhythms - are unnecessary. As you can imagine, these things are quite expensive, with a $90,000 lifetime price tag. The good news, according to the study authors, is that a simple heart rhythm test can distinguish patients who will benefit from the device from those who won't.

the "too much drug advertising" department...

Drug advertising costs are up 9% from last year. Thanks to the Health Wisdom Blog for pointing out this item in BrandWeek. According to the article, pharmaceutical companies spent $4.1 billion on advertising last year. All of us are paying those bills.

and the "in case you were worried it was all bad news" department...

After last January's depressing stories in the New York Times on diabetes in New York City, this one cheered me up considerably: it's an effort by the city of Asheville, NC, to offer preventive diabetes care and free diabetes medicine to municipal employees via specially trained pharmacists. The 10-year-old program has resulted in a doubling of the number of employees with their blood sugar under control and lower health care costs for the city; they estimate annual savings of $2000 per patient.

A call to action: improving the culture of aging

Abigail Trafford offers an inspiring, multilevel agenda for improving the lives of older people - which will be most of us someday, let's not forget - in her column in this past Tuesday's Washington Post. I particularly noted this item:

Expose ageism. Prejudice against older people is insidious. In a recent study by the International Longevity Center in New York, researchers found bias and negative stereotyping in many arenas, from health care to the media. Discrimination in the workplace is so prevalent that AARP advises people of a certain age not to list age or graduation dates on their résumé.