Linkworthy 2.0

Many people I know seem to have been spending the past couple of weeks in a state of semi-hibernation, emerging from their homes only long enough to go to work and run a few essential errands. These cold, snowy winter days can be a great time to do some reading, so here’s a roundup of various interesting/thought-provoking/informative items I’ve run across recently online.

– Most of us have probably heard of the term "herd immunity," but do we fully understand what it means – and the extent to which it can be compromised if we start skipping childhood immunizations? A story in USA Today explores the implications, using several tragic real-life examples, including two from Minnesota families. The article was sparked by a study, published this week in the Archives of Pediatrics and Adolescent Medicine, that found that unvaccinated children are significantly more likely to get sick with whooping cough or chickenpox.

An excerpt from the USA Today article:

Danielle Romaguera’s daughter, Gabrielle, was only 7 weeks old when she died from whooping cough – one week before she would have received her first shot.

Shannon Duffy Peterson of Minnesota says she realized the dangers of diseases such as chickenpox and pneumococcus only after her children became ill. She didn’t vaccinate her son or daughter against either disease after their pediatrician said the shots weren’t needed.

In 2001, both children were hospitalized because of a bacterial illness called invasive pneumococcal disease. Her 5-year-old son survived. Her daughter, Abigale, who was two weeks shy of turning 6, died.

The story is accompanied by an eye-catching chart that shows the change in the average annual number of deaths, before and after effective vaccines were introduced, on common childhood infectious diseases such as diphtheria, measles, rubella and whooping cough.

– Believe it or not, the growth of health care spending in the United States apparently slowed in 2008, at least according to figures newly released by the Centers for Medicare and Medicaid Services. The summary, which uses data collected by the National Health Expenditure Accounts:

U.S. health care spending growth decelerated in 2008, increasing 4.4 percent compared to 6.0 percent in 2007. Total health expenditures reached $2.3 trillion, which translates to $7,681 per person or 16.2 percent of the nation’s gross domestic product. The health spending share of GDP reached 16.2 percent, up from 15.9 percent in 2007.

You can read more highlights here, here and here.

– Should people with chronic illnesses have children? More to the point, how do individuals with chronic illness feel when other people presume to judge their childbearing choices? This question gets Laurie Edwards, who blogs at A Chronic Dose, all riled up. She writes:

I completely understand and respect women/couples who, given their particular life and health situations, decide pregnancy – and perhaps parenthood itself – is not for them. (I am focusing on this in relation to chronic illness; I realize these family-building decisions are incredibly complex absent chronic illness, too.)

But what bother me are the blanket generalizations that people with chronic illness shouldn’t have children because they will pass on their bad genes and/or because that child’s quality of life will not be what it could (should?) be if a parent is sick.

Read the whole post; it’s thoughtful and thought-provoking.

– Americans may be living longer, but the end often can be preceded by increasing debilitation, or what this entry from The New Old Age blog at the New York Times calls "the frail years." Many seniors and their families don’t take this into account, however, as they make health care decisions and plans for their future – and perhaps they should, suggests author Paula Span. She notes that more than two-thirds of Americans who are 65 years old will at some point need assistance to cope with daily living.

– The patient, a vigorous man in his early 60s, had pancreatic cancer, and it fell to Dr. Richard Frank, his new oncologist to break the bad news. In these situations, what do you say to the patient and his family? What is it like to tell a family something that will permanently alter their lives? In the latest issue of the Journal of Clinical Oncology, Dr. Frank reflects on this task, which he describes as "the hardest job in medicine." Read all the way to the end to discover how it turned out.

– Finally, stay tuned later this month for a local connection that’s scheduled to be featured on National Public Radio. Reporters from Minnesota Public Radio interviewed a Dawson-area family last week about music therapy in hospice care, and specifically about the Reverie Harp, which was introduced this past year by Rice Hospice. Rice Hospice staff were interviewed as well. The segment is supposed to air Jan. 26-28 for the "Music That Matters" segment at the end of NPR’s "Performance Today" program, at 12:45 p.m.

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