Noteworthy 1.0

Noteworthy stuff that has crossed my desk in recent days:

- It’s all about the nicotine: Efforts to reduce the health impact of tobacco use have historically concentrated on two key strategies: finding ways to help people successfully stop smoking, and preventing them from starting the habit in the first place. But in a rather striking development, a group of tobacco research and policy experts recommends giving new priority to the development of lower-nicotine cigarettes that are less addictive.

The thinking is that by lowering the nicotine level in cigarettes, current smokers will be less likely to become dependent. Also, adolescents might be less likely to experiment with smoking and progress into addiction. The proposal appears in the most recent edition of the Tobacco Control journal.

At first glance, it seems counterintuitive. Why would you focus on reducing the nicotine level in cigarettes, yet allow the behavior itself, i.e. smoking, to continue? But the researchers explain that prior studies suggest smokers won’t necessarily just smoke more to make up for the lower amount of nicotine in each cigarette; often they’ll smoke fewer cigarettes and many of them eventually quit altogether.

The authors of the Tobacco Control article think this strategy could reduce the prevalence of adult smoking in the U.S. from 20 percent, which is the current number, to 5 percent. It should be noted that the researchers include some heavy-hitters from Minnesota: Dr. Dorothy Hatsukami, who is director of the University of Minnesota’s Tobacco Use Research Center and the Masonic Cancer Center’s Cancer Control and Prevention Research Center, and Mark LeSage of the Minneapolis Medical Research Foundation and University of Minnesota.

- Reading the fine print: OK, so the health care reform law is controversial. But look at what it’s delivering to Minnesota: nearly $3.4 million in grant money to help boost the supply of health care professionals, especially in primary care.

Here’s how the money is being distributed: $1.3 million to the College of St. Scholastica in Duluth to expand the number of slots in its training program for primary care nurse practitioners and nurse midwives; $1.9 million to Hennepin Healthcare Systems to increase the number of primary care residencies for physicians in training; and a $149,000 planning grant to the Minnesota Department of Employment and Economic Development so it can assess the state’s current health care workforce and develop a plan to address the gaps.

Nationally, the Affordable Care Act is allotting a whopping $320 million to strengthen the health care workforce in the U.S. The grants are being coordinated through the U.S. Department of Health and Human Services.

Grouse all you want about the health care reform bill and its 2,000-page heft; this is one juicy tidbit that could prove to be enormously beneficial for the future of primary care.

- The kids are all right: How are the kids doing? They’re all right, at least in Minnesota – but there are hints of trouble, according to a newly released report from Children’s Hospitals and Clinics of Minnesota.

A couple of key findings: Children in Minnesota fall below the national average in childhood obesity. Among Minnesota children ages 10 to 17, 11 percent are considered obese; the national average is 16 percent. Almost three-fourths of children in the seven-county Twin Cities metro area also live in households with private insurance coverage.

Although this sounds encouraging, a closer look at the data reveals several areas of concern. Children from lower-income families aren’t as healthy as those from households that are better off. These youngsters also are less likely to have access to health care. There’s also considerable variation in health care coverage across the state. Nearly 13 percent of children in northwestern Minnesota are uninsured, and the lack of dental insurance is highest in the west central and southwestern parts of the state.

The report is the first in a series of whitepapers by Children’s Hospitals and Clinics, examining some of the most critical current issues facing children’s health. Data for the reports is analyzed by the State Health Access Data Assistance Center at the University of Minnesota.

Look for these issues to come up in the Minnesota governor’s race. On Oct. 11, Children’s Hospitals and Clinics and the Minnesota Early Learning Foundation will host a debate featuring all three candidates – Mark Dayton, Tom Emmer and Tom Horner – from noon to 1 p.m. at the Minnesota Children’s Museum in St. Paul. Can’t be there in person? Participate through social media channels at www.minnesotachildrensforum.org.

- Going local: How feasible is it for hospitals to buy local foods? Nearly 40 health care facilities in Maryland and Washington, D.C., gave it a try this summer, serving at least one food from a local farmer each day during a weeklong Buy Local Challenge. Collectively they spent more than $15,000 on fruits, vegetables, eggs and meat from local farms. More than half of the hospitals who joined the challenge were already buying local fruits and vegetables during the growing season.

Obviously there are challenges for hospitals who want to go local with some of their food purchases. Cost and institutional efficiency are major issues, as are nutritional requirements. There are also the medical needs of patients to consider. (Would lime Jell-O qualify as a local food?) Still, it’s an area in which hospitals can potentially set a community example in healthful, sustainable food choices.

Until I saw this news release, I wasn’t aware there’s an international organization called Health Care Without Harm, and that it has a “Healthy Food in Health Care Pledge” that to date has been signed by more than 300 U.S. hospitals. The pledge commits these hospitals to gradually increasing the amount of local and sustainably produced foods they serve to patients, staff, visitors and surrounding communities.

- Dog-gone amazing: We’ve all heard of service dogs and therapy dogs, and the benefits they can bring to their human companions. It seems some service dogs are now taking on a new role – sniffing out diabetes.

Assistance Dogs of the West in Santa Fe, N.M., is training dogs to detect the rise and fall of blood sugar levels via the scent of skin and breath in a person with diabetes. ADW says they placed a scent-trained dog with a man with diabetes just last month.

I’ve always thought dogs were amazingly wonderful creatures but this sounded rather far-fetched, so I did some online research, and sure enough, a small handful of studies have found that some dogs can tell when their human is having a hypoglycemic attack and can be trained to sound an alert. It’s obviously a huge leap to suggest people with diabetes would benefit from having a service dog, nor does there appear to be any scientific evidence yet that would support this. But to those of us who love animals, it’s a nice reminder of how smart and how aware the canine species can be and why it’s good to have dogs in our lives.

HealthBeat photo by Anne Polta

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