Staying Well Connecteds

Staying Well. Connected.

Forecast: 90% of Mexico’s population overweight/obese by 2018

A recent report by the Instituto Mexicano del Seguro Social (IMSS) indicates that if current trends continue over the next ten years, the percentage of the Mexican population considered overweight (BMI between 25 and 30) or obese (BMI over 30) could rise as high as 90% by 2018.

Although the press release indicates the percentage of Mexico’s population that is overweight or obese places it second only to the US in that category, that ranking may change soon if it has not already. The 2006 Encuesta Nacional de Salud y Nutrición placed that figure at nearly 70% for adults over age 20 in Mexico, compared with 66% for US adults over age 20 published in NCHS’s 2003-2004 National Health and Nutrition Examination Survey.

In the IMSS press release, specialists from the Department of Nutrition & Dietetics at the IMSS’s Centro Médico Nacional La Raza indicate that globalization has brought to Mexico not only lifestyle changes, but also changes in nutritional habits:

“We are suffering a dietary transition, in which we are changing our nutritional habits, leaving aside the traditional diet, which was based on grains, corn and … giving way to the culture of fast-food diets,” confirmed nutritionist Dr Georgina Nanclares Delgado.

Dr Rosa María Andrade García said Mexicans’ diets are becoming more and more like those of industrialized countries like the United States and China. At the same time, sedentary lifestyles are becoming strongly prevalent. “This transculturization is affecting us, we are taking on behaviors of other countries which really bring a certain type of diet which harms us, consuming large quantities of energy [calories], proteins and supersaturated fats, but with little fiber, vitamins and minerals,” she indicated.

Funding Received for Valley Stroke Center

The results of having a stroke can be debilitating and life-changing. But learning how to prevent and best treat a stroke once it has occurred are primary concerns of the Hispanic Stroke Center for Excellence. Thanks to $170,000 in federal funding received by the Valley Baptist Medical Center, the programs of the Stroke center can be expanded, and more can be done to make the Harlingen community aware of stroke prevention and treatment.

The money will be used to expand community-education programs and gather information on health problems in the Rio Grande Valley. Likely, the funds will be used to develop educational materials, offer more health screenings, and conduct preliminary research on Diabetes…a known risk factor for stroke. As U.S. Rep. Solomon Ortiz, D-Corpus Christi said in a statement…”We need to be more aggressive in educating citizens on the causes of stroke, and the Hispanic Stroke Center of Excellence will prove to be an important tool in our struggles against the disease.”.

Surgeon General’s Workshop on Improving Health Literacy

Proceedings from the Surgeon General’s Workshop on Improving Health Literacy, held on September 7, 2006, were recently made available on the DHHS Web site. A separate panel focused on the needs of special populations, with findings and recommendations especially relevant to health literacy initiatives in South Texas and along the US-Mexico border.

Helping doctors help patients learn online

A number of items in the medical news and blogosphere over the past week have focused on patients who research their own (or their friends’ and family’s) health conditions online, and how those patients relate to their doctors.

First, the Center for Medicine in the Public Interest released a report entitled “Insta-Americans: The Empowered (and Imperiled) Health Care Consumer in the Age of Internet Medicine” [856 KB PDF] which led to a certain amount of press coverage (like this TV news item from KVUE-24 in Austin) looking at the high proportion of health-related search results that point at unreliable sources. It’s too bad the CMPI missed a really good opportunity to promote specific reliable health search sites, but fortunately they did reiterate 10 of the 12 items the National Cancer Institute’s excellent guide, “How to Evaluate Health Information on the Internet.”

Second, pediatrician Rahul Parikh MD wrote a piece entitled “Is There a Doctor in the Mouse?” in the online magazine Salon, which responded in part to a November article, “When the Patient is a Googler,” by Time magazine medical writer Dr Scott Haig. Parikh says in part:

“…a 2001 study of doctors showed that barely half of them encouraged their patients to go online (although the trend has been increasing over time), and 80 percent actually warned them against doing so. In one regard, this is simply bad business. Pew tells us that patients either fire doctors unwilling to help them with the Web or keep going online without telling them. More important, when patients do venture online themselves, they can sink into a swamp of outdated medical studies, confront a lot of misinformation, and risk creating a rift in the doctor-patient relationship.”

Like the CMPI report, Parikh cites the struggle that doctors have had against Internet misinformation regarding “links” between vaccines and autism. But Parikh sees that struggle as an argument for doctors to better engage the Internet, point their patients toward reliable sources, and promote Open Access medical literature that can help to rebut and dispel the misinformation. He continues:

“Today, there are many accurate, high-quality health sites, and doctors should make it a standard practice to recommend them to each and every patient. Besides reducing the randomness of a Web search, this can reinforce a physician’s advice during a visit, which is especially helpful, as studies show that patients typically remember no more than half of what their doctor tells them.”

For public health practitioners, the act of going to see a doctor is evidence of a patient’s motivation to improve his or her health, so it’s an optimal time to harness that motivation by proposing healthier behaviors. Librarians, likewise, know that when a patron is motivated to address a particular information need, it’s a particularly “teachable” moment to introduce effective information-seeking behaviors. When patients come to their doctors with information they have found on the Internet, doctors can either look at it as a threat, or as an opportunity to engage a motivated and interested patient to take responsibility for his or her health information needs.

As librarians, how can we help? One small way is to encourage doctors to engage their patients and direct them to reliable online sites with materials like the new “MedlinePlus for Health Professionals” brochure [PDF format] [Word format] and materials from the InformationRx Store. It’s unfortunate that both CMPI and Parikh missed out on mentioning MedlinePlus — because it’s a lot to ask of doctors to keep up with the huge proliferation of consumer health sites as well as their own professional online resources, but if we can start with just one site they can consistently feel confident recommending to their patients, MedlinePlus is a great place to start.

National Maternal and Child Oral Health Resource Center

The National Maternal and Child Oral Health Resource Center (OHRC) addresses the current and emerging public oral health issues. They support the health professionals, educators, and others who have a goal of improving oral health services for the public. The OHRC collaborates with agencies, foundations, and associations to develop and gather quality health information. They also offer a library of free publications for those interested in public oral health issues. You can read more details about the OHRC and their services on their fact sheet.

Upcoming Women’s Health Conference in Laredo

Texas A&M International University and KLRN have joined together to bring the Women’s Health Conference to the TAMIU Student Center in Laredo, on Saturday, Jan. 19.

The purpose of the conference is to help women make informed choices about their health through the exchange of information in the form of speakers, breakout sessions, and health screenings.

Women need 400 mcg of folic acid daily

The CDC says that women who could become pregnant need 400 mcg (micrograms) of folic acid every day. Folic acid, which is a B vitamin, stimulates the formation of new cells. Most important, it helps to prevent birth defects. If a woman has enough folic acid in her body before and while she is pregnant, her baby is less likely to have a major birth defect of the brain or spine. Since these birth defects occur early in the fetal growth period, it is important that women get enough folic acid even before becoming pregnant. One easy way a woman can be sure she is getting enough folic acid is to take a vitamin that has folic acid in it every day. Read the whole discussion of the importance of folic acid at http://www.cdc.gov/Features/FolicAcid/.

“Ready or Not? Protecting the Public’s Health from Disease, Disasters, and Bioterrorism”

The fifth annual report, “Ready or Not? Protecting the Public’s Health from Disease, Disasters, and Bioterrorism,” from the Trust for America’s Health was released in December 2007. “Ready or Not?” includes state-by-state health preparedness scores based on 10 indicators to assess health emergency preparedness capabilities.

According to the report, Texas scored 8 out of the possible 10 points. Information on emergency preparedness in Texas (details in both English and Spanish) is available from the Texas Department of State Health Services at http://www.dshs.state.tx.us/preparedness/default.shtm

January is National Birth Defects Prevention Month

According to the March of Dimes website, Hispanics are the largest and fastest growing ethnic group in the United States. Hispanic woman of childbearing age (15-44 years) give birth to nearly one-quarter of the babies born in the United States each year. The March of Dimes also reports that nearly one out of every eight Hispanic babies is born too soon. While the preterm birth rate for Hispanics is similar to rate for the general population, it has grown more than 8 percent in the last decade.

Prematurity is the leading killer of newborns in America and babies who survive often face the risk of lifelong disabilities such as cerebral palsy and mental retardation, chronic lung disease, and vision and hearing loss, as well as other developmental problems.

The March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For more quick reference information and fact sheets go to March of Dimes site for professionals.

The March of Dimes website is also available in Spanish: http://nacersano.org/.

Promotional materials (in English & Spanish) for 2008 Birth Defects Prevention Month may be found at the National Birth Defects Prevention Network (NBDPN) website.

Parent/family-centered interventions and Hispanic youth risk behavior

A recent Science Update from the National Institute of Mental Health highlights a new study that appears in the Dec 2007 issue of the Journal of Consulting and Clinical Psychology. The study suggests that interventions focused on strengthening the family system, including interventions with parents to encourage involvement and improved communication, may be more effective in reducing Hispanic teen risk behaviors than interventions that target those behaviors specifically. University of Miami researchers randomly assigned Hispanic eighth-graders and their primary caregivers to one of three combined interventions for a period of one year:

  • Familias Unidas plus Parent-Preadolescent Training for HIV Prevention (PATH)
  • English for Speakers of Other Languages (ESOL) plus PATH
  • ESOL plus HeartPower for Hispanics, an American Heart Association program

“Familias Unidas plus PATH was designed to promote positive adolescent development by increasing parental involvement and teaching more effective parental communication techniques. The program was designed to be more consistent with Hispanic cultural expectations, in which life is family-centered and vital to an individual’s emotional support. PATH is designed to specifically increase parent-adolescent communication about sexual behavior and HIV risks, but it does not target family dynamics specifically. HeartPower for Hispanics is designed to encourage healthier behaviors among Hispanic youth to reduce obesity and heart disease risks.”

Assessments at midway through the intervention year, at the end of the intervention year, and one and two years afterwards showed that the Familias Unidas + PATH intervention was:

  • more effective than either of the other two in reducing cigarette use,
  • more effective than ESOL + HeartPower in reducing illicit drug use, and
  • more effective than ESOL + PATH in reducing unsafe sexual behavior.

The researchers caution that Mexican-Americans, which represent the majority of Hispanic residents of the US, were not well-represented in their study, so they encourage further study of the effectiveness of family-centered interventions among Mexican-Americans before generalizing the results to the wider US Hispanic population — certainly an opportunity for researchers here in South Texas.

Prado G, Pantin H, Briones E, Schwartz SJ, Feaster D, Huang S, Sullivan S, Tapia MI, Sabillon E, Lopez B, Szapocznik J. A randomized controlled trial of a parent-centered intervention in prevention substance use and HIV risk behavior in Hispanic adolescents. J Consult Clin Psychol. 2007 Dec; 75(6): 914-926. doi: 10.1037/0022-006X.75.6.914 PubMed link