TIME Asthma

Study: Fear of Job Loss Can Increase Asthma Risk

The report looked at German adults during the recent economic downturn

Fear of losing one’s job can cause a marked increase in the risk of developing asthma, according to a new study released Tuesday.

The study, published online in the Journal of Epidemiology and Community Health, found that for every 25% increase in job security that a worker felt, that worker’s likelihood of developing asthma increased by 24%. For people who told researchers it was more likely than not that they would lose their job, the risk of developing asthma climbed 60%.

Fear of losing one’s job has been linked to a number of negative health outcomes, but this is the first time it has been linked to the risk of developing asthma, the study’s authors said.

The study surveyed the records of more than 7,000 working German adults between 2009 and 2011, a time in which European economies were in downturn.

TIME Soccer

FIFA May Mandate Concussion Breaks in Soccer Games

Germany v Scotland - EURO 2016 Qualifier
Christoph Kramer of Germany jumps for a header Boris Streubel—Getty Images

After head injuries marred this summer's World Cup

FIFA’s medical committee proposed a new policy Tuesday that would require a three-minute stop if a player is suspected of suffering from head trauma.

“The incidents at the World Cup have shown that the role of team doctors needs to be reinforced in order to ensure the correct management of potential cases of concussion in the heat of the competition,” the committee said in a release. “The referee will only allow the injured party to continue playing with the [authorization] of the team doctor, who will have the final decision.”

The proposal has been sent to the FIFA Executive Committee, which will vote on the matter.

In this summer’s World Cup, controversy arose when Uruguay’s Alvaro Pereira was allowed to stay in the game after taking a knee to the head, while dazed German midfielder Christoph Kramer was allowed to play for 14 minutes after a collision that left him so disoriented, he asked the ref “Is this the final?” (It was).

According to the Center for Injury Research and Policy, more high school soccer players suffered from head injuries in 2010 than softball, wrestling, basketball, and baseball players combined. And these sustained injuries can have lasting health repercussions: Although Brazilian soccer star Bellini, winner of the 1958 World Cup, was thought to have died due to Alzheimer’s complications in March at age 83, new research reveals that he actually suffered from a degenerative brain disease also afflicting many boxers and football players.

 

TIME Obesity

Are Diabetes Rates Really “Leveling Off”?

For the first time in several decades, we’re starting to see a slowing of new diabetes diagnoses, suggests new data published in JAMA.

The study authors examined data collected from more than 600,000 adults between ages 20-79 from 1980 to 2012—part of the Centers for Disease Control and Prevention (CDC)’s National Health Interview Survey. A broad view paints a grim picture: From 1990 to 2008, the prevalence of diabetes as well as new cases of the disease both doubled. But from 2008-2012, those rates of change leveled off. So while people are still being diagnosed with diabetes, the rate of growth is decelerating.

“It’s encouraging that we may be seeing this slowing and plateauing,” says Ann Albright, PhD, RD, director of the division of diabetes translation at the CDC and one of the study’s authors. The study cites a slowing of rates of obesity—one of the biggest contributors to type 2 diabetes, found one study—as a partial explanation for the results. Black and Hispanic adults, however, have continued to see a rise in new diabetes cases, and prevalence also grew among people with a high school education or less. These disparities, Albright says, could get worse.

“This data is telling us that we are doing some things right,” Albright says, which is especially important given that the population is aging, and baby boomers are hitting peak years for diabetes. Driving down diabetes prevalence is great, but the best way to get there is to curb new cases—not to have people in the diabetes pool die off early, she adds.

“[This study] is important to note, but it doesn’t mean we have this licked and we’re all done,” she says. “We still have a lot of work to do.”

TIME politics

Lawmakers Push Increased Access to Emergency Contraception

Bipartisan U.S. Budget Deal Said to Ease Automatic Spending Cuts
Sen. Patty Murray (D-Wash.), who introduced a bill to increase access to emergency contraception. Bloomberg—Bloomberg via Getty Images

Bill comes ahead of a midterm elections in which women are expected to be a key voting bloc

Updated: September 23, 4:40 p.m. ET

Five Democratic senators introduced legislation Tuesday that would require any federally-funded hospital to provide emergency contraception to rape survivors.

The Emergency Contraception Access and Education Act of 2014 was introduced by Sen. Patty Murray (D-Wash.), with Sens. Elizabeth Warren (D-Mass.), Barbara Boxer (D-Calif.), Richard Blumenthal (D-Conn.) and Cory Booker (D-N.J.) signing on as co-sponsors. The bill would ensure that any hospital receiving Medicare or Medicaid funds provides accurate information and timely access to emergency contraception for survivors of sexual assault, regardless of whether or not they can pay for it. It would also require the Secretary of Health and Human Services to disseminate information on emergency contraception to pharmacists and health care providers.

“As we saw in the aftermath of the Hobby Lobby decision, and as we’ve seen in state legislatures across the country, Republicans are intent on standing in the way of women and their ability to make their own decisions about their own bodies and their own health care,” Senator Murray told TIME. “This means, now more than ever, it is our job to protect these kinds of decisions for women, their families, and particularly for survivors of sexual assault. Emergency contraception is a critical part of these family planning choices and it’s time Republicans join us in supporting this safe and responsible means of preventing unintended pregnancies.”

“It is unacceptable that a survivor of rape or incest can be denied access to emergency contraception in the emergency room, and therefore forced to carry a pregnancy caused by her attacker,” Planned Parenthood president Cecile Richards said in a statement. “Decisions about emergency contraception, like all forms of birth control, should be between a woman and her doctor, not her pharmacist, her boss, or her Congressman.”

The bill may face opposition from congressional Republicans, and comes just two months before the midterm elections, in which many expect women to be a decisive voting bloc.

TIME Food & Drink

Coke and Pepsi Pledge to Cut Calories

Coca-Cola, PepsiCo and the Dr Pepper Snapple aim to lower calorie consumption by 20% over the next 10 years

The country’s three largest soda companies promised Tuesday to reduce the calories in sugary drinks by 20% over the next decade, an unprecedented effort by the beverage industry to fight obesity in the U.S.—and a tacit recognition of consumers’ increasing aversion for high-calorie soft drinks.

Coca-Cola, PepsiCo and the Dr Pepper Snapple will expand the presence of low- and zero-calorie drinks and sell drinks in smaller portions, as well as provide calorie counts and promote calorie awareness where their beverages are sold, the American Beverage Association said in a statement.

The commitment was announced at the 10th annual Clinton Global Initiative in New York.

“This is huge,” former President Bill Clinton told the New York Times. “I’ve heard it could mean a couple of pounds of weight lost each year in some cases.”

Consumers over the next 10 years will see the beverage giants’ new marketing strategy and product mix everywhere from company-owned vending machines and coolers in convenience stores, to fountain soda dispensers in fast-food restaurants and movie theaters, to grocery store sales and end-of-aisle promotions.

“This initiative will help transform the beverage landscape in America,” said Susan K. Neely, president of the American Beverage Association in a statement. “It takes our efforts to provide consumers with more choices, smaller portions and fewer calories to an ambitious new level.”

Read more from the American Beverage Association here.

TIME Mental Health/Psychology

70% of People Suffer After Violent Crime, But Few Get Help

Victims who knew the perpetrator were more likely to report it

Nearly 70% of people endure severe social or emotional problems after being the victim of a violent crime, but only about 12% of those who had problems received help from victim services, according to a new report from the Department of Justice. Just over half of victims who suffered from socio-emotional problems reported the crime to the police.

“A victim with socio-emotional problems may experience a range of emotional and physical symptoms,” the report reads, citing anxiety, trouble sleeping and depression.

Trends varied across demographic groups, particularly gender. Women were much more likely than men to experience socio-emotional problems. Nearly 80% of women who suffered from a serious violent crime said they had such problems, while only 58% percent of their male counterparts said the same.

Whether the victim knew the crime’s perpetrator also affected whether they experienced social or emotional problems. Victims harmed in acts of intimate partner violence were more likely to experience issues, regardless of the type of crime. Nearly three in four victims of intimate partner violence suffered from physical problems, with 61 percent saying they had trouble sleeping.

The report, which looked at data from more than 160,000 people across the U.S., also found low rates of reporting violent crime. Only about a third of victims who experienced severe distress reported the crime to the police. About half of victims who knew the perpetrator reported the crime, while 41% of those who didn’t know the offender did so.

TIME Exercise/Fitness

We Drink More Alcohol When We Exercise

gym treadmill
Getty Images

First we sweat, and then we swig: A new Northwestern Medicine study published in the journal Health Psychology finds that people tend to drink more alcohol on days they’ve exercised.

The study looked at 150 adults between the ages of 18-89 who used a smartphone app to record how much they exercised each day — and how much alcohol they drank for three weeks at different points of the year.

Previous studies have found that the more active among us are also the larger lushes. But this study didn’t exactly confirm that. Instead, the stronger link occurred between exercise days and the number of drained glasses, with beer being the most popular post-workout alcoholic beverage. Both physical activity and alcohol intake increased Thursdays through Sundays. Even after the researchers controlled for the fact that people have more alcohol-related social events on the weekend, that many prefer to drink primarily on weekends, and that drinking patterns often differ by season, the association still stuck.

The scientists aren’t sure why there’s such a close link, but they have some ideas. “It could be that people who are more physically active on a given day have to use all their willpower and cognitive resources to get themselves to be active, and they don’t have enough willpower left to resist the temptation of a drink at the end of the day,” says David E. Conroy, lead study author and professor of preventive medicine and deputy director of the Center for Behavior and Health at Northwestern University Feinberg School of Medicine. Other possible reasons: people proud of their workout might want to reward themselves for being good, socialize further over drinks, or even (mistakenly) view alcohol as a good way to replenish fluids, the study says. But other studies show that too much alcohol can negate some of the good that exercise does — in addition to adding calories after a hard-earned burnoff, alcohol might even impair muscle recovery.

If “dehydrate to rehydrate'” is your motivation to get to the gym, you’re not alone. But it might be time to choose a different mantra.

TIME Healthcare Policy

Getting Poor to Get Help: How a Tragic Accident Trapped My Family in Poverty

Trapped in America's Safety Net
Trapped in America's Safety Net Courtesy University of Chicago Press

Campbell is the author of the new book, Trapped in America’s Safety Net: One Family’s Struggle.

When Andrea Louise Campbell's sister-in-law was horribly injured, she and her family had to spend down their money and assets to get the medical care they needed

Nearly one-third of American households live in or near poverty. The causes are myriad – and much contested. Those on the political right tend to cite the personal shortcomings of poor individuals while those on the left blame systemic barriers to upward mobility. But as my family has painfully learned, there is another shocking cause: government policy.

In February 2012 my sister-in-law Marcella was in a car accident on her way to nursing school, where she was working towards a career which she hoped would catapult her and my brother Dave into middle-class security. Instead, the accident plunged them into the world of American poverty programs. Marcella is now a quadriplegic, paralyzed from the chest down. She needs round-the-clock personal care and assistance. The only source – public or private – for a lifetime of such coverage is Medicaid. But because Medicaid is the government health insurance for the poor, she and my brother must be poor in order to qualify. (Medicare does not cover long-term supports and services, and private long-term care insurance is time-limited and useless to a 32-year-old who needs decades of care). Thus, Marcella and Dave embarked on a hellish journey to lower their income and shed their modest assets to meet the state limits for Medicaid coverage.

To meet the income requirement, my brother reduced his work hours to make just 133 percent of the poverty level (around $2,000 per month for their family). Anything he earns above that amount simply goes to Medicaid as their “share of cost” – a 100 per cent tax.

Worse: the asset limit. In California, where they live, they can own only $3,150 in assets beyond their home and one vehicle. They’re “lucky,” a social worker tells Dave: if not for the baby (Marcella was pregnant at the time of the accident; the baby miraculously survived), the asset limit would be $3,000. As if you can raise a child on $150. This asset limit was last raised in 1989. It has fallen by half in real value since then.

Dave and Marcella began to liquidate. Under California rules, retirement plans are not exempt from the asset test. Marcella had to cash in a small 401(k) account from a previous job, paying the early withdrawal penalty to boot. Dave had to abandon his hobby, working on old cars, which violated the asset test. He sold them all, keeping a 1968 Datsun pickup because its tiny value didn’t impinge on the asset limit. The pickup is 45 years old, weighs less than a Miata, and has no modern safety features. The only able-bodied adult in the family has to drive to work in an unsafe vehicle. And they had to empty their bank account, watching their hard-earned security disappear.

As Dave and Marcella spent down their assets, they had to keep track of every penny. They could only put the money into the exempt items, the house and the used wheelchair van they bought for Marcella. They could not use the money to pay credit card bills, household bills, or Marcella’s student loans from her undergraduate degree. And they are barred from doing any of the things the middle class is constantly advised to do: save for retirement. Create an emergency fund. Save for college with a tax-free 529 plan. Just $3,150 in assets – that’s it.

What happens in an emergency? One day the van’s wheelchair ramp stopped working. The repair cost $3,000—the sum of their meager assets. Fortunately their tax refund had just come in and went straight back out to pay for the repair. We don’t know what they’ll do next time.

What would help folks like Marcella and Dave?

True universal health insurance. A universal social insurance program for long-term care, not just Medicaid. And one modest change: no asset test. Policy is already trending in that direction. Under the Affordable Care Act, those newly eligible for Medicaid face no asset test. (Unfortunately those in the original eligibility categories, including the disabled like Marcella, are still under the old rule.) About half of the states have no asset test for any Medicaid recipient; perhaps someone realized that trying to ferret out the tiny amount of resources most Medicaid applicants have is inefficient. As for Dave and Marcella, I suppose they might move to a state with more generous rules. However, no state helps with wheelchair renovations. Lacking the assets to buy a new house elsewhere, they must remain in the home their friends renovated for them on an entirely volunteer basis.

It’s bad enough that America’s system of social supports is so limited. That the government also forces some of its citizens to get poor to get the help they need is an abomination.

 

Andrea Louise Campbell is professor of political science at the Massachusetts Institute of Technology. She is the author of Trapped in America’s Safety Net, out this month.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Infectious Disease

CDC: Cases of Ebola Could Double Every 20 Days

Members of a burial team wearing protective suits bury an Ebola victim in Freetown, Sierra Leone.
Members of a burial team wearing protective suits bury an Ebola victim at King Tom Cemetery, which is bitterly resented by residents of the adjoining slum, called Kolleh Town, in Freetown, Sierra Leone, Sept. 21, 2014. Samuel Aranda—The New York Times/Redux

A new CDC report predicts the enormous cost of delayed response to Ebola

If Ebola conditions continue without a scaled-up effort, the CDC estimates that cases of Ebola in West Africa will double every 20 days — and in an absolute worst-case scenario without any intervention, numbers could reach 1.4 million by Jan. 20.

Using a new Ebola Response prediction tool, the CDC has published results that show that if current trends continue unimpeded, Liberia and Sierra Leone will have approximately 8,000 total Ebola cases, or 21,000 if the tool accounts for underreporting, by Sept. 20. Liberia will account for about 6,000 of those cases.

The numbers are frighteningly high, but it should be noted that it’s a prediction of a hypothetical situation in which absolutely no intervention were to happen. That won’t be the case if many countries and the UN keep their promises. The model also shows that a big response could turn the outbreak around. In another hypothetical situation, the outbreak could ease up and eventually end if 70% of people with Ebola are placed in medical care facilities, Ebola treatment units, or somewhere where transmission could be contained.

“The model shows that a surge now can break the back of the epidemic,” said Dr. Tom Frieden, director of the CDC, in a press conference. “The importance of implementing effective programs rapidly cant be over-emphasized. The cautionary finding of the modeling is the enormous cost of delay.”

During the press conference, Dr. Frieden said the outbreak is very fluid and changing, but that he does not think West Africa will meet their worst case scenario predictions. “If you get enough people effectively isolated, the epidemic can be stopped…Even in dire scenarios, if we move fast enough we can turn it around. I do not think the most dire circumstances will come to pass,” he said.

The CDC report comes out on the same day the World Health Organization released their reports on the outbreaks at six months in all affected countries, and it appears that cases in Nigeria and Senegal have stabilized “for the moment.” Last week, President Obama announced a deployment of 3,000 U.S. military personnel and over $500 million in defense spending to go to West Africa, and the UN announced a new task force called the U.N. Mission for Ebola Emergency Response. The hope is that an exponentially increased response will prevent these possible scenarios.

TIME medicine

When Doctors Ignore Their Own Advice

doctor with donut
Getty Images

What to do about docs who smoke, drink, and tan

I live near a health clinic, and on more than one occasion, have walked by men and women in scrubs smoking cigarettes. No human being is immune to nicotine’s addictiveness, but since health care professionals are supposed to advise patients against such behaviors, it’s extremely hard to justify the habit.

Earlier this month, a report published in The BMJ showed that one in 10 doctors admit to using tanning beds. The survey sample was small at only 163 U.K. doctors, but considering skin cancer is the most common cancer in the U.S., the fact that any physician would choose to partake in an activity that puts them at a direct risk for cancer is pretty mindboggling.

But indoor tanning isn’t the only doctor vice. Smoking, poor eating habits, being sedentary, and heavy drinking–while still not the norm–are behaviors not completely eradicated from the medical community.

An unforgiving culture

“It’s unrealistic to expect that knowledge should prompt physicians to avoid unhealthy behaviors,” says Anthony Montgomery, an associate professor of work and organizational psychology at the University of Macedonia in Greece. “Just like everybody else, they have a low risk perception with regard to their health.”

Montgomery says a big part of the problem is how physicians cope when they encounter health problems. In a 2011 study, Montgomery and his colleagues conducted an analysis published in Occupational Medicine that looked at 27 studies on doctors self-medicating. They wanted to examine the implications of a persisting culture within medicine where doctors do not expect themselves or their colleagues to be sick.

“We found that there was considerable evidence that physicians and medical students engage in high levels of inappropriate self treatment for reasons that include avoiding the patient role and occupational norms–keeping things inside the profession,” he says.

The study concluded that these behaviors could be occupational hazards for doctors, and that these problems are not benign for patients. Congruent research finds that doctors with bad health habits are less likely to counsel their patients on the same issues.

“Fifty years ago smoking was very common among physicians and nurses, though fortunately we’ve reduced that significantly,” says Shiv Gaglani, co-founder of a pledge for medical students called The Patient Promise. “Now however, physicians and nurses have the same level of obesity as the general population. Our caregivers are human too and can succumb to same behaviors that everyone else can.”

Montgomery, who typically studies doctor burnout, is working on a report that collected data from health care professionals in Croatia, Portugal, Macedonia, Greece, Turkey, Romania and Bulgaria and found that the effects of burnout were significant predictors of fast food consumption, infrequent exercise, drinking alcohol and using painkillers.

“Certainly most physicians I’ve met understand the paradox between what they preach and what they practice,” says Gaglani. “Seeking help is often complicated by the fact that you don’t want word to spread about your issues because it would spread within the community you practice. In some cases it could even mean the end of your career.”

Solutions

Gaglani created The Patient Promise in 2008 with his roommate at Johns Hopkins Medical School after they attended a course on obesity and motivational interviewing of patients.

“We realized that many of the harmful lifestyle behaviors we were learning to counsel against as future physicians were actually becoming part of our daily lives,” says Gaglani.

The pressure and stress of medical school was causing Gaglani and his peers to eat less nutritious food, exercise fewer times each week, and get significantly less sleep. “We asked the simple question: How can we counsel patients on important lifestyle behaviors if we couldn’t practice them ourselves?” says Gaglani.

And so the Patient Promise was created, and still serves as a pledge for health care workers to live the lifestyles they are recommending for their patients. The movement calling for doctors to be healthy has spread to many health care facilities.

Some hospitals have even incentivized healthy behaviors, like the Cleveland Clinic, which took staff health to task in 2014 and asked all of its employees to wear an activity tracker called Pebble. Target goals were set across the board, and participating in the program allows employees to get lower health insurance premium rates. So far out of the 26,790 employees and spouses participating, 18,302 have already met their target goal for the year: 100,000 steps a month or 600 activity minutes a month for six months.

The Patient Promise is available for all health care workers to sign as a pledge to patients and themselves. “We believe in the power of partnership and shared accountability between clinicians and their patients to lead healthier lives,” says Gaglani.

Your browser, Internet Explorer 8 or below, is out of date. It has known security flaws and may not display all features of this and other websites.

Learn how to update your browser