Monday, November 28, 2011

The Cold or The Flu?

For years, The Centers for Disease Control and Prevention along with the U.S. Department of Health and Human Services have been touting the difference between the cold and influenza, a.k.a. the flu. They are very different and thus should be treated differently.

The common cold is typically identified by sneezing, itchy throat and runny nose. According to the National Center for Health Statistics (NCHS), 62 million cases of the common cold occur annually throughout the United States. Symptoms usually last one to two weeks and is considered the leading cause of doctor visits and missed days from school and work in the United States.  NCHS also states that it is normal for children to have between two and six colds a year while adults will generally suffer with one to three colds annually.

Influenza is a contagious respiratory infection. Its symptoms are similar to the common cold but will often involve a fever or chills, muscle or body aches, headache, and general fatigue. Also like the common cold, the flu is not a bacterial infection; it is a viral infection. It is also important to remember that a cold never “turns into” the flu. A cold virus is a very different virus than influenza. They neither cross-breed nor turn into one or the other.

Despite all the claims from product manufacturers on television and in other advertisements, there is no cure for the common cold. Relief from symptoms can come by taking some sort of medication but it will not reduce the length of time you have a cold and it will never rid you of the cold itself. Antibiotics are not a cure for the common cold, which is a viral infection. Antibiotics are used to treat bacterial infections. Over the past decades, people had been consuming antibiotics believing that they cured the cold or lessened its time of infection. This is far from the truth. The overuse of antibiotics only caused further complications in the human body. Over time, antibiotics can build up in a person’s system, making them ineffective against serious bacterial infections such as MRSA and similar harmful bacterial diseases.
Unlike the cold, influenza does have a bit of an edge in two ways. First, the best prevention against the illness is to obtain the vaccine. While September and October are the most beneficial times to receive the vaccination, it is not too late to be inoculated against the 2011-2012 influenza threat. Check with your doctor or the local health center for information on getting your flu shot now. In addition, the CDC has suggested using standard precautions to help prevent the spread of germs that cause the flu. This includes regular hand washing, use of hand sanitizers, covering your mouth when you cough or sneeze, and limit your contact with those who are ill.

If you end up with the flu, you have the option of either allowing the infection to run its course or have your doctor prescribe one of two drugs approved by the Federal Drug Administration. These drugs, which assist in treating the flu, are usually prescribed over the course of five days and should be started within the first two days of diagnosis. The approved drugs are Tamiflu (generic name oseltamivir) and Relenza (generic name zanamiyir).

In some cases, both the common cold and influenza can cause complications. Both viruses have been known to spark bacterial infections of the middle ear or sinus. Influenza can also trigger complications in the form of pneumonia and bronchitis. In these cases, antibiotics are appropriate and will likely be prescribed by your personal care physician. However, the National Institute of Allergy and Infectious Diseases (NIAID) strongly warns people to “not use antibiotics ‘just in case’ because they will not prevent bacterial infections.

Both the CDC and NIAID have detailed information posted on their websites on the common cold and the flu. Visit either http://www.cdc.gov/ or www.niaid.nih.gov for more details. If you do not have access to the internet, talk with your doctor or the local health center at 814-332-6947.



References:

The Centers for Disease Control and Prevention. (2011). Seasonal influenza (flu). Retrieved November 25, 2011 from http://www.cdc.gov/flu/index.htm.
The National Institute of Allergy and Infectious Diseases. (2011). Common cold. Retrieved November 25, 2011 from http://www.niaid.nih.gov/topics/commonCold/Pages/default.aspx.


Tuesday, November 15, 2011

Rewarding and Penalizing Health Behaviors

A recent NPR poll revealed some interesting results about handling the rapidly growing costs of health care. The poll of 3,000 adults was conducted in September via telephone by NPR and Thomson Reuters Health and showed support for a rewards and penalty system for health behaviors.

For example, 59% of the respondents believed that smokers should pay more for healthcare while only 31% favored penalizing those who are overweight or obese. Regarding smoking behaviors, some employers agree with the poll.  When it released it poll results, NPR also reported that Wal-Mart, the nation’s largest private employer, will start charging between $260 and $2,340 more annually for health insurance for those who smoke. On the other hand, they will also offer free smoking cessation assistance to any of their employees. These policies take effect in January.

Regarding obesity, it may be of importance to mention that 69% (just over one-third of the poll group) did not favor a penalty. Interestingly, that number represents about the same percentage of Americans who are considered overweight or obese.  

There was resounding support for insurance breaks or rewards rather than penalties when it comes to health behaviors. NPR found that 85 of the people felt that a rewards system is better than a penalty system to improve health. For years, companies have been promoting health by offering financial incentives for healthy behaviors. According to a 2007 study by the National Business Group on Health and Watson Wyatt found that 355 large employers across the nation provide such incentives, revealing that the action has resulted in lower costs for sick leave, long-term disability, short-term disability, and general health coverage. It wasn’t until this year that companies are now stepping up to not only reward healthy behaviors but penalize poor healthy choices such as smoking.

My opinion of the poll results is rather mixed. If companies have been offering rewards for healthy behaviors for years, then why is our nation still suffering from an obesity epidemic that keeps growing?  Why do we have a significant number of smokers?  We need to question whether the rewards are enticing enough to promote positive behaviors or reverse poor health choices. It begs the question of whether we, as human beings, respond to positive reinforcement for health-related behaviors. According to Dr. Alex Lickerman from the University of Chicago, positive reinforcement is definitely the best approach if done correctly. According to Lickerman, rewards for positive health behaviors must be large enough and have strong perceived importance, and also should be presented immediately following the desired behaviors to promote long-term health.

If positive reinforcement is the best practice, I can’t help but wonder if the companies who are providing insurance breaks and other financial rewards are following Lickerman’s advice for implementing a reward system. I can’t help but think that they are not. Perhaps the incentive isn’t enough, perhaps it’s not perceived as an important reward, or perhaps it is not presented in a timely fashion. If all these factors were happening, wouldn’t we be seeing a reversal of obesity rates, or a reduction of smoking prevalence?

While I don’t know what the solution is, I believe that a combination of both would be the optimal action. I am fully supportive of penalizing poor health choices. We basically already do that with things such as the cigarette tax and alcohol tax. While these haven’t eliminated the problem, studies have shown that some penalties have certainly helped reduce tobacco and alcohol use. We have also penalized those with poor driving habits such as ticketing those for not wearing a seatbelt, or for speeding. Again, the problem is not gone, but motor vehicle deaths have dropped as a result of increased seatbelt use and speed limits.

Overall, I believe people should pay or are already paying the price for their health choices: both positive and negative. If you want to smoke, you should pay the price for that behavior. You will have long-term health effects (which are preventable) such as emphysema, lung cancer, or COPD that will cost the country’s health care system more money. If you subscribe to overeating unhealthy eating behaviors, the health care costs will also be exorbitant over your lifespan as you might suffer diabetes, heart disease, and various cancers that are preventable. Again, I support initiatives of increased insurance rates for such behaviors. If you subscribe to regular exercise to maintain your health, I again have no problem with the cost. Those people are already sinking money into their health care in the form of fitness center memberships, personal trainers, and exercise equipment among other costs.

While I was not among those questioned in the NPR poll, I would have been among those who supported penalties for health behaviors. I have no qualms with insurance companies or employers hiking their rates for people who subscribe to poor health choices. But, I also support positive reinforcement for positive behaviors. I am in favor of companies fully paying for smoking cessation efforts, drug/alcohol rehabilitation, and weight loss clinics. I am also in favor of companies offering discount or free memberships to fitness clubs to maintain their employees’ health. Many companies are already doing both, and I applaud their efforts.

I’m interested in what Tribune readers have to say about this? Are you in favor of financial penalties for poor health behaviors? Do you support positive reinforcement? Please let me know your opinion on my blog at www.crawfordcountyhealth.blogspot.com. It’s your choice if you wish to leave your name, but I’d love to hear your opinion.



References:

Hensley, S. (2011). Insurance penalties for smokers draws wide support. Retrieved November 8, 2011 from http://www.npr.org/blogs/health/2011/11/03/141984867/insurance-penalties-for-smokers-draw-wide-support?ft=1&f=103537970.

Lickerman, A. (2011). Positive reinforcement can motivate preventive behaviors. Retrieved November 8, 2011 from http://www.kevinmd.com/blog/2010/08/positive-reinforcement-motivate-preventive-behaviors.html.

Selko, A. (2008). Employers offering financial rewards for healthy behaviors. Retrieved November 8, 2011 from http://www.industryweek.com/articles/employers_offering_financial_rewards_for_healthy_behavior_15505.aspx.

Tuesday, November 1, 2011

Beware of Gummy Bears, Candy Corn and Peppermint Sticks

We all could heed a little warning from a recent news broadcast out of Detroit that enlightened parents about the candy their children bring home. The latest trend seems hiding alcohol inside candy of any type.

Be it Gummy Bears, Red Hots, chocolate, peppermint sticks, candy corn, and just about any other kind of candy available, youngsters – in an attempt to get a buzz – are soaking this innocent candy in vodka. The candy absorbs the liquid and becomes infused with the alcohol, creating a very potent treat for children as well as adults. Because vodka is nearly odorless and colorless, the candy appears normal, and often smells as it should right off the shelf – but it contains enough vodka to place a child into an alcoholic coma.

According to the Citizens Rally for Change on Alcohol (CRCA), the vodka-laced candy tastes normal, leading the eater to consume several handfuls of the sweet treat. Besides obtaining the obvious short sugar rush, the children will also experience an increase in their blood alcohol level at an extremely rapid pace, making overdose is quite possible. Furthermore, CRCA noted that children found with the candy in their possession could be issued a ticket for MIP, minor in possession. Of interest, this is no different than if a child were found drinking a cup of alcohol – you name it: rum, whiskey, beer, wine, etc.

The scary part is that parents may know their child is eating Gummy Bears or candy corn, but are completely oblivious to the possible presence of alcohol. And, apparently, that’s the point. The CRCA claims that parents should be suspicious of candy that has not come out of its original wrapper. While that Zip-lock bag of Swedish Fish looks safe, it may have been soaked in vodka. Smelling the candy may not always reveal any alcohol content, so parents are urged to taste it before allowing your child to have it. Better yet, it may be safer to simply throw it away if there is any suspicion of liquor.

Having recently gone through the traditional Halloween trick-or-treating ritual, your child may be loaded with all sweets of all sorts. Parents are encouraged to check the candy for any substances dangerous to your children. More importantly, it may be best to chat with your child about alcohol and its dangers. Unfortunately, experimenting with alcohol is common; however, it is not safe, especially for a growing child. It’s important to discuss alcohol use and abuse early to ward off deviant and illegal behaviors.

The CRCA suggests that parents educate themselves in order to protect their children from using or abusing alcohol. Here are four suggestions:

1.      Be a good role model. Consider how your use of alcohol may influence your children.

2.      Educate yourself about alcohol and current trends. Read and collect information that you can share with your child.

3.      Build your child’s self-esteem. Children are more likely to feel good about themselves when their parents emphasize and positively reinforce healthy behaviors.

4.      Teach healthy stress management skills. By showing your child healthy coping mechanisms for stress, they are less likely to engage in poor behaviors such as using drugs or alcohol.

References:

Click on Detroit. (2011). How teens smuggle booze under your nose. Retrieved October 26, 2011 from http://www.clickondetroit.com/video/29384556/index.html.

Citizens Rally for Change on Alcohol. (2011). Parents, do you know what is in the candy your child is eating? Retrieved October 26, 2011 from http://www.crcadanecountywi.com/candy_anyone.