Healthcare Policy

Good News on Baby Shots, But… (Article)

We still have more children to immunize as the recent Disney measles outbreak demonstrates, but there is great cause for celebration by pediatricians and public health officials: vaccination rates among young children are actually quite high. From 2012-2013, many of the most important vaccines for young children such as the measles vaccine (MMR), hepatitis B vaccine, poliovirus vaccine, and chicken pox vaccine have been administered to over 90% of children aged 19 -35 months. It is estimated that this level of vaccination in children born between 1994 and 2013 will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths during these children’s lifetimes.  What a tremendous achievement! But it is too early to rest on our laurels. In order to get the maximum benefit from vaccines for our children, we need to continue to improve vaccine delivery for every child. Currently, we are having problems getting the children of families with either very low and very high incomes vaccinated.

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The Cost of Childhood Obesity (Article)

Tackling the obesity problem has been on the forefront of the minds of politicians, doctors, and parents. Childhood obesity, defined as a BMI greater than 99% of the population, affects 20% of the children between the ages of 6 to 19 years old. This rate has doubled during the last two decades. A US Task Force on Childhood Obesity has set an ambitious goal to reduce that number to 5% by 2030. With the help of everyone who cares for children, I believe this is both achievable and cost effective.

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Mandatory Flu Shot for Preschoolers? (Article)

Should the influenza vaccine be made mandatory for young children? Though childcare facilities have long required many vaccines to prevent children from contracting diseases, the influenza vaccine has often been overlooked. As the flu is generally perceived to be less threatening than diseases such as Hepatitis B, polio, or diphtheria, many parents forgo the recommended influenza vaccine and focus on more serious disease vaccines. However, the flu spreads rapidly and relentlessly, especially throughout childcare facilities, and it can cause a child to become very sick. Typically, the flu causes a high fever, sore throat, coughing, nausea, vomiting, and severe body aches, but in more severe cases, it can lead to hospitalization and even death. Pre-school aged children are especially prone to severe flu-related illnesses and complications. Thus, the flu cannot be overlooked, and if a small annual vaccine can prevent it, perhaps it’s time to tweak the list of recommended vaccines.

The state of Connecticut was the second U.S. state to implement the required influenza vaccines for children between the ages of 6 and 59 months who were entering childcare facilities. Since September of 2010, when Connecticut added the vaccine to the required vaccine list, the vaccine rate increased from 67.8 % to 84.1%, while the number of hospitalizations showed a marked decrease. Connecticut is a prime example of the effectiveness of the vaccine in preventing the spread of the illness.

As we can see, the influenza vaccine is incredibly effective. If this one little step in prevention can prevent our children from suffering the miserable symptoms of the flu and spreading it to others, perhaps our states should reconsider their vaccine policies. For those who would be against the vaccine for medical or religious reasons, waivers would be available, so overall, such policies would do far more good than harm. Even if states are slow to enact such changes, consider getting your child vaccinated anyway. Your precious child will be kept safe from the flu virus inevitably found hiding all over childcare facilities. In addition to the vaccine, washing hands, avoiding contact with the sick, and avoiding touching the eyes, nose, and mouth will help reduce the risk of getting the flu. Most importantly, for your child’s sake, don’t hesitate, vaccinate!

I welcome your comments at my blog, Until next time.

Smo Notes:

Written collaboratively by Keri Register and Paul Smolen M.D.

The Power of Advertisers (Article)

I was perusing my CDC weekly mortality and morbidity report a few weeks ago, and I saw an interesting statistical graph: smoking by occupation in the U.S. As we have talked about many times in this blog, smoking rates have been–and continue to–decline in the United States, thank goodness. Currently 20% of the population smokes, down from 50% during my childhood years. As you can see in the graph, the CDC has further broken down smoking by occupation, and I am happy to report that healthcare and social assistance occupations were the lowest group of smokers by percentage, currently at 16%.

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Just a few decades ago, the picture of the healthcare industry’s relationship with smoking was a very different one. Just take a look at these ads featuring doctors, babies, mothers, and cigarettes. Engaging pictures of distinguished looking doctors, cute babies, and young vital, attractive mothers were used to endorse cigarettes. A careful examination of the message in these ads to me revealed two essential messages:

1.  Loving, kind, respected, attractive people around you want you to smoke.

2.  The advertisers of particular brand of cigarette claiming that their brand is less “irritating” than the other brands.

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In other words, the makers of cigarettes knew, long before the devastating effects of tobacco smoke were fully understood, that some cigarettes were less likely to make smokers sick than others.

Oh, what a difference a few decades can make in behavior and attitude. I think we can conclude from all this information that the anti-smoking campaign, waged in the past 50 years, has been extremely effective. These new statistics once again reveal how effectively advertising can change behavior. Remember the government tobacco settlement with cigarette makers just a few years ago? Tobacco companies were forced to turn over a staggering amount of money to be spent mostly on anti-smoking advertising. I think we have to admit that these ads seemed to have worked. Negative images and messages about tobacco have had a big impact on our behavior, especially the behavior of healthcare workers and children. Isn’t it wonderful that without banning the sale or use of tobacco, a little negative advertising could convince so many millions of Americans not to sicken themselves by using tobacco? America: for our children’s sake, let’s not stop until we are completely tobacco free.

I welcome your comments. Visit today. You’ll be glad you did. Until next time.

Smo Notes: