Headline News, Science Views II (1993) / Chapter Skim
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4 HEALTH CARE
4 HEALTH CARE
Pages 65-90
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From page 67... ...
As one who helped develop childhood vaccines, what especially disturbs me is that so many American children now suffer needlessly from preventable health problems. How can a society that claims to care deeply about its children excuse the recent resurgence of measles or unnecessarily high rates of infant mortality?
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From page 68... ...
This is especially true in cases where a pregnancy is complicated by the mother's diabetes, poor diet, alcoholism, drug abuse, age or other risk factors. Every expectant mother should be provided with prenatal care.
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From page 69... ...
It is true that a causal relation exists between the DPT and rubella vaccines and certain health problems. Our committee of the Institute of Medicine of the National Acad
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From page 70... ...
Weaker evidence suggests a causal relation between the DPT vaccine and two conditions shock and acute encephalopathy, a brain disorder. In other words, the DPT vaccine does have the potential to harm some children.
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From page 71... ...
Another danger sign is lethargy or difficulty in awakening. Five years ago the federal government established a program to provide compensation for those children who do suffer severe reactions.
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From page 72... ...
For example, adolescent girls are at much greater risk for eating disorders like anorexia and bulimia. Male adolescents outnumber females in completed suicides, but attempted suicides are more common among females.
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From page 73... ...
Our ignorance about them is tying our hands in efforts to prevent or more effectively treat drug abuse, eating disorders, crime and delinquency, mental and emotional disturbances, and other adolescent problems. It also leads to a
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From page 74... ...
Stresses on adolescents are multiplying even as federal, state and other support for basic mental health and other vital services declines. ironically, some adolescents receive expensive treatment, such as hospitalization, while many others remain underserved or not served at all.
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From page 75... ...
In many countries whose statistics we envy, public health measures are seen as important national health strategies. Tough drunk-driving and gun control laws or contraception and sex education to prevent unwanted pregnancies all are used effectively.
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From page 76... ...
Nor is there much contact with public health faculty and researchers. Medical schools should expand their curricula and begin teaching not only how to treat low-birthweight babies, but also how to bring about the prenatal care and community services that lead to healthier births.
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From page 77... ...
It uses a combination of employer-mandated and state-subsidized insurance. · A year earlier, Massachusetts began implementing legislation requiring employers to "play or pay"-to provide health insurance or pay into a state fund for the uninsured.
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From page 78... ...
In all, at least 28 states have developed programs to expand health insurance coverage or to improve access to care for the uninsured. These experiments provide a valuable laboratory to learn about approaches that might relieve a national system straining under the weight of 33 million people without health insurance, besieged hospital emergency rooms, soaring medical care costs and a myriad of other problems.
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From page 79... ...
Finally, since 1974 Hawaii has required employers to offer a basic package of health benefits at a controlled price and to purchase health insurance for all employees. Mandated health insurance forces small employers to "pay their share" and avoids tapping state treasuries, but remains controversial because of the potential impacts on small businesses and on employment itself.
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From page 80... ...
They include premature birth, malnutrition, social and educational deprivation in childhood, automobile crashes and other injuries, violence, alcohol and other drug abuse, and chronic diseases. When these conditions do occur, the resultant physical or mental impairment often can be reversed or minimized by prompt medical care and rehabilitative services.
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From page 81... ...
All of these factors can be ameliorated, as can many causes of heart disease, respiratory problems, hearing loss and other disabling conditions. Or think about the I.3 million people who sustain head injuries each year.
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From page 82... ...
Shope Most Americans wrongly view acute infectious diseases as a problem of the past. Actually, the danger posed by infectious diseases remains very real.
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From page 83... ...
Suburban development and reforestation of farmland in the United States and expanding human populations and deforestation elsewhere bring people into closer proximity with pests and other animals that transmit the diseases. People around the world who suffer from the diseases often have primitive or nonexistent medical attention.
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From page 84... ...
Unless we become more vigilant, some of these outbreaks could become new deadly epidemics, outdoing even today's AIDS crisis or the influenza pandemic that killed 20 million people worldwide after World War I November 22, 1992 Joshua Lederberg, a Nobel laureate, is University Professor and SackJer Foundlation Scholar at Rockefeller University in New York.
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From page 85... ...
~ served recently on a committee of the Institute of Medicine of the National Academy of Sciences that examined research at academic departments of obstetrics and gynecology across the country. We found that only a few are providing a research environment as vibrant as one finds for AIDS, heart disease, Alzheimer's and other health problems.
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From page 86... ...
Women represent nearly half of all OB/GYN residents and face special obstacles in choosing the laboratory over cTini ~ , cal practice. The problems include coping with pregnancy and childbirth during crucial early faculty years, isolation from traditional support networks and a dearth of female role models.
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From page 87... ...
Society must act decisively to prevent additional suffering from AIDS in these new populations. But one thing we should not do, and which some health experts have suggested, is mandate routine screening of all pregnant women and newborns for HIV.
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From page 88... ...
Rates of HIV infection among women vary widely across the United States, and some states-particularly those with few cases of infection-may decide to spend their resources on other health services. State health authorities are in the best position to determine whether an HIV screening program is the best way to spend limited funds.
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From page 89... ...
For the time being, however, the only routine thing about HIV screening should be that it remain anonymous for newborns and strictly voluntary for pregnant women. February 17, 1991 Marie C
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