Category Archives: Public health

Experts say new tools, tougher government oversight can reduce foodborne illnesses #ahcj13

Lacey McLaughlin

About Lacey McLaughlin

Lacey McLaughlin is a features writer at The Daytona (Fla.) Beach News-Journal. She is attending Health Journalism 2013 on an AHCJ-Healthier Beat Fellowship, which is supported by the Leona M. & Harry B. Helmsley Charitable Trust.

Placing food safety above profits, and using new regulatory power and testing techniques could help protect consumers from foodborne illnesses, three experts in food safety said today.

The experts – an executive at America’s largest organic food producer, a food safety attorney and a federal food and safety regulator – discussed the challenges of protecting consumers from illnesses such as E. coli, salmonella and listeria on a panel called, “Why is food still making us sick in the 21st century?” during Health Journalism 2013 in Boston.

Bill D. Marler, managing partner at the law firm Marler Clark, began litigating personal injury cases related to foodborne illness cases in 1993 after E.coli-contaminated meat from the fast-food chain Jack in the Box resulted in the deaths of four children and illness in hundreds of consumers. Marler said that when companies take shortcuts, or focus on profits more than food safety, it can compromise consumer safety.

“Food production is a risky business with a competitive market,” said Marler, who started the website foodsafetynews.com. “Good safety practice isn’t always on everyone’s minds because of stockholder pressures.”

But even companies that follow strict food testing procedures can’t always stop outbreaks. Earthbound Farm Senior Vice President Will Daniels said despite following strict safety guidelines, his company had to recall spinach contaminated with E. coli in 2006 after three people died and 300 became sick.

“This changed my life,” Daniels said. “There was no smoking gun, no break in our system and no deliberate contamination. The source of contamination was never proven.”

Earthbound Farm is now a leader in the food industry when it comes to safety standards. By using the newest technology, Earthbound Farms is able to test food products twice before delivering them to consumers, he said. New technology has made it possible for the products to be tested in a 12-hour time frame, whereas older methods took three to five days.

“Before, I couldn’t wait five days to test results on the raw side of the product and then again at the end of the process,” he said. “That was almost half the life of the product.”

The Food Safety Modernization Act of 2010 shifts the role of regulators from responding to outbreaks to preventing them. For the first time, the law gives the U.S. Food and Drug Administration the authority to order recalls of contaminated food. But, with 80 percent of seafood and 20 percent of vegetables imported from overseas, FDA Deputy Commissioner Michael Taylor said there are even more obstacles for ensuring safety regulations are followed.

The law “creates a mandate for companies to meet comprehensive safety standards,” Taylor said. “It also strengthens government authority to make sure those standards are being met. But to build a national integrated food-safety system, we need aggressive partnerships between state and local governments.”

Causes, consequences of Nashville’s diabetes hot zone

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In The Tennessean (and USA Today), Tom Wilemon has assembled a series of reports on what he calls “the diabetes hot zone,” “a cluster of predominantly African-American, inner-city neighborhoods where diabetes rates soar to more than double the Davidson County average.”

After establishing the outlines and perils of the hot zone in his first piece, Wilemon follows up by looking into the scarcity of transplants and pervasiveness of dialysis in the area.

Although organ transplants can occur between races, matches are more difficult to achieve for blacks. Transplant recipients must have similar genes in their immune systems to those of the donor. Otherwise, the body will reject the organ.

Whites account for 68 percent of all organ donors, while African-Americans account for only 14 percent, according to the U.S. Organ Procurement and Transplantation Network. Although the number of blacks and whites waiting for a kidney in 2011 was about the same, whites received just over half of kidney transplants that year, while blacks received less than a third.

Finally, he examines the causes of the diabetes epidemic and, in the process, wading deep into the “soul food” versus “fast food” debate.

Wilemon is a 2012-13 AHCJ Regional Health Journalism Fellow and wrote this story with support from USC’s Annenberg School of Journalism.

KC Star: Centralization of Big Beef also aggregates risk

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Mike McGraw’s recent investigation into “big beef” at The Kansas City Star begins with an interesting assumption: Regardless of their safety record, massive slaughterhouses and meatpacking plants introduce unacceptable systemic risk based on their size alone. Or, as he summarizes the argument, “When processing speed and volumes rise, so do the chances for contamination to be introduced and spread widely from its source to other meat inside the plant and at other plants that process it further.”

In particular McGraw focuses on mechanical tenderizing, a relatively new process in which tougher pieces of beef are penetrated with sharp metal blades to break up their fibers. The blades can also pick up E. coli from the meat’s exterior and ram it deep inside, where it’s less likely to be killed when the future steak is seared and served. Statistics are hard to come by, but because the practice is so widespread in the nation’s meat supply, the risk it introduces enjoys similar reach.

USDA data analyzed by The Star show that large plants until recently had higher rates of positive E. coli tests than smaller plants. Federal meat safety officials said the latest data show big plants are improving.

But the volume of meat a plant produces is a key issue. A USDA study published in March showed that from 2007 through 2011, E. coli positives at very small plants resulted, The Star found, in only 465,000 pounds of contaminated beef. A slightly lower rate of positive tests at large plants, however, produced more than 51 million pounds of contaminated beef.

Regardless, experts agree that most E. coli generally originates at larger slaughter plants, where pathogen-laden manure is a bigger problem because that’s where cattle are coming in from the feedlots.

LA Times: While board investigates, doctors’ ‘reckless prescribing’ kills

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

By zeroing in on one particular type of dangerous physician behavior, known as “reckless prescribing,” Los Angeles Times reporters Lisa Girion and Scott Glover were able to draw a powerful link between the state medical board’s inaction and patient death in an investigation titled “Dying for Relief.”

For the piece, reporters reviewed state medical board records and coroner’s files, assembling evidence that “At least 30 patients in Southern California have died of drug overdoses or related causes while their doctors were under investigation for reckless prescribing. The board ultimately sanctioned all but one of those 12 doctors, and some were criminally charged – too late to prevent the deaths.”

For its part, the board has been hit hard by state budget cuts and, the reporters write, is hamstrung because “Unlike medical regulators in other states, it cannot suspend a doctor’s license or prescribing privileges on its own, even to prevent imminent harm.” The resulting lack of oversight has led to pervasive overprescribing and uneven enforcement. For more details and a powerful narrative hook, I strongly recommend reviewing the paper’s brilliantly produced online package.

Hospitals to workers: Get flu shot or get fired

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In a story that could be replicated in many areas, The Morning Call‘s Tim Darragh writes that hopitals, both locally and nationally, are pushing hard for workers – both medical and otherwise – to get flu vaccines, as the Joint Commission moves toward stiffer requirements and CMS threatens to cut reimbursement rates for non-compliant hospitals.



Photo by Lance McCord via Flickr

Some of the Lehigh Valley region’s hospitals…. are mandating employees get flu vaccines if they have contact with patients — even if the employees don’t want the shots. If they don’t comply or get a valid exemption, they will be fired.

The list of staff affected by the policy is broad. It includes not only doctors and nurses and others directly involved in patient care but also housekeeping and maintenance workers.

Across the country, the stricter regulations seem to be making a difference, Darragh reports. A health system in Ohio has already issued termination notices to non-vaccinated workers, and even civil rights advocates known for taking the workers’ side admit that it is difficult to argue that hospital workers shouldn’t be vaccinated.

The ever popular (and quotable) Dr. Arthur Kaplan agrees.

Without greater compliance, the work environment won’t attain a level of immunity that will provide sufficient protection to the sick, said Dr. Arthur Caplan, a bioethicist at New York University’s Langone Medical Center. “You don’t get the ‘herd immunity’ until you hit 90 percent,” said Caplan, a proponent of mandatory vaccinations.

CDC official details response to meningitis outbreak

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

John Jernigan, M.D., M.S., the CDC’s clinical team lead on the multistate meningitis outbreak and director of the CDC’s Office of Health Associated Infections Prevention Research and Evaluation, briefed AHCJ members, including the 2012-13 Regional Health Journalism Fellows, in Atlanta about the agency’s response to the multistate fungal meningitis outbreak.

Thanks to AHCJ board member Maryn McKenna, who used Storify to share information from the briefing as well as a blog post. UPDATE: Tom Wilemon of The Tennessean and Tom Corwin of The Augusta (Ga.) Chronicle, both Regional Health Journalism fellows, also wrote about the briefing. Click through to see McKenna’s Storify about the event. Continue reading

Brawley speaks to Atlanta chapter of AHCJ

Andy Miller

About Andy Miller

Andy Miller (@gahealthnews) is the editor and publisher of the nonprofit Georgia Health News. The former health care reporter for The Atlanta Journal-Constitution is a member of AHCJ's board of directors and leads the association's Atlanta chapter.

PHOTO BY LEN BRUZZESE, AHCJ Otis Brawley, M.D., chief medical officer of the American Cancer Society, answers questions at Health Journalism 2012 earlier this year.

The Atlanta chapter of AHCJ met on Sept. 25 to hear Otis Brawley, M.D., speak on various health care topics.

WebMD’s Dan DeNoon introduced Brawley, an American Cancer Society executive and physician who earlier in the year addressed AHCJ’s annual conference in Atlanta.

Brawley spoke about cancer treatment, waste in medical spending – including in prescription drugs – and the health reform law in an hourlong talk to 15 to 20 chapter members.

He then fielded several questions from attendees, and stuck around for an informal chat with members afterward.

As always, Brawley was a dynamic speaker, stirring chapter members with compelling facts and insights about the health care system.

AHCJ’s Atlanta chapter will next meet on Dec. 3, when journalists will hear from the CDC’s John Jernigan, M.D., M.S. As the clinical team leader on the Multistate Meningitis Outbreak and director of the CDC’s Office of Health Associated Infections Prevention Research and Evaluation, he will talk about the agency’s response to the recent fungal meningitis outbreak.

Battles over water fluoridation spread across the country

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

As the election returns rolled in, armies of reporters across the country went to work exploring the fate of candidates in local state and national races.

Annie Calovich of The Wichita (Kan.) Eagle had the task of exploring the fate of fluoride.

Mary OttoMary Otto, AHCJ’s topic leader on oral health is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care.

If you have questions or suggestions for future resources on the topic, please send them to mary@healthjournalism.org.

The city’s hotly contested fluoride initiative, backed by local doctors and dentists, but strongly opposed by anti-fluoride activists, went down to defeat on Nov 6. Voters in city of Wichita rejected fluoridated water as they did in 1964 and 1978.

All over the country, jurisdictions are fighting over fluoride. In September, the city council in Portland, Ore., voted to fluoridate city drinking water in an effort to reduce tooth decay. In August, Milwaukee reduced the level of fluoride in its water after a city alderman launched a campaign to completely eliminate it. A year ago, in a decision that also had implications in Nov. 6 elections, Pinellas County, Fla., commissioners voted to stop adding fluoride to drinking water (more about that in a minute.)

Public health officials and state and local dental groups stand up for community fluoridation, which has been hailed by the Centers for Disease Control as one of the great public health achievements of the 20th century. For more than 65 years, communities across the United States have been supplementing naturally occurring fluoride in water supplies to promote oral health. At what are considered optimum levels, numerous studies have shown fluoride reduces cavities.

But too much fluoride can be a bad thing, public health officials have acknowledged. Consumption at excess levels may cause fluorosis and skeletal deformities, research has found. Continue reading

Election could affect ACA’s expansion of dental care

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Dental coverage might not have grabbed top billing in the Patient Protection and Affordable Care Act, but the law does contain provisions that promise to extend dental care to millions of poor and uninsured children as well as to expand the nation’s safety net clinics and oral health infrastructure.

What will happen to those initiatives if Republicans make substantial gains on Nov. 6?

Mary OttoMary Otto, AHCJ’s topic leader on oral health is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care.

If you have questions or suggestions for future resources on the topic, please send them to mary@healthjournalism.org.

That was the question asked of a panel of experts gathered for the American Public Health Association annual meeting.

“Healthcare could change from night to day in the next three weeks depending on changes in the Senate and presidency,” public health dentist Myron Allukian Jr. said at the meeting, covered by Donna Domino for DrBicuspid.com under the headline “APHA Analyzes Healthcare Reform’s Impact on Dentistry.”

Panelists weighed in on what could be at stake, Domino reports:

The ACA’s pediatric dental care component “is projected to provide care to 3 million children by 2018,” said Herb Schultz, a regional director of the U.S. Department of Health and Human Services. Continue reading

Seniors have special concerns in natural disasters like Sandy

Judith Graham

About Judith Graham

Judith Graham (@judith_graham), a Colorado-based freelancer, is AHCJ’s topic leader on aging, and as such curates related material at healthjournalism.org. She welcomes questions and suggestions on aging issue resources and tip sheets at judith@healthjournalism.org.

It’s well known that older adults are more vulnerable in times of natural disaster. But there’s nothing like a storm the size of Sandy to drive this point home.

Judith GrahamJudith Graham (@judith_graham), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society.

If you have questions or suggestions for future resources on the topic, please send them to judith@healthjournalism.org.

In the past week, we’ve read about New York City hospitals and nursing homes that decided to wait out the storm rather than evacuating. Sheri Fink, who won a Pulitzer Prize for her report on decisions made at Memorial Medical Center in the wake of Hurricane Katrina, got out ahead of Sandy and talked to city and state health officials as well as facility executives. Her ProPublica story is must-reading for anyone who wants to understand the thinking of officials responsible for preparing for the storm.

A take-home point: Evacuations can be extremely difficult for frail seniors living in nursing homes. Balancing the potential impact of displacing residents against the potential impact of sheltering in place during a storm isn’t easy.

I hope that reporters writing these kinds of Sandy-related stories take this into account. For another look at decisions made by city and state decisions vis a vis nursing homes, see this piece by Ben Hallman in the Huffington Post. Kudos to this reporter for going out during the storm and going to a site where nursing home residents were being sheltered. Continue reading