07-15-2021, 05:00 PM
How is it that people turn a blind eye to the of thousands deaths from opioid overdoses and the obesity problem in this country? With the closing of gyms, beaches, parks in some states, people closed up in their homes, working from home, children prevented from sports, etc., covid has exacerbated the problem. The evil ones behind the plandemic were well aware of these two prevalent, already existing health issues and knew exactly what they were doing. Lockdowns are killing people.
Obesity, the second-most preventable cause of U.S. deaths
Society needs better strategies to address obesity, a public health emergency
The opioid crisis and deaths related to e-cigarette use among teenagers have dominated news headlines recently. Recently, the Centers for Disease Control and Prevention reported that 34 people had died as a result of vaping and, in 2017, opioid addiction was responsible for more than 47,000 deaths in the U.S. Opioid addiction has been declared a public health emergency.
Yet these serious public health threats obscure an ever-present and growing calamity of obesity in the United States. Obesity is second only to cigarette smoking as a leading preventable death in the U.S. Nearly one in five deaths of African Americans and Caucasians age 40 to 85 is attributed to obesity, a rate that is increasing across generations.
Clearly society needs better strategies to address this public health emergency. As a health economist who has spent decades studying ways to prevent disease, I believe there are some policy options that could help.
Obesity crisis
Many factors contribute to obesity, including genetics, diet, physical inactivity, medications, lack of education and food marketing.
People who are obese face heightened risk for diabetes, heart disease, stroke, high blood pressure and certain types of cancers, among other conditions. The estimated annual medical cost of obesity in the United States is $147 billion, with most of those costs hitting public programs such as Medicare and Medicaid. Similar trends have been observed internationally among developed countries.
So what can we do about it? The massive public and private efforts to control smoking provide both a template for addressing obesity and a benchmark for social impact. Tactics such as education, cigarette taxes and smoke-free public spaces resulted in a 66% decline in smoking between 1965 and 2018, when cigarette smoking reached an all-time low of 13.7% among U.S. adults.
This outcome is associated with major health improvements — reduced cardiovascular disease, stroke, various cancers and mortality from lung cancer. Medicaid alone saves an estimated $2.5 billion a year from smoking-related health improvements.
From a public investment perspective, the potential bang for the buck is even bigger for obesity than it is for tobacco. In my view, a successful anti-obesity campaign must encourage people to be less sedentary; invest in new medical treatments and nutrition science; and create regulatory and health insurance policies that reward behavioral change. It also means broader access to effective therapies.
Our current emphasis on behavioral interventions has been disappointing. Society needs to find a way to talk about obesity and come up with ways to deal with it that do not involve body-shaming. Losing weight means eating less or exercising more, or both, but there are no guarantees with either approach. Getting people to exercise is difficult. Nearly 80% of adults are not meeting the key guidelines for both aerobic and muscle-strengthening activity.
Getting people to change their diet is similarly ineffective. According to one study, half of dieters had gained 11 pounds five years after starting their diet; some progress but hardly enough. Similarly, nutritional labels have had little effect on consumers’ food intake and body mass index.
So what should policymakers do? I think it is time to take several new approaches.
Economic models
The intellectual property rights of companies that develop novel approaches to weight loss, such as mimicking the effects of exercise, should be protected and rewarded with patent law and other mechanisms. Currently, if a company discovers a way to get people to go for a walk with a new app or program, protection for intellectual property and reimbursement is uncertain.
Given the stakes, the U.S. government should offer greater rewards for behavioral interventions that can demonstrate long-term gains under the same rigorous regulatory standards similar to those required of new drugs. U.S. companies invest billions of dollars to develop pharmaceuticals. By contrast, there is less social investment in other prevention activities.
While not a solution for everyone, gastric bypass and adjustable gastric banding, among other procedures, have proven effective. New incentives could expand access to these surgeries by lowering the BMI threshold for eligibility. Some insurers have put up barriers to this treatment because obesity is not immediately life-threatening or related to our traditional notion of disease.
We need to find better ways to annuitize the cost of surgery and increase access while tying reimbursement to outcomes. Other insurers with an interest in long-term outcomes, including the life insurance industry, can play an important role. They have a vested financial interest in avoiding mortality and disability but have traditionally remained on the sidelines while Americans grow fatter.
Evidence points to a 20% reduction in BMI persisting up to 10 years after surgery. In 2017, 228,000 Americans received bariatric surgeries. Of those, only 10% of are eligible under current criteria.
New meds
Another approach is to consider new medications and utilize the successful approach that has been used to fight high blood pressure. About 50 years ago, hypertension was considered untreatable. Diet and exercise were the predominant means of controlling it. The discovery of multiple agents to combat hypertension, beginning with diuretics and beta blockers, proved transformative. A similar story emerged for elevated cholesterol. About half the decline in U.S. deaths from coronary heart disease can be attributed to medical therapies like these.
Several clinically proven anti-obesity medications are already available for people who do not respond to lifestyle modification. Furthermore, there is a robust clinical pipeline, with approximately 250 compounds under development, including dozens of novel compounds. Drugs such as these can help change the trajectory of the obesity epidemic, if they are made widely available and reimbursed — challenges in today’s health care insurance system.
Another avenue to consider includes levying taxes on sweetened beverages, or the so-called “soda tax.” One study found that implementing a 1 cent per ounce soda tax would reduce sugar-sweetened beverage consumption by 20% over 10 years. The result would be a $23.6 billion savings in health care and improved population health.
Finally, the food and restaurant industry deserves some of the blame. Restricting access — like the United States tried with the ban on the consumption and sale of alcohol — won’t work. But responsible steps to regulate portions might.
Smart, bold strategies helped us address public health crises before, including smoking and hypertension. We need to be similarly aggressive with obesity if we want to avert hundreds of thousands of unnecessary deaths. As we did with smoking, it is time to make obesity a No. 1 public health priority..
Yet these serious public health threats obscure an ever-present and growing calamity of obesity in the United States. Obesity is second only to cigarette smoking as a leading preventable death in the U.S. Nearly one in five deaths of African Americans and Caucasians age 40 to 85 is attributed to obesity, a rate that is increasing across generations.
Clearly society needs better strategies to address this public health emergency. As a health economist who has spent decades studying ways to prevent disease, I believe there are some policy options that could help.
Obesity crisis
Many factors contribute to obesity, including genetics, diet, physical inactivity, medications, lack of education and food marketing.
People who are obese face heightened risk for diabetes, heart disease, stroke, high blood pressure and certain types of cancers, among other conditions. The estimated annual medical cost of obesity in the United States is $147 billion, with most of those costs hitting public programs such as Medicare and Medicaid. Similar trends have been observed internationally among developed countries.
So what can we do about it? The massive public and private efforts to control smoking provide both a template for addressing obesity and a benchmark for social impact. Tactics such as education, cigarette taxes and smoke-free public spaces resulted in a 66% decline in smoking between 1965 and 2018, when cigarette smoking reached an all-time low of 13.7% among U.S. adults.
This outcome is associated with major health improvements — reduced cardiovascular disease, stroke, various cancers and mortality from lung cancer. Medicaid alone saves an estimated $2.5 billion a year from smoking-related health improvements.
From a public investment perspective, the potential bang for the buck is even bigger for obesity than it is for tobacco. In my view, a successful anti-obesity campaign must encourage people to be less sedentary; invest in new medical treatments and nutrition science; and create regulatory and health insurance policies that reward behavioral change. It also means broader access to effective therapies.
Our current emphasis on behavioral interventions has been disappointing. Society needs to find a way to talk about obesity and come up with ways to deal with it that do not involve body-shaming. Losing weight means eating less or exercising more, or both, but there are no guarantees with either approach. Getting people to exercise is difficult. Nearly 80% of adults are not meeting the key guidelines for both aerobic and muscle-strengthening activity.
Getting people to change their diet is similarly ineffective. According to one study, half of dieters had gained 11 pounds five years after starting their diet; some progress but hardly enough. Similarly, nutritional labels have had little effect on consumers’ food intake and body mass index.
So what should policymakers do? I think it is time to take several new approaches.
Economic models
The intellectual property rights of companies that develop novel approaches to weight loss, such as mimicking the effects of exercise, should be protected and rewarded with patent law and other mechanisms. Currently, if a company discovers a way to get people to go for a walk with a new app or program, protection for intellectual property and reimbursement is uncertain.
Given the stakes, the U.S. government should offer greater rewards for behavioral interventions that can demonstrate long-term gains under the same rigorous regulatory standards similar to those required of new drugs. U.S. companies invest billions of dollars to develop pharmaceuticals. By contrast, there is less social investment in other prevention activities.
While not a solution for everyone, gastric bypass and adjustable gastric banding, among other procedures, have proven effective. New incentives could expand access to these surgeries by lowering the BMI threshold for eligibility. Some insurers have put up barriers to this treatment because obesity is not immediately life-threatening or related to our traditional notion of disease.
We need to find better ways to annuitize the cost of surgery and increase access while tying reimbursement to outcomes. Other insurers with an interest in long-term outcomes, including the life insurance industry, can play an important role. They have a vested financial interest in avoiding mortality and disability but have traditionally remained on the sidelines while Americans grow fatter.
Evidence points to a 20% reduction in BMI persisting up to 10 years after surgery. In 2017, 228,000 Americans received bariatric surgeries. Of those, only 10% of are eligible under current criteria.
New meds
Another approach is to consider new medications and utilize the successful approach that has been used to fight high blood pressure. About 50 years ago, hypertension was considered untreatable. Diet and exercise were the predominant means of controlling it. The discovery of multiple agents to combat hypertension, beginning with diuretics and beta blockers, proved transformative. A similar story emerged for elevated cholesterol. About half the decline in U.S. deaths from coronary heart disease can be attributed to medical therapies like these.
Several clinically proven anti-obesity medications are already available for people who do not respond to lifestyle modification. Furthermore, there is a robust clinical pipeline, with approximately 250 compounds under development, including dozens of novel compounds. Drugs such as these can help change the trajectory of the obesity epidemic, if they are made widely available and reimbursed — challenges in today’s health care insurance system.
Another avenue to consider includes levying taxes on sweetened beverages, or the so-called “soda tax.” One study found that implementing a 1 cent per ounce soda tax would reduce sugar-sweetened beverage consumption by 20% over 10 years. The result would be a $23.6 billion savings in health care and improved population health.
Finally, the food and restaurant industry deserves some of the blame. Restricting access — like the United States tried with the ban on the consumption and sale of alcohol — won’t work. But responsible steps to regulate portions might.
Smart, bold strategies helped us address public health crises before, including smoking and hypertension. We need to be similarly aggressive with obesity if we want to avert hundreds of thousands of unnecessary deaths. As we did with smoking, it is time to make obesity a No. 1 public health priority..
AND THERE'S THIS ARTICLE:
US overdose deaths hit record 93,000 in pandemic last year
NEW YORK (AP) — Overdose deaths soared to a record 93,000 last year in the midst of the COVID-19 pandemic, the U.S. government reported Wednesday.
That estimate far eclipses the high of about 72,000 drug overdose deaths reached the previous year and amounts to a 29% increase.
“This is a staggering loss of human life,” said Brandon Marshall, a Brown University public health researcher who tracks overdose trends.
The nation was already struggling with its worst overdose epidemic but clearly "COVID has greatly exacerbated the crisis,” he added.
Lockdowns and other pandemic restrictions isolated those with drug addictions and made treatment harder to get, experts said.
Jordan McGlashen died of a drug overdose in his Ypsilanti, Michigan, apartment last year. He was pronounced dead on May 6, the day before his 39th birthday.
“It was really difficult for me to think about the way in which Jordan died. He was alone, and suffering emotionally and felt like he had to use again,” said his younger brother, Collin McGlashen, who wrote openly about his brother's addiction in an obituary.
Jordan McGlashen’s death was attributed to heroin and fentanyl.
While prescription painkillers once drove the nation's overdose epidemic, they were supplanted first by heroin and then by fentanyl, a dangerously powerful opioid, in recent years. Fentanyl was developed to treat intense pain from ailments like cancer but has increasing been sold illicitly and mixed with other drugs.
“What’s really driving the surge in overdoses is this increasingly poisoned drug supply,” said Shannon Monnat, an associate professor of sociology at Syracuse University who researches geographic patterns in overdoses. “Nearly all of this increase is fentanyl contamination in some way. Heroin is contaminated. Cocaine is contaminated. Methamphetamine is contaminated."
There’s no current evidence that more Americans started using drugs last year, Monnat said. Rather, the increased deaths most likely were people who had already been struggling with addiction. Some have told her research team that suspensions of evictions and extended unemployment benefits left them with more money than usual. And they said “when I have money, I stock up on my (drug) supply,” she said.
Overdose deaths are just one facet of what was overall the deadliest year in U.S. history. With about 378,000 deaths attributed to COVID-19, the nation saw more than 3.3 million deaths.
The Centers for Disease Control and Prevention reviewed death certificates to come up with the estimate for 2020 drug overdose deaths. The estimate of over 93,000 overdose deaths translates to an average of more than 250 deaths each day, or roughly 11 every hour.
The 21,000 increase is the biggest year-to-year jump since the count rose by 11,000 in 2016.
More historical context: According to the CDC, there were fewer than 7,200 total U.S. overdose deaths reported in 1970, when a heroin epidemic was raging in U.S. cities. There were about 9,000 in 1988, around the height of the crack epidemic.
The CDC reported that in 2020 drug overdoses increased in all but two states, New Hampshire and South Dakota.
Kentucky's overdose count rose 54% last year to more than 2,100, up from under 1,400 the year before. There were also large increases in South Carolina, West Virginia and California. Vermont had the largest jump, of about 58%, but smaller numbers — 118 to 186.
The proliferation of fentanyl is one reason some experts do not expect any substantial decline in drug overdose deaths this year. Though national figures are not yet available, there is data emerging from some states that seems to support their pessimism. Rhode Island, for example, reported 34 overdose deaths in January and 37 in February — the most for those months in at least five years.
For Collin McGlashen, last year was “an incredibly dark time” that began in January with the cancer death of the family's beloved patriarch.
Their father's death sent his musician brother Jordan into a tailspin, McGlashen said.
“Someone can be doing really well for so long and then, in a flash, deteriorate,” he said.
Then came the pandemic. Jordan lost his job. “It was kind of a final descent.”
Link
That estimate far eclipses the high of about 72,000 drug overdose deaths reached the previous year and amounts to a 29% increase.
“This is a staggering loss of human life,” said Brandon Marshall, a Brown University public health researcher who tracks overdose trends.
The nation was already struggling with its worst overdose epidemic but clearly "COVID has greatly exacerbated the crisis,” he added.
Lockdowns and other pandemic restrictions isolated those with drug addictions and made treatment harder to get, experts said.
Jordan McGlashen died of a drug overdose in his Ypsilanti, Michigan, apartment last year. He was pronounced dead on May 6, the day before his 39th birthday.
“It was really difficult for me to think about the way in which Jordan died. He was alone, and suffering emotionally and felt like he had to use again,” said his younger brother, Collin McGlashen, who wrote openly about his brother's addiction in an obituary.
Jordan McGlashen’s death was attributed to heroin and fentanyl.
While prescription painkillers once drove the nation's overdose epidemic, they were supplanted first by heroin and then by fentanyl, a dangerously powerful opioid, in recent years. Fentanyl was developed to treat intense pain from ailments like cancer but has increasing been sold illicitly and mixed with other drugs.
“What’s really driving the surge in overdoses is this increasingly poisoned drug supply,” said Shannon Monnat, an associate professor of sociology at Syracuse University who researches geographic patterns in overdoses. “Nearly all of this increase is fentanyl contamination in some way. Heroin is contaminated. Cocaine is contaminated. Methamphetamine is contaminated."
There’s no current evidence that more Americans started using drugs last year, Monnat said. Rather, the increased deaths most likely were people who had already been struggling with addiction. Some have told her research team that suspensions of evictions and extended unemployment benefits left them with more money than usual. And they said “when I have money, I stock up on my (drug) supply,” she said.
Overdose deaths are just one facet of what was overall the deadliest year in U.S. history. With about 378,000 deaths attributed to COVID-19, the nation saw more than 3.3 million deaths.
The Centers for Disease Control and Prevention reviewed death certificates to come up with the estimate for 2020 drug overdose deaths. The estimate of over 93,000 overdose deaths translates to an average of more than 250 deaths each day, or roughly 11 every hour.
The 21,000 increase is the biggest year-to-year jump since the count rose by 11,000 in 2016.
More historical context: According to the CDC, there were fewer than 7,200 total U.S. overdose deaths reported in 1970, when a heroin epidemic was raging in U.S. cities. There were about 9,000 in 1988, around the height of the crack epidemic.
The CDC reported that in 2020 drug overdoses increased in all but two states, New Hampshire and South Dakota.
Kentucky's overdose count rose 54% last year to more than 2,100, up from under 1,400 the year before. There were also large increases in South Carolina, West Virginia and California. Vermont had the largest jump, of about 58%, but smaller numbers — 118 to 186.
The proliferation of fentanyl is one reason some experts do not expect any substantial decline in drug overdose deaths this year. Though national figures are not yet available, there is data emerging from some states that seems to support their pessimism. Rhode Island, for example, reported 34 overdose deaths in January and 37 in February — the most for those months in at least five years.
For Collin McGlashen, last year was “an incredibly dark time” that began in January with the cancer death of the family's beloved patriarch.
Their father's death sent his musician brother Jordan into a tailspin, McGlashen said.
“Someone can be doing really well for so long and then, in a flash, deteriorate,” he said.
Then came the pandemic. Jordan lost his job. “It was kind of a final descent.”
Link