Archive for September, 2009

Sep 25 2009

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Report: less-healthy seniors and meager medical resources could swamp Nevada health care

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Nevada elders drink and smoke more than seniors nationally. They eat fewer fruits and vegetables. They are twice as prone to suicide. And they live in one of the states most shorthanded in terms of health-care professionals.

Those are among the findings in the latest edition of a state fact book on the health of older adults, Elders Count Nevada, 2009. The 80-page report was prepared and published by the Sanford Center for Aging in collaboration with the Nevada Department of Health and Human Services, the state Health Division and the Nevada Aging and Disability Services Division.

Some of the researchers involved in compiling the report gave a summary of its contents this week at the annual meeting of the Nevada Public Health Association, held at the University of Nevada, Reno.

Because of its rapid growth, Nevada is at the leading edge of the so-called “aging tsunami,” the demographic wave carrying 78 million baby boomers into their retirement years. As Nevada’s overall population boomed between 2000 and 2007, the state’s population of people 65 and older grew almost four times faster than the national average.

This is the second edition of Elders Count Nevada, and it tells much the same story as the first (published in 2007): Old or young, many Nevadans don’t practice the healthiest of living habits. And Nevada trails almost every other state in terms of its supply of medical and health-care professionals.

As the report details, only four states (Kansas, Oklahoma, Idaho and Mississippi) have fewer active physicians per capita, and only one (Arizona) has fewer nurses. Nevada ranks last in terms of dentists and medical students per capita, and it has fewer than half the national rate of nursing-home beds per capita.

The report shows that the roughly 300,000 Nevadans 65 and older are similar to seniors in other states in some respects, including life expectancy (about 76 years). However, there are noteworthy differences, including rates of:

Suicide. Nevada’s elder-suicide rate (35.4 per 100,000 population) is more than double the national rate. Isolation in rural parts of the state and the widespread possession of firearms (the most common means of suicide) are believed to be contributors.

Obesity. A smaller share of Nevada elders meet the definition of “obese” than is the case nationally (18 percent vs. 23 percent). But Nevada is above the national average in the less-severe category, “overweight” (43 percent vs. 41 percent), plus the trend is discouraging. In 1995, 13 percent of Nevada adults of all ages were obese. By 2007, the rate had grown to 25 percent.

Smoking. In 2007, 18 percent of Nevadans 65 and older smoked, double the national rate. But things are looking up. Although about one in four Nevada seniors smoked daily in 1996, 10 years later that rate had been halved, to 12 percent. Unfortunately, that’s still one-third higher than the national daily smoking rate for seniors (9 percent).

Heavy drinking. Almost twice as many Nevada seniors drink heavily than is the case nationally (4.9 percent vs. 2.9 percent). Heavy drinking is defined as men who have more than two drinks per day and women who have more than one.

Along with statistics, Elders Count Nevada 2009 offered a set of policy recommendations. These included expanding several relatively low-cost programs for seniors, programs that are already partially funded or operated by state agencies and the Sanford Center for Aging.

One example is the Medication Therapy Management program, which analyzes seniors’ drug and vitamin/supplement regimens to check for potentially dangerous interactions and duplications. Adverse reactions to medications are believed to be the fifth-leading cause of death in the United States. Almost one in three hospitalizations of elders is due to preventable medication-related errors.

The entire Elders Count Nevada 2009 report can be read or downloaded online at http://www.unr.edu/sanford/documents/EldersCountReport09.pdf.

Presenting details of the Elders Count report at the NPHA conference were Dominique Joseph, M.P.H., research assistant and geriatric fellowship coordinator for the Sanford center; Teresa M. Sacks, M.P.H., health research analyst for the Sanford center; and Lawrence J. Weiss, Ph.D., the CEO of the Center for Healthy Aging.

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Sep 25 2009

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Nearly half of Nevada pharamcists think they should have the right to refuse to fill prescriptions

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Federal regulations handed down during the Bush Administration allow health-care providers to refuse care due to moral objections. Some states have adopted related policies.

At the Nevada Public Health Association annual conference, held this week at the University of Nevada, Reno, a team of researchers presented findings from a survey of Nevada pharmacists that related to this issue.

The team included Daniel M. Cook, Ph.D., an assistant professor in the UNR School of Community Health Sciences who is also associated with the Sanford Center for Aging.

Among 668 responses from licensed Nevada pharmacists, 47.9% said they believed they should not be required to fill all valid prescriptions.

Other findings:

  • 43.4% said they would refuse a prescription if allowed;
  • 76.9% thought that if a pharmacist refused to fill a prescription that pharmacist should be obligated to find a pharmacist who would fill it;
  • Roughly a third (28%) said they knew of cases of refusals despite local rules;

Current Nevada law requires pharmacists to honor all valid prescriptions, Cook said.

The other authors of the study were: Clare T. Pettis and Laura Davidson, both doctoral candidates in interdisciplinary social psychology at UNR; Amber J. Joiner, a doctoral candidate in public policy and administration at UNR and a senior research analyst with the Nevada Legislative Counsel Bureau; and Craig M. Klugman, Ph.D., Stewart & Marianne Reuter Endowed Professor of Medical Humanities and assistant director for ethics education at the Center for Medical Humanities & Ethics at the University of Texas Health Science Center in San Antonio.

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Sep 25 2009

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Few suprises in who isn’t getting screened for colon cancer

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Colorectal cancer is the third-most-common cancer diagnosed in men and women and the second-leading cause of death from cancer.

So why don’t more people get screened for it?

Research presented at the Nevada Public Health Association annual meeting, held this week at the University of Nevada, Reno, sheds some light.

The study was done by faculty and research assistants from the Sanford Center for Aging and University of Nevada School of Medicine.

Using data from the 1997–2006 Nevada behavioral risk factor surveillance system (BFRSS), the researchers  found that among elders 50 and older who had ever had a colonoscopy/sigmoidoscopy or a fecal occult blood test, those LEAST likely to undergo one or the other tests were:

  • age 50 to 59
  • rural residents
  • people with lower incomes
  • people with lesser education
  • those who described themselves as healthy

The findings were presented by Sreekanth Donepudi, M.D., M.P.H., geriatrics fellow of University Of Nevada School Of Medicine; and Dominique Joseph, M.P.H., research assistant with the Sanford center, on behalf of their co-investigators Wei Yang, M.D., M.P.H., of the UNR School Of Public Health; and Diane Chau, M.D., of the University of Nevada School Of Medicine.

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Sep 25 2009

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Sanford center grad assistant wins scholarship

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Paula Valencia-Castro

Paula Valencia-Castro

One of the Sanford Center for Aging’s graduate assistants, Paula Valencia-Castro, was awarded a $500 scholarship at the Nevada Public Health Association’s annual meeting this week at the University of Nevada, Reno.

In a letter congratulating her on the award, NPHA President Nancy Menzel, Ph.D., R.N., said the scholarship recognized the quality of her submission including identification of a public health issue facing Nevada, her professional goals, and plans to contribute to the field of public health.

Originally from Chile, Paula graduated from the Universidad de Playa Ancha, Chile, in 2001 with a Bachelor of Science in Kinesiology. In 2008 she earned her Master of Public Health in Epidemiology from UNR. She is currently working as a research assistant for the Medication Therapy Management program at the Sanford Center for Aging while pursuing a Ph.D in Environmental Sciences and Health.

She is interested in investigating the impact of the built environment and area of residency on individuals’ health. Specifically, she is concerned about how these affect older adults’ well-being and its impact on their health and access to health care and medications.

After earning her Ph.D. she plans to continue working in public health, particularly translating research into practice and developing programs to serve older adults.

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Sep 24 2009

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What’s wrong with Nevada?

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Nevada seems like such a great place to live. You might not realize that it’s in terrible shape health-wise relative to other states.

That’s the picture painted by statistics presented at the Nevada Public Health Association annual conference, which was held Sept. 21 & 22 at the University of Nevada, Reno.

Here’s a sampling of numbers mentioned:

In terms of state health expenditures as a percentage of GSP, Nevada ranks 48th.

Number of primary-care physicians per 100,000 population: 46th

Registered nurses per 100K population: 50th

Children uninsured: 50th

Children immunized: 50th

Percentage of adults who visited a doctor in the past two years: 47th

Percentage of adults with poor mental health: 51st

Then there was this frightener: 35.7 percent of kindergarten students in Nevada are considered to be either overweight or at risk of overweight.

On the plus side (finally!), Nevada is No 3 in seat belt use.

What’s especially frustrating, said Jay Kvam, a health program specialist at the Nevada State Health Division, is that Nevada’s numbers are lower than surrounding states and lower than they one would expect them to be based on the state’s wealth and population.

More data can be found in the Nevada Health Scorecard prepared by the Nevada Academy of Health.

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