Severe Combat Injuries Linked to Risk of Chronic Diseases

MONDAY, Nov. 2, 2015 (HealthDay News) — U.S. soldiers who’ve suffered severe combat injuries are at high risk for chronic diseases, according to a new study.

“The more severely a service member is injured, the more likely they are to develop a wide variety of chronic medical conditions, including high blood pressure, diabetes, chronic kidney disease and hardening of the arteries,” study lead author Major Ian Stewart, a researcher at the David Grant Medical Center at Travis Air Force Base in California, said in a news release from the American Heart Association.

The study included more than 3,800 soldiers injured in Afghanistan or Iraq. All received scores ranging from 1 to 75 based on the severity of their wounds. The higher the score, the worse the injuries.

The researchers found that for every five-point increase in injury score, the risk of high blood pressure rose 6 percent; coronary artery disease and diabetes jumped 13 percent; and chronic kidney disease increased 15 percent.

The investigators also found that veterans who developed chronic diseases tended to be older, had higher injury scores and more serious kidney damage.

When wounds were complicated by kidney damage, the risk of high blood pressure rose 66 percent and the risk of chronic kidney disease was nearly five times higher, the study revealed.

High blood pressure rates were 69 percent higher among injured black veterans than wounded white veterans, the researchers said.

Among the most severely injured veterans, rates of high blood pressure, coronary artery disease and diabetes were significantly higher than overall in the U.S. military, according to the study published Nov. 2 in the journal Circulation.

Inflammation may be the reason why combat injuries increase the risk of chronic disease, the study authors suggested. Post-traumatic stress disorder — a mental health disorder common among wounded veterans — may also play a role directly through inflammation or indirectly by leading to weight gain or substance abuse, the researchers said.

“Our study lays important ground work to better understand the longer-term effects of combat-related injury on the risk of chronic disease,” Stewart said in the news release.

More information

The U.S. National Library of Medicine has more about veterans and health.

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Sweetened Drinks Might Raise Men’s Risk for Heart Failure

By Dennis Thompson
HealthDay Reporter

MONDAY, Nov. 2, 2015 (HealthDay News) — People who regularly consume sodas or sweetened fruit drinks may have a higher risk for heart failure, researchers report.

In the study, Swedish men who drank two or more servings of sweetened beverages a day had a 23 percent higher risk of suffering heart failure, said lead author Susanna Larsson, an associate professor of epidemiology at the Karolinska Institute in Stockholm.

“People who regularly consume sweetened beverages should consider reducing their consumption to lower their risk of heart failure as well as obesity and type 2 diabetes and possibly other diseases,” Larsson said.

Sweetened drinks have been linked to stroke, diabetes, obesity and other health problems, but so far scant attention has been paid to the effects of excess sugar on heart health, said Dr. Christopher O’Connor, director of the Heart Center at Duke University School of Medicine and editor-in-chief of the journal JACC: Heart Failure.

Heart failure occurs when the heart grows too weak to pump enough blood to meet the body’s needs, according to the U.S. National Institutes of Health. Patients tire easily, suffer shortness of breath and develop fluid buildup in their feet, ankles and legs.

Only about half of those diagnosed with heart failure are still alive five years later, researchers said in background material. More than 23 million people worldwide have heart failure, including about 5.8 million in the United States.

Soft drinks have been associated with an increased risk in high blood pressure and heart disease, so it makes sense that sweetened beverages might also increase the risk of heart failure, the researchers said.

Using national registry data, they tracked the health of 42,400 men living in two counties of Sweden between 1998 and 2010.

The men, aged 45 to 79, were asked to record their average consumption of 96 food and drink items over the preceding year. One serving of a sweetened drink was defined as 200 milliliters, or nearly 7 ounces.

The questionnaire made no distinction between drinks sweetened with sugar or artificial sweeteners. Fruit juices, coffee and tea were not included in the study.

Over an average of 12 years of monitoring, more than 3,600 new cases of heart failure were diagnosed. More than 500 people died of the condition.

After accounting for other potential factors, researchers found that at least two servings of sweetened drinks a day increased heart failure risk by 23 percent, compared with people who consumed no soft drinks or sweetened beverages.

“We controlled for other food groups that could reflect an overall healthy or unhealthy diet such as intakes of fruits, vegetables, fish, processed red meat and coffee consumption,” Larsson said. “We also adjusted for total energy intake.”

The findings were published online Nov. 2 in the journal Heart.

While the study only included men, “we expect that the association would be similar in women,” Larsson said. However, he added that because this is an observational study, it does not establish a cause-and-effect relationship.

Men in Sweden tend to weigh less and are more physically fit than American men, which means this association is likely to be amplified in the United States, O’Connor said.

“In the United States, you have people who are farther down the curve,” O’Connor said. The potential effect “would be larger and faster here.”

O’Connor noted some design problems that affect the clarity of the findings. For example, food surveys tend to be inaccurate because they rely on people’s memories of what they eat, and the beverage question included all sweetened drinks, whether they contained sugar or an artificial sweetener.

But this likely “just reduces the signal,” masking what is probably an even greater effect on heart health than observed here, O’Connor concluded. “The fact the signal is still there means it’s probably real,” he said.

The American Beverage Association responded to the findings by drawing attention to a new industry initiative aimed at reducing beverage calories in the American diet by 20 percent for every person by 2025.

“This initiative will have significant real-world impact by helping people reduce their consumption of calories and sugar from beverages,” the industry group said in a statement. “To reduce the incidence of heart disease, health professionals, industry and others must work together to educate Americans about all the risk factors and encourage people to maintain a healthy weight by balancing their calories and physical activity.”

More information

For more about heart failure, visit the U.S. National Institutes of Health.

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Why Interrupted Sleep Is Worse Than Short Sleep

Photo: Getty Images

We’re a nation of unhealthy sleepers. Ten percent of us are insomniacs, many more wake up constantly throughout the night and a growing number are simply too enthralled with our smartphones to put them down and go to bed.

But what’s the worst kind of sleep for your health: the kind where you keep a normal bedtime but are constantly up every few hours, or the kind where you go to bed late and only get a few hours of shut-eye? Scientists might finally have an answer.

Reporting in the journal Sleep, lead author Patrick Finan, assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, and his colleagues conducted one of the first studies comparing the two types of sleep—interrupted sleep and abbreviated sleep—in a group of 62 healthy men and women who were good sleepers. The participants spent three days and nights in a sleep lab and answered questions about their mood every evening before dozing off. While they slept, the researchers measured their sleep stages so they could document when and how much of each stage of sleep, from light to deeper slumber, each volunteer got every night. A third were randomly assigned to be woken up several times a night, another third were not allowed to go to sleep until later but weren’t woken up, and the final group, which acted as the control, was allowed to sleep uninterrupted through the night.

When Finan compared the three groups’ mood ratings, he found that the interrupted and short sleepers both showed drops in positive mood after the first night. But on the next nights, the interrupted sleepers continued to report declining positive feelings while the short sleepers did not—they stayed at about the same level they had reported after the first night. This drop in positive mood occurred regardless of what the participants reported on the negative mood scale. So having disrupted sleep, says Finan, may have a stronger effect on dampening positive mood than it does on increasing negative emotions.

When he looked at the brain patterns of the two disrupted sleep groups, he found that those who woke up repeatedly showed less slow wave sleep, or the deep sleep that is normally linked to feeling restored and rested, than those getting the same amount of sleep but in a continuous session. “We saw a drop in slow wave sleep so large and sudden, and it was associated with a striking drop in positive mood that was significantly different than in the other group,” he says.

This article originally appeared on Time.com.

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Brad Pitt Describes the Moment He Heard About Angelina’s Cancer Scare

 

In case you forgot who holds the crown for most heart-warming power couple in history, Brad Pitt and Angelina Jolie are here to remind you that it’s them.

On the Today show this morning, Tom Brokaw interviewed the pair to promote their upcoming film By the Sea. While it’s exciting that the movie, which was also written and directed by Jolie, will be the first time the duo have worked together on-screen since Mr. and Mrs. Smith, the best parts came when the couple opened up about supporting one another through Jolie’s health struggles the past few years.

Jolie is a carrier of the BRCA 1 gene, which gives her an 87% chance of breast cancer and a 50% chance of developing ovarian cancer; her mother, grandmother, and aunt died of cancer. In 2013, Jolie had a preventive mastectomy to avoid breast cancer. Earlier this year, she announced that a blood test revealed possible signs of early ovarian cancer, so she made the decision to have her ovaries and fallopian tubes removed as well.

“I made the choices I made because I believe they were right for me,” Jolie said of her surgeries.

RELATED: What You Should Know About Angelina Jolie’s Cancer-Preventing Surgery

Pitt recalled the moment he got the news that his wife may have ovarian cancer, saying the hardest part was not being by her side.

“I was out in France, and Angie called me and I got straight on a plane to return,” Pitt said. “Seeing my wife have to be her strongest and knowing that it’s the scariest of news is terribly moving. And not being there is a horrible feeling.”

Pitt also called her decision to go through the surgery “mature.”

It was like, “this is our life and we’re going to make the best of it,” Pitt explained. “There was strength in that. It was just another one of those things in life that makes you tighter. She was doing it for the kids, and she was doing it for her family, so we could be together. It was… It trumped everything,” he told Brokaw.

Jolie added that her husband’s support played a huge role in getting her through this difficult time.

“I knew through the surgeries that he was on my side and that this wasn’t something where I was going to feel less of a woman because my husband wasn’t going to let that happen,” Jolie added. “To face these issues together and speak about them and talk about what it is to be human, I think can be a beautiful thing.”

RELATED: What Breast Cancer Docs Really Think About the “Angelina Effect”

 

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Antibiotics May Not Help After ‘Complicated’ Appendectomy

MONDAY, Nov. 2, 2015 (HealthDay News) — Antibiotics may not reduce the risk of infections in patients who undergo what’s known as a “complicated” appendix removal, a new study finds.

“The traditional teaching is that all patients with complicated appendicitis receive post-operative antibiotics to reduce the risk of wound infection or deep organ space infection,” study lead author Dennis Kim, of the Los Angeles Biomedical Research Institute, explained in an institute news release.

But is that advisory warranted? To find out, Kim’s team tracked five-year outcomes for 410 patients. All of the patients had complicated appendectomies, meaning that their appendix was found to be perforated or gangrenous.

About two-thirds of the patients received antibiotics after surgery. Those who received antibiotics had no fewer infections, Kim’s team said, and they stayed in hospital an average of one day longer than those who didn’t receive antibiotics.

The bottom line, according to Kim: “Our study indicates antibiotics may not be necessary following surgery for complicated appendicitis.”

He explained that “antibiotics are not without risks, costs or complications.”

Further study into the issue may be warranted, the researchers said. In the meantime, Kim said, “surgeons and physicians may wish to re-examine or be more selective in deciding which patients may potentially benefit from post-operative antibiotic therapy for complicated appendicitis.”

Acute appendicitis affects more than 250,000 people a year in the United States, and up to one-third may have complicated appendicitis, the study authors noted.

“The medical profession is beginning to re-examine the role of antibiotics for treating other common acute surgical disease processes, and our study shows this re-evaluation is warranted in complicated appendectomies,” Kim said.

The study was published online recently in the American Journal of Surgery.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about appendicitis.

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New Advisory Says Some Athletes With Heart Conditions OK to Play

MONDAY, Nov. 2, 2015 (HealthDay News) — Some people with a potentially deadly type of irregular heartbeat may be able to play competitive sports, new guidelines say.

The scientific statement from the American Heart Association and the American College of Cardiology pointed out that recent research indicates the risk of sudden cardiac arrest is lower than previously thought for some athletes with irregular heartbeat caused by long QT syndrome and athletes with long QT syndrome who have implanted pacemakers or defibrillators.

People with long QT syndrome can experience fast and chaotic heartbeats that can be life-threatening.

The new statement applies only to athletes with long QT syndrome who play competitive sports directed by a coach, including baseball, football and basketball. It doesn’t apply to people who occasionally play sports for exercise or fun.

Since every patient is different, people with long QT syndrome must get their doctor’s approval before participating in competitive sports, according to the statement in the journal Circulation and the Journal of the American College of Cardiology.

Dr. Barry Maron, director of the Hypertrophic Cardiomyopathy Center at the Minneapolis Heart Institute Foundation, co-chaired the committee that wrote the statement. He said it is intended to promote decision-making based on the latest research and the patient’s understanding of his risk and the health care provider’s clinical judgment.

In a news release from the American Heart Association, Maron said that the recommendations are not mandates and are not intended to make “the general medical (and legal) standard of care applicable to all competitive athletes.

“It should be noted that the guidance for patients with hypertrophic cardiomyopathy has not changed,” he added. “We still recommend avoiding intense competitive sports for people who have this condition.”

People with hypertrophic cardiomyopathy have abnormally thick heart muscles, increasing their risk for life-threatening irregular heartbeat, especially during intense exercise.

Statement writing group co-chairman Dr. Douglas Zipes said in the news release, “The ultimate incentive is to prevent sudden cardiac death in the young, although it is also important not to unfairly or unnecessarily remove individuals from a healthy athletic lifestyle.” Zipes is a professor and director of the cardiology division of the Krannert Institute of Cardiology at the Indiana University School of Medicine in Indianapolis.

More information

The U.S. National Heart, Lung, and Blood Institute has more about long QT syndrome.

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Fast-Food Menus With Calorie Counts Not Changing New Yorkers’ Habits

MONDAY, Nov. 2, 2015 (HealthDay News) — Calorie labeling on menus has had little effect on the number of calories consumed by people eating at fast-food restaurants in New York City, a new study shows.

The findings suggest that menu calorie information alone is not enough to lower obesity rates, the NYU Langone Medical Center researchers said.

In 2008, New York City ordered chain restaurants to provide customers with calorie counts of menu items.

The researchers analyzed items purchased by nearly 7,700 people who ate at McDonald’s, Burger King, KFC and Wendy’s restaurants in New York City and nearby New Jersey cities between January 2013 and June 2014.

They compared that information to results of a survey of more than 1,000 fast-food restaurant customers conducted just after the New York City policy was introduced.

Calorie consumption in the 2013-14 survey averaged between 804 and 839 per meal at restaurants with calorie counts, and between 802 and 857 per meal at restaurants without calorie counts.

In the 2008 survey, calorie consumption averaged 783 per meal at restaurants with calorie counts and 756 per meal at restaurants without calorie counts.

The study appears in the November issue of the journal Health Affairs.

“Our study suggests that menu labeling, in particular at fast-food restaurants, will not on its own lead to any lasting reductions in calories consumed,” senior investigator Brian Elbel, an associate professor in the Department of Population Health at NYU Langone Medical Center, said in a Langone news release.

The findings could provide an early indication of the possible impact of nationwide menu labeling to be introduced in December 2016 under the Affordable Care Act.

While menu calorie-labeling by itself may have little impact on the nation’s obesity epidemic, it might be effective when used with other measures, such as marketing regulations or price subsidies for healthy foods, Elbel suggested.

Calorie “labels may yet work at non-fast-food, family-style restaurant chains, or for specific groups of people with a greater need than most to consume fewer calories and eat more healthily. We will have to wait and see, while continuing to monitor and analyze the policy’s impact,” he said.

More information

The U.S. National Library of Medicine offers tips for healthy eating when dining out.

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Severe Obesity Costs Medicaid $8 Billion Annually, Study Finds

By Alan Mozes
HealthDay Reporter

MONDAY, Nov. 2, 2015 (HealthDay News) — Severe obesity is putting a huge financial strain on both the U.S. Medicaid system and severely obese patients themselves, new research suggests.

The study pegs the national bill for providing obesity-related health services for the severely obese at $69 billion a year. Severely obese is defined as a body mass index (BMI) of 35 or higher, the study authors said. (BMI is a rough estimate of a person’s body fat based on their height and weight.)

Medicaid pays just over 10 percent of the annual cost of treating the severely obese. That works out to about $8 billion a year, the researchers said. And that figure is likely to rise as Medicaid — the government-run insurance program for poorer Americans — expands under the health-reform law known as the Affordable Care Act, sometimes called Obamacare.

“Severe obesity affects one in seven adults,” said study co-author Michael Long, an assistant professor at the Milken Institute School of Public Health at George Washington University in Washington, D.C. “And it increases the risk of disease and death at a much higher rate than moderate obesity,” he added.

Moderate obesity is a BMI between 30 and 35, the study authors noted.

“So although severe obesity accounts for only 41 percent of the 81.5 million Americans who are obese, the costs associated with treating it are actually 60 percent of all obesity-related costs combined,” Long explained.

“And Medicaid patients, who have low resources and a high burden of disease and obesity, are not covered completely,” he said. “So severe obesity is a big burden on both Medicaid and patients.”

Long and his colleagues reported their findings in the November issue of Health Affairs.

Obesity has tripled over the last 30 years in the United States, according to the study authors.

Dr. David Katz is director of the Yale University Prevention Research Center in New Haven, Conn. He said that “obesity is, inevitably, enormously expensive, because it is on the causal pathway to every major chronic disease that plagues modern societies, diabetes most indelibly.”

Katz explained that “the costs of obesity extend out to the costs of all such conditions: heart disease, cancer, diabetes, stroke, arthritis, dementia, and more.”

Those disease risks and costs are even higher for the 33 million Americans now considered severely obese. (For example, Long noted that for a 5-foot 4-inch woman, being severely obese means weighing about 204 pounds, or 60 pounds above normal. For a 5-foot 9-inch man, that would be a weight of about 236 pounds, or 67 pounds above normal.)

To get a better idea of the costs of obesity, the team crunched data from two national studies conducted between 2007 and 2013. The studies included more than a half million people.

The researchers found that the moderately obese pay $941 more per year for health care, compared with someone of normal weight. By contrast, people who are severely obese pay $1,980 more, the findings showed.

Private insurances covered more than one-quarter of these expenses, while Medicare covered about 30 percent. State-run Medicaid programs footed 11 percent of those bills, the investigators found.

And, patients were left to cover 30 percent out of their own pockets, the study said.

Some state Medicaid programs pay more than others. For example, Wyoming’s program now covers 58,000 severely obese adults at a cost of $64 million per year (at the low end of the scale). Meanwhile, California spends about $9.1 billion for 3.2 million adults (at the high end), the study reported.

Regardless, the study authors concluded that severe obesity appears to be “disproportionately responsible” for a lion’s share of the whole nation’s health care bill.

“Our primary public health goal has been trying to reduce and prevent childhood and adult obesity,” Long said. “But that effort, while important, is unlikely to reverse the problems faced by adults already struggling with severe obesity, or the health care costs related to those problems.”

Any solution, he suggested, will have to address two issues: identifying cheaper but effective clinical interventions, while also expanding treatment access for the severely obese.

“That might actually cost more money in the short-run,” he acknowledged. “But it will have long-term payoffs, for both the patients and Medicaid. And we have to do something, because this problem is just the tip of the iceberg. If we just let this continue as is, the costs will only grow over time,” Long said

Katz added, “The only hope for the future of public health and the economy alike is to change the trajectory we are on, and put out this fire.” But he said that, in his opinion, “the answer is not more drugs and surgery, but a culture-wide commitment to better use of feet, and forks.” In other words, exercise more and eat healthier.

More information

There’s more on severe obesity at the American Heart Association.

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Better Diets May Be Extending Americans’ Lives

By Randy Dotinga
HealthDay Reporter

MONDAY, Nov. 2, 2015 (HealthDay News) — Despite the stereotype that Americans are eating more unhealthful foods that leave them vulnerable to assorted diseases, a new study suggests the opposite may be true.

Harvard researchers report that they found evidence that better diets since 1999 have saved more than one million people from dying prematurely. They also believe improved diets have significantly cut diabetes and heart disease, and even slightly trimmed cancer cases.

The findings paint a surprising picture of American health. But study author Dong Wang, a graduate student with the departments of nutrition and epidemiology at Harvard T.H. Chan School of Public Health in Boston, cautioned that it’s not time to declare victory in the battle against unhealthy eating.

“The overall American diet is still poor,” he said. “Huge room exists for further improvement.”

The researchers wanted to understand how changes in the American diet in the 21st century affected health over time. To get insight into the answer, they analyzed the results of seven health and nutrition surveys including almost 34,000 adults aged 20 and older between 1999 and 2012.

The researchers ranked diets on a healthy eating scale from 0 (poor diet) to 110 (perfect diet). From 1999 to 2012, the overall rating increased, from 40 to 48.

On the positive side, over time, Americans ate more fruit, whole grains, nuts and legumes and polyunsaturated fatty acids, Wang said. They also ate less trans fats, sugar-sweetened beverages and juice, and red and processed meat. But the intake of salt actually went up.

The researchers extrapolated their findings and estimated that the improvement in diets prevented over one million premature deaths and lowered heart disease cases by almost 9 percent, type 2 diabetes cases by nearly 13 percent and cancer cases by just over 1 percent.

According to Wang, the study findings suggest that healthier diets lower the risk of death in a variety of ways. Among other things, improved diets appear to lower the risk of chronic diseases and boost the survival of people who have those conditions. Even a year or two of a better diet appears to have the power to affect survival rates, he said.

The study authors didn’t analyze whether their estimates match up to actual death rates in the United States. But other research has pinpointed a decline in death rates in this century, Wang said.

Dr. Sonia Anand, a professor of medicine and epidemiology at McMaster University in Hamilton, Canada, praised the study, saying it’s “reasonable” to link changes in diet to death rates in this way. But, she said, nutrition research like this has limitations because it relies on people’s memories of what they ate. As a result, she said, it’s crucial to look at a variety of studies and see if trends hold up.

According to study author Wang, trans fats have been almost eliminated from the food supply, so what is needed next is more taxation on sugary drinks and more regulations requiring salt to be reduced in food.

He also said the government can do more to improve diets for the poor, who haven’t seen the same level of improvements as other groups. One option, he said, is to increase the number of farmers markets that accept food stamps.

The study is published in the November issue of Health Affairs.

More information

For more about healthy eating, visit the U.S. Centers for Disease Control and Prevention.

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Substance Abuse, Suicide Killing More White, Middle-Aged Americans: Report

By Karen Pallarito
HealthDay Reporter

MONDAY, Nov. 2, 2015 (HealthDay News) — A largely unnoticed “epidemic” is killing white, middle-aged Americans in growing numbers, a new analysis reveals.

Princeton University researchers report that the overall death rate of white adults in midlife has risen sharply over the past 15 years, largely because of drug and alcohol overdoses, suicide, chronic liver disease and cirrhosis of the liver. The tally is on par with the nation’s AIDS deaths, they added.

“We sort of fell off our chairs when we saw that in the data, because that’s just not what’s happening elsewhere,” said study author Anne Case, a professor of economics and public affairs.

No other industrialized nation has experienced a similar deterioration in health during the timeframe studied — 1999 to 2013, the researchers said in background notes. Meanwhile, death rates of U.S. Hispanics and blacks continue to plummet.

Results of the analysis, funded by the U.S. National Institute on Aging, were published online Nov. 2 in the Proceedings of the National Academy of Sciences.

The study raises important questions about the future of white Americans in their 40s and 50s as they approach old age in worse health than the preceding generation.

“It happened very quietly,” Case said. “The despair is really there. It’s just that the focus has not been on it.”

Dr. Wilson Compton, deputy director of the U.S. National Institute on Drug Abuse, said the analysis provides the first evidence that behavioral issues, such as misuse of alcohol and narcotic painkillers, are affecting the overall death rate for an entire group of people often considered exempt from such issues.

“Pretty startling,” he said.

Aaron White, senior scientific advisor to the director of the U.S. National Institute on Alcohol Abuse and Alcoholism, called the results “very alarming.”

“Now there are more people 45 to 54 dying from alcohol and drug poisonings than from lung cancer,” he said.

Using data from multiple sources, Case and study co-author Angus Deaton, a professor of economics and international affairs at Princeton, connected rising death rates to factors such as increasing reports of pain, growing psychological distress, more alcohol poisonings and greater availability of prescription painkillers such as OxyContin and Vicodin.

Adults with the least education (a high school degree or less) experienced the sharpest increase in death rates — up 22 percent, the study found.

The turnabout in the health of middle-aged whites comes after two decades of life-extending health improvements.

Between 1978 and 1998, the death rate for white, middle-aged Americans fell 2 percent a year, on average, mirroring rates in other rich nations, including France, Germany, Great Britain and Sweden, the study found.

After 1998, death rates in other rich nations continued to decline. But in the United States, deaths of whites began climbing by half a percent a year through 2013, the study found.

Deaths related to drug and alcohol poisoning, suicide, chronic liver disease and cirrhosis rose for every age group studied. Liver disease and cirrhosis are linked to alcohol abuse. The difference is that the number of deaths in the midlife group was substantial enough to bend the overall mortality rate.

Why only whites, and least-educated whites in particular?

Dr. Paula Braveman, director of the Center on Social Disparities in Health at the University of California, San Francisco, said one possible explanation is despair.

“Perhaps they perceived that the deck was stacked against them, with widening inequality, not only in wealth, but in the most basic opportunities to give them a fighting change of upward mobility,” she said. “People of color never had that hope.”

Whatever the underlying causes may be, the toll on human health is remarkable.

If the 1998 death rate of whites had held steady, 96,000 lives would have been saved between 1999 and 2013, the authors estimated.

And if the death rate had continued its descent at the same pace established in the prior two decades, nearly a half million deaths would have been avoided from 1999 to 2013.

That’s comparable to the number of U.S. lives lost to AIDS through mid-2015, the study authors pointed out.

Physicians are “the canaries in the cage” for some of these causes of death, because they are the most likely to spot someone who’s drinking too heavily or misusing medications, White said.

“We need to take these data and arm physicians with the numbers so that they can help their patients,” he said.

But Braveman said, “This health issue will not be solved by medical care; it will require changes in social policy.”

More information

See the U.S. National Institute on Drug Abuse for more about addiction.

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