Headline News, Science Views (1991) / Chapter Skim
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4 The Nation's Health
4 The Nation's Health
Pages 79-104
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From page 81... ...
Fortunately, we can answer that question with much greater confidence as a result of the widely publicized report on diet and health that was released earlier this month by the National Research Council. ~ chaired the committee of 19 experts that sifted through more than 5,000 scientific articles to prepare the report, which provides comprehensive information on the relationship between diet and chronic diseases such as heart disease, cancer and diabetes.
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From page 82... ...
We found very strong evidence that saturated fat and cholesterol intake affect the frequency of arteriosclerotic coronary artery disease. There are also excellent data showing that salt intake increases blood pressure.
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From page 83... ...
* The Spitting Image: Baseball Players and Chewing Tobacco Tohn C
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From page 84... ...
During the last two years, ~ have helped lead a team of researchers from the School of Dentistry at the University of California at San Francisco that has conducted an extensive study of smokeless tobacco use and its health effects on baseball players. Our team gathered data to help convince players to give up tobacco for their own health and for the sake of their fans.
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From page 85... ...
Similarly, many baseball teams no longer allow manufacturers of smokeless tobacco to leave free samples in locker rooms. The San Francisco Giants, for example, provide free sunflower seeds instead.
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From page 86... ...
Seventy percent of adult Americans drink alcohol, and many of them have at least occasional problems ranging from quarrelsome behavior to drunk driving. Yet, when people seek to solve these problems, they often feel overwhelmed by the prospect of enrolling in a residential treatment center.
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From page 87... ...
Make no mistake; specialized hospital and residential treatment programs often do an outstanding job helping people to overcome alcoholism. As valuable as they are, however, they are not required for everyone.
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From page 88... ...
As the director of the nation's oldest center offering in vitro fertilization therapy for infertile couples, ~ weary of saying, "Sorry, your chances are not the best." Our center has helped more than 500 couples bear one or more children. Yet an estimated 4.4 million women of childbearing age in the United States experience difficulty conceiving a child, and many of them might become pregnant with better treatment methods.
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From page 90... ...
Such research raises many difficult ethical and social issues, such as whether embryos are human, how "spare" embryos from fertilization procedures should be handled and whether fetal tissue from abortions ought to be used in research. These questions are profound, and they have been addressed in more than 85 reports from 25 countries.
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From page 91... ...
Yet the progress achieved with animals is pertinent, and it contrasts with the slow pace of research on human reproduction. Increasing this pace could lead not only to better treatment of infertility, but also to improvements in contraception, food production and efforts to sustain endangered species.
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From page 92... ...
Some of these changes have been beneficial, but others are more questionable. Notably, there is considerable evidence that routine use of electronic fetal monitoring in normal pregnancies is both expensive and unnecessary, occasionally leading to inappropriate Cesarean sections.
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From page 93... ...
Extending additional immunity to physicians at governmentfinanced clinics, contributing to liability coverage for Medicaid providers, and expanding the National Health Service Corps are possible ways to encourage doctors to provide obstetrical services. The current situation in obstetrics cannot be allowed to persist until the malpractice issue is resolved for medicine generally, a process that could take many years.
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From page 94... ...
Similarly, when people are severely injured, their families usually focus on the need for rehabilitation and long-term care not on preventing similar accidents. Contrast that with the tradition of supporting medical research on heart disease, cancer or whatever disease killed a loved one.
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From page 95... ...
Stronger safety standards in automobiles could be enacted and existing ones enforced more vigorously. More could be done to change social norms involving dangerous behaviors, as has been done with drunk driving.
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From page 96... ...
Theoretically, the spread of the HIV virus that causes AIDS could be virtually stopped by altering the behaviors known to transmit it: unsafe sex and intravenous drug use. Over the past several clecades, social and behavioral scientists have accumulated valuable knowledge about modifying unhealthy
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From page 97... ...
Similarly, some intravenous drug users who cannot obtain or accept treatment immediately, for whatever reason, may find it easier to stop sharing drug paraphernalia or to sterilize injection equipment than to practice abstinence. To be effective, behavioral intervention programs need to consider people's health beliefs and perceptions of their own efficacy.
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From page 98... ...
's Committee on AIDS Research and the Behaviora] , Socia]
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From page 99... ...
, ~ What, then, is the harm in lLetAs we learned during our recent study of AIDS and HIV infection for the Institute of Medicine and the National Academy of Sciences, medical researchers, physicians, AIDS patients and others have been struggling with the ethics of this difficult situation. Our committee concluded that the most compassionate course is for drug trials to continue to follow rigorous scientific guidelines.
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From page 100... ...
In the case of AIDS drugs, it is frequently overlooked that people can be made sicker by experimental therapy. This is what happened with the drug suramin, which looked promising but proved in clinical trials to have serious toxicity and no clear benefit.
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From page 101... ...
Consider hip fractures, which an Institute of Medicine committee recently examined. About 260,000 Americans,
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From page 102... ...
Direct medical care costs total about $6 billion per year. Yet no clear consensus exists among physicians about certain aspects of the treatment of hip fractures, such as how long patients should be hospitalized, which surgical options to use, or the most effective sequence of surgical interventions.
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From page 103... ...
In recent years, our country's familiar health care system has been swept by a host of changes, from proliferating health maintenance organizations to hospital emergency rooms overwhelmed by uninsured patients. Some valuable changes have improved quality and efficiency while controlling costs.
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