Making Sense of the Measles Outbreak

As of the end of January, the CDC has reported over 100  cases of measles related to the ongoing outbreak in the U.S.   Many, but not all, of the cases are related to exposure over the past 2 months at California’s Disneyland amusement park.  Most of people who are sick live in California, but the outbreak extends beyond that state.

A child infected with the measles rests on a blanket. Julien Harneis/ Creative Commons via Flickr

A child infected with the measles rests on a blanket. Julien Harneis/ Creative Commons via Flickr

This is the first major outbreak of 2015 but if last year was any indication – it won’t be the last.  According to this graph from the CDC there were 23 outbreaks last year – a dramatic increase over previous years.
Many health professionals say there are two main reasons for this.

First, measles is an incredibly contagious disease. The CDC says the virus can live in the air for up to 2 hours.   And those infected can unwittingly spread the virus for days before experiencing any symptoms and seeking treatment.

Second, more and more people in developed countries are avoiding the measles vaccine. Most of the people contracting measles in the California outbreak were not vaccinated.  Dr. Rebecca Sunenshine of the Maricopa County Department of Health notes   “Vaccines are never perfect, but the measles vaccine is the closest to perfect that we have”. As this graphic from Vox illustrates, even a small number of un-vaccinated people puts many others at risk.

Those in the “anti-vax” movement fear the Measles vaccine (MMR) causes autism. This idea has been discredited by numerous scientific studies.  And yet this series of maps from the Washington Post shows the number of Californians refusing vaccines is growing.  Similar maps illustrating this trend in other states are not available at this point.

Some medical professionals hope this latest outbreak will change the minds of parents opposed to vaccinations and those who hesitate to vaccinate their children.  The Washington Post reports, in some cases, that seems to be working.  But according to this L.A. Times article, many parents are still resistant.

Parents aren’t the only ones who need to be vigilant..  This L.A. Times article points out that physicians who entered the profession in the last 30 years – when measles was considered eliminated in the U.S. – have not been well prepped to diagnose the disease.  Some are now getting a crash course in identifying the symptoms.

There is no treatment for measles.  The CDC says most people do not die from disease but complications do lead to death in 1 to 2 children out of 1,000.

End of Life & Ethical Wills

When preparing for end of life, people often make a legal will, a living will or health directive, and some create another document – an “Ethical Will” or “Legacy Letter”. These are documents, videos, slideshows, or other kinds of presentations that capture a person’s values, beliefs and wisdom.

This New York Times article points out a practical side of an ethical will saying “they can soothe ruffled feathers when dispensing family assets”. But the main point, as this article in Barron’s points out, is the immeasurable value for the person creating the document and those receiving it.

In this episode of MPR’s “A Beautiful World” host Heather McElhatton explores the power of the “Legacy Letter” for a young woman whose mother passed away.

This Thursday night. Jan. 29th at 7pm, Suzanne Pekow, the woman featured in the story, will host a live event called “An Introduction to Legacy Letters”. She will be joined by Dr. Barry Baines, author of Ethical Wills; Putting Your Values on Paper and Rachael Freed, Senior Fellow at the University of Minnesota Center for Spirituality and Healing.

The event will be in the UBS Forum in downtown St. Paul. It’s free but you need a ticket to attend. You can register here.

A Community Conversation about Toxic Stress & Early Childhood

New research finds that children who experience high levels of stress in early childhood may suffer enduring problems in learning, physical well-being, and social development. The research into “toxic stress” is helping us understand how the stress of abuse and neglect impacts early neurological development and seriously affects children’s long-term resilience and learning.

Healthy States brought together experts and community leaders to discuss the neurological connection between toxic stress in childhood and lifelong health, and to hear how child welfare advocates in Minnesota are addressing it. First, Megan Gunnar, Ph.D., from the University of Minnesota’s Institute on Child Development presented findings on the connection between neurological development and early childhood stress.

Then MPR News reporter Sasha Aslanian, the event’s moderator, invited community leaders to discuss their work to mitigate toxic stress. The group included MayKao Y. Hang, president and CEO of the Wilder Foundation, Sondra Samuels, president and CEO of Northside Achievement Zone, and Dr. Michael Troy, medical director of Behavioral Health Services at Children’s Hospitals and Clinics of Minnesota. Dr. Troy also shared his takeaways from the gathering on the Children’s health blog.

Profiles in Health: Al Vogt

By Jennifer Vogel

Al Vogt

“Even more importantly, it’s going to take people engaged from the very ground floor to do the innovative and creative thinking to try to put the right kinds of systems in place so that we can continue to be an independent hospital, a very strong independent hospital.” – Al Vogt / Derek Montgomery for Healthy States

Al Vogt breezes along the nature-themed hallways of Cook Hospital, the facility he has run for 25 years. He shows off remodeled examination rooms, a lively senior care wing, and the hospital’s new emergency department. “People come to northern Minnesota to find out how to jump into a boat and get fish hooks stuck in their fingers,” he says. “And to clunk their heads on everything.”

Located in a city of 600 people in what most consider the wilderness, an hour and a half north of Duluth, Vogt has spent his career making the case that this 14-bed hospital must continue to exist. Besides employing 135 people, the hospital serves a 2,500-square-mile area of pine and rock with an older- and poorer-than-average population.

Driving long distances to larger cities for medical care isn’t an option for many, he says. “Some people don’t have cars. Or they can’t afford the gas. For a number of individuals up here, Social Security is their only income.”

For Vogt, who started at the hospital nearly 40 years ago as lab supervisor, the rural health care mission is personal. Not only were two of his kids born here, but now that the 65-year-old is retiring at the end of January, he expects to return as a patient himself, both as he faces the normal vagaries of aging and as he continues to treat the multiple myeloma cancer he was diagnosed with five years ago.

Vogt has championed technological innovation, by running a well-equipped lab and by installing electronic medical records. He also has implemented telemedicine, which allows him, and other patients, to see specialists at larger hospitals via the Internet. Vogt’s oncologist is in Duluth. “We can talk by video,” he says. “I can do all my labs or imaging or testing up here in Cook and transmit all that stuff to him.” Of his staff, he says, “These are people I trust. These are people I know. I’ll come to Cook every time.”

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Top Health Stories of 2014

‘Tis the season to read year-end listicles, and we’ve found a few persuasive lists of the most important health and medical stories of the last year, beginning with this conversation from MPR News’ “The Daily Circuit” that reviews stories ranging from the rollout of the Affordable Care Act to Ebola to e-cigarettes.

WebMD offers up the ALS ice bucket challenge and includes the legalization of medical marijuana while The Huffington Post cites breakthroughs in wearables and health technology.

Forbes is drawing out the annual “top 10″ tradition with its top 10 health quotes and top 10 health charts. Some charts tell the story of increase in the number of people with health care coverage under the ACA. One particularly striking chart tracks the Ebola outbreak in West Africa using World Health Organization data.

Ebola virus

A colorized transmission electron micrograph (TEM) of a Ebola virus virion. Centers for Disease Control and Prevention, via Getty Images.

And, of course, each year health news includes studies and claims that turn out to be sensationalized or, as Vox puts it, just plain bogus. Their list of the 8 “most bogus health claims of 2014″ include many of the myths that circulated when Ebola dominated U.S. news.

Aside from these lists, The Atlantic and TIME magazine have lifted Ebola out of the listicle. The Atlantic asks experts about the lessons learned from the epidemic. And TIME honors the medical workers who put their lives at risk to help those suffering and dying from the disease.

Reinventing the Concept of Community in Health

At the Mayo Clinic Center for Innovation’s 2014Transform symposium, Healthy States interviewed a few of the presenters about their creative thinking and innovative work in transforming health care. Here, as part of a podcast we’re beta testing, APM’s Chris Farrell speaks with Lauren Taylor and Prabjhot Singh. They both are reinventing the concept of community in health, and both have used health care systems in other countries as a starting point for modeling more effective health care in the United States. But that’s where the similarity ends. Listen to their insights on making health care more affordable and effective, and on the importance of community.

You can also watch their full presentations on the Transform website, and hear an edited version of both Taylor’s and Singh’s talk as broadcast on “MPR News Presents.”

Is Workplace Wellness Worth It?

Employers spend billions of dollars each year on wellness programs in an attempt to keep down rising health costs. But does that investment result in widespread better health? There’s reason to believe it does not, even though wellness programs account for a 6-10 billion dollar industry in this country.

Workplace wellness

Argonne National Laboratory employees participate in the company’s bike share program. Argonne National Laboratory / Creative Commons via Flickr

That said, Harvard Business Review reported in 2010 that Johnson & Johnson realized a return of $2.71 on every dollar spent on wellness.

Some companies offer breaks on health premiums for employees who participate in health risk assessments. Others may require employees to quit smoking or lose weight.

Gallup reports that there is much more to an effective wellness program than simply making it available, and explores ways to make wellness a meaningful value in the workplace.

But Kaiser Health News’ Julie Rovner reports that overall it is unclear whether such programs result in better health.

Dissonance: Music, Creativity and Mental Health

Dissonance 2014 group

“Dissonance: Mental Health and Music” with Adam Levy, Justin Pierre, Astronautilis, Caroline Smith, David Campbell, Sarah Souder Johnson and David Lewis.  Photo: Stacy Schwartz / McNally Smith

Is creativity linked to mental imbalance? How do working artists come to terms with obsession and addiction?

McNally Smith College of Music, 89.3 The Current, and Healthy States recently offered an evening of performance and personal conversation about music and mental health featuring Adam Levy of The Honeydogs, Justin Pierre of Motion City Soundtrack, Andy Bothwell (Astronautalis) and Caroline Smith. Each shares their music and personal story of their path toward mental health and artistic expression.

Hosted by The Current’s David Campbell and Sarah Souder Johnson, Director of Student Life and Counseling at McNally Smith, this event challenged the stigma of mental illness and the misperceptions about the connections between creativity and mental health through inspiring stories of recovery and self-expression.

In the Twin Cities, tune in to 89.3 The Current on Sunday, December 14th, at 10:00pm CT for the event’s broadcast. Check out The Current’s online feature and enjoy the entire evening in video.

David Katz and Prabjhot Singh Transform Public Health

MPR News Presents” continues its series of broadcasts from the Mayo Clinic Center for Innovation’s 2014 Transform symposium. Dr. David Katz, an author, clinician and researcher, reports on new epigenetic findings that lifestyle changes can actually alter the genetic codes that predict health futures. Katz says that  “lifestyle as medicine” can create better outcomes for cancer and other serious illness.

“MPR News Presents” also features Dr. Prabjhot Singh, a physician and co-founder of City Health Works, a Harlem-based clinic that imports African models of care to help people before they get sick. City Health Works bases its approach on a model in Cape Town, South Africa that uses community heath educators to help individuals address chronic health problems.

Healthy States was a media sponsor of the 2014 Transform symposium, held in Rochester, Minnesota.