0 America's health: we're not number one

The United States spends twice as much per person on health care as the rest of the developed world, with little to show for it except shorter and unhealthier lives than citizens of its peer nations enjoy.

That's the depressing conclusion of a study, just released by a panel of experts assembled by the Institute of Medicine, comparing the health of Americans with that of residents of 16 other wealthy nations.

The dire state of health in the U.S. surprised even the scientists who worked on the study. "I expected we would find some problems in certain areas and good news in other areas," said the panel's chairman, Dr. Steven H. Woolf of Virginia Commonwealth University. "I personally was stunned by how pervasive the disadvantage was across so many areas."

Some examples:

The U.S. has the next-to-lowest life expectancy at birth of all the nations, and we rank at or near the bottom in terms of mortality at every age from birth to 75. Or, to put it another way, the nation ranks dead last, by a significant margin, in the numbers of people who die prematurely before the age of 50.

We die violently much more often than people in these other countries. Our murder rate is almost seven times higher, and our rate of gun homicides almost 20 times higher. In fact, 80 percent of all firearms deaths in rich countries occur in the United States. We also have the highest death rate from traffic accidents, both absolutely and per vehicle miles traveled.

We have more STDs and HIV infections, die more often from drug and alcohol abuse, are fatter, and have more diabetes, heart disease and lung disease.

The IOM panel said our abysmal showing likely has multiple causes, including: the roughly 50 million Americans who have no heath insurance, our toleration of much higher rates of poverty and inequality than in other wealthy countries, and our patchy system of public health and primary care.

There's one area where we're number one, however: in the percentage of American adults who believe their health is "good" or "very good."

That may be one reason why the panel recommended a vigorous public education campaign to explain to Americans just how bad things really are.

Source:
U.S. Health in International Perspective: Shorter Lives, Poorer Health [National Academies Press]

0 What color is your drug today? Changing appearances may make you less likely to take your medication

A change in the shape or color of a drug can make you less likely to take it, according to a new study. It found that people who regularly took generic antiseizure drugs but who were given pills with differing appearances at each refill appeared less likely to take their medications as prescribed.

The finding, published in the Archives of Internal Medicine, is important because it highlights a serious problem with how generic drugs are sold in this country. While the FDA stipulates that generic medications must have the same active ingredients in the same strength, be absorbed in the body the same way and at the same rate, and be as effective as brand-name drugs, they don't have to look identical. In fact, because of patent laws, they're often required to look different.

What's more, multiple manufacturers of the same generic medication often make pills that are of different shapes, colors, and sizes. The result? The possibility of a different-looking drug each time you go to the pharmacy.

To avoid confusion, and to make sure you're not one of the 50 to 75 percent of people who don't take their medications as directed, take the following steps:

• Inspect your meds before you leave the pharmacy and ask the pharmacist about any concerns you might have with the shape, color, or size of the pills you received.
• At home, check if you've got the right medication by using Drugs.com's Pill Identifier tool. That allows you to search by shape, color, the drug's name, or the letters or numbers that appear on the pill, itself.
• Organize your pills in a weekly pill box.

For drugs that are effective and safe only within a small dosing range, such as blood thinners, antiseizure drugs, or thyroid medication, our medical consultants say to consider sticking with one manufacturer's product (although this will likely require the cooperation of your pharmacist). There can be very small variations among the same generics with different manufacturers, and, although allowed by the FDA, such minor variances could affect some people's response to the medication. These sorts of differences can sometimes even be found between the same brand-name drug that is manufactured at different times.

Sources:

Variations in Pill Appearance of Antiepileptic Drugs and the Risk of Nonadherence [Archives of Internal Medicine]

Ask the Pharmacist: Why do my pills look different each time I fill the same prescription? [Consumer Reports]

Are generic drugs safe? [Consumer Reports]

0 CES 2013: HAPIfork tells you when to slow down and chew your food

Think you eat too fast? A new, high-tech utensil, the HAPIFork, will let you know. It tracks how fast you eat, with the idea that the information will help you slow down so you lose weight and control acid reflux, among other health benefits.

The HAPIFork is just one product in the booming field of electronic health devices that monitor your eating and exercise habits, as well as your heart rate and blood pressure. The smart fork tracks your forkfuls per meal and per minute and times the interval between each. It will light up and vibrate if you take more than one forkful every 10 seconds.

The $100 HAPIFork, on sale this spring, is water-resistant, so you can throw it into the dishwasher along with your other utensils.

It's unknown whether the device will really help you lose weight, though eating slowly is a commonly recommended dietary strategy. Chances are the HAPIFork won't make much of a difference if you don't make other changes, too. Our new Ratings of diet plans, based on feedback from thousands of dieters about an array of commercial and do-it-yourself weight-loss programs, will help you find a diet that will work for you.

The HAPIFork is one of a slew of new products our reporters saw at this year's Consumer Electronics Show in Las Vegas. Check out the rest of our CES 2013 coverage for news about the hottest new computers, digital cameras, smart phones, tablets, TVs, and tons of other products.

Source:
Enjoy Your Food with HAPIfork by Jacques Lepine [HAPILabs]

0 Video: Prepaid phone service can save you money

Are you looking to cut down on your cell phone costs? Some prepaid cell plans could help you cut your bills considerably.

In a survey of subscribers, we found that the average American household spends over $1,500 a year on phones and services. Some even spend twice as much. But two-thirds of survey respondents who switched from a contract to a prepaid service were able to reduce monthly phone expenses by $20 or more.

Find out which services might save you money in our video. And check our story, Smart ways to save on smart phones, for more dollar-saving tips.

0 Fisher-Price recalls Rock 'N Play infant sleepers due to mold risk

Fisher-Price Inc., of East Aurora, N.Y., has "recalled to inspect" 800,000 Newborn Rock 'n Play Sleepers for mold that can develop between the seat cushion and frame when it remains moist or is infrequently cleaned. The recall was announced today by the Consumer Product Safety Commission.

Fisher-Price received 600 reports of mold on the product, and 16 consumers have reported that their infants were treated for respiratory issues, coughs, and hives after sleeping in the product. The recall is being done to ask owners to inspect the Rock N' Play infant recliners for mold.

If you own one of the recalled sleepers, check for mold under the seat cushion. Dark brown, gray, or black spots can indicate the presence of mold. If you find mold, call Fisher-Price for cleaning instructions and further assistance at 800-432-5437, Monday through Friday, 9 a.m. to 6 p.m. ET, or visit www.service.mattel.com.

The recalled sleepers were sold at mass merchandise stores nationwide and online since September 2009 for $50 to $85. Only products that show signs of mold after use by consumers are included in the recall.

Designed for babies up to 25 pounds and made of a soft plastic seat held by a metal rocking frame, the Rock N' Play infant recliner seat has a removable, fabric cover that comes in 14 patterns and color palettes.

Consumer Reports doesn't recommend using products such as the Newborn Rock 'n Play infant recliner as a sleeper for your child. Although A crib may seem like a big place to put your tiny newborn, it's actually the safest place for your infant to sleep. Read our crib buying guide for more. Play yards can also provide your baby with a safe, enclosed place for napping.

Source:
Fisher-Price Recalls to Inspect Rock 'N Play Infant Sleepers Due to Risk of Exposure to Mold [CPSC]

0 Many patients unaware of radiation risks from CT scans

Last time you had a CT scan did your doctor tell you that it would expose you to radiation? Probably not, according to a study out this week. And even if you were told, you might underestimate the radiation dose, too.

Researchers from the University of Washington School of Medicine's radiology department in Seattle surveyed 235 patients who had undergone non-urgent computed tomography (CT) or single photon emission computed tomography (SPECT) cardiac scans from February through December 2011. About a third of the patients said they did not know that the scans exposed them to radiation. And of the 154 patients who did understood that, only 45 percent said that the health care provider who ordered the imaging test had informed them about the radiation exposure.

Almost 90 percent of the patients said they were not worried about scan radiation. But about the same percentage (85 percent) underestimated their exposure, and only 5 percent understood that scan radiation might increase their lifetime risk of cancer. The study was published this week in Archives of Internal Medicine.

As we've reported, CT scans can provide essential diagnostic information. But they pose risks, too. Radiation from CT scans--which are equivalent to between 100 and 500 chest X-rays--might contribute to an estimated 29,000 future cancers a year, a 2009 study suggests. Yet some hospitals, including several large, well-known ones, continue to order too many of them, exposing patients to needless risk and expense, according our updated hospital Ratings.

Bottom line: The survey was small and conducted at a single academic medical center, so the results may not apply to other patient populations. But the findings suggest that some health care providers may do a poor job of informing patients about the radiation dose and the associated health risks of common imaging tests.

"There is no excuse for patients to be uninformed about risks as basic as radiation," says John Santa, M.D., director of the Consumer Reports Health Ratings Center. "It suggests that those providing these tests do not have an appropriate perspective on the risks. Technology can be difficult for patients to understand but it is the physician's job to make sure that each patient is well informed of benefits and risks."

Avoiding unnecessary tests once you're in the hospital is challenging, because you or someone who cares for you must ask difficult questions of the staff. So even before checking into a hospital, consider checking our hospital Ratings. If a doctor orders a CT scan, for example, ask whether an imaging test that doesn't emit radiation, such as an MRI or an ultrasound, could be used instead. And if you're told you need a double CT scan, one with a contrast agent (which can make the image clearer) and another without, ask whether it's really necessary. And see our article How Safe Is Your Hospital and our tips for staying safe in the hospital.

Source

Patient Knowledge and Understanding of Radiation From Diagnostic Imaging [Archives of Internal Medicine]

0 Flu season is a bad one, but it's not too late to get vaccinated

This year's flu season is coming on fast and strong, especially in the South and Southeast. The extra bad news: Only about a third of people got vaccinated early this year, according to the Centers for Disease Control and Prevention. The good news: This year's vaccine seems to very effective, there are no reported shortages, and it's still not too late to get it.

The number of people hospitalized by the flu this season is up sharply compared with this time last year, as are the number of children who have died of it, with 16 pediatric deaths reported from October to the end of December. The disease appeared first in states like Texas, Alabama, and Mississippi back in November, and has since spread into the Midwest and Northeast. And the CDC expects the season to get much worse before it gets better, potentially making it one of the worst flu seasons in the last decade.

Despite that, many people remain skeptical of the flu vaccine. That's a mistake, says Marvin Lipman, M.D., Consumer Reports chief medical adviser. "The benefits of the regular flu vaccine far outweigh any risks," he says. "Thousands of people die from this disease every year. Get your shot now." (If you need more convincing, see our article 12 Reasons For Skipping the Flu Shot Are Exposed)

However, our medical experts do say that people should be cautious with the high-dose flu vaccine, Fluzone. The vaccine was approved by the FDA for people 65 and older in 2009, but has not been proved to be more effective, and seems to cause more side effects like headaches and malaise. We think that until more is known about it's long-term safety and effectiveness, older people should stick with the standard flu vaccine.

If you already have the flu, see our advice on how to ease the symptoms.

Source: Flu Activity and Surveillance [CDC]