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Rural Appalachia may be a hotspot for Alzheimer’s disease

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Alzheimer’s disease is more common in rural Appalachian areas of Ohio than in other rural parts of the state, new research shows.

For the study, the investigators analyzed 11 years of Medicare data, ending in 2017, and found that Alzheimer’s rates were 2% to 3% higher in rural Appalachian counties than in other rural counties in Ohio.

The study, published online recently in the Journal of Alzheimer’s Disease, raises a number of concerns, according to the authors.

“Those who live in rural Appalachia, in particular, are both much more disadvantaged on the whole from a socioeconomic perspective and have a higher burden of Alzheimer’s disease and related disorders compared to those who live elsewhere. It’s a double whammy,” said Jeffrey Wing, an assistant professor of epidemiology at Ohio State’s College of Public Health.

Wing also noted that there are barriers to care in rural Appalachia, particularly specialized care.

“You really need to see a neurologist to get diagnosed with Alzheimer’s, and that is likely more challenging for many in Appalachia than it is for people elsewhere in Ohio,” Wing said in an Ohio State University news release.

There is no cure for Alzheimer’s, but early diagnosis can delay disease progression, improve a patient’s quality of life, and provide an opportunity for patients and caregivers to connect with other supportive resources, according to Wing.

“There aren’t many studies that have been able to provide an estimated prevalence of Alzheimer’s in geographically diverse populations, and we’re hopeful that this information will help illuminate potential needs in Appalachia — that could include more screenings, earlier screenings and reallocation of medical and support resources,” he said.

The researchers also want to identify the factors that might be associated with the higher rate of Alzheimer’s in rural Appalachia.

“We’re trying to think about some structural and sociodemographic factors that may be driving this, including race and ethnicity, as proxies for racism, education and income,” Wing said.

More information

The U.S. National Institute on Aging has more about Alzheimer’s disease.

Copyright 2020 HealthDay. All rights reserved.



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Study: Less restrictive reproductive rights reduce birth complications risk by 7%

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Oct. 13 (UPI) — Women living in states with less restrictive reproductive rights policies are 7% less likely have low birth weight babies than those living in states with more stringent laws, according to an analysis published Tuesday by the American Journal of Preventive Medicine.

The risk was 8% lower for Black women living in less-restrictive states, the data showed.

“Our study provides evidence that reproductive rights policies play a critical role in advancing maternal and child health equity,” study co-author May Sudhinaraset, of the UCLA Fielding School of Public Health, said in a statement.

Since the Supreme Court‘s decision in Roe v. Wade in 1973, which effectively legalized abortion, states have had “substantial discretion” in creating policies governing whether Medicaid covers the costs of contraception or reproductive health care.

Some states have taken steps that effectively limit access to abortion services and other reproductive care, Sudhinaraset and her colleagues said.

Black women are more likely to die in pregnancy and childbirth than any other race group, experience more maternal health complications than White women and generally have lower quality maternity care, they said.

In addition, women of color are more likely to experience adverse birth outcomes.

Compared to infants of normal weight, low-birth-weight babies face many potential health complications, including infections early in life and long-term problems, such as delayed motor and social development or learning disabilities.

Sudhinaraset and her colleagues analyzed birth record data for the nearly 4 million births that occurred in the 50 states and Washington, D.C., in 2016, comparing reproductive rights policies and adverse birth outcomes in each state.

They also evaluated if the associations were different for women of color and immigrants.

The findings indicate that expanding reproductive rights may reduce the risk of low-birth weight, particularly for U.S.-born Black women, the researchers said.

“Important policy levers can and should be implemented to improve women’s reproductive health overall, including increasing abortion access and mandatory sex education in schools,” Sudhinaraset said.



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Pandemic-related job cuts have led 14.6M in U.S. to lose insurance

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Up to 7.7 million U.S. workers lost jobs with employer-sponsored health insurance during the coronavirus pandemic, and 6.9 million of their dependents also lost coverage, a new study finds.

Workers in manufacturing, retail, accommodation and food services were especially hard-hit by job losses, but unequally impacted by losses in insurance coverage.

Manufacturing accounted for 12% of unemployed workers in June. But because the sector has one of the highest rates of employer-sponsored coverage at 66%, it accounted for a bigger loss of jobs with insurance — 18% — and 19% of potential coverage loss when dependents are included.

Nearly 3.3 million workers in accommodation and food services had lost their jobs as of June — 30% of the industry’s workforce. But only 25% of workers in the sector had employer-sponsored insurance before the pandemic. Seven percent lost jobs with employer-provided coverage.

The situation was similar in the retail sector. Retail workers represented 10% of pre-pandemic employment and 14% of unemployed workers in June. But only 4 in 10 retail workers had employer-sponsored insurance before the pandemic. They accounted for 12% of lost jobs with employer-sponsored insurance and 11% of potential loss including dependents.

The study was a joint project of the Employee Benefit Research Institute, the W.E. Upjohn Institute for Employment Research and the Commonwealth Fund.

“Demographics also play an important role. Workers ages 35 to 44 and 45 to 54 bore the brunt of [employer insurance]-covered job losses, in large part because workers in these age groups were the most likely to be covering spouses and other dependents,” said Paul Fronstin, director of EBRI’s Health Research and Education Program.

“The adverse effects of the pandemic recession also fell disproportionately on women,” Fronstin added in an EBRI news release. “Although women made up 47% of pre-pandemic employment, they accounted for 55% of total job losses.”

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

Copyright 2020 HealthDay. All rights reserved.



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Study: Medicines, frequent counseling helps cancer patients quit smoking

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Oct. 13 (UPI) — A program that included telephone counseling sessions and one of two smoking cessation drugs was 50% more effective than telephone consultations alone at helping cancer patients quit smoking, a study published Tuesday by JAMA found.

Among cancer patients who underwent treatment with four bi-weekly and three monthly counseling sessions by telephone and either bupropion, marketed as Wellbutrin, or varenicline, marketed as Chantix, for up to six months, 35% were able to successfully quit smoking, the data showed.

But only 22% of the cancer patients who underwent treatment with the telephone counseling sessions had successfully quit after six months, according to the researchers.

“Counseling plus medication is the state-of-the art tobacco treatment for cancer patients,” study co-author Elyse R. Park told UPI.

“Smoking cessation assistance should be an integral part of cancer care and sustained tobacco support can be effective for cancer patients who smoke,” said Park, an associate professor of psychiatry at Harvard Medical School.

More than 34 million adults in the United States smoke, and some 16 million are living with smoking-related diseases, including cancer, according to the Centers for Disease Control and Prevention.

Up to 20% of cancer survivors continue to smoke, despite the fact that quitting improves prognosis with the disease, research suggests.

For their study, Park and her colleagues evaluated smoking cessation treatment programs in 303 adults recently diagnosed with breast, gastrointestinal, genitourinary, gynecological, head and neck, lung, lymphoma or melanoma cancers.

Roughly half — 153 — underwent “intensive” treatment for smoking, with telephone counseling and their choice of bupropion or varenicline, with the rest receiving “standard” care, with telephone counseling only, for up to six months, the researchers said.

Both bupropion and varenicline have been approved for smoking cessation treatment by the U.S. Food and Drug Administration.

The most common adverse events in the two treatment groups were nausea, rash, hiccups, mouth irritation, difficulty sleeping and vivid dreams, and all were more common in the patients who received “intensive” care, the researchers said.

“Nausea is a side effect of varenicline, so [its use] should be monitored for patients who are experiencing nausea from their cancer treatment,” Park said.

In addition, patients on tamoxifen for breast cancer should not take bupropion, or receive a reduced dose, because of interactions between the two drugs, she said.



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