Maryland / Regional
Mental
health advocate emphasizes prevention
(Frederick News-Post)
Budget
action awaits possible U.S. funds
(Baltimore Sun)
Lawmakers, advocates push to insure all children
(Cumberland Times-News)
Giant to
continue free antibiotic program
(Daily Record)
Fire at senior complex in Reisterstown injures one
(Baltimore Sun)
But low
rainfall could keep mosquitoes away
(Capital News Services)
National /
International
Teenage Birthrate Increases For Second Consecutive Year
(Washington Post)
Prostate Cancer Screening May Not Reduce Deaths
(Washington Post)
US
births break record; 40 pct out-of-wedlock
(Washington Post)
Young blacks face higher risk of heart failure, study finds
(Baltimore Sun)
Food Safety Fallout, Teens and Tanning, and the Rise of
Infectious Disease (New York Times)
Grassley Urges
Primary Health Care
(Wall Street Journal)
Food
Industry Safety Inspections Challenged
(Wall Street Journal)
Medicare
Rules on Equipment Worry Patients (Wall
Street Journal)
Opinion
The enablers in Annapolis
(Baltimore Sun)
Homeless have more than handwashing to fret over
(Salisbury Daily Times)
Maryland / Regional
Mental
health advocate emphasizes prevention
By Ashley Andyshak
Frederick News-Post
Thursday, March 19, 2009
Beth Santa Maria, director of prevention programs at the Mental
Health Association, displays several puppets used to discuss
sensitive issues with children. Santa Maria received a grant
from the Laughlin Continuing Education Fund to get her master’s
degree.
When Beth Santa Maria was hired at the Frederick County Mental
Health Association in 2005, she had already applied to graduate
school.
She hoped to earn a master's degree in social work from the
University of Maryland, and she soon found that her new employer
was willing to help.
The Laughlin Continuing Education Fund paid for "a good
percentage" of Santa Maria's schooling, she said. Dr. Henry
Laughlin and his wife, Page, started the fund through the
association six years ago to help staff continue their
education. Since then, the fund has directly benefited four
employees.
"I couldn't have done it without this assistance," Santa Maria
said.
Santa Maria's supervisor, executive director Pat Hanberry, was
also cooperative. She permitted Santa Maria to cut back to
part-time work while in school.
"It's rare to find an employer that offers the flexibility
needed to achieve these goals," she said. "They're very
family-friendly, and they support and value education."
Santa Maria has worked with children and families since her
undergraduate days at Old Dominion University in Virginia. Her
graduate studies included both clinical work, and management and
community organization, with a specialization in children and
families.
"I know that's my passion," she said. "You hear a lot of
discouraging stories every day, and horror stories of family
circumstances. I know I'm making a difference every day."
Santa Maria balanced graduate school and part-time work
alongside time with her family and five children, ages 9 to 19.
Finishing grad school allowed Santa Maria to see the pride on
her children's faces, she said.
"It was sending them a message that education is so important,"
she said.
Santa Maria continues to work full time as the association's
director of prevention programs.
"Our society doesn't put a lot of emphasis on prevention; a lot
of money goes to solving problems instead," she said. "We can
tackle these problems before they happen."
Copyright 1997-09 Randall Family, LLC. All rights reserved.
Budget action
awaits possible U.S. funds
Baltimore Sun
Thursday, March 19, 2009
Maryland lawmakers delayed action on major budget decisions
yesterday as hopes were raised at the last minute that the state
could receive additional federal stimulus funds because of a
sharp uptick in the unemployment rate. Gov. Martin O'Malley's
office said it now expects to be eligible for about $90 million
in extra Medicaid funding next year, on top of $3.7 billion
already anticipated as part of the stimulus package. The
Medicaid formula is dependent on the state's unemployment rate,
which climbed to a 16-year high of more than 6 percent in
January. The extra money could mean fewer spending cuts are
needed to balance the budget. Lawmakers began combing through
the budget but postponed action on big-ticket items, including
$80 million in cuts to localities for maintaining highways and
roads.
Laura Smitherman
Copyright 2009 Baltimore Sun.
Lawmakers, advocates push to insure all children
Cumberland Times-News
Thursday, March 19, 2009
ANNAPOLIS Lawmakers and advocates urged the Senate Finance
Committee recently to pass a bill that would require health care
for all Maryland children.
The bill, introduced by Sen. Rob Garagiola, D-Montgomery, would
require that parents provide health care for their children and
allow families who make more than 300 percent of the federal
poverty level about $66,000 a year for a family of four to buy
into the Maryland Childrens Health Program.Garagiola said this
requirement would be a soft mandate, enacted primarily as an
education and outreach program, because 100,000 of the 140,000
children in the state without health insurance are already
eligible for existing state health care programs. The goal is to
make sure families know about and take advantage of these
programs, he said.
The mandate would take effect in 2010, but the enforcement
statute a $25 tax penalty for single filers and $50 for joint
filers would not occur until the 2012 tax season and would
sunset in 2013.
The Maryland Childrens Health Program provides health care to
poor families at a significant discount. Under current law,
families living at up to 300 percent of the federal poverty
level are eligible, and if passed, families who make more would
be eligible to buy in at about $170 per child per month,
according to the Maryland Health Care Commission.
The legislation would also require the Maryland Health Care
Commission, the Department of Health and Mental Hygiene and the
Maryland Insurance Administration to file reports with the
General Assembly in 2011 and 2013 outlining recommendations for
further education and outreach, as well as possible ways to
assist more families to provide health care for their children.
Garagiola said he has heard concerns about the requirement to
provide children with health insurance, but that the bill has
broad support from health care providers and senators.
Health care advocates said having more children insured will
reduce overall costs.For asthmatic kids, four times as many
uninsured asthmatic children are hospitalized (than insured
asthmatic children), and twice as many utilize the hospital
emergency department for an acute asthma attack, said Diane
Briggs, director of external affairs for the Primary Care
Coalition of Montgomery County.
Pegeen Townsend, senior vice president of legislative policy for
the Maryland Hospital Association, called the legislation an
incremental step toward covering everybody in the state.Not only
will (the bill) incentivize those parents in that next level of
income to purchase insurance for their children, Townsend said.
But in addition, it will also help flush out those who are
currently eligible for the Medicaid program and who are not
right now enrolled.Michael Sullivan, director of communications
for CareFirst BlueCross BlueShield, said his company supports
the legislation, and that it is an embarrassment that 140,000
children in the state go without health insurance.
Dr. Virginia Keane, president of the Maryland chapter of the
American Academy of Pediatrics, said she supported the bill, but
had reservations about whether the Maryland Childrens Health
Program would be affordable for families making more than 300
percent of the poverty level. She fears they would choose to buy
cheaper childrens insurance programs with poor benefits.We are
most concerned that families may opt to purchase these low-cost
programs that are basically catastrophic programs that have very
high deductibles, that have very high co-pays, and really dont
give kids the access to the care they need, Keane said.
Copyright 2009 Cumberland Times-News.
Giant to
continue free antibiotic program
Associated Press
Daily Record
Thursday, March 19, 2009
Giant Food said Wednesday its free antibiotic program, which was
slated to end on Saturday would instead be extended through July
11.
Customers with a prescription and a Giant BonusCard will be
given free, selected, antibiotics.
"As customers navigate challenging times, we are continuing to
support them through this major consumer wellness initiative,
Giant consumer advisor Andrea Astrachan said in a prepared
statement. “Many customers are not filling prescriptions because
they need to use their money for other necessities. This program
was designed to help customers facing difficult economic times."
Landover-based Giant Food LLC, a subsidiary of Ahold N.V., has
182 supermarkets in Maryland, Delaware, Virginia and the
District of Columbia. The company has 164 full-service
pharmacies in the stores.
Copyright 2009 Daily Record.
Fire at senior complex in Reisterstown injures one
By Baltimore Sun reporter
Baltimore Sun
Thursday, March 19, 2009
A fire at a senior living complex in Reisterstown sent one
person to the hospital this morning, according to the Baltimore
County Fire Department.
The fire in the 300 block of Cantata Court began shortly before
10 a.m. and was put out by 10:13. The blaze was contained to a
single ground-floor apartment in the four-story complex,
officials said.
One person was taken to the Maryland Shock Trauma Center as a
result of this morning's fire, but their injuries were not
life-threatening, officials said.
Due to incorrect information from the fire department, an
earlier version of this story incorrectly stated that the
complex was the scene of an earlier four-alarm fire. The
Baltimore Sun regrets the error.
Copyright 2009 BaltimoreSun.
But low
rainfall could keep mosquitoes away
By Lauren C. Williams
Capital News Service
Thursday, March 19, 2009
WASHINGTON - Warmer weather and sunny skies are just around the
bend, which, sadly, means the mosquitoes are not too far behind.
But it may not be time to stock up on the bug repellent and
cortisone cream just yet.
There are "multiple factors" that determine the strength of the
mosquito population's emergence, said Kim Mitchell, chief of
Rabies and Vector-Born Diseases at the state Department of
Health and Mental Hygiene. She listed climate and the specific
species' resiliency to environmental change as factors.
This year, Maryland's lack of precipitation and low groundwater
levels might curb or at least delay the pest's seasonal debut.
Thus far, Maryland is behind in precipitation, with deficits of
more than three-quarters of an inch for the month of March and
nearly 5 inches for the year to date, according to National
Weather Service data taken at BWI Thurgood Marshall Airport.
The region has had a string of cold days and may have a few
really hot days this summer, but these temperature fluctuations
have only temporary effects on mosquito populations, said Mike
Cantwell, state Department of Agriculture mosquito control
program man-ager.
"Rainfall and high tides affect the numbers (of mosquitoes)," he
said.
Mosquitoes and wet conditions not only make for more swatting
and scratching itchy red bumps, but also increase the incidence
of potentially life-threatening diseases such as malaria and
West Nile virus.
"In recent years we've seen a general decline in West Nile virus
cases," said Mitchell, who said the disease seems to have moved
west to unexposed areas.
In 2003, Maryland's West Nile cases peaked with 73 infected
humans and eight resultant deaths, and 204 infected horses. Last
year, there were only 14 human cases and no deaths.
Except for the storm that blanketed the East Coast with nearly a
foot of snow earlier this month, neither rain nor snow has been
sufficient in the region recently.
Rain and snow replenish groundwater supplies and saturate the
soil, Cantwell said, and these warm-weather pests need water to
breed and multiply.
"(Ground)water levels are getting kinda low," said Dan Soeder,
hydrologist for the U.S. Geological Survey in Baltimore. "And
we're heading into a drought" if dry conditions persist.
Up near the Mason-Dixon Line, the levels are more or less
normal, Soeder said. But in southern Maryland, which never
recovered from the 2002 drought, levels are very low.
Low groundwater levels easily translate into low stream levels
and dry soil, which can impede gardening and farming.
"It kind of snuck up on us," Soeder said. "It got dry over the
winter and we didn't notice it."
However, Cantwell expects Maryland to see just as many
mosquitoes as last year.
"Eggs are still out there, and (some species) can survive years
in the egg stage waiting for rain," he said. "And when the rain
comes the mosquitoes will come."
As a survival mechanism, "mosquitoes can exploit every type of
stagnant, still or contained water," no matter how little water
is available, Cantwell said.
But too much water from floods, hurricanes, or just several
inches of rain "can flush these mosquito breeding sites out," he
added.
If trends continue, Maryland could see a dry spring and summer,
which could present a variety of problems, Soeder said. Then he
quipped: "Or it could rain."
Copyright 2009 Capital News Services.
National / International
Teenage Birthrate Increases For Second Consecutive Year
By Rob Stein and Donna St. George
Washington Post
Thursday, March 19, 2009; A01
The rate at which teenage girls in the United States are having
babies has risen for a second year in a row, government
statistics show, putting one of the nation's most successful
social and public health campaigns in jeopardy.
Teen births in the District, Maryland and Virginia mirror the
national trend, the numbers show, and local health experts say
they are alarmed by the shift.
Nationally, the birthrate among 15-to-19-year-olds rose 1.4
percent from 2006 to 2007, continuing a climb that began a year
earlier. The rate jumped 3.4 percent from 2005 to 2006,
reversing what had been a 14-year decline.
Although researchers will have to wait at least another year to
see whether a clear trend emerges, the two consecutive increases
signal that the long national campaign to reduce teen
pregnancies may have stalled or even reversed.
"We've now had two years of increases," said Stephanie J.
Ventura of the National Center for Health Statistics, which
issued the report yesterday. "We may have reached a tipping
point. It's hard to know where it's going to go from here."
The reasons for the increase remain unclear, although experts
speculated that it could be a result of growing complacency
about AIDS and teen pregnancy, among other factors. The rise may
also reflect a broader trend that affects all age groups,
because birthrates have also increased among women in their 20s,
30s and 40s and older unmarried women.
The increase raised concerns across the ideological spectrum and
fueled an intense debate over federal funding for sex-education
programs that focus on encouraging abstinence until marriage.
Opponents and proponents are girding for a new round in the
battle over funding of abstinence education when President Obama
reveals within weeks whether he will seek to continue or cut
that funding.
"This is certainly not the time to remove any strategy that is
going to provide skills for teens to avoid sex," said Valerie
Huber of the National Abstinence Education Association.
But opponents said the findings provide new evidence that the
approach is ineffective and that the money should be shifted to
programs that include educating young people about
contraceptives -- efforts that have been shown to be highly
effective.
"The United States can no longer afford to fund failed
abstinence-only programs," said James Wagoner of the group
Advocates for Youth.
Abstinence programs had been receiving about $176 million in
federal funding each year, but Congress cut about $14 million
from the current budget.
White House spokesman Reid H. Cherlin called the new numbers
"highly troubling."
"President Obama is committed to reducing the number of
unintended pregnancies in this country, and we are reviewing
these programs as part of the budget process," he said. "The
president has supported abstinence programs if they are part of
a comprehensive, age-appropriate and evidence-based effort to
reduce teenage pregnancy."
The teen birthrate rose sharply from 1986 to 1991, leading to a
widespread campaign that caused teenage sexual activity and
births to decrease. But a long decline in teenage sexual
activity appeared to level off in 2001, and teen births
increased in 2005. Experts were uncertain, however, whether the
rise represented a one-year aberration or the beginning of a
trend.
The latest data, from an annual analysis of birth certificates
nationwide, found that while the birthrate among girls ages 10
to 14 remained unchanged, the overall rate for those ages 15 to
19 rose again, from 41.9 births per 1,000 to 42.5.
Locally, the percentage of all births among teenagers in the
District increased from 12 percent to 12.1 percent, while the
rate in Maryland increased from 8.8 percent to 8.9 percent. It
remained unchanged in Virginia at 8.6 percent.
"This should make everyone redouble their efforts on
prevention," said Brenda Rhodes Miller, executive director of
the DC Campaign to Prevent Teen Pregnancy. "It's troubling after
so many years of seeing the numbers decline to see the numbers
increase."
India Stevens, who was 16 when she had her daughter in December,
said she had always planned on waiting to become a mother until
she had a stable job. But she found out she was pregnant as a
sophomore at Bell Multicultural High School.
"I was shocked," said Stevens, who lives in Northwest and has
two friends who have been pregnant. She said she took a health
class in school that included some discussion about
contraception and abstinence.
"We went over it, but it wasn't anything in depth," said
Stevens, who thinks that teenagers should talk more to their
parents about sex and that there should be more education about
contraception and abstinence.
"It's good to wait, but if it happens you should just roll with
it," she said.
While the national increase from 2005 to 2006 occurred across
all ethnic groups, the trends between 2006 and 2007 were not
uniform. The birthrate increased 2 percent among whites and
Asians and 1 percent among blacks, but it decreased 2 percent
among Hispanics.
The mixed statistics and modest increase raised the odds that
the two years of increases could be a statistical blip, Ventura
said. But other experts said the two-year data probably
represent a trend and fit with other research showing a stall in
the long drop in sexual activity among teenagers, as well as a
decrease in condom use.
"I think it's a real trend," said John S. Santelli of Columbia
University, who studies teenage sexual behavior. "It's a huge
disappointment and a huge failure in public policy to see this
reverse itself."
Experts noted that the U.S. rate remains far higher than that of
other industrialized nations.
"This is deeply disturbing," said Sarah S. Brown of the National
Campaign to Prevent Teen and Unplanned Pregnancy. "It should be
a wake-up call."
One contributing problem may be teenagers having repeat
pregnancies, said Margaret Rodan of Georgetown University, who
directs the research project GirlTalk, which tracks first-time
teenage mothers and pairs them with counselors who help them set
goals, do better in school and space their next pregnancy.
"We have seen in the past that if you have a first pregnancy at
14, the likelihood of having a second pregnancy at 16 or 17 is
very high," said Davene White, director of a program at Howard
University Hospital that provides support services for maternal
and child health.
Yasmin Herrera, 19, said she learned a month ago that she is
pregnant with her second child, at a time when she had a new
prescription for birth-control patches but not enough money to
fill it. She and her boyfriend live together in Hyattsville with
his family and their first child, who is 3.
"We were planning some other things we wanted to do," she said.
But she said that they adjusted to the news without a problem.
"I just look at it as a part of life."
The economy also may be at work in the rise in teen births, said
Lee Beers, director of the Healthy Generations Program at
Children's National Medical Center.
"Teen pregnancy is not an issue in isolation," she said. When
families are stressed by economic forces, parental communication
and supervision may decline, which in turn may have an effect,
she said.
Copyright 2009 Washington Post.
Prostate Cancer Screening May Not Reduce Deaths
Studies Cast Doubt on Usefulness of Common Test for Disease
By Rob Stein
Washington Post
Thursday, March 19, 2009; A02
Men are being urged to carefully consider risks before
undergoing prostate cancer screening in the wake of two large,
long-awaited studies that did not produce convincing evidence
that routine testing significantly reduces the chance of dying
from the disease.
The PSA blood test, which millions of men undergo each year, did
not lower the death toll from the disease in the first decade of
a U.S. government-funded study involving more than 76,000 men,
researchers reported yesterday. The second study, released
simultaneously, was a European trial involving more than 162,000
men that did find fewer deaths among those tested. But the
reduction was relatively modest and the study showed that the
tests resulted in a large number of men undergoing needless,
often harmful treatment.
Together, the studies -- released early by the New England
Journal of Medicine to coincide with presentations at a
scientific meeting in Stockholm -- cast new doubt on the utility
of one of the most widely used tests for one of the most common
cancers.
"Americans have been getting screened for prostate cancer
because there is this religious faith that finding it early and
cutting it out saves lives," said Otis W. Brawley of the
American Cancer Society. "We've been doing faith-based screening
instead of evidence-based screening. These findings should make
people realize that it's a legitimate question about whether we
should be screening for prostate cancer."
Other experts were more circumspect, arguing that the European
study did indicate at least some benefit for some men, and that
the U.S. trial could eventually confirm those findings as it
follows the men for longer periods. But they agreed that the new
findings should prompt patients and their doctors to discuss the
risks and benefits of the testing.
"It shouldn't be a knee-jerk response to get tested," said
Christine D. Berg of the National Cancer Institute, which
sponsored the U.S. study. "We should be telling these guys to go
talk to their physician and say, 'In light of the current
evidence and what you know about me and my health, what should I
do?' "
Some researchers, however, remain supportive of routine testing,
saying the U.S. study has flaws that could have limited its
ability to detect a reduction in deaths.
"I don't think that screening should be summarily dismissed
based on these trials," said E. David Crawford, a urology
professor at the University of Colorado at Denver who helped
conduct the U.S. study and heads the Prostate Conditions
Education Council, which promotes testing. "I think they say we
should be more smart when we screen."
The findings address perhaps the most important and contentious
issue in men's health: how best to detect and treat prostate
cancer. The disease is diagnosed in more than 218,000 U.S. men
each year and about 28,000 die of it, making it the most common
cancer after skin cancer and the second-leading cancer killer
among men.
The PSA test, which measures a protein produced by prostate
tissue called the prostate-specific antigen, has significantly
increased the number of prostate cancer cases being caught at
early stages. But it has been far from clear whether that
translates into a reduction in deaths from the disease. Prostate
cancer often grows so slowly that many men die from something
else without ever knowing they had it.
Because it is not clear precisely what PSA level signals the
presence of cancer, many men experience stressful false alarms
that lead to surgical biopsies, which can be painful and in rare
cases can cause serious complications.
Even when the test detects a real cancer, doctors are uncertain
what, if anything, men should do about it. Many are simply
monitored. Many others, however, undergo surgery, radiation and
hormone treatment, which often leave them incontinent, impotent
and experiencing other sometimes debilitating or even possibly
life-threatening complications.
"I know guys who are morbidly depressed because of the
complications of their prostate cancer treatment," Brawley said.
"I know three people who attempted suicide. I know widows of
guys who died from their treatment. There are significant harms
associated with over-treatment of prostate cancer."
Because of the uncertainty, many major medical groups have
stopped recommending routine PSA testing. Nevertheless, its use
remains widespread, and many experts were hoping the two large
trials would help settle the issue.
In the U.S. study, researchers randomly assigned 76,693 men ages
55 to 74 at 10 centers, including Georgetown University, to
receive either six annual screenings consisting of PSA testing
and physical examinations or whatever their doctors recommended
on their own, which could include screening.
After seven years, 17 percent more prostate cancers were
diagnosed after 10 years. But there was no significant
difference in deaths from the disease between the two groups.
Although the men will continue to be followed for at least 13
years, and a benefit might emerge with more time, an independent
panel monitoring the study decided the researchers had a duty to
inform the participants of the interim findings and make the
results public.
The researchers noted that there were actually more deaths
overall in the screened group -- 312 vs. 225 -- and they could
not rule out that the excess may have been the result of
over-treatment.
In the European study, 162,243 men ages 55 to 69 in seven
countries were randomly assigned to undergo PSA screening every
four years, or no screening. After a median follow-up time of
nine years, 20 percent fewer prostate cancer deaths were found
among those screened. Because of the study's design, however,
several experts said that reduction was hard to interpret. At
best, it means about 10,000 men would have to be screened for
about 10 years to prevent seven deaths. Put another way, 1,410
men would need to be screened and 48 would have to be treated to
prevent one death.
"It's very disturbing," said Fritz H. Schroder of the Erasmus
Medical Center in the Netherlands, who led the study. "That
means in order to save one life, you treat a very large number
of men."
Experts cautioned that the decision to undergo screening remains
individual. For men whose family members have died from prostate
cancer, are relatively young and know they are at risk, the
downside of potentially undergoing unnecessary treatment may be
worthwhile. For others, especially older men with shorter life
spans, it may not.
"Some men would say, 'If I can reduce my chance of dying from
cancer, I'll take that risk and face the music.' Other men would
say, 'Gee if you have to diagnose 50 to save one life, my
chances are high I'll be part of the 49. I'll take my chances
without it.' I think that's reasonable. This isn't a
one-size-fits-all result," said Michael J. Barry of Harvard
Medical School, who wrote an editorial on the study.
Copyright 2009 Washington Post.
US
births break record; 40 pct out-of-wedlock
Associated Press
By Mike Stobbe
Washington Post
Thursday, March 19, 2009
ATLANTA -- Remember the baby boom? No, not the one after World
War II. More babies were born in the United States in 2007 than
any other year in the nation's history - and a wedding band made
increasingly little difference in the matter. The 4,317,119
births, reported by federal researchers Wednesday, topped a
record first set in 1957 at the height of the baby boom.
Behind the number is both good and bad news. While it shows the
U.S. population is more than replacing itself, a healthy trend,
the teen birth rate was up for a second year in a row.
The birth rate rose slightly for women of all ages, and births
to unwed mothers reached an all-time high of about 40 percent,
continuing a trend that started years ago. More than
three-quarters of these women were 20 or older.
For a variety of reasons, it's become more acceptable for women
to have babies without a husband, said Duke University's S.
Philip Morgan, a leading fertility researcher.
Even happy couples may be living together without getting
married, experts say. And more women - especially those in their
30s and 40s - are choosing to have children despite their single
status.
The new numbers suggest the second year of a baby boomlet, with
U.S. fertility rates higher in every racial group, the highest
among Hispanic women. On average, a U.S. woman has 2.1 babies in
her lifetime. That's the "magic number" required for a
population to replace itself.
Countries with much lower rates - such as Japan and Italy - face
future labor shortages and eroding tax bases as they fail to
reproduce enough to take care of their aging elders.
While the number of births in the U.S. reached nearly 4.3
million in 2006, mainly due to a larger population, especially a
growing number of Hispanics, it's not clear the boomlet will
last. Some experts think birth rates are already declining
because of the economic recession that began in late 2007.
"I expect they'll go back down. The lowest birth rates recorded
in the United States occurred during the Great Depression - and
that was before modern contraception," said Dr. Carol Hogue, an
Emory University professor of maternal and child health.
The 2007 statistical snapshot reflected a relatively good
economy coupled with cultural trends that promoted childbirth,
she and others noted.
Meanwhile, U.S. abortions dropped to their lowest levels in
decades, according to other reports. Some have attributed the
abortion decline to better use of contraceptives, but other
experts have wondered if the rise in births might indicate a
failure in proper use of contraceptives. Some earlier studies
have shown declining availability of abortions.
Cultural attitudes may be a more likely explanation. Morgan
noted the pregnancy of Bristol Palin, the unmarried teen
daughter of former GOP vice presidential candidate Sarah Palin.
The young woman had a baby boy in December, and plans for a
wedding with the father, Levi Johnston, were scrapped.
"She's the poster child for what you do when you get pregnant
now," Morgan said.
Teen women tend to follow what their older sisters do, so
perhaps it's not surprising that teen births are going up just
like births to older women, said Sarah Brown, the chief
executive for the National Campaign to Prevent Teen and
Unplanned Pregnancy.
Indeed, it's harder to understand why teen births had been
declining for about 15 years before the recent uptick, she said.
It may have been due to a concentrated effort to reduce teen
births in the 1990s that has waned in recent years, she said.
The statistics are based on a review of most 2007 birth
certificates by the National Center for Health Statistics, part
of the Centers for Disease Control and Prevention. The numbers
also showed:
*Cesarean section deliveries continue to rise, now accounting
for almost a third of all births. Health officials say that rate
is much higher than is medically necessary. About 34 percent of
births to black women were by C-section, more than any other
racial group. But geographically, the percentages were highest
in Puerto Rico, at 49 percent, and New Jersey, at 38 percent.
*The pre-term birth rate, for infants delivered at less than 37
weeks of pregnancy, declined slightly. It had been generally
increasing since the early 1980s. Experts said they aren't sure
why it went down.
*Among the states, Utah continued to have the highest birth rate
and Vermont the lowest.
CDC officials noted that despite the record number of births,
this increase is different from occurred in the 1950s, when a
much smaller population of women were having nearly four
children each, on average. That baby boom quickly transformed
society, affecting everything from school construction to
consumer culture.
Today, U.S. women are averaging 2.1 children each. That's the
highest level since the early 1970s, but is a relatively small
increase from the rate it had hovered at for more than 10 years
and is hardly transforming.
"It's the tiniest of baby booms," said Morgan in agreement.
"This is not an earthquake; it's a slight tremor."
On the Net:
The CDC report, including some state-by-state
figures:http://www.cdc.gov/nchs
© 2009 The Associated Press.
Young blacks face higher risk of heart failure, study finds
By Kelly Brewington
Baltimore Sun
Thursday, March 19, 2009
Young African-Americans are 20 times as likely as whites to
develop heart failure, according to a new study published today.
The deadly illness strikes one in every 100 blacks under the age
of 50.
"We usually thought of heart failure as a disease of older
people, but that's based on studies by mostly white
participants," said Dr. Kirsten Bibbins-Domingo, an assistant
professor at the University of California, San Francisco and the
study's lead author. "The rates we're seeing of blacks in their
30s and 40s are similar to the rates you will see of whites in
their 60s and 70s."
Researchers and cardiology specialists called the findings
alarming and a call to action. The scientific community should
step up its research on the risk factors and design clinical
trials to study specialized treatment for black patients, they
said.
The findings also should come as a wake-up call to young
African-Americans to eat healthier and exercise. And health
officials should launch prevention and education efforts as
early as high school, they said.
"It's scary," said Dr. Mandeep R. Mehra, chief of cardiology at
the University of Maryland Medical Center. "I think one could
describe this in many ways as an epidemic in the young
African-American patient, and really, it calls for structured
health care efforts in the patient."
While medical experts have known for years of racial disparities
in cardiac illnesses, researchers say this study is the first to
examine young people with heart failure, in which a weakened
heart can't pump blood to all the places in the body that need
it.
The data do not reveal why blacks are more likely to develop
heart failure. Experts believe genetic differences, blacks'
higher rates of hypertension and obesity, and lack of access to
health care all play a role. But they say more research is
needed to pinpoint the causes of the disparity and develop
methods to attack it.
The findings, published in the New England Journal of Medicine,
come from an analysis of a 20-year study of 5,115 black and
white men and women under 50. The Coronary Artery Risk
Development in Young Adults Study began in 1985 with healthy
participants between the ages of 18 and 30 recruited from four
sites across the country. It was conducted by the National
Heart, Lung and Blood Institute, a division of the National
Institutes of Health.
By the end of the study, 27 men and women had developed heart
failure; all but one was black. Five of the black patients had
died.
About 5 million people in the United States have heart failure,
and it results in about 300,000 deaths a year. The leading
causes of heart failure are coronary artery disease, high blood
pressure and diabetes.
The study's researchers found that black patients who were obese
or had low levels of "good" cholesterol were more likely to
develop heart disease. Those with hypertension or kidney disease
were also at risk.
Bibbins-Domingo said that the most important risk factor found
in the study was high blood pressure, particularly diastolic
blood pressure (the bottom number in a blood pressure reading,
measured in millimeters of mercury). The study found that an
increase of 10 millimeters of mercury in diastolic blood
pressure among blacks in their 20s doubled the likelihood of
developing heart failure 10 to 20 years later.
Young people rarely know they have high blood pressure because
they are less likely to go to the doctor or to have insurance,
Bibbins-Domingo said. Even when high blood pressure is detected,
doctors appear less likely to treat it in young people, often
advising lifestyle changes without considering medication, she
said.
"We can't just let our guard down and expect that the
consequences are really far in the future," she said.
"The consequences of having such a chronic debilitating disease
in your 30s and 40s is really devastating, not only to the
individual patient, but to their family, their community and to
society as a whole."
Wanda Pate, a-38-year-old respiratory therapist from Owings
Mills, never suspected she had heart failure. But the mother of
two young daughters had all the symptoms: fatigue, swellingand
shortness of breath that made it nearly impossible to climb a
flight of stairs. She suspected she had a lingering cold or
pneumonia. Her doctor thought she might have an acid reflux
problem and sent her to a specialist for tests.
The symptoms got worse until one day a serious dizzy spell sent
her to the emergency room, where tests confirmed heart failure.
"I was devastated," Pate said. "The first week or two, and even
the first month, I just cried. I couldn't believe how this was
possible. It's like I went to bed, woke up one day and was in
heart failure."
Pate's case is unusual in that she did not have common risk
factors, such as high blood pressure. But she acknowledges that
she did not always eat well and exercise.
For now, doctors are monitoring her closely, hoping that through
medications they can strengthen her heart. Last summer, a
surgeon placed a defibrillator in her chest, which gives energy
to her heart when she needs it.
Today, Pate follows a strict diet and exercises in her living
room, using workout tapes. Doctors told her not to return to her
job because it involves too much manual labor. She is starting
an event-planning business from her home and volunteers at her
daughters' school. But she misses her career and her health.
"Some days I feel good, like 'I can do this, I can beat it',"
she said. "Other days, I look at my kids and ask, 'Am I going
there? Are they going to remember me?'"
Mehra, at the University of Maryland, said researchers are
discovering that in addition to commonly known health risks,
genetics play a role in how blacks and whites develop heart
failure. More research is needed on those differences, he said.
His research has shown that black patients respond differently
to medication for heart failure. They tend to need different
doses of medication and at different frequencies than whites, he
said. And some medicines don't work at all in black patients.
The best prevention for heart failure, however, is to have a
healthy lifestyle, Mehra said. Blacks tend to be more sensitive
to salt, which is associated with high blood pressure, so it is
vital that young African-Americans limit their salt intake. They
should also eat healthy foods rich in fish oils and antioxidants
- which have been shown in some studies to promote heart health
- and exercise regularly, he said.
"The rising tide of adolescent obesity suggests that this is not
something that will be addressed in the future. It means we need
to redouble our efforts now," said Bibbins-Domingo. "These are
the risk factors sitting in our teenagers, particularly our
minority teenagers. This is a wake-up call."
Copyright 2009 Baltimore Sun.
Food Safety Fallout, Teens and Tanning, and the Rise of
Infectious Disease
By Roni Caryn Rabin
New York Times Morning Rounds
Thursday, March 19, 2009
Food Maker Calls for Increased Federal Regulation
Even the giant cereal maker Kellogg is calling for more
government regulation of food safety, The Associated Press
reports. Kellogg lost $70 million recently when it had to recall
millions of peanut butter products, and chief executive David
Mackay will call for annual federal inspections of food
processing plants when he testifies before a House subcommittee
today.
AIDS Organizations Condemn Pope's Remarks
AIDS activists are blasting the pope's remarks denouncing condom
use in the fight against AIDS, Agence France-Presse reports.
Pope Benedict XVI made the remarks en route to Africa, prompting
officials in France and Belgium to express concern. The head of
the Global Fund to Fight AIDS, Tuberculosis and Malaria demanded
that the pope retract the statement.
Infectious Diseases a Growing Threat, WHO Says
A World Health Organization report says infectious diseases are
killing more people worldwide because of massive urbanization
and failure to control mosquito populations in the tropics,
Reuters reports. Air travel also has helped spread infectious
diseases like dengue, which killed more than 3,000 people in
Southeast Asia last year. The WHO report says communicable
diseases like malaria and H.I.V./AIDS are responsible for more
than half the deaths worldwide.
State Lawmakers Attempt to Keep Teens From Tanning Booths
Texas wants to make it harder for teenagers to use tanning
booths, The Associated Press reports. Proposed state legislation
would require anyone under 18 to get a doctor's note before
using a tanning bed and would require parents to accompany
minors.
Meanwhile, state lawmakers in Florida are considering a bill
that would bar teens under 16 from using tanning beds
altogether. Some experts say the ultraviolet light may increase
the risk of skin cancer, and young people may be more
vulnerable.
Restrictions on Medical Equipment Proposed for Medicare
Medicare patients could face new restrictions on where they go
to buy or rent medical equipment. A cost-cutting reform would
require the government to use only approved suppliers who are
selected through competitive bidding, The Wall Street Journal
reports.
Copyright 2009 The New York Times Company.
Grassley Urges
Primary Health Care
By Patrick Yoest
Wall Street Journal
Thursday, March 19, 2009
WASHINGTON -- Plans to overhaul the U.S. health insurance system
must make primary health care a more attractive career field,
U.S. Sen. Charles Grassley said Thursday.
Sen. Grassley (R., Iowa), the top Republican on the Senate
Finance Committee, told reporters that many areas of the U.S.
currently overuse medical specialists, resulting in higher costs
throughout the health-care system.
"We've upset the whole practice of medicine to such a point that
we don't have many primary caregivers," Sen. Grassley said.
"That has driven up the cost of medicine itself with emphasis on
specialists, and it has reduced the quality of delivery
particularly in rural areas."
Many experts say a lack of family physicians and primary care
physicians means many patients receive unnecessary and expensive
treatments from specialists. MedPAC, an outside organization
that advises the government-run Medicare program, has suggested
that Medicare increase payments for primary care physicians.
Sen. Grassley endorsed a similar approach Thursday.
"The government policy has driven doctors and it's encouraged
over-utilization, it's encouraged abuse of the system, it's
encouraged gaming of the system, and we're going to take the
gaming of the system out," Sen. Grassley told the Kaiser Family
Health Foundation.
The senator later told reporters that he did not foresee a
compromise by which Republicans would agree to legislation that
created a public health insurance option to compete with private
insurers. But he didn't rule it out either.
"Is there a compromise in between? I don't see one today," Sen.
Grassley said, but added, "If you're going to negotiate in good
faith, everything is on the table."
Sen. Grassley has said in the past he feared a public plan
option would create an unfair playing field that would
effectively push private insurers out of the market, and he
reiterated those comments Wednesday. He pointed to broad
consensus among Democrats and Republicans that those who
currently have insurance should be able to keep their current
plans.
Sen. Grassley indicated he could support taxing health insurance
benefits -- a thorny issue on which the White House has sent
mixed signals. President Barack Obama said he opposed taxing
health benefits during the 2008 presidential campaign, but
Office of Management and Budget director Peter Orszag has
recently suggested that it is still on the table.
Sen. Grassley argued that excluding health benefits from
taxation creates higher utilization of health-care and raises
costs.
"That is a contributing factor to the inflation of health costs
by maybe two or three percentage points," Sen. Grassley said.
Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved.
Food
Industry Safety Inspections Challenged
Associated Press
Wall Street Journal
Thursday, March 19, 2009
WASHINGTON -- The food industry's self-policing system failed to
catch poor conditions at a peanut processing plant blamed for a
nationwide salmonella outbreak, lawmakers said Thursday.
The House Energy and Commerce investigations subcommittee
released new documents and pictures Thursday that attested to
long-standing sanitary problems at facilities owned by
Lynchburg, Va.-based Peanut Corp. of America. The company is at
the center of a nationwide outbreak that has sickened nearly 700
people and is being blamed for at least nine deaths.
The outbreak was traced to a Peanut Corp. company facility in
Georgia. Later, another Peanut Corp. plant in Texas was also
found to have serious problems. Peanut Corp. is under criminal
investigation.
Rep. Bart Stupak (D., Mich.) chairman of the investigations
subcommittee, questioned how dozens of food companies that
bought peanut paste and other ingredients from Peanut Corp.
failed to pick up the problems. Part of the reason, Rep. Stupak
said, is that they relied on safety audits by inspectors who
were hired by Peanut Corp.
"There is an obvious and inherent conflict of interest when an
auditor works for the same supplier it is evaluating," said Rep.
Stupak, calling it a "cozy relationship." Peanut Corp.'s private
inspector, a company called AIB, awarded it a certificate of
achievement in 2008 for "superior" quality at the Texas plant.
At least one food company that used its own auditors, Nestle,
decided not to do business with Peanut Corp.
The committee released a 2002 inspection report from Nestle.
"They found that the place was filthy," said Rep. Henry Waxman
(D., Calif.).
Lawmakers have introduced legislation to take food safety
oversight away from the Food and Drug Administration and give it
to a new agency with stronger legal powers and more funding.
Thursday's hearing came as a major food company joins consumer
groups in saying the U.S. food safety system is broken.
The head of Kellogg Co., the world's largest cereal maker, is
calling for an overhaul of how the government polices the
industry. Kellogg lost $70 million in the salmonella outbreak
after it had to recall millions of packages of peanut butter
crackers and cookies.
Kellogg's chief executive, David Mackay, wants food safety
placed under a new leader in the Health and Human Services
Department. He is also calling for new requirements that all
food companies have written safety plans, annual federal
inspections of facilities that make high-risk foods and other
reforms.
Mr. Mackay's call for major changes could boost President Barack
Obama's efforts to remake the system. Last week, Mr. Obama
launched a special review of food-safety programs, which are
split among several departments and agencies, and rely in some
cases on decades-old laws. Critics say more funding is needed
for inspections and basic research.
"The recent outbreak illustrated that the U.S. food safety
system must be strengthened," Mr. Mackay said in his prepared
remarks. "We believe the key is to focus on prevention, so that
potential sources of contamination are identified and properly
addressed before they become actual food safety problems."
Peanut Corp. produced not only peanut butter, but peanut paste,
an ingredient found in foods from granola bars and dog biscuits
to ice cream and cake. More than 3,490 products have been
recalled, including some Kellogg's Austin and Keebler peanut
butter sandwich crackers.
FDA inspectors swooped down on the Georgia plant in January and
found multiple sanitary violations. The problems included
moisture leaks, improper storage and openings that could allow
rodents into the facility.
Tests by the FDA found salmonella contamination within the
plant. After invoking bioterrorism laws, the FDA obtained Peanut
Corp. records that showed the company's own tests repeatedly
found salmonella in finished products.
How persistent problems at the Georgia plant managed to escape
the attention of state inspectors and independent private
auditors is one of the main unanswered questions in the
investigation.
Copyright © 2009 Associated Press.
Medicare
Rules on Equipment Worry Patients
Competitive Bidding Will Save Money on Supplies, but Quality of
Service Could Be at Risk
By Barbara Martinez
Wall Street Journal
Thursday, March 19, 2009
Millions of older and disabled people could face stiff new
restrictions on where they can go for medical equipment under a
Medicare plan to overhaul how the federal insurer pays for such
devices.
Patients have long been able to choose any supplier, and
Medicare would buy or rent the equipment based on a set schedule
of fees. Now, the government plans to pay for devices sold only
by approved suppliers, to be selected by competitive bidding.
The change is expected to reduce costs for the government and
save money for seniors, who pay 20% of the cost of their
equipment. But it also may mean new hassles for patients, say
suppliers and some patient-advocacy groups. And some patients
worry about no longer being able to do business with providers
they have come to rely on for life-saving equipment.
"Competitive bidding is going to eliminate 90% of home-care
providers," says Tyler Wilson, president of the American
Association for Homecare, which represents home-equipment
suppliers. "The result is going to be lower quality and lower
access to care for seniors and people with disabilities." The
group also notes that the savings would be relatively small --
Medicare is expected to spend less than 2% of its roughly $500
billion budget this year on home medical equipment.
As hospitals relegate more patients with chronic conditions to
home care, more seniors and disabled rely on medical equipment
for their daily needs. Some 1.5 million Medicare patients, for
example, need home oxygen equipment for a variety of lung
diseases, such as chronic obstructive pulmonary disease, and
other conditions, including congestive heart failure. And about
one million patients rely on the federal insurer for their
wheelchairs. In total, an estimated 50% to 75% of the 44 million
Medicare beneficiaries use some type of durable-medical
equipment in any given year.
The Centers for Medicare and Medicaid Services, or CMS, which
oversees the Medicare program, says the amounts it pays for
medical equipment are excessive. That's because the fees aren't
based on underlying market prices. Instead, they are generally
based on prices from 1986 and 1987, and then adjusted using the
consumer-price index to account for inflation or by an
occasional act of Congress.
Cheaper Online
Medicare pays $4,000 for a power wheelchair, for instance. It
says the same item can be bought on the Internet for $2,200. A
hospital bed that costs the insurer $1,800 goes for half that
amount online. Medicare, which is expected to spend $8.7 billion
on medical equipment in 2009, says the planned change could save
the government $1 billion a year.
The government's competitive-bidding program will provide "value
to Medicare and its beneficiaries, as well as taxpayers," says
Laurence D. Wilson, director of the chronic-care policy group at
CMS.
Mr. Wilson says the program includes mechanisms to ensure
patients are getting high-quality equipment. Winning bidders
will be vetted to ensure they are financially sound and can
provide ample customer service, he says. And approved vendors
will need to have industry accreditation, which isn't currently
required of all suppliers. The program also will assure a
certain amount of participation by small vendors, CMS says.
CMS is expected to solicit competitive bids from equipment
suppliers some time after April, and it would likely announce
winning bidders within a year. The program would first be rolled
out in nine metropolitan areas and then expanded to most of the
rest of the country in subsequent years.
A CMS spokeswoman says the approved suppliers won't necessarily
be the lowest bidders. CMS also expects to provide "ample
notice" before patients must select new suppliers in order to
ease the transition, she says.
Finding a New Supplier
Potential problems with the new program could outweigh the
savings, some patient groups say. "What ends up happening is
people who have a relationship with certain dealers are going to
end up having to find somebody else to provide that service, and
that may be a burden because maybe it's not in their local
area," says Lee Page, associate director of advocacy for
Paralyzed Veterans of America, which opposes the program.
"You get what you pay for," says Jerry Jones, a 49-year-old with
severe pulmonary hypertension who is concerned about having to
switch suppliers. The Hamilton, Ohio, resident, who requires
oxygen around the clock, uses several pieces of equipment that
he gets locally. The supplier "checks everything once a week" to
make sure vital equipment, like his ventilator, is working
properly. "We've got just a nice little thing going," Mr. Jones
says.
This is Medicare's second attempt at putting a
competitive-bidding program in place for medical equipment, a
change mandated by a law passed in 2003. Last year, the
government solicited bids from suppliers and, in the summer,
notified patients in 10 metropolitan areas that they could use
only approved vendors. Within two weeks, however, Congress voted
to suspend that rollout, after vendors argued that the program
was detrimental to patients and could put many suppliers out of
business.
A Wheelchair That Fits
That limited rollout caused some concerns that the number of
suppliers left after the bidding process wouldn't be able to
properly care for patients who need individualized attention.
"We saw in Florida, the number of places that people could turn
to was narrowed down significantly," says Peggy Hathaway, vice
president for public policy at the United Spinal Association, a
patient-advocacy group.
In the Miami area last year, for instance, only four suppliers
qualified to serve Medicare patients' needs for complex power
wheelchairs, down from nearly 400 vendors before, Ms. Hathaway
says. "If you're in the wrong wheelchair, you can develop sores,
infections," she says. "And then Medicare ends up paying for the
hospitalization or surgery because your wheelchair didn't fit
you properly."
More Study Urged
It's unclear whether the competitive-bidding program could be
blocked from proceeding again this year. In a letter to the
Department of Health and Human Services this month, Republican
Sen. Arlen Specter of Pennsylvania, who serves on the Special
Committee on Aging, among other positions, recommended that the
department scrap the current plan and "do a thorough and
complete analysis of the competitive-bidding program to
determine the best way to move forward for beneficiaries."
Health-Care Politics
Other members of Congress fall on both sides of the debate. The
Obama administration has set health reform as a major goal, and
though competitive-bidding plans were launched under former
President Bush, the program could offer useful lessons for how
to proceed to reduce health-care spending.
A CMS spokeswoman says the Obama administration is "committed to
implementing requirements that ensure that Medicare purchases
services and supplies in the most efficient manner while
ensuring beneficiary access." She adds that the administration
"understands that there were concerns from a range of
stakeholders" and is taking steps to "ensure that the program
can go forward."
Backers of the bidding program, including some members of
Congress, say last year's limited rollout was expected to shave
about a quarter or more from equipment costs. For example,
patients in Orlando, Fla., who use a machine that delivers
concentrated amounts of oxygen would have saved 29% in 2008 if
the program had been in effect, CMS officials say. Under the
current system, Medicare pays 80% of the $199.28 monthly rental
fee for the oxygen concentrator, and the patient pays the other
20%. Based on last year's competitive-bidding process, however,
the same device would have cost $140.82, reducing the patient's
co-insurance cost to $28.17 from $39.86.
Write to Barbara Martinez at
Barbara.Martinez@wsj.com
Pricing Controls
Medicare plans to change how beneficiaries obtain their
medical equipment.
* Suppliers would be chosen by competitive bidding, to
bring down costs.
* Patients would need to use approved vendors to receive
Medicare assistance.
* Advocacy groups worry that customer service will
suffer as patients are forced to switch suppliers.
Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved.
Opinion
The enablers in Annapolis
Our view: Too long ignored, antiquated alcohol tax rates need a
boost
Baltimore Sun Editorial
Thursday, March 19, 2009
Before Gov. Martin O'Malley and Maryland legislators cut another
penny from classroom aid, before they balance the budget by
reducing mental health services or Medicaid and before state
employees are furloughed again, they must reform a decrepit
alcohol tax structure that's become impossible to stomach.
How bad is it? Maryland has the lowest tax on distilled spirits
in the nation at $1.50 per gallon. The taxes on beer, 9 cents
per gallon (less than one penny per 12-ounce can), and wine, 40
cents per gallon, rank near the bottom of the list, too.
This has been a boon for those who make a living selling
alcohol, but it's profoundly misguided public policy. This
failure to keep up with inflation - the tax on spirits was set
in 1955 - means everyone is, in essence, underwriting the sale
of booze. It doesn't take a prohibitionist to see the harm in
that.
Sales taxes, income taxes, property taxes, tobacco taxes, all
have risen significantly over the years. The comparison to
tobacco is particularly apt - cigarette smokers contribute
nearly 20 times more to the state budget than those who prefer
Johnnie Walker or Jim Beam.
Yet the health effects are nearly as bad. Alcoholism, drunken
driving, domestic violence, all and more of society ills are
linked to the excess consumption of alcohol, and they are surely
worsened when the government chooses to help keep prices low.
The national averages for alcohol excise taxes are two to three
times higher at $3.62 per gallon for spirits, 74 cents for wine
and 24 cents for beer.
Some lawmakers would like to raise the tax to make health
insurance more affordable, others to pay for much-needed
services for the developmentally disabled. The bottom line is
the tax needs to be increased regardless of what it finances.
For too long, lawmakers have caved to the interests of tavern
owners and wholesalers, a powerful lobby that gives a lot of
money to politicians.
The biggest obstacle may be the cowardice of lawmakers who fear
voters won't tolerate another tax increase after the
budget-balancing efforts of 2007. But if elected officials fail
to take action, they'll have to explain why they preferred to
raise the sales tax, cut education funding or made myriad other
difficult choices to slay the deficit while leaving alcohol
taxes in the Eisenhower years.
A wholesale tax increase amounts to pennies on the drink.
Martini olives cost more.
Copyright 2009 Baltimore Sun.
Homeless have more than handwashing to fret over
Salisbury Daily Times Letter to the Editor
Thursday, March 19, 2009
Through my work with the homeless in our area and association
with the Tri-County Alliance for the Homeless, I received an
e-mail from Lore Chambers, Salisbury's assistant city
administrator.
It acknowledged that organizations and persons are providing
food to homeless individuals on the streets and indicated
concern about health and proper handling and heating/cooling of
the food. The e-mail went on to suggest that organizations
providing meals collaberate with area churches that are willing
to provide space where homeless individuals may be served a meal
in a decent environment, have access to facilities for
handwashing and be treated with dignity and respect. It
requested that organizations providing meals take this into
consideration.
I appreciate the concern for appropriate practices, but feel
strongly that the city must put its priorities in order.
Worrying about handwashing seems silly, knowing that people
gather food and eat from Dumpsters. I'd be happy to show anyone
the better Dumpsters -- but if I did, I'm afraid I'd be sealing
the fate of those who use them for sustenance.
As March comes to an end and area emergency shelters close, we
will be adding to the number of people on the streets who
survived the winter in tents or other makeshift shelters. The
community shelters have done an outstanding job keeping people
safe and fed.
What happens now?
One thought: Lou Rimbach (410-370-6561) and I (410-749-7682)
have helped 11 people get jobs recently at Mountaire in
Selbyville and Millsboro. We need help with transporting people
for the interview/hiring process. Any takers?
Kay Spruell
Salisbury
Copyright 2009 Salisbury Daily Times.
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