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Want to know how healthy your county is?

Now you can find out.

A new ranking of nearly every county in the nation shows significant disparities in the overall health of residents, depending on where they live.

Researchers from University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation used data on premature deaths, self-reports about health and factors such as smoking rates, obesity, teen births, the percentage of children in poverty and number of liquor stores vs. grocery stores to rank more than 3,000 counties nationwide against others in their state.

Researchers then chose each state’s healthiest county and compared it to each state’s unhealthiest county. Among the findings:
Suburban and urban counties tend to be healthier than rural counties. About 48 percent of the healthiest counties were urban or suburban, while 84 percent of the unhealthiest counties were rural.
The unhealthiest counties had 2.5 times the premature death rate, or people who die under age 75, than the healthiest counties.
Residents of the unhealthiest counties were more than twice as likely to consider themselves in fair or poor health than those in the healthiest counties.
Those in the least healthy counties were 60 percent more likely to be admitted to the hospital for a preventable conditions. Misuse of hospitals for non-emergency or preventable conditions is often a symptom of not having access to outpatient care and primary care doctors, either because of lack of insurance or lack of providers.
Children are three times more likely to live in poverty in the least healthy counties (30 percent) compared to the healthiest counties (9 percent).
Counties ranked the unhealthiest are less likely to have at least one grocery store where people can buy healthy foods such as fresh produce. About 33 percent of zip codes in the unhealthiest counties had a grocery store, while 47 percent of zip codes in the healthiest counties had a grocery store.

Dr. Patrick Remington, associate dean for public health at the University of Wisconsin, said the rankings are a call to action for state and local social service providers, environmental health experts, health care professionals, educators, elected officials and other community leaders to identify where their region is falling short and how they can improve.

“Whenever you rank people or places or teams or colleges, people pay attention. They want to know where they are on the list and they want to know what factors were included in the ranking,” Remington said. “Everyone in the nation can look at this report and see how the health of where they live or work compares to their neighboring counties and to other counties in the state.”

In the study, researchers ranked counties on two overall measures: health outcomes, which included information on mortality, self-reported health and low birth weight babies; and about 25 other factors that can impact health but don’t directly measure it. Those factors included rates of motor vehicle accidents, uninsured adults and violent crime; the number of primary care doctors in an area and usage of hospice for the terminally ill; measures of air pollution, liquor store density and the percentage of high school and college graduates.

Because each state collects data differently, the study ranks states only against others in the same state, Remington explained. That also means that one state’s “unhealthy” could be another state’s “healthy” and vice versa.

For example, it’s possible that a relatively unhealthy county in a state such as Vermont, which was ranked the healthiest in the nation by a recent report, “America’s Health Rankings,” could actually be healthier than a relatively healthy county in Mississippi, ranked the least healthy state.

Maggie Elehwany, vice president of government affairs and policy for the non-profit National Rural Health Association, said she was not surprised to see that rural counties tended to have poorer overall health.

“We believe there are greater health disparities in rural counties,” Elehwany said. “It’s an older population per capita, a sicker population per capita, which means they have more heart disease and diabetes, and it’s a poorer population per capita, which means they are more dependent on state and federal programs such as Medicaid and Medicare.”

Rural areas also tend to have higher rates of people without any health insurance at all, as well as a lack of primary care doctors. When you couple those factors with the sheer distances people have to travel to seek medical care, getting proper treatment and follow up for chronic illnesses often doesn’t happen, Elehwany explained.

About 20 percent to 25 percent of the U.S. population live in rural areas, she added.

SOURCES: Patrick Remington, M.D., M.P.H., associate dean, public health, University of Wisconsin, School of Medicine and Public Health, Madison; Maggie Elehwany, J.D., vice president, government affairs and policy, National Rural Health Association, Washington, D.C.

Infants who develop flat head syndrome may be more apt to experience delays in physical and mental development, a new study has found.

An infant can develop the syndrome, called positional plagiocephaly, by spending extended periods of time lying on a hard surface in one position. The condition can occur because an infant’s skull is still soft and malleable.

“For every 10 babies, one or two may have at least mild plagiocephaly,” Matthew L. Speltz, chief of outpatient psychiatric services at Seattle Children’s Hospital and professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, said in a hospital news release.

“Many parents and physicians have dismissed it as a cosmetic issue or one that babies will grow out of as they develop, but our study indicates that we should look deeper,” Speltz said.

The study, which involved 472 babies, 4 months to 1 year old, found that those with flat head syndrome had lower scores on tests of cognitive and motor skills development. The tests included simple tasks that required the following: problem-solving and memory (such as searching for a hidden toy); the ability to imitate, vocalize, observe and respond to their environment; and motor skills such as crawling, rolling from side to side and being able to lift up from a tummy position.

The findings suggest an association between flat head syndrome and developmental delay, but they do not show a direct causal link. The researchers explained that there could be a reverse association: Infants with pre-existing motor skills delays could be more likely to develop flat head syndrome because they might move less or remain in one position for longer periods of time.

The findings, published online Feb. 15 in Pediatrics, indicate “that babies with flat head syndrome should be screened and monitored for possible cognitive and motor delays,” Speltz said.

“However,” he added, “it’s also important to note that our study examined babies at one particular point in time so we cannot say with certainty whether these observations continue to hold true as these infants grow older. Our future studies will revisit this population at 18 and 36 months of age to see whether this association persists as these infants mature.”

People across Africa who took AIDS drugs were far less likely to infect their partners with the virus, researchers said on Wednesday.

The study, presented at a meeting of AIDS experts, is one of the first to show so clearly that the drugs can prevent infection as well as keep patients healthy.

It could boost efforts to provide the AIDS drugs to people, especially in the hardest-hit countries in Africa.

Dr. Deborah Donnell of the Fred Hutchinson Cancer Research Center in Seattle and colleagues followed 3,400 couples in which one partner was infected and the other was not in seven African countries.

The couples were all counseled on how to protect themselves and given free condoms. Each patient with HIV began taking a drug cocktail when he or she became eligible based on a measure of immune system damage called CD4 count.

Over the next one to three years, 103 of the previously uninfected people became infected. Nearly all, 102 infections, happened before the infected partner started taking the drugs, Donnell told the Conference on Retroviruses and Opportunistic Infections in San Francisco.

“Only one happened when the partner was on antiretroviral therapy,” she told reporters in a telephone briefing.

“That amounts to a final reduction of 92 percent when on antiretroviral therapy.”

The AIDS virus infects 33 million people globally and has killed 25 million since the pandemic began in the 1980s. There is no cure and no vaccine but combinations of drugs called antiretrovirals can keep patients healthy.

There is a debate over whether treating patients also reduces the likelihood that they will infect others. It is an important point as governments and non-profit groups spend billions on treatment and prevention programs.

“We think it is very likely that antiretroviral treatment is going to reduce the risk of HIV transmission,” Donnell said. “Our data will be informative for policymakers.”

Donnell said the study was unique as the couples were followed closely and tested every few months. Tests showed whether newly infected partners were actually infected by their sexual partner or by someone else.

Your collarbone, medically called the clavicle, is the bone near the shoulder that helps attach the arm to the body.

The American Academy of Orthopaedic Surgeons says here’s what you can expect during recovery from a broken collarbone:
Wear a sling to keep the arm still for between three and four weeks for children, or as long as six to eight weeks for adults.
Take anti-inflammatory medications, such as ibuprofen or aspirin.
A large bump usually forms on the collarbone, but typically shrinks over time.
You’ll have limited motion and function of the shoulder until the collarbone has healed.
Avoid sports and vigorous exercise until the fracture has healed. With your doctor’s approval, you can begin gentle strengthening exercises once the area is no longer painful.

Getting plenty of sleep not only helps keep truck drivers safe and alert on the road, it also seems to fuel healthy eating habits, new research hints.

In surveys of truckers working at U.S. trucking terminals, those who felt they regularly got adequate sleep tended to consume more fruits and vegetables and fewer sugary drinks and snacks, Dr. Orfeu M. Buxton, at Harvard Medical School in Boston, Massachusetts, and colleagues found.

These real-world findings are consistent with laboratory studies showing that insufficient sleep increases hunger and “induces greater eating, especially unnecessary snacking,” Buxton noted in an email to Reuters Health.

Buxton and associates assessed self-reported diet, sleep, and job-related factors of 542 male Teamster union members who were 49 years old on average.

Sixty-six percent worked as pick-up and delivery truck drivers, 20 percent as over-the-road truckers, and 15 percent served dual roles as dockworkers and truck drivers, they note in the American Journal of Public Health.

Most of the workers (87 percent) were satisfied with their job and a little more than half (52 percent) said they got enough nightly shuteye “to feel rested upon waking up.”

These well-rested truckers also said they ate an average of about 3 servings of fruits and vegetables (not including French fries), less than one serving of a sugar-added drink, and less than half a serving of a sugary snack daily.

By contrast, truckers reporting insufficient sleep reported eating about two fruit and vegetable servings, and slightly more than one sugary drink and nearly one sugary snack each day.

The investigators conclude that workplace programs to encourage adequate worker sleep may have positive benefits on employee health.

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Children with poor reading skills who underwent an intensive, six-month training program to improve their reading ability showed increased connectivity in a particular brain region, in addition to making significant gains in reading, according to a study funded in part by the National Institute of Mental Health (NIMH). The study was published in the Dec. 10, 2009, issue of Neuron.

“We have known that behavioral training can enhance brain function.” said NIMH Director Thomas R. Insel, M.D. “The exciting breakthrough here is detecting changes in brain connectivity with behavioral treatment. This finding with reading deficits suggests an exciting new approach to be tested in the treatment of mental disorders, which increasingly appear to be due to problems in specific brain circuits.”

For the study, Timothy Keller, Ph.D., and Marcel Just, Ph.D., both of Carnegie Mellon University, randomly assigned 35 poor readers ages 8–12, to an intensive, remedial reading program, and 12 to a control group that received normal classroom instruction. For comparison, the researchers also included 25 children of similar age who were rated as average or above-average readers by their teachers. The average readers also received only normal classroom instruction.

Four remedial reading programs were offered, but few differences in reading improvements were seen among them. As such, results for participants in these programs were evaluated as a group. All of the programs were given over a six month schooling period, for five days a week in 50-minute sessions (100 hours total), with three students per teacher. The focus of these programs was improving readers’ ability to decode unfamiliar words.

Using a technology called diffusion tensor imaging (DTI), the researchers were able to measure structural properties of the children’s white matter, the insulation-clad fibers that provide efficient communication in the central nervous system. Specifically, DTI shows the movement of water molecules through white matter, reflecting the quality of white matter connections. The better the connection, the more the water molecules move in the same direction, providing a higher “bandwidth” for information transfer between brain regions.

At the outset of the study, poor readers showed lower quality white matter than average readers in a brain region called the anterior left centrum semiovale. Six months later, at the completion of the intensive training, the poor readers showed significant increases in the quality of this region. Children who did not receive the training did not show this increase, suggesting that the changes seen in the remedial training group were not due to natural maturation of the brain.

In an effort to further pinpoint the mechanism underlying this change, the researchers deduced that a process called myelination may be key. Myelin is akin to electrical insulation, allowing for more rapid and efficient communication between nerve cells in the brain. However, the directional association between brain changes and reading improvements remains unclear — whether intensive training brings about increased myelination that results in improved word decoding skills, or whether improved word decoding skills leads to changes in reading habits that result in greater myelination.

“Our findings support not only the positive effects of remediation and rehabilitation for reading disabilities, but may also lead to improved treatments for a range of developmental conditions related to brain connectivity, such as autism,” noted Just.

The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit the www.nimh.nih.gov.

Genetic testing of people who’ve suffered sudden unexplained death is an effective and cost-efficient way of identifying genetic mutations that may put surviving relatives at increased risk for potentially deadly heart rhythm disturbances, a new study suggests.

Genetic defects that can cause sudden cardiac death occur in 25 percent to 30 percent of victims of sudden unexplained death. The current recommended approach is for first-degree relatives of sudden unexplained death victims to undergo comprehensive cardiac testing.

In this study, U.S. researchers compared the results and costs of postmortem genetic/molecular autopsy testing in 146 sudden unexplained death cases and found that 40 of the victims (26.7 percent) had either a catecholaminergic polymorphic ventricular tachycardia mutation (18 people) or a long QT syndrome mutation (22 people). Both are known to cause sudden death.

The researchers then estimated the costs of testing the 584 relatives of the sudden unexplained death victims. The total cost of postmortem genetic testing, genetic confirmation testing of the 160 relatives of victims who tested positive for mutations, and cardiac tests for both relatives of mutation-positive and mutation-negative sudden unexplained death victims was $6.78 million.

In comparison, comprehensive cardiac testing for all 584 relatives of the sudden unexplained death victims, followed by directed genetic testing, would have been more than $7.7 million.

“With less than 150 sudden unexplained death cases, use of a cardiac channel molecular autopsy would be estimated to save almost $1 million indicating a much less expensive way of evaluating those left behind,” study co-author David Tester, a senior research technologist at Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minn., said in a news release.

“If you identify a mutation in a sudden unexplained death victim, you can do a simple genetic test in first-degree relatives to assess their risk and perform a disorder-directed clinical evaluation rather than a full clinical evaluation. If a relative is negative for the causative mutation, they may not need to undergo further clinical evaluation at all, and that saves money,” Tester explained.

The study was to be presented Sunday at the American Heart Association’s annual meeting in Orlando, Fla.

A hammer toe occurs when a toe bends over in a hammer-like or claw-like shape. Most common in the second toe, the condition can affect any toe.

A person can be born with a hammer toe, or it can develop over time, particularly from wearing shoes that are too small.

Early treatment may prevent the need for surgery. The U.S. National Library of Medicine offers this list of other potential treatment options:
Splinting the toe, which seems to work best for mild cases or among children.
Using foot manipulation, also an effective remedy for children.
Wearing properly fitted shoes that don’t squeeze the toes.
Wearing a protective pad or using a corrective foot device.
Exercising the toes. Speak to your doctor about what may work for you.

Tranexamic acid (Lysteda) has been approved by the U.S. Food and Drug Administration as the first non-hormonal drug to treat heavy menstrual bleeding, a medical condition called menorrhagia. It works to stabilize a protein that helps blood clot.

Some 3 million women in the United States report the condition each year, usually with no apparent cause, the FDA said in a news release.

Tranexamic acid has been used since the mid-1980s to reduce or prevent bleeding after tooth extraction in people with hemophilia, a genetic disorder caused by lack of a blood clotting factor.

Common side effects among people using Lysteda include headache, sinus and nasal symptoms, back or abdominal pain, muscle or joint pain, anemia and fatigue.

People who use Lysteda while also taking hormonal contraceptives may run the risk of increased blood clots, stroke or heart attack. So women who take a hormonal contraceptive should only use Lysteda if there is a strong medical need, the FDA stressed.

Lysteda is made by Kentucky-based Xanodyne Pharmaceuticals.