According to a new survey by the Pew Research Center’s Internet and American Life Project and the Project for Excellence in Journalism, in the United States the Internet is now a more popular source of news than print newspapers and radio. That makes it the third most popular news platform overall, behind only national and local television news.

The 2010 survey, “Understanding the Participatory News Consumer: How Internet and Cell Phone Users Have Turned News into a Social Experience,” was based on responses from more than 2,000 American adults. Its findings include:

• Nearly 60% of Americans get daily news from both Internet and print sources.
• 46% obtained news from four to six media platforms per day, while only 7% get news from a single platform.
• 33% of cell phone owners access news on their portable phones.
• 28% of Internet users have a homepage personalized with news sources, and 37% have participated in news creation, commentary and dissemination.

While the Internet is an increasingly popular news source, the survey found that Americans have mixed feelings about it. While more than half say it is easier to keep up with news and information today than it was five years ago, 70% feel overwhelmed by the amount of news and information available. In addition, nearly 75% of respondents have concerns that many news sources are biased in their coverage.

Tags: consumer affairs, news

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Efforts to create healthy workplaces generally focus on safety. Programs that support employees’ choosing healthier behaviors — being more physically active or adopting a better diet, for example — are less common.

However, as indicated by a 2010 study published in the Harvard Business Review, such choices can have a significant effect on an employer’s health care costs. The study, “What’s the Hard Return on Employee Wellness Programs?” finds that a well-run employee wellness program can yield significant returns — as much as $6 in health care savings for every $1 invested. Other benefits can include reduced days lost to sickness, lower workers’ compensation insurance premiums and higher rates of employee retention.

The authors studied ten organizations in a number of industries to better understand the concrete benefits of employee wellness and the characteristics of the most effective programs. Findings include:

• A successful employee wellness program involves engagement by leadership on multiple levels and strong alignment with the corporation’s vision and identity.
• To ensure employees’ participation, the programs need to be of high quality, comprehensive, relevant and accessible.
• Programs thrive through sustained partnerships between internal and external stakeholders as well as strong internal promotional communication.

This research underscores the importance of employers to adopt a more proactive approach in encouraging and enabling employee wellness. In turn, companies can reap benefits such as lower health costs, greater worker productivity and improved morale.

Tags: employment, exercise, medicine, nutrition

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The benefits associated with being physically active include higher levels of fitness and lower risks of developing a number of chronic diseases.  In terms of weight management, however, most people who lose weight from increased physical activity are not able to sustain the loss over time.

A 2010 study by researchers from the Harvard Medical School, Harvard School of Public Health and the Boston Veterans Affairs Healthcare System, published in the Journal of the American Medical Association, “Physical Activity and Weight Gain Prevention,” seeks to examine the relationship between different amounts of physical activity with weight changes. The sample used in this study was a large cohort of middle-aged and older women over a period of 13 years.

The study’s key findings are:

• On average, subjects gained 2.6 kg over the 13 years of the study.
• Those who averaged 60 minutes a day of moderate-intensity physical activity gained less weight than those who were less active.
• Women with a body mass index of 25 or lower exhibited significant weight loss from physical activity.
• Subjects with a BMI over 25 did not exhibit significant weight loss from physical activity.

Because the study indicated that women with BMIs over 25 had fewer weight-loss benefits from physical activity, researchers suggested that measures to prevent weight gain should be emphasized. In addition, they recommended following the U.S. Department of Health and Human Services’ physical activity guidelines for Americans, which suggest that 150 minutes of exercise per week can help individuals reap significant health benefits.

Tags: aging, exercise, obesity

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Hearing loss in the United States has been shown to be on the rise — a 2008 survey found that 35 million Americans suffer from the partial or complete loss of the ability to hear. While some of this is due to the  aging of the baby boomer generation, hearing loss among younger Americans has also increased.

A 2010 study by researchers from Harvard University and Vanderbilt University and Brigham and Women’s Hospital, “Change in Prevalence of Hearing Loss in U.S. Adolescents,” finds that the rate of hearing loss among U.S. adolescents has risen sharply in the past three decades.

The study, published in the Journal of the American Medical Association,finds that:

• About one in every five Americans ages between 12 and 19 years old were found to experience some hearing loss in 2005-2006. This proportion was about 30% higher compared to the prevalence rate in 1988-1994.
• Teens from families living below the poverty line are more likely to suffer hearing loss.
• Males are significantly more likely to experience hearing loss compared to females.
• No significant difference in the prevalence of hearing loss by age or race/ethnicity.

The researchers note that hearing loss by adolescents can have significant implications on speech perception, self-image, social skills development and learning.

Prolonged exposure to loud music could be an important determinant to this rise in hearing loss, the researchers state. They suggest further research to determine other contributory factors as well as policies to mitigate the worsening of hearing loss among the young.

Tags: safety, technology, youth, poverty

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The issue of gender gap in test scores has long been part of the education-policy debate, and explanations remain highly contested.  While the gaps between men and women in the math and science fields have closed in recent decades, strategies to address the disparities are still evolving and being tested in the classroom.

A 2010 paper in the Journal of Economic Perspectives, “Geographic Variation in the Gender Differences in Test Scores,” looks at how the disparity in test scores might be explained by state or regional differences.

The paper’s key findings include:

• The mean test scores of men and women do not differ very substantially. Compared to female students, male students registered higher mean math and science scores by 0.17 and 0.06 standard deviations respectively. The mean male students’ reading score is 0.38 standard deviation lower.
• The disparities widen at higher percentiles of the tests. At the top 5%, the ratios of male-to-female students’ math and science scores are 1.87 and 1.40 standard deviations respectively. Conversely, the ratio of female-to-male students’ reading score is 2.31.
• Gender stereotypes prevail more strongly in certain states and regions. States with higher male-to-female score ratios in math and science tests are more likely to register higher female-to-male score ratios in reading tests.

The authors conclude that because individuals’ genetic makeup is likely to be consistent across all states, the variation in test scores “suggests environments significantly impact gender disparities.”

Tags: gender, math, science

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Smoking bans have been found to reduce heart attacks, but how such laws bring about other improved health outcomes is less clear. Little is known about the degree to which bans reduce second-hand smoke exposure, for example.

A 2010 paper by researchers from the University of California, Irvine, and Queen’s University, Canada, “Public-Place Smoking Laws and Exposure to Environmental Tobacco Smoke (ETS) in Public Places,” seeks to bridge this gap. Using data from Canada, the study examines the effects of smoking laws on smoking prevalence and second-hand smoke exposure, and thus, the broader public health implications of smoking laws.

The study’s key findings include:

• Smoking laws reduced the probability of second-hand smoke exposure in a restaurant by 75% relative to a mean exposure rate of 54% in 2005.
• Laws reduced second-hand smoke exposure inside a bar was 64% relative to a mean exposure rate of 37.6% in 2005.
• From 2000 to 2008, public-place second-hand smoke exposure declined from 23% to 11%.  Public-place smoking laws could account for 7.3% of the reduction.
• While smoking bans reduce second-hand smoke exposure in public places, they have no significant effect in reducing smoking intensity.

While the researchers note that the study has limitations — for example, the data is self-reported — they conclude that its findings suggest that public-place smoking bans have the potential to improve public health.

Tags: medicine, safety

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The U.S. Congressional Budget Office estimates that gross spending on the Medicare program is expected to nearly double in nominal terms to $1,038 billion in 2020. In addition, as a proportion of gross domestic product, Medicare spending would likely grow from 3.5% in 2009 to 4.6% in 2020.

A 2010 study published in the New England Journal of Medicine, “Geographic Variation in Medicare Drug Spending,” examines spending on non-drug medical services and pharmaceutical expenses by patients across various geographical regions.

The study’s findings include:

• More than 20% of total Medicare spending was made up of pharmaceutical expenses.  However, there were large variations across hospital-referral regions due mainly to the amount of and cost of drugs prescribed.
• Variations in non-drug medical spending were even more substantial than pharmaceutical expenses.
• No strong correlation between pharmaceutical spending and non-drug medical spending across hospital-referral regions, after accounting for patients’ characteristics.

The authors conclude that the “weak correlation between the level of medical spending and the level of drug spending is consistent with drugs’ being a substitute for medical care for some patients and a complement to medical care for others.” To better understand the deeper causes of geographic variations in Medicare spending, the authors suggest that studies on resource deployment and usage would shed light on public policy design to improve the quality and cost-effectiveness of U.S. health care.

Tags: health care reform

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Prisoners suffering from mental illness or showing its symptoms are common among criminal justice populations. The potential relationship between crime and mental illness could have important policy implications, particularly if increased more widespread mental health treatment could prove to have wide effects on rates of criminality.

A 2010 paper by the Harvard Medical School for the National Bureau of Economic Research, “Mental Health Treatment and Criminal Justice Outcomes,” examines whether treating children and adult with mental health illnesses could reduce crime. The paper includes a survey of past studies as well as original research. The findings include:

• Children who exhibited serious behavioral problems between the age of 6 and 9 are 14.3% more likely to be suspended or expelled by the age of 17.
• Children who exhibited serious behavioral problems between the age of 6 and 9 are 5% more likely to be arrested or convicted by the age of 16.

While such data are suggestive of a link between mental illness and crime, the author cautions that the causal connection is not overwhelming. Consequently, “the case for broad-based expansion of mental health prevention or treatment would need to rest on grounds other than crime reduction.” These include better mental health and better social functioning.

The authors conclude by considering the cost-effectiveness of mental health courts and mandatory outpatient treatment.

Tags: mental health, prisons, children

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Bicycle commuting is a relatively common in many parts of Europe, China and India, but less so elsewhere. While it is gaining support in the United States — a federal tax break for bicycle commuters became law in 2008 — it remains significantly less popular here than abroad.

In a 2010 study published in Transport Policy, “U.S. Immigrants and Bicycling: Two-wheeled in Autopia,”  a UCLA researcher found evidence of a bicycling “immigrant effect”: Recently arrivals are significantly more likely to commute by bicycle than native-born Americans, but the effect is reduced over time.

The paper finds that:

• New immigrants are 41 times more likely to choose cycling over driving compared with native-born Americans.  This likelihood is reduced by half in the first four years.
• The probability of using bicycles falls as incomes rise and immigrants substitute cycling with other forms of transportation.
• Immigrants from East and Southeast Asia are more likely to use the bicycle compared to other immigrant groups and native-born Americans.

The author suggests that future research look at factors that affect immigrants’ bicycle use to better inform future policy-making. These could include advocacy efforts, addressing transportation constraints that immigrants face and involving immigrants in the bicycle policy planning process.

Tags: bicycling, bicycle, bikes, Asia, Europe

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The goal of the U.S. Nutrition Labeling and Education Act of 1990 was to enable the public make better-informed dietary choices through improved labeling on packaged foods.  A requirement of 2010 Affordable Health Care Act extends the concept to chain restaurants, requiring them to disclose similar information on the food they sell.

A 2010 paper by scholars from the Seattle Children’s Research Institute and the University of Washington, “Nutrition Menu Labeling May Lead to Lower-Calorie Restaurant Meal Choices for Children,” looks at the law’s potential effects on parents’ and childrens’ food choices.

The authors approached this question by conducting a randomized controlled trial of parents’ food choices for their children. The study finds that, on average:

• Parents who viewed menus with nutrition information ordered food with 102 fewer calories for their children, compared with parents who viewed menus without the information.
• After controlling for parents’ characteristics, their frequency of eating fast food and the physical characteristics of the children, parents who viewed menus with nutrition information ordered food with 20% fewer calories.
• Parents of both groups do not choose food differently for themselves.

The authors conclude by discussing some of the limitations of the study such as the validity of self-reported health information and the extent to which the sample is representative of the general population.  Despite these concerns, this result provides additional support for laws that institute menu labeling standards and has implications of future policy to address the rise of obesity.

Tags: children, nutrition, obesity, Obamacare

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The high variability in hospital costs for the elderly Medicare beneficiaries has been cited as evidence of hospitals’ inefficient resource use. Nonetheless, an accurate analysis on hospital efficiency must take account of both health outcomes and resource usage.

A 2009 paper published in Circulation: Cardiovascular Quality and Outcomes, “Looking Forward, Looking Back: Assessing Variations in Hospital Resource Use and Outcomes for Elderly Patients With Heart Failure,” addresses one of the key drawbacks of existing research that analyzed only individuals who have died (i.e., the “looking back” method). Adopting the “looking forward” approach, this study is able to account for the differences on health outcomes for those who have survived. Analyzing patients with heart failures, the study finds that Californian teaching hospitals that used more resources had lower mortality rates.

The specific findings from this study include:

• Using the “looking forward” methodology, the risk-adjusted hospital means ranged from 17% to 26% for mortality.
• The “looking forward” risk-adjusted hospital means ranged between 7.8 to 14.9 total hospital days, compared with 9.1 to 21.7 days for “looking back.”
• In terms of indexed total direct costs, “looking forward” method found that to be 0.66 to 1.30 times of the mean, compared with 0.91 to 1.79 times for “looking back.”

The authors conclude with a discussion of the caveats of this study and the future research direction of distinguishing between inefficient and beneficial resource use.

Tags: aging

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In the food industry, the federal Pathogen Reduction Hazard Analysis and Critical Control Program regulates meat and poultry processing plants. Estimates of the compliance costs of this program range from as low as 0.04 cents per pound to as much as 20 cents per pound.  While these estimates include actual costs, they do not distinguish between the different components of the rule itself and other indirect factors that could also affect costs.

By addressing some of the weaknesses of these past studies, a 2008 Center for Economic Studies paper, “The Direct and Indirect Costs of Food Safety Regulation,” quantifies the direct and indirect regulator effects of the PR/HACCP rule and the outcomes of direct private actions on the costs of the food safety control process.

The study’s key findings include:

• The cost of federally mandated processing tasks is the largest portion of the PR/HACCP rule for most industries surveyed.
• The larger plants experienced substantial cost advantage when compared with smaller plants, due to economies of scale.
• Nearly half of the cost of compliance with the PR/HACCP rule is attributed to direct private actions; i.e., buyer contracts and plant food safety capital investment.

While the results cannot be generalized to the wider population, the author states that any bias is likely to be quite small.

Tags: safety, nutrition

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The Hispanic population in the United States grew from 35.3 million in the 2000 Census to 46.9 million (or 15.4% of the total population) in 2008.  Of these, 62% are native born while 38% are foreign born. Historically, Hispanic participation in the census has been lower than other groups. In 2000, their return rate was 69%, compared to 79% for non-Hispanic households. This lead the Census Bureau to dedicate 20% of its ad budget on awareness campaigns aimed at Hispanics.

With the approach of the 2010 Census, the Pew Hispanic Center conducted a nationwide survey in March 2010 of 1,003 Latino adults on their awareness of and attitude toward the Census.  The results were published in “Latinos and the 2010 Census:  The Foreign Born Are More Positive.”

Its findings include:

• 79% of Spanish-speaking and 69% of bilingual Hispanics are positive and knowledgeable about the census, compared with 53% of English-speaking Hispanics.
• Foreign-born Hispanics (80%) are more likely to say that the census is good for the Hispanic community, compared with native-born Hispanics (57%).
• 69% of foreign-born Hispanics are likely to correctly say the census cannot be used to determine whether or not someone is in the country legally, versus only 57% of native-born Hispanics.
• 56% of foreign-born Hispanics reported that they have received pro-census messages, compared with 38% of native-born Hispanics.
• 91% of foreign-born Hispanics reported that they have sent in their census form or definitely will, compared with 78% of native-born Hispanics.

In addition, the researchers report, foreign-born Hispanics are also more likely to trust the Census Bureau to keep their personal information confidential.

Tags: California, Hispanic, Latino, race

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Historically, smoking and obesity have had the greatest impact on disease and mortality rates in the United States. However, the relative importance of the two factors, has evolved significantly in the past two decades.

A 2010 paper by researchers from Columbia University and the City College of New York, “Trends in Quality-Adjusted Life-Years Lost Contributed by Smoking and Obesity,” looks at the change in quality-adjusted life-years (QALYs) based on a large sample of U.S. adults from 1993 to 2008. QALYs are measured on a qualitative basis, based on individuals’ perception of their quality of life.

The paper’s key findings include:

• During the years studied, the proportion of smokers among U.S. adults declined from 22.7% to 18.5%.
• During the same period, the proportion of patients who were obese increased from 14.5% to 26.7%.
• Smoking accounted for a relatively stable rate of 0.0436 QALYs lost per population.
• QALYs lost for obesity more than doubled, increasing from 0.0204 in 1993 to 0.0464 in 2008, surpassing smoking.
• Smoking had a larger impact on mortality than disease, while obesity had a greater effect on disease than mortality.

The authors states that the methodology employed in the paper can be extended to the national, state and local levels for health disparities examinations and health care progress evaluations.

Tags: medicine, obesity

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Substance among women has been shown to have high costs, yet intervention efforts continue to lag behind needs. To address this gap, researchers at Yale University and Washington University of St Louis conducted a randomized controlled trial of various types of health care interventions.

The resulting study, published in PLoS ONE in 2012, “Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial,” considers three types of peer-intervention methods.  The baseline treatment consisted of HIV pre- and post-test counseling, blood collection and results, and a standard intervention for reducing HIV infection (SI). The second treatment included the “well woman exam” (WWE), which provided additional breast and pelvic examinations and a pap smear. The third treatment included four educational sessions (4ES).

The study examines the differences in the outcomes of the WWE and 4ES treatments over four- and 12-month time horizons compared with the baseline treatment.  Key findings include:

• To obtain an additional cocaine abstainer, WWE cost $5,665 at four months and $2,918 at twelve months compared to standard intervention.
• To obtain an additional alcohol abstainer, WWE cost $3,526 at four months and $7,273 at twelve months compared to standard intervention.
• At twelve months, 4ES was more costly and less effective than WWE for abstinence outcomes.
• For nonabstinence outcomes, the interventions generally yielded low incremental cost-effectiveness ratios (ICER).

The authors conclude by noting some of the limitations of their study, including those that relate to sample particularities, data constraints and the types of interventions.

Tags: addiction, drugs, gender, medicine, HIV/AIDS

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