Public Health

When a person dies, clinicians often look at the cause of death to determine whether it could have been avoided, either by medical prevention such as vaccines or by treatments like antibiotics. These types of deaths are known as avoidable mortalities, and in most high-income countries around the world, the number is going down.

But in the United States, avoidable deaths have been on the rise for more than a decade, according to a new study by researchers at the Brown University School of Public Health and Harvard University, who examined mortality trends across U.S. states and 40 high-income countries. Their findings were published in JAMA Internal Medicine.

There's a sizzling debate on social media over seed oils, with some people adamantly claiming they are unhealthy.

But new research, which expands on previous studies in this area, finds that they could reduce your risk of an early death.

Adding fuel to the social media controversy is Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services, who has also taken aim at seed oils.

In October, he posted on social media platform X, claiming that seed oils are poisoning Americans and are a driving cause of obesity.

Health experts continue to push back, saying seed oils are, in fact, not toxic. And they say it's processed foods, not the oils themselves, that are the problem.

I'm unfamiliar with this topic so I don't want to comment further, here are some key excerpts from the article:

Findings Our search identified 2037 studies, of which 42 peer-reviewed articles and nine grey literature reports met inclusion criteria: these studies were in Canada (n=3), Australia (n=17), New Zealand (n=9), and the USA (n=22). With the exception of Māori children in New Zealand, who seem to have similar rates of epilepsy to children of European ancestry, the incidence and prevalence of epilepsy seemed to be higher in Indigenous peoples in these regions than non-Indigenous populations. In the included studies, Indigenous peoples showed a higher number of epilepsy hospital presentations, decreased access to specialists, decreased access and longer waits for antiseizure medication, and increased prescriptions for enzyme-inducing antiseizure medications when compared with non-Indigenous peoples. In Australia, the number of disability-adjusted life years among Aboriginal and Torres Strait Islander peoples with epilepsy was double that for non-Indigenous people with epilepsy. Mortality rates for Indigenous peoples with epilepsy in New Zealand and Australia were higher than in non-Indigenous people with epilepsy.

Interpretation Although Indigenous people from CANZUS have unique cultural identities, this review identified similar themes and substantial disparities experienced by Indigenous versus non-Indigenous people in these nations. Concerningly, there were relatively few studies, and these were of variable quality, leaving substantial knowledge gaps. Epidemiological epilepsy research in each specific Indigenous group from CANZUS countries is urgently required to enable health policy development and minimise inequity within these countries.

Excerpt of the summary:

Childhood diseases have profound lifelong effects on health, livelihoods, and societies. Investment in early childhood results in highly cost-effective changes to lifelong health, productivity, and human capital returns. Yet, there remain substantial gaps in knowledge on the efficacy and safety of many paediatric interventions, which represents a failure to establish shared priorities and alignment across governments, researchers, communities, and funders. Children are frequently marginalised from clinical trials, which is an issue of equity. Challenges include mismatched priorities and funding, risk adversity, poor design, power imbalances, and inadequate infrastructure.

Some graphs:

Figure 2 Demographic characteristics of paediatric clinical trials 2020–23

Figure 3 Registered paediatric clinical trials by country (2020–23)

The study, which analysed data from 26 countries, found that if international support declines, an additional 4.43 to 10.75 million new HIV infections – including up to 880 000 in children – could occur by 2030. In the same period, 770 000 to 2.93 million more people could die from HIV-related causes, with up to 120 000 of these deaths affecting children.

Trump's federal funding cuts are shutting down studies on Alzheimer’s care, uterine fibroids and pregnancy risks — all because they focus on gender.

Author:

• Brenda Vrkljan | Professor of Occupational Therapy, School of Rehabilitation Science, McMaster University

Kim’s son Zack was diagnosed with a glioblastoma multiforme. It is a brain tumour that is very rare in children and is usually seen in adults over 45.

Zack had chemotherapy treatments but doctors said there was no hope of him ever recovering. He died at just six years old.

Years later, social media and community chatter made Kim start to think that her son was not an isolated case. Perhaps he was part of a bigger picture growing in their community surrounding Coldwater Creek.

In this part of the US, cancer fears have prompted locals to accuse officials of not doing enough to support those who may have been exposed to radiation due to the development of the atomic bomb in the 1940s.

A compensation programme that was designed to pay out to some Americans who contracted diseases after exposure to radiation expired last year - before it could be extended to the St Louis area.

Here is a small summary, there is additional context in the article

Community partners advocated for research queries to support greater policy impact

Researchers used community input to design Advanced Clean Truck (ACT) air-quality model experiments. Community asked for ACT policy simulations that convert 48% of medium- and heavy-duty vehicles into zero tailpipe emission versions. Researchers simulated how this policy would change pollution levels in Illinois. They found the policy would likely prevent 500 premature deaths and 600 new pediatric asthma cases annually within the greater Chicago area.

We might be on the precipice of a pivotal moment in Alzheimer’s disease research. In clinical trial data released this week, scientists have presented early evidence that it’s possible to delay symptoms in people genetically fated to develop Alzheimer’s at a young age.

Researchers at the Washington University School of Medicine led the study, which aimed to test whether an experimental anti-amyloid drug called gantenerumab could help people with an inherited form of Alzheimer’s. In a subset of patients treated the longest, the drug appeared to reduce their risk of developing symptoms as expected, by 50%. The findings will require a follow-up, but outside experts are cautiously optimistic about what this could mean for the future of treating Alzheimer’s.

I'm not sure what the best community for this is, but it felt relevant to public health

Finasteride — or Propecia, its most popular brand name — was invented by Merck. The pharmaceutical company insists that it's rare for men on the medication to experience side-effects, and has long maintained they vanish once the medication is stopped.

But 25 people interviewed by CBC/Radio Canada during a six-month investigation of finasteride's side-effects tell a different story. They say the drug caused sexual, psychological and physical side-effects for them that have lasted months if not years after they ceased taking the drug.

The men interviewed by CBC/Radio-Canada said their symptoms are debilitating: loss of libido, erectile dysfunction, infertility, cognitive and physical issues, anxiety, insomnia, depression and, in many cases, suicidal ideation.

"It's a complete chemical castration where you have no chemical reaction to anything sexual, anything in life," said Michael, a British Columbia man who says his symptoms have lasted more than 15 years.

"It's important to remember that the majority of patients will not experience permanent symptoms with this type of medication," he said. "The problem is that we don't know which men could develop these symptoms or why."

(emphasis mine)

Since its launch, Propecia's product monograph has mentioned the risk of side-effects such as decreased libido, erectile dysfunction and ejaculation disorder, but states that "the incidence of each of the above side-effects decreased to ≤0.3 per cent by the fifth year of treatment."

In these internal exchanges, however, a Merck scientist calls this safety data "misleading." He points out that to achieve such a low number, his colleagues had excluded all men who had left the studies because of sexual side-effects.

While the company has long claimed that side-effects disappear when users stop the drug, other internal emails suggest some of the clinical trial participants did have persistent adverse effects after cessation.

"Nothing has been reported about these men who developed these persistent side-effects. So we don't know if they ever recovered or not," said Irwig.

Wealthy, educated Americans face far fewer health risks