Amy Wallace’s Wired feature, “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All” looks at the life and times of Paul Offit, vaccine inventor and advocate, and the anti-vaccine pseudo-science he battles as he attempts to convince parents not to give in to fear and disinformation, and to follow the science that will keep their kids safe.

At this year’s Autism One conference in Chicago, I flashed more than once on Carl Sagan’s idea of the power of an “unsatisfied medical need.” Because a massive research effort has yet to reveal the precise causes of autism, pseudo-science has stepped aggressively into the void. In the hallways of the Westin O’Hare hotel, helpful salespeople strove to catch my eye as I walked past a long line of booths pitching everything from vitamins and supplements to gluten-free cookies (some believe a gluten-free diet alleviates the symptoms of autism), hyperbaric chambers, and neuro-feedback machines.

To a one, the speakers told parents not to despair. Vitamin D would help, said one doctor and supplement salesman who projected the equation “No vaccines + more vitamin d = no autism” onto a huge screen during his presentation. (If only it were that simple.) Others talked of the powers of enzymes, enemas, infrared saunas, glutathione drips, chelation therapy (the controversial — and risky — administration of certain chemicals that leech metals from the body), and Lupron (a medicine that shuts down testosterone synthesis).

Offit calls this stuff, much of which is unproven, ineffectual, or downright dangerous, “a cottage industry of false hope.” He didn’t attend the Autism One conference, though his name was frequently invoked. A California woman with an 11-year-old autistic son told me, aghast, that she’d personally heard Offit say you could safely give a child 10,000 vaccines (in fact, the number he came up with was 100,000 — more on that later). A mom from Arizona, who introduced me to her 10-year-old “recovered” autistic son — a bright, blue-eyed, towheaded boy who hit his head on walls, she said, before he started getting B-12 injections — told me that she’d read Offit had made $50 million from the RotaTeq vaccine. In her view, he was in the pocket of Big Pharma.

An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All

On October 26th, 1977, a hospital cook in Somalia named Ali Maow Maalin was diagnosed with smallpox. What makes this so remarkable is that no naturally-occurring cases of smallpox have been diagnosed in the 32 years since.

The global eradication of smallpox was certified, based on intense verification activities in countries, by a commission of eminent scientists on 9 December 1979 and subsequently endorsed by the World Health Assembly on 8 May 1980[10][48] as Resolution WHA33.3. The first two sentences of the resolution read: “Having considered the development and results of the global program on smallpox eradication initiated by WHO in 1958 and intensified since 1967 … Declares solemnly that the world and its peoples have won freedom from smallpox, which was a most devastating disease sweeping in epidemic form through many countries since earliest time, leaving death, blindness and disfigurement in its wake and which only a decade ago was rampant in Africa, Asia and South America.”

Smallpox once killed millions of people every year, and may have been responsible for up to 500 million deaths in the 20th century. National vaccination programs began in the early 1800s, but it was a global push by the World Health Organization begun in 1958 that finally led to the eradication of the disease worldwide.

Link -via Bad Astronomy Blog

I use a lot of sea salt. In fact, it’s been a long time since I bought a cylinder of regular table salt with the girl carrying the umbrella logo. I buy sea salt with a fancy French name, and I buy kosher salt. For this reason, I was a bit alarmed recently when I suddenly realized that most sea salt is not iodized. I don’t know why this never occurred to me before, but after the realization hit me, I did a bit of research, and what I found was worrying:

You see, iodine is a nutrient that’s essential for health. If your body is deficient in it, your thyroid can have problems functioning properly, which can result in depression, weight gain, and even mental problems. If pregnant women don’t get enough iodine, it can cause miscarriage or babies with low IQ or developmental disabilities.

Until the early 1900s, many people around the world were iodine deficient; this was the cause of the goiters (enlarged thyroid glands) that plagued members of previous generations. In the 20th century, most Western countries solved this problem by adding iodine to salt, which pretty much eliminated iodine deficiency in the developed world. (Though it’s still common in third-world countries without iodized salt—in 2006, The New York Times reported that iodizing salt would be the easiest way to raise the world’s IQ.)

Most brands of sea and kosher salt, however, do not have iodine added. There’s a common misperception that sea salt comes by the mineral naturally, due to the fact that sea water (and foods such as seaweed and fish) contains iodine. However, the information I turned up indicated that the amount of iodine in most sea salt is negligible—certainly not enough to supply the 150 micrograms needed daily by the average adult. And even iodine-rich foods don’t supply enough, unless you eat seaweed almost every day. On the other hand, a quarter-teaspoon of iodized table salt contains 115 micrograms, so if you eat that plus an iodine-rich food such as milk (iodine is added to most animal feed in the U.S.) you’re all set.

The salt issue is interesting because, like many people interested in healthy eating I think, I had just assumed that sea salt was healthier for me because it was less processed than table salt. It never occurred to me that I might be depriving my body of an essential nutrient by taking the “natural” route. And, without knowing it, I was also adding to the problem by choosing eggs from local animals that are probably not given iodine-enriched feed.

This also brings up a larger issue: How can those of us who try to eat a more “natural” diet be sure that we’re making the best choice for ourselves and our families? I’d be willing to bet that many of the same mothers who spend thousands of dollars on tutoring and “enrichment” toys for their children also buy sea salt and grass-fed milk. How would they feel if they thought their dietary choices during pregnancy might have lowered their children’s IQ’s by a few points?

One final thought: Some types of sea salt, including many from Greece and Italy, are iodized. (In fact, this is my new favorite.) But flaky Maldon salt from England and fleur de sel from France are not among them. So, if you’re worried about getting enough iodine and want to continue using sea salt, I’d be sure to check the label on your brand. And for more on the amounts of iodine in various foods, see this very comprehensive article from the Linus Pauling Institute at Oregon State University.

Study: Most Children Strongly Opposed To Children’s Healthcare

“Obama hasn’t created the perfect plan, he’s created something arguably more impressive: a plan that actually might pass. That plan might not do enough to change the system, and it may not spend enough to protect everybody, but there is plenty in the proposal that will better the lives, health coverage, and financial security for millions of real people. It will insure around 30 million Americans and protect tens of millions more from insurer discrimination, medical bankruptcy and rescission. It will bring more evidence to medicine and more competition to the insurance market. That may not be perfection, but it is improvement. And it is achievable.”

Ezra Klein, blogger for the Washington Post

“Obama says he doesn’t want to demonize insurance companies–he just wants to hold them accountable.  This is the best line of the night.”

Megan McCardle, the Atlantic

“After an August in which the health care debate threatened to drive into a ditch, President Obama tried to steer it back into the center lane, if there is such a thing to be found on an endeavor so ambitious as remaking one-sixth of the economy. He defended the public option, and yet downplayed it. The package that he described is about the size of the framework released yesterday by Senate Finance Chairman Max Baucus–$900 billion, which is the lower limit of what anyone is estimated that it would take over the next decade. And though he is not likely to get more than one or two GOP votes, Obama went out of his way to point out the ideas in his plan that can trace their parentage to the Republicans–including his former adversary, John McCain. And he laid on the table an issue that has been something of the Holy Grail to the right: tort reform.”

Karen Tumulty, Time Magazine blogger

Atul Gawande, MD is an accomplished surgeon at Brigham & Women’s, a Rhodes scholar and recipient of a MacArthur “genius” grant, and a writer with two well-received books that are collections of essays he has written for The New Yorker.

He recently published one of these essays called The Cost Conundrum about health care reform, quality and the costs of health care. And I am happy to see more and more brain power, like Gawande’s, spent on the topic. As President Obama recently said, “The greatest threat to America’s fiscal health is not Social Security, though that’s a significant challenge. It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”

Looking at Medicare data on how much is spent per enrollee, in specific areas around the country, he travelled to McAllen, TX to see what made that market the most expensive place in the country when it comes to Medicare expenditures. He talked to the physicians there and researched the quality of care provided there. He compared McAllen, TX to places like Mayo Clinic and Grand Junction, CO, which provide superior care at 1/3′rd the cost.

He did not find McAllen’s costs to be higher because doctors and hospital’s were profitting inappropriately, or due to higher malpractice insurance costs, or because the doctors there are providing extraordinarily good medicine. His conclusion will likely make physicians AND patients squirm a little: the source of the difference in health care spending is “overuse of medicine” by hospitals and physicians alike. When it comes to ordering expensive tests and procedures, more is definitely not better. “Physicians in places like McAllen behave differently from others. The $2.4-trillion question is why. Unless we figure it out, health reform will fail,” writes Gawande.

Gawande’s argument is that simply achieving universal insurance – whether it’s a public single payer plan or a mix of private and public programs – will not be enough. Costs will continue to run amok, and quality will decline, if we don’t foster carefully researched and coordinated care for populations instead of giving physicians incentives to flog (or reward) patients with unnecessary and tests and treatments. Here’s Gawande’s final paragraph:

As America struggles to extend health-care coverage while curbing health-care costs, we face a decision that is more important than whether we have a public-insurance option, more important than whether we will have a single-payer system in the long run or a mixture of public and private insurance, as we do now. The decision is whether we are going to reward the leaders who are trying to build a new generation of Mayos and Grand Junctions. If we don’t, McAllen won’t be an outlier. It will be our future.

(As a follow-up to this essay The New Yorker has also published the text of Dr. Gawande’s recent commencement speech at the University of Chicago Medical School, which further addresses the subject, in a truly elegant way.)

Here’s an interesting collection of old medical advertisements.

Next month, the American Academy of Pediatrics will, for the first time, address the problem of childhood bullying when it publishes a policy statement on preventing school violence. Goals include changing school culture and re-socializing the bully to change behavior, including…

…a recommendation that schools adopt a prevention model developed by Dan Olweus, a research professor of psychology at the University of Bergen, Norway, who first began studying the phenomenon of school bullying in Scandinavia in the 1970s. The programs, he said, “work at the school level and the classroom level and at the individual level; they combine preventive programs and directly addressing children who are involved or identified as bullies or victims or both.”

Dr. Perri Klass discusses the role of pediatricians, parents and schools in solving bullying problems in a new article on the NYTimes website:  At Last, Facing Down the Bullies (and their enablers).

Major health insurance companies own nearly $4.5 billion worth of stock in tobacco companies, according to a Harvard University study. It kinda makes sense: health insurers know tobacco sickens people, and so as long as people are smoking, why not profit from the killer? It’s what David Himmelstein, a co-author of the study, calls “the combined taxidermist and veterinarian approach: either way you get your dog back.”

The largest tobacco investor on the list, the 160-year old Prudential company with branches in the US and the UK, has more than $1.5 billion invested in tobacco stocks. The runner-up was Toronto-based Sun Life Financial, which apparently holds over $1 billion in Philip Morris (Altria) and other tobacco stocks. In total, seven companies that sell life, health, disability, or long-term care insurance, have major holdings in tobacco stock.

Why is it a big deal? “If you own a billion dollars [of tobacco stock], then you don’t want to see it go down,” says Himmelstein, “You are less likely to join anti-tobacco coalitions, endorse anti-tobacco legislation, basically, anything most health companies would want to participate in.”

This is something to keep in mind this summer as Congress debates health care reform. Mandating health insurance using commercial, for-profit insurers may not be in our best interests.