Alcohol Kills Men More Often, but Women’s Death Rates Are Catching Up

Women are catching up to men when it comes to dying from alcohol abuse, a new study finds.

Although men are nearly three times more likely to die from alcohol abuse than women, such deaths among women are rising at a faster rate. Between 2018 and 2020, alcohol-related deaths rose 12.5% among men, but jumped nearly 15% among women.

“It’s really concerning,” said lead researcher Dr. Ibraheem Karaye, an assistant professor of population health at Hofstra University in Hempstead, N.Y.

For the study, he and his colleagues examined data on nearly 606,000 alcohol-related deaths between 1999 and 2020.

Karaye said he can’t say with certainty why this trend is happening. However, he thinks that the obesity epidemic among women may be tied to alcohol-related deaths because it comes with a higher risk of alcohol concentration.

“You are more likely to observe toxicity and develop complications and die as a result of that,” he said.

Moreover, alcohol-related deaths are also compounded by simultaneous opioid use, Karaye added.

“In some alcohol-related deaths, there is a very high chance that individuals do not only consume alcohol but also opiates,” he said. “Studies increasingly show that alcohol and opioid co-involved mortality absolutely exist.”

The researchers also found that among white, Hispanic and Black women, the use of alcohol is on the rise as are alcohol-related deaths. Alcohol-related deaths among women are higher in the South and West than in the Northeast and Midwest, Karaye added.

Linda Richter is senior vice president for prevention research and analysis at the Partnership to End Addiction.

“This study highlights the importance of not losing sight of the risks of alcohol, despite the widespread and deeply-ingrained normalization of its use in our society. With all the focus on opioids like fentanyl, we’ve taken our eye off the real dangers associated with excessive alcohol use, which causes significantly more deaths annually than all drugs,” said Richter, who was not part of the new study.

The harms are not limited to the most extreme consequence of death, she noted. “In recent years, we’ve seen increases in risky drinking, with rates of increase higher among females than males. This narrowing of the long-standing sex gap in risky alcohol use and, as this study shows, mortality, underscores the need to drive more resources to raise public awareness and offer effective and early interventions to stem this tide.”

Along with greater acceptance of alcohol use, including binge drinking and excessive use, some of the risk factors for drinking that are more prevalent in females have increased as well, including stress, anxiety and depression, Richter added.

“And due to physiological sex differences in alcohol’s effects, biological females who drink excessively experience alcohol-related harms more quickly and intensely than males — a fact well known to researchers and clinicians, but not widely understood by the general public,” Richter said.

The narrowing of the sex gap in risky alcohol use is most prominent among younger people, although that does not appear in these mortality data, she said.

“But to reduce these increasing mortality rates in the long term, we must invest in prevention efforts that start early and continue throughout the life span in age-appropriate and research-informed ways,” Richter added.

For more on alcohol and your health, see the U.S. National Institute on Alcohol Abuse and Alcoholism.

What to know about bone diseases

Certain conditions or diseases can affect bone strength and flexibility and result in health complications.

Bone is a living, growing tissue that mainly consists of collagen and calcium. Bones provide a rigid framework, known as the skeleton, which protects soft organs and supports the body.

There are two types of bone in the body. Cortical bones are compact and dense and form the outer layer of the bones. Trabecular or cancellous bones make up the bones’ inner layer and are spongy with a honeycomb structure. The bones not only protect the organs from injury but also allow the body to move and provide support. Additionally, bones act as a reservoir for minerals such as calcium.

A person may have a condition or diseaseTrusted Source that affects the flexibility and strength of the bones. These conditions may arise from various sources, including genetics, environmental factors, diet, and infections.

In this article, we will explore some of the diseases that can affect the bones, as well as potential causes and symptoms.

Some common bone conditions include:

Osteoporosis

Osteoporosis is a disease that results in a decrease in bone mass and mineral density. The quality and structure of the bone may also change. Osteoporosis can decrease bone strength and increase the risk of fracturing.

The risk of osteoporosis increases with age and affects people of all ethnic groups. It most commonly affects non-Hispanic white females and Asian females.

Osteopenia

Osteopenia refers to a decrease in bone mineral density below a normal level but not low enough for a doctor to classify it as osteoporosis.

A T-score is a measure of bone density. A person with a T-score between -1 and -2.5 will receive a diagnosis of osteopenia, whereas a doctor would classify a T-score lower than -2.5 as osteoporosis. The prevalence of osteopenia is 4 times higherTrusted Source in females compared with males.

Paget’s disease

Paget’s disease is a condition that affects the bone remodeling process. This refers to the action by which the body breaks down old bone tissue and replaces it with new bone tissue.

In people with this chronic condition, the process of rebuilding bones takes place at a faster rate, resulting in an unusual bone structure. This can either cause the bones to become softer or larger, making them more susceptible to complications such as bending or fractures.

Osteogenesis imperfecta

Osteogenesis imperfecta (OI) is a disorder that causes the bones to fracture easily. Some people may also refer to OI as brittle bone disease. The condition results from a change or mutation in the genes that carry information for making a protein known as type I collagen. This protein is necessary for strong bones.

People with a family history of OI have a higher risk of having the disease as a person can inherit the gene mutation through one or both of their parents. There are different types of OI. The most common and mildest type is type I, while type II is the most severe.

Osteonecrosis

Osteonecrosis, also known as avascular necrosis or aseptic necrosis, occurs when there is a disruption to a bone’s blood flow, leading to bone tissue deathTrusted Source. This can cause the bone to break down and the joint to collapse.

While osteonecrosis may occur in any bone in the body, it commonly affects the shoulders, hips, and knees. The condition occurs most often in people aged 20–50 years. These individuals also often have a history of trauma, corticosteroiduse, or excessive alcohol intake.

Osteoarthritis

Osteoarthritis is the most common form of arthritis. This condition affects the body’s joints by degrading cartilage, the tissue that covers the surface of joints. Osteoarthritis can also change the shape of bones. Osteoarthritis most frequentlyTrusted Source affects the hands, hips, and knees.

Osteomyelitis

Osteomyelitis describes an infection or inflammationTrusted Source of the bone, with myelitis referring to inflammation of the fatty tissues within the bone. It typically occurs when a bacterial or fungal infection enters a bone from the bloodstream or surrounding tissue. It can happen at any age but is more common in young children.

Fibrous dysplasia

Fibrous dysplasia occurs when abnormal fibrous tissue replaces healthy bone tissue. The unusual scar-like tissue makes the bone weaker. This can cause the bone to change shape and increase the risk of fractures.

Fibrous dysplasia typically occurs due to a gene mutation that results in bone cells producing an abnormal type of fibrous bone. While it can develop in any bone, it occurs most often in the thigh bone, shin bone, ribs, skull, humerus, and pelvis.

Bone cancer and tumors

Bone cancer is an uncommon type of cancer that begins when cells in a bone start to grow out of control. Any of the cells in the bone can develop into cancer.

Primary bone cancers are cancers that start in the bone. The most commonTrusted Source types of primary bone cancers include osteosarcoma and Ewing sarcoma. Cancer cells can also spread to the bone from other areas of the body. Doctors refer to these as bone metastasesTrusted Source. The most common site for bone metastases is the spine.

Osteomalacia

Osteomalacia, also known as bone softening, refers to a condition where the bone does not harden the way it should after forming. This metabolic bone disease occurs when there is incomplete mineralization of the bone. Mineralization refers to the process where minerals coat the inner layer of the bone, forming a hard outer shell. The incomplete formation of this shell leaves the collagen soft and vulnerable.

Rickets

Rickets is a childhood bone condition similar to osteomalacia, but it occurs due to imperfect mineralization.

It results in soft, weak bones, typically due to a vitamin D deficiency. Without sufficient vitamin D, the body cannot metabolize calcium and phosphorous, which are essential for proper bone development and growth. Vitamin D deficiency may result from inadequate nutrition, lack of sun exposure, or malabsorption.

Autoimmune conditions

An autoimmune condition occurs when the immune system attacks the body’s own cells, tissue, and organs. Bone diseases can develop secondary to some autoimmune diseases, increasing the risk of complications such as bone loss and fractures. These conditions includeTrusted Source:

  • Type I diabetes: People with this condition produce minimal or no insulin, meaning the body cannot absorb sugar from food easily. People with type I diabetes have a higher risk of developing osteoporosis.
  • Systemic lupus erythematosus (SLE): This condition can result in widespread inflammation affecting many parts of the body. Some treatment options for SLE may put people at a higher risk of bone loss and fractures.
  • Rheumatoid arthritis (RA): This condition causes the body’s immune system to attack the membranes around the joints and causes the cartilage to degrade. There is an increased risk of bone loss and fractures in people with RA.
  • Celiac disease: This condition causes the body to develop an intolerance to gluten, a protein commonly present in food products such as wheat, rye, and barley. The immune system attacks and damages the lining of the small intestine. A person with untreated celiac disease may develop bone disease due to difficulty absorbing calcium, which is necessary for healthy bones.

Bone disease symptoms can vary depending on the condition, and some may present no symptoms at all. For example, osteoporosis is known as a “silent” disease because there are usually no symptoms until a broken bone occurs.

General symptoms of bone disease may include:

A person may also have symptoms specific to a type of bone disease. For example, someone with osteomyelitis may experienceTrusted Source redness, swelling, and warmth at the infection site.

A person with bone cancer may also experience other symptoms, including weight loss and fatigue, or may have a lump in the area of the tumor.

A number of factors can cause bone disease. Some may be specific to a certain type of bone disease. Causes include:

  • Genetics: A person may have a higher riskTrusted Source of developing a type of bone disease due to a mutation or change in a gene or a history of bone disease in their family. A person may inherit a gene mutation from one or both parents.
  • Aging: As people age, the mineral content of their bones begins to decrease, resulting in the bones becoming less dense and more fragile.
  • Nutrition: A balanced diet is essential for healthy, strong bones. In particular, people need to consume sufficient levels of calcium and vitamin D.
  • Problems with bone remodeling: After age 20, a person may experience an imbalance where the body breaks down old bone tissue quicker than it can replace it. This can result in a loss of bone strength and quality.
  • Hormonal changes: Imbalances of certain hormones may increase the risk of developing osteoporosis. For example, low estrogen levels during menopause or low levels of testosterone can increase a person’s risk of osteoporosis.
  • Medications: Certain medications can increase the risk of bone disease development. For example, corticosteroids, thyroid medicines, and drugs that reduce levels of sex hormones can harm bone health.
  • Lifestyle factors: Lifestyle factors including low physical activity levels, smoking, and excessive alcohol consumption can predispose a person to osteoporosis.

A person will need to contact a doctor to receive a diagnosis of a bone condition. The doctor will normally start by taking a person’s medical history. This may include questions about how long they have been experiencing any symptoms and whether they have a family history of bone disease.

The doctor may also carry out a physical examination to check for:

  • loss of height or weight
  • change in posture
  • changes in balance or the way a person walks
  • changes in muscle strength
  • any redness or swelling, such as occurs with osteomyelitis

The doctor may also order tests to diagnose the type of bone disease a person has, including:

  • X-ray imaging: The most common type of X-ray imaging a doctor may use is a dual-energy X-ray absorptiometry scan. This uses a low amount of X-rays to measure the body’s bone mineral density.
  • MRI scans: This test uses a magnet to create an image of the body and provides detailed images of bones and other tissues, including cartilage and ligaments.
  • Blood tests: A doctor may orderTrusted Source blood tests to help confirm a bone cancer diagnosis and provide information on the stage of cancer.
  • Biopsy: A doctor may take a small amount of bone tissue from the affected area to examine it under a microscope for an accurate diagnosis.

The most appropriate treatment option will depend on the type of bone disease and how serious the condition is.

For example, with osteoporosis and osteopenia, the goal of treatment is to stop further bone loss and prevent fractures from occurring. Therefore, treatment may include:

  • recommending nutritional guidance
  • making lifestyle changes such as performing more physical activity and quitting smoking
  • putting measures in place to reduce the risk of falls to prevent fractures
  • prescribing medication

Some conditions, such as OI, do not currently have effective treatments. Therefore, the goal of treatment is to prevent or control symptoms and improve muscle strength and bone mass. In addition to taking medication, a person with OI may have physical therapy to improve muscle strength and mobility.

Certain conditions may require surgical options. For example, a person with osteonecrosis will generally requireTrusted Source surgery to preserve the joints. A person with a bone tumorTrusted Source may require surgery for its removal.

People with bone cancer may also need additional therapies, such as chemotherapy or radiation therapy, depending on how advanced the bone cancer is.

It is advisable for a person to contact a doctor if they fracture a bone or experience symptoms such as bone pain. They should also contact a doctor if they notice a change in their posture, height, weight, or movement when walking.

This is important as early detection can prevent the disease from progressing further.

Bone diseases refer to conditions that alter the strength or flexibility of bones. They can result in symptoms such as bone pain, difficulty moving, and a higher risk of bone fractures. These conditions can have many potential causes, including aging, genetics, hormonal changes, and nutritional deficiencies. Lifestyle factors such as low levels of physical activity, smoking, and alcohol consumption can also increase the risk of bone disease.

A doctor can perform tests to identify bone diseases. After diagnosis, a doctor can suggest a suitable treatment plan, which may include medication, lifestyle changes, and surgery.

Stretch Your Brain as You Age, Lower Your Dementia Risk?

Researchers in Australia found that journaling, using a computer, taking education classes and other “literacy enrichment” activities might lessen the risk of developing dementia by 11%. Playing games, cards or chess and doing crosswords or other puzzles could slash the risk by 9%.
“These findings highlight the types of activities which may be most beneficial to preserve cognitive health with aging,” said lead researcher Joanne Ryan, head of the biological neuropsychiatry and dementia unit at Monash University, in Melbourne.

Other activities linked to a lower risk of dementia included artistic activities, such as craftwork, woodwork or metalwork, and painting or drawing. Even passive activities, such as reading, watching television, and listening to music or the radio helped thwart mental decline, but to a lesser degree.
Interpersonal networks, social activities and outings, however, did not affect dementia risk, the researchers noted.
This study can’t prove that these mental activities actually prevent or delay dementia, only that there seems to be a correlation, Ryan said.
“We can’t show a cause-and-effect relationship,” she said. “But these activities likely help maintain and build neural networks in the brain, and through these activities, we can develop new knowledge and new ways of thinking about things, which we refer to as building cognitive reserve.”
These activities could help people maintain good cognitive function, even if they have some degree of Alzheimer’s or vascular dementia, she said. “They can develop compensatory mechanisms and, thus, don’t develop dementia until later,” Ryan explained.
It is possible there are other reasons for the findings, Ryan said. “Although we accounted for things like differences in education and socioeconomic status, as well as health status, it is possible that people who engage regularly in these mental activities are different in other ways that we haven’t been able to account for, which explains why they have reduced dementia risk,” she said.
It’s unlikely that mentally stimulating activities can completely prevent dementia but they might delay its onset, Ryan added.
“Continued learning and engagement in new activities which challenge and stimulate the mind may be the best way to help promote good cognitive function with age,” she suggested.
One expert agreed that keeping your brain active can help keep it healthy.
“Music, art, other activities, crossword puzzles, things like that absolutely help reduce the transitioning into dementia,” said Dr. Theodore Strange, chairman of medicine and a gerontologist at Staten Island University Hospital in New York City.
“Even plaque buildup may slow over time if you continue to do these cognitive activities that use the brain,” he said.
The brain isn’t a muscle, Strange said, but like a muscle, it can atrophy if not used. It’s not clear, however, how mental activity protects the brain, he noted.
Still, “a healthy lifestyle, an active lifestyle, a lifestyle filled with activities that utilize the brain are important to keep the brain functioning for as long a period of time as you can,” Strange added.
For the study, Ryan and her colleagues collected data on more than 10,300 men and women with a median age of 74 (half younger, half older), who took part in the ASPREE Longitudinal Study of Older Persons. All were in relatively good health. From March 2010 through November 2020, the researchers looked at the participants’ lifestyles and who developed dementia.
The report was published online July 14 in JAMA Network Open.
For more on keeping your brain healthy, head to the Alzheimer’s Association.

Medical Myths: All about stroke

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, over 795,000 people in the United States have a stroke every year, and around 610,000 are first strokes.

In 2019, stroke was the leading cause of mortality globally, accounting for 11% of deaths.

There are three main types of stroke. The first and most common, accounting for 87% of cases, is an ischemic stroke. It occurs when blood flow through the artery that supplies oxygen to the brain becomes blocked.

The second is a hemorrhagic stroke, caused by a rupture in an artery in the brain, which in turn damages surrounding tissues.

The third type of stroke is a transient ischemic attack (TIA, which is sometimes called a “ministroke.” It happens when blood flow is temporarily blocked to the brain, usually for no more than 5 minutes.

While stroke is very common, it is often misunderstood. To help us dispel myths on the topic and improve our understanding, we got in touch with Dr. Rafael Alexander Ortiz, chief of Neuro-Endovascular Surgery and Interventional Neuro-Radiology at Lenox Hill Hospital.

1. Stroke is a problem of the heart

Although stroke risk is linked to cardiovascular risk factors, strokes happen in the brain, not the heart.

“Some people think that stroke is a problem of the heart,” Dr. Ortiz told MNT. “That is incorrect. A stroke is a problem of the brain, caused by the blockage or rupture of arteries or veins in the brain, and not the heart.”

Some people confuse stroke with a heart attack, which is caused by a blockage in blood flow to the heart, and not the brain.

2. Stroke is not preventable 

“The most common risk factors [for stroke] include hypertension, smoking, high cholesterol, obesity, diabetes, trauma to the head or neck, and cardiac arrhythmias,” said Dr. Ortiz.

Many of these risk factors can be modified by lifestyle. Exercising regularly and eating a healthy diet can reduce risk factors such as hypertension, high cholesterol, obesity, and diabetes.

Other risk factors include alcohol consumption and stress. Working to reduce or remove these lifestyle factors may also reduce a person’s risk of stroke.

3. Stroke does not run in families 

Single-gene disorders such as sickle cell disease increase a person’s risk for stroke.

Genetic factors including a higher risk for high blood pressure and other cardiovascular risk factors may also indirectly increase stroke risk.

As families are likely to share environments and lifestyles, unhealthy lifestyle factors are likely to increase stroke risk among family members, especially when coupled with genetic risk factors.

4. Stroke symptoms are hard to recognize 

The most common symptoms for stroke form the acronym “F.A.S.T.“:

  • F: face dropping, when one side of the face becomes numb and produces an uneven “smile”
  • A: arm weakness, when one arm becomes weak or numb and, when raised, drifts slowly downward
  • S: speech difficulty, or slurred speech
  • T: time to call 911

Other symptoms of stroke include:

  • numbness or weakness in the face, arm, leg, or one side of the body
  • confusion and trouble speaking or understanding speech
  • difficulty seeing in one or both eyes
  • difficulty walking, including dizziness, loss of balance and coordination
  • severe headaches without a known cause

5. Stroke cannot be treated 

“There is an incorrect belief that strokes are irreversible and can’t be treated,” explained Dr. Ortiz.

“Emergency treatment of a stroke with injection of a clot busting drug, minimally invasive mechanical thrombectomy for clot removal, or surgery can reverse the symptoms of a stroke in many patients, especially if they arrive to the hospital early enough for the therapy (within minutes or hours since the onset of the symptoms),” he noted.

“The longer the symptoms last, the lower the likelihood of a good outcome. Therefore, it is critical that at the onset of stroke symptoms — ie. trouble speaking, double vision, paralysis or numbness, etc — an ambulance should be called (911) for transport to the nearest hospital,” he continued.

Research also shows that those who arrive within 3 hours of first experiencing symptoms typically have less disability 3 months afterward than those who arrived later.

6. Stroke occurs only in the elderly 

Age is a significant risk factor for stroke. Stroke risk doubles every 10 years after age 55. However, strokes can occur at any age.

One study examining healthcare data found that 34% of stroke hospitalizations in 2009 were under age 65.

A review in 2013 points out that “approximately 15% of all ischemic strokes occur in young adults and adolescents.”

The researchers noted that stroke risk factors including hypertension, diabetes, obesity, lipid disorders, and tobacco use were among the most common co-existing conditions among this age group.

7. All strokes have symptoms 

Not all strokes have symptoms, and some research suggests that symptom-free strokes are far more common than those with symptoms.

One study found that out of the over 11 million strokes in 1998, 770,000 presented symptoms, whereas close to 11 million were silent.

Evidence of these so-called silent strokes appears on MRI scans as white spots from scarred tissue following a blockage or ruptured blood vessel.

Often, silent strokes are identified when patients receive MRI scans for symptoms including headaches, cognitive issues, and dizziness.

Although they occur without symptoms, they should be treated similarly to strokes with symptoms. Silent strokes put people at risk of future symptomatic strokes, cognitive decline, and dementia.

8. A ministroke is not so risky

“The term ministroke has been used incorrectly as some think that it is related to small strokes that carry low risk,” said Dr. Ortiz. “That statement is incorrect, as a ministroke is a transient ischemic attack (TIA).”

“It is not a small stroke, but a premonition that a large stroke can occur. Any symptom of acute stroke, transient or persistent, needs emergency workup and management to prevent a devastating large stroke,” he added.

9. Stroke always causes paralysis 

Stroke is a leading cause of long-term disability, but not everyone who has a stroke will experience paralysis or weakness. Research shows that stroke leads to reduced mobility in over half of stroke survivors aged 65 and over.

However, the long-term impacts of stroke vary on many factors, such as the amount of brain tissue affected and the area affected. Damage to the left brain, for example, will affect the right side of the body and vice versa.

If the stroke occurs in the left side of the brain, effects may include:

  • paralysis on the right side of the body
  • speech and language problems
  • slow and cautious behavior
  • memory loss.

If it affects the right side of the brain, paralysis may also occur, this time on the left side of the body. Other effects may include:

  • vision problems
  • quick and inquisitive behavior
  • memory loss.

10. Stroke recovery happens fast

Recovery from stroke can take months, if not years. However, many may not fully recover. The American Stroke Association says that among stroke survivors:

  • 10% will make an almost complete recovery
  • another 10% will require care in a nursing home or another long-term facility
  • 25% will recover with minor impairments
  • 40% will experience moderate to severe impairments

Research suggests there is a critical time window between 2–3 months after stroke onset, during which intensive motor rehabilitation is more likely to lead to recovery. Some may also be able to spontaneously recover during this period.

Beyond this window, and beyond the 6-month mark, improvements are still possible although are likely to be significantly slower.

Cancer

Cancer

Cancer is one of our nation’s most feared diseases, with more than 1.6 million new cases diagnosed each year. But thanks to National Institute of Health (NIH) research, this number is now falling. Between 1991 and 2014, #cancer death rates went down 25 percent.

NIH research has transformed the way we think about cancer from affecting specific parts of the #body to a much more precise understanding of the molecular cause. For example, the drug pembrolizumab is one of a new class of cancer drugs that works by engaging a patient’s immune system to attack his or her tumors. Doctors already use this drug to treat some patients with several specific cancer types, including lung cancer and head and neck cancer. And, very recently, it became the first cancer therapy approved by the Food and Drug Administration (FDA) to treat any type of tumor, regardless of its location in the body, as long as the tumor has specific genetic features that make it much more likely to shrink after treatment with the drug. This is just one example of how genomics has revolutionized our understanding of cancer (see Precision Oncology, p.18).

Despite gains, there is much work to do. Many clinical trials are testing new targeted treatments, as well as combinations of different cancer therapies. With other federal agencies, NIH is participating in the Cancer MoonshotSM, a bold initiative to accelerate cancer research that aims to make more therapies available to more patients while also improving our ability to prevent cancer and detect it at an early stage.

Good Health for All

Many people in America are more likely to get certain #diseases and to die from them, compared to the general population. One of NIH’s greatest challenges is to understand and eliminate profound disparities in health outcomes for these individuals. We know the causes of health disparities are many. They include biological factors that affect disease risk; but most of the causes turn out to be non-biological factors such as socioeconomics, culture, and environment. Teasing apart health outcomes that differ among racial/ethnic groups is providing clues. For example, NIH research shows that among cigarette smokers, African Americans and Native Hawaiians are more susceptible to lung cancer than Whites, Japanese Americans, and Hispanics. Scientists are also intrigued by the “Hispanic paradox,” in which U.S. Hispanics often experience similar or better health outcomes across a range of diseases compared with non-Hispanic Whites. Understanding this advantage may help us identify contributing factors and effective interventions.

5 Public Health Crises Facing America

Public Health Crises: Five Big Ones Facing America Right Now

  • Obesity
  • Heart Disease
  • Addiction/Substance Abuse
  • Dementia
  • Food Safety

Obesity, dementia, and heart disease – these are among some of the most concerning public health crises faced by the US today. Why are we facing some of these issues, and what are the known facts at this point? Follow along for the scoop on five of today’s most pressing public health crises in the US.

1. Obesity

The advantages of living in a modernized society include more luxury and more ready access to consumables of all sorts. This becomes a problem when the end result is obesity in a significant portion of the population. According to most research, the 1980s marked the beginning of the obesity epidemic in America today.

So, what does this particular health crisis look like? U.S. News shares that around 40 percent of Americans over the age of 20 are said to be obese. These numbers and the numbers of obese children are steadily on the rise. At the end of the day, what makes this such a critical issue overall is the fact that obesity is directly linked to early death and the onset and even further complication of diabetes, heart disease, liver disease, cancer, and many other ailments.

2. Heart Disease

As discussed above, heart disease itself is often a derivative of obesity. In other cases, it can be brought on by unhealthy lifestyle choices, environmental factors, and sometimes, genetics. At the end of the day, this condition is a major problem plaguing Americans’ health at present.

Heart disease, often called by several other names, is essentially stress and damage taken on by the heart that can worsen and lead to heart attacks, strokes, and even fatal events, ultimately in some cases. Factors that help to remediate the various forms of heart disease include healthy dietary choices, regular exercise, and avoidance of illicit drug and alcohol use. These remediating factors are many of those very same ones that Americans struggle to healthily maintain so often in today’s times.

3. Addiction/Substance Abuse

Addiction and substance abuse represent some of the most notable public health crises happening right now in the US. The reasons for this current epidemic are many and complex, but the effects of it are crippling to the individual sufferer and entire communities alike. According to the National Institute on Drug Abuse, an average of more than 130 people die each day in the US from opioid overdose alone. The economic burden placed on the country as a whole, just from prescription opioid abuse itself, is estimated by officials to be around $78.5 billion each year. With these kinds of figures, it’s easy to begin to see how detrimental this particular crisis has become in recent times.

4. Dementia

Dementia, the detrimental mental degradation associated with many cognitive diseases, is yet another looming and major public health crisis faced by the US right now. According to a group of top U.S. Surgeons General in a pivotal op-ed featured in the Orlando Sentinel recently, the public was made aware of the impending weight of the crisis at hand. It was therein estimated by experts that dementia numbers in the public double every five years and the numbers of those affected are unequivocally unprecedented and a potentially system-overwhelming problem.

 

5. Food Safety

Food safety is rated by a number of government and research organizations as another, top crisis concern for the US right now. This is because of the mass number of food producers, production associations, and even weak points in the continuum of the food markets. Food-born illness spread en-mass can quickly affect thousands of people, while cases of intentional endangerment to the food supply, such as through tampering or deceitful production practices, also can have major implications. For these many, compounding reasons, food safety in the US is a major concern today.

Public health crises can certainly be a great cause for concern. However, with the application of science and subsequent public awareness, many “worst-case scenarios” can be avoided altogether. As of now, the five above-mentioned public health crises are widely regarded as being among the most important and foreshadowing to address.

Men’s Mental Health: Warning Signs & Where to Go for Help

Men typically don’t want to discuss mental health issues, much less get treatment for one.

That’s a problem, given how many males struggle with mental health problems: Six million American men suffer from depression every year, while 3 million struggle with anxiety disorder, according to Mental Health America. Beyond that, 90% of those diagnosed with schizophrenia by age 30 are men, and 25% of those with binge eating disorder are males. Unfortunately, men are less likely to seek professional help for their problems.

When it comes to suicide, the picture is also troubling. While women are more likely to attempt suicide, it is the 7th leading cause of death among males, and white men over the age of 85 are the most likely to die by suicide.

Here, experts describe the most common mental health conditions men experience, the symptoms that may differ in men versus women, and what resources are available for those seeking help and treatment options.

Common mental health conditions in men

According to Mental Health America, the most common men’s mental health conditions are:

  • Depression
  • Suicide
  • Anxiety
  • Bipolar disorder
  • Eating disorders
  • Schizophrenia
  • Substance abuse

“It’s a sign of strength to talk about these issues with your health care provider, counselor or a supportive family member or friend,” Piedmont Healthcare family medicine physician Dr. Siraj Abdullah said in a recent article. “As men, we tend to let stress build up until it affects our mental and physical health. Talking about your mental health is a way to take care of your body.”

How men’s mental health symptoms may show up differently than in women

The reasons that mental health symptoms can be different for men and women are complex, according to McLean Hospital chief of psychology Kathryn McHugh.

She noted in a hospital article that “biology is not the only piece of the puzzle. There are also many social and cultural factors that play a role in mental health and wellness, such as social role expectations, discrimination and violence.”

The Anxiety and Depression Association of America states that the main mental health symptoms in men that may be different from those found in women are:

  • Abuse or misuse of drugs or alcohol
  • Noticeable changes in mood, appetite or energy levels
  • Violent, controlling or abusive behavior
  • Digestive issues, headaches and pain
  • Escaping into work, sports or other distracting behavior
  • Risk-taking

Men with depression are also more likely than women to report symptoms of fatigue and loss of interest in work or hobbies, according to Mental Health America.

Men are particularly susceptible to suicide. According to the U.S. Centers for Disease Control and Prevention, men are four times more likely to die by suicide than women, and gay and bisexual men under the age of 25 are at a higher risk for attempting suicide than the general male population, according to Mental Health America.

The Suicide Prevention Resource Center notes that one of the reasons for higher male suicide rates is that men are less likely to get mental health care than women. The center suggests getting help before a mental health crisis occurs. This can include:

  • Seeking behavioral health care, such as seeing a therapist
  • Connecting to family, friends, community and social organizations
  • Learning life skills like problem-solving and strategies for adapting to change
  • Engaging with spiritual, religious or other belief practices that discourage suicide

If you’d like to begin or continue a behavioral health care plan, you can reach out to the SAMHSA National Helpline for a treatment referral.

Men’s mental health resources: How to get help

APA Psychologist Locator Tool

The American Psychological Association offers a database of thousands of therapists. Just put in your ZIP code, provider name or practice area. Once the results show up, you can sort the psychologists by a variety of categories, such as gender and treatment methods.

If you’re looking for a men’s mental health hotline to discuss your issues confidentially at no charge, the Mental Health Hotline provides a toll-free number with counselors on stand-by 24/7. The organization also lists several condition-specific hotlines for health issues like anxiety, depression, PTSD (post-traumatic stress disorder) and more — plus links to helpful resources on these conditions.

Fictional Dr. Rich Mahogany “runs” this site, which is actually administered by multiple agencies, including the Colorado Department of Public Health. It combines helpful mental health techniques and quizzes with humor and a uniquely human touch. There’s an online peer chat, 20-point head inspection and a worried-about-someone page to help loved ones of men who may be experiencing mental health issues.

Multicultural care meets mutual aid at Therapy for Black Men, where the coaches and counselors strive to offer free or discounted services to Black men with mental health issues. You can meet in person or online for a session, and there’s also a host of articles and social resources, including community organizations aimed at helping your mental health thrive.

Mental health medications

Several medications may be prescribed by your doctor to help you improve your mental health. According to the U.S. National Institute of Mental Health, these include:

  • Antidepressants
  • Anti-anxiety medications
  • Antipsychotics
  • Stimulants
  • Mood stabilizers

If you’re experiencing a mental health crisis or suicidal ideation and need to talk to someone, call 988, the Suicide & Crisis Lifeline. The Lifeline offers free, confidential emotional support across the United States, 24 hours a day, 7 days a week.

US Mayors Cite ‘Unprecedented’ Mental Health Crisis as Top Concern

Substance abuse, homelessness and access to health services are among the issues that city officials say demand more resources in a new US Conference of Mayors survey.

An “unprecedented” mental health crisis is overwhelming US cities, which lack adequate resources to address growing challenges, according to a new report released today by the US Conference of Mayors. In recent years, the Covid-19 pandemic exacerbated mental health issues, particularly involving substance abuse, said a survey of mayors of 117 cities in 39 states.

“Addressing this surging mental health crisis is one of the most pressing issues facing America’s cities,” said Tom Cochran, executive director of the US Conference of Mayors, a nonpartisan organization of cities with populations of 30,000 or more. The report also cited “staggering increases in stress, depression, isolation, loneliness, and accompanying mental health hurdles faced by Americans of all ages.”

In a survey conducted this spring, 97% of mayors said requests for mental health services increased in their city in the past two years, but 88% lack resources to address the crisis. Participating cities spanned the US, and included Chicago; Seattle; Montgomery, Alabama; and Atlanta.

Substance abuse was the main cause for increasing mental health problems, 85% of cities reported. That was followed by Covid-19, homelessness and economic concerns.

Substance use disorders topped the list of mental and behavioral health problems in 65% of cities, followed by homelessness stemming from mental illness in 56%. Other challenges included shortages of mental and behavioral health workers, including school counselors, as well as a lack of access to behavioral health services.

Among youth, depression is the leading primary mental health problem, according to 89% of cities. More than 43% said teen suicide is a significant problem.

Nineteen cities called for more funding for services, but several noted that most funding goes to county — not city — governments.

Although the vast majority of cities reported inadequate mental health resources, 82% have developed new initiatives and/or increased funding to mental health programs. Ninety-three percent reported they have improved their emergency response to behavioral health crises. Meanwhile, 94% of cities said their police department provides mental health programs to officers.

Examples of initiatives cited in the survey include Mesa, Arizona, where its police department is coordinating with a nonprofit crisis line and system. Since 2018, the city has increased the types of emergency calls transferred, including children with behavioral issues, second-hand suicide reports, as well as dementia, psychosis, anxiety, PTSD, and basic problem-solving help. In 2022 alone, more than 3,500 911 calls were sent directly to its crisis hotline, away from Mesa’s police and fire departments, according to the city’s survey response.

In Las Vegas, an outreach team provides services to unhoused people to divert them from emergency rooms and into appropriate treatment. A crisis response team also works with the fire department to deescalate non-emergency mental health issues.

Long Beach, California, has established mobile homeless and behavioral health services, and teams of mental health clinicians to do homeless outreach. In 2022, Hartford, Connecticut, launched a non-law enforcement crisis intervention program in response to emergency 911 calls for people in mental health crises.

City leaders from Orlando, Florida, expressed their support for the “Housing First” model as a means of addressing homelessness, and said mental health challenges are easier to address when people are housed. But respondents from the city of Fontana, California commented, “Hiding someone away in an apartment or hotel room does not cure them from mental illness. Housing first without mental health support DOES NOT WORK.” [SIC]

Officials from Issaquah, Washington, observed: “Stable housing must be coupled with other intensive support services. Housing alone does not improve mental health outcomes.” They added that for chronically unhoused people, “adjusting to living indoors is often underestimated and if housing is not accompanied by extra supports to help with the transition, people are more likely to fall back into homelessness.”

Cardiovascular Disease Is Primed to Kill More Older Adults, Especially Blacks and Hispanics

Cardiovascular disease — the No. 1 cause of death among people 65 and older — is poised to become more prevalent in the years ahead, disproportionately affecting Black and Hispanic communities and exacting an enormous toll on the health and quality of life of older Americans.

The estimates are sobering: By 2060, the prevalence of ischemic heart disease (a condition caused by blocked arteries and also known as coronary artery disease) is projected to rise 31% compared with 2025; heart failure will increase 33%; heart attacks will grow by 30%; and strokes will increase by 34%, according to a team of researchers from Harvard and other institutions. The greatest increase will come between 2025 and 2030, they predicted.

The dramatic expansion of the U.S. aging population (cardiovascular disease is far more common in older adults than in younger people) and rising numbers of people with conditions that put them at risk of heart disease and stroke — high blood pressure, diabetes, and obesity foremost among them — are expected to contribute to this alarming scenario.

Because the risk factors are more common among Black and Hispanic populations, cardiovascular illness and death will become even more common for these groups, the researchers predicted. (Hispanic people can be of any race or combination of races.)

“Disparities in the burden of cardiovascular disease are only going to be exacerbated” unless targeted efforts are made to strengthen health education, expand prevention, and improve access to effective therapies, wrote the authors of an accompanying editorial, from Stony Brook University in New York and Baylor University Medical Center in Texas.

“Whatever focus we’ve had before on managing [cardiovascular] disease risk in Black and Hispanic Americans, we need to redouble our efforts,” said Clyde Yancy, chief of cardiology and vice dean for diversity and inclusion at Northwestern University’s Feinberg School of Medicine in Chicago, who was not involved with the research.

Of course, medical advances, public health policies, and other developments could alter the outlook for cardiovascular disease over the next several decades.

More than 80% of cardiovascular deaths occur among adults 65 or older. For about a dozen years, the total number of cardiovascular deaths in this age group has steadily ticked upward, as the ranks of older adults have expanded and previous progress in curbing fatalities from heart disease and strokes has been undermined by Americans’ expanding waistlines, poor diets, and physical inactivity.

Among people 65 and older, cardiovascular deaths plunged 22% between 1999 and 2010, according to data from the National Heart, Lung, and Blood Institute — a testament to new medical and surgical therapies and treatments and a sharp decline in smoking, among other public health initiatives. Then between 2011 and 2019, deaths climbed 13%.

The covid-19 pandemic has also added to the death toll, with coronavirus infections causing serious complications such as blood clots and millions of seniors avoiding seeking medical care out of fear of becoming infected. Most affected have been low-income individuals, and older non-Hispanic Black and Hispanic people, who have died from the virus at disproportionately higher rates than non-Hispanic white people.

“The pandemic laid bare ongoing health inequities,” and that has fueled a new wave of research into disparities across various medical conditions and their causes, said Nakela Cook, a cardiologist and executive director of the Patient-Centered Outcomes Research Institute, an independent organization authorized by Congress.

One of the most detailed examinations yet, published in JAMA Cardiology in March, examined mortality rates in Hispanic, non-Hispanic Black, and non-Hispanic white populations from 1990 to 2019 in all 50 states and the District of Columbia. It showed that Black men remain at the highest risk of dying from cardiovascular disease, especially in Southern states along the Mississippi River and in the northern Midwest. (The age-adjusted mortality rate from cardiovascular disease for Black men in 2019 was 245 per 100,000, compared with 191 per 100,000 for white men and 135 per 100,000 for Hispanic men. Results for women within each demographic were lower.)

Progress stemming deaths from cardiovascular disease in Black men slowed considerably between 2010 and 2019. Across the country, cardiovascular deaths for that group dropped 13%, far less than the 28% decline from 2000 to 2010 and 19% decline from 1990 to 2000. In the regions where Black men were most at risk, the picture was even worse: In Mississippi, for instance, deaths of Black men fell only 1% from 2010 to 2019, while in Michigan they dropped 4%. In the District of Columbia, they actually rose, by nearly 5%.

While individual lifestyles are partly responsible for the unequal burden of cardiovascular disease, the American Heart Association’s 2017 scientific statement on the cardiovascular health of African Americans notes that “perceived racial discrimination” and related stress are associated with hypertension, obesity, persistent inflammation, and other clinical processes that raise the risk of cardiovascular disease.

Though Black people are deeply affected, so are other racial and ethnic minorities who experience adversity in their day-to-day lives, several experts noted. However, recent studies of cardiovascular deaths don’t feature some of these groups, including Asian Americans and Native Americans.

What are the implications for the future? Noting significant variations in cardiovascular health outcomes by geographic location, Alain Bertoni, an internist and professor of epidemiology and prevention at Wake Forest University School of Medicine, said, “We may need different solutions in different parts of the country.”

Gregory Roth, a co-author of the JAMA Cardiology paper and an associate professor of cardiology at the University of Washington School of Medicine, called for a renewed effort to educate people in at-risk communities about “modifiable risk factors” — high blood pressure, high cholesterol, obesity, diabetes, smoking, inadequate physical activity, unhealthy diet, and insufficient sleep. The American Heart Association has suggestions on its website for promoting cardiovascular health in each of these areas.

Michelle Albert, a cardiologist and the current president of the American Heart Association, said more attention needs to be paid in medical education to “social determinants of health” — including income, education, housing, neighborhood environments, and community characteristics — so the health care workforce is better prepared to address unmet health needs in vulnerable populations.

Natalie Bello, a cardiologist and the director of hypertension research at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles, said, “We really need to be going into vulnerable communities and reaching people where they’re at to increase their knowledge of risk factors and how to reduce them.” This could mean deploying community health workers more broadly or expanding innovative programs like ones that bring pharmacists into Black-owned barbershops to educate Black men about high blood pressure, she suggested.

“Now, more than ever, we have the medical therapies and technologies in place to treat cardiovascular conditions,” said Rishi Wadhera, a cardiologist and section head of health policy and equity research at the Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center in Boston. What’s needed, he said, are more vigorous efforts to ensure all older patients, including those from disadvantaged communities, are connected with primary care physicians and receive appropriate screening and treatment for cardiovascular risk factors, and high-quality, evidence-based care in the event of heart failure, a heart attack, or a stroke.

What is high blood pressure in pregnancy?

Blood pressure is the force of your blood pushing against the walls of your arteries as your heart pumps blood. High blood pressure, or hypertension, is when this force against your artery walls is too high. There are different types of high blood pressure in pregnancy:

  • Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don’t have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. It sometimes can be severe, which may lead to low birth weight or preterm birth. Some women with gestational hypertension do go on to develop preeclampsia.
  • Chronic hypertension is high blood pressure that started before the 20th week of pregnancy or before you became pregnant. Some women may have had it long before becoming pregnant but didn’t know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
  • Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. In rare cases, symptoms may not start until after delivery. This is called postpartum preeclampsia. Preeclampsia also includes signs of damage to some of your organs, such as your liver or kidney. The signs may include protein in the urine and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby.

What causes preeclampsia?

The cause of preeclampsia is unknown.

Who is at risk for preeclampsia?

You are at higher risk of preeclampsia if you:

  • Had chronic high blood pressure or chronic kidney disease before pregnancy
  • Had high blood pressure or preeclampsia in a previous pregnancy
  • Have obesity
  • Are over age 40
  • Are pregnant with more than one baby
  • Are African American
  • Have a family history of preeclampsia
  • Have certain health conditions, such as diabetes, lupus, or thrombophilia (a disorder which raises your risk of blood clots)
  • Used in vitro fertilization, egg donation, or donor insemination

What problems can preeclampsia cause?

Preeclampsia can cause:

  • Placental abruption, where the placenta separates from the uterus
  • Poor fetal growth, caused by a lack of nutrients and oxygen
  • Preterm birth
  • A low birth weight baby
  • Stillbirth
  • Damage to your kidneys, liver, brain, and other organ and blood systems
  • A higher risk of heart disease for you
  • Eclampsia, which happens when preeclampsia is severe enough to affect brain function, causing seizures or coma
  • HELLP syndrome, which happens when a woman with preeclampsia or eclampsia has damage to the liver and blood cells. It is rare, but very serious.

What are the symptoms of preeclampsia?

Possible symptoms of preeclampsia include:

  • High blood pressure
  • Too much protein in your urine (called proteinuria)
  • Swelling in your face and hands. Your feet may also swell, but many women have swollen feet during pregnancy. So swollen feet by themselves may not be a sign of a problem.
  • Headache that does not go away
  • Vision problems, including blurred vision or seeing spots
  • Pain in your upper right abdomen
  • Trouble breathing

Eclampsia can also cause seizures, nausea and/or vomiting, and low urine output. If you go on to develop HELLP syndrome, you may also have bleeding or bruising easily, extreme fatigue, and liver failure.

How is preeclampsia diagnosed?

Your health care provider will check your blood pressure and urine at each prenatal visit. If your blood pressure reading is high (140/90 or higher), especially after the 20th week of pregnancy, your provider will likely want to run some tests. They may include blood tests other lab tests to look for extra protein in the urine as well as other symptoms.

What are the treatments for preeclampsia?

Delivering the baby can often cure preeclampsia. When making a decision about treatment, your provider take into account several factors. They include how severe it is, how many weeks pregnant you are, and what the potential risks to you and your baby are:

  • If you are more than 37 weeks pregnant, your provider will likely want to deliver the baby.
  • If you are less than 37 weeks pregnant, your health care provider will closely monitor you and your baby. This includes blood and urine tests for you. Monitoring for the baby often involves ultrasound, heart rate monitoring, and checking on the baby’s growth. You may need to take medicines, to control your blood pressure and to prevent seizures. Some women also get steroid injections, to help the baby’s lungs mature faster. If the preeclampsia is severe, you provider may want you to deliver the baby early.

The symptoms usually go away within 6 weeks of delivery. In rare cases, symptoms may not go away, or they may not start until after delivery (postpartum preeclampsia). This can be very serious, and it needs to be treated right away.