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HealthyStart MARCH-APRIL 2014 Vol. XIV


Missed the HEALTH INSURANCE DEADLINE? Here are 5 ways to get covered, maybe avoid a fine

High cholesterol & hypertension Early detection necessitate moderate lifestyle changes

Sharing the gospel of Organ Donation Signs of High Blood The Quiet Disease


It's All About Familia

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healthbriefs Spring 2014 Health Tips Signs of High Blood Pressure

Diet Detective: Spring Health Tips 2014 1.

Avoid Stress and Reduce Allergies

The Quiet Disease

According to a study published in Annals of Allergy, Asthma & Immunology, allergy sufferers with persistent stress experience more allergy flare-ups. According to the researchers, "While alleviating stress won't cure allergies, it may help decrease episodes of intense symptoms." You can reduce stress with meditation and/or deep breathing exercises. Go for a walk or a run; take a bike ride or a spin class. Eat right, get enough sleep, and take care of other health conditions.

You feel well, are active, nothing hurts. So you’re healthy, right? What about your blood pressure? Do you think you would catch the signs of high blood pressure? The answer is likely, no. One in three adults has high blood pressure, but may not be aware of it, because the signs of hypertension are largely silent. High blood pressure might be wreaking havoc on your body without any warning signs. Left untreated high blood pressure can lead to a host of serious problems, including:

By Charles Platkin Be Aware of the "Allergy Capitals"


The Allergy Capitals is a research project conducted by the Asthma and Allergy Foundation of America (AAFA) to identify "the 100 most challenging places to live with allergies" during the spring and fall seasons. The data measured and compared each season include: Pollen scores (airborne grass/tree/weed pollen and mold spores) ! Number of allergy medications used per patient ! Number of allergy specialists per patient !

Here are the 20 worst pollen cities: 1. 2. 3. 4. 5. 6.

Louisville, Kentucky Memphis, Tennessee Baton Rouge, Louisiana Oklahoma City, Oklahoma Jackson, Mississippi Chattanooga, Tennessee


7. Dallas, Texas 8. Richmond, Virginia 9. Birmingham, Alabama 10. McAllen, Texas 11. Dayton, Ohio 12. Wichita, Kansas 13. New York, New York 14. Columbia, South Carolina 15. San Antonio, Texas 16. Knoxville, Tennessee 17. Providence, Rhode Island 18. New Orleans, Louisiana 19. Tulsa, Oklahoma 20. St. Louis, Missouri 3.

portions. What about those hot cross buns? They are about 250 calories per bun. What about all that candy?

Watch the Easter Eating

Easter is coming, and you need to beware of the calorie costs of holiday eating. Traditional honey-glazed Easter ham can be about 150 to 200 calories per 3 ounces, and you will most likely have at least two

• Cadbury Creme Egg, 150 calories • Cadbury Mini Eggs Candy, 12 pieces (40 grams), 190 calories • Snickers Chocolate Egg (1.15 ounces), 160 calories • Reese's Peanut Butter Eggs, 1 piece, 170 calories • Pez Hippity Hoppities, one roll, 35 calories • Bunny Peeps, four bunnies, 110 calories • Jelly Beans, 4 calories per bean • Hershey's Hollow Milk Chocolate Egg (570 calories for the shell alone) with four candy-coated milk choco late eggs inside (90 more calories)

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! ! ! ! ! ! !

Heart disease, including chest pain (angina) Heart attack Congestive heart failure – a weakened heart muscle Aneurysms or bulging of the arteries, which can lead to disability or death Stroke and resulting damage to the brain Kidney failure Eye damage and loss of vision

These conditions occur because untreated high blood pressure can damage the lining of the arteries throughout the body. As they experience continued higher pressure flowing through them, the arteries harden and become less elastic. Blood flows through them less efficiently, causing problems with the organs they are feeding, including the heart, brain, eyes and kidneys. The good news? This particular disease is easy to identify – and can be treated. A simple blood pressure reading, performed by your doctor or even in a grocery store blood pressure machine, can alert you if your blood pressure is rising.

Fruits and Veggies May Reduce Death Risk, Study Suggests diet filled with fresh produce is good for your health, and now a large study suggests that eating plenty of fruits and vegetables may substan-

Milwaukee Community Journal 3612 North Martin Luther King Drive Milwaukee WI. 53212 Patricia O'Flynn Pattillo Publisher Mikel Holt, Editor Editor, Coordinator and Marketing Sales Administration Telephone (414)-265-5300 Jimmy Johnson Sales and Advertising 414-265-5300 Advertising Email: Editorial Telephone (414) 265-6647Email: Mike Mullis Webmaster Media Center Bright Boateng Producer and Designer

tially cut your risk of death. Researchers analyzed the eating habits of more than 65,000 people in England between 2001 and 2013. They found that those who ate seven or more portions of fresh fruits and vegetables a day had a 42 percent lower risk of death at any age than those who ate less than one portion a day. The risk of death was reduced by 36 percent with five to seven portions, 29 percent with three to five portions, and 14 percent with one to three portions, according to the findings in the Journal of Epidemiology and Community Health. But the study didn't prove that eating lots of fruits and vegetables can cut your risk of death. It only found an association between fresh produce consumption and lower death risk. The researchers said their findings suggest that eating seven or more portions of fruits and vegetables reduced the risk of death from heart disease by 31 percent and the risk of death from cancer by 25 percent. Overall, vegetables appeared to have a stronger health benefit than fruit. Each daily portion of fresh vegetables reduced overall death risk by 16 percent, compared with 13 percent per portion of salad and 4 percent per portion of fresh fruit, the researchers said. "We all know that eating fruit and vegetables is healthy, but the size of the effect is staggering," study author Oyinlola Oyebode, at the department of epidemiology and public health of University College London, said in a university news release.

"Vegetables have a larger effect than fruit, but fruit still makes a real difference. If you're happy to snack on carrots or other vegetables, then that is a great choice but if you fancy something sweeter, a banana or any fruit will also do you good," Oyebode added. The study found no significant health benefit from fruit juice. And canned or frozen fruit appeared to boost death risk by 17 percent per portion, the researchers said. "Most canned fruit contains high sugar levels and cheaper varieties are packed in syrup rather than fruit juice," Oyebode said. "The negative health impacts of the sugar may well outweigh any benefits." -- HealthDay Reporter

MARCH-APRIL 2014 / HealthyStart / Page 3

April is National Donate Life Month

Sharing the gospel of organ donation

sonal testimony on the importance of blood and organ donation. In addition to his wife, who needed nine units of blood, he said his father later suffered from leukemia and required blood and marrow transfusions. That procedure added 19 years to his life. Bishop Hines’ mother also required blood for a major medical procedure.


“We are a people of faith,” he told the audience,

rought up in a strict Church of God in Christ (COGIC) household, Darrell Hines was raised to believe in shunning traditional medical treatment. God would take care of the sick, his family believed.

by Mikel Holt

The future COGIC bishop adhered to that interpretation of biblical scripture until his wife, Pamela, suffered from complications of childbirth and required a blood transfusion. Without it, she could possibly die, physicians told him. Hines prayed extensively over the matter and ultimately agreed to the transfusion. That seemingly simple medical procedure saved his wife’s life, he told clerics and community leaders during a recent luncheon at the Bacchus restaurant, located inside the Cudahy Towers, which rests on a bluff near the lakefront. The luncheon was coordinated by the Blood Center of Wisconsin and sponsored by renowned restaurateur Joe Bartolotta. Its purpose was not only to satisfy the palates of the 45 invitees with one of Bartolotta’s signature dishes, but also to feed their minds with the knowledge that through organ donation and blood drives they could save hundreds of African American lives. Organ, blood and tissue donation is a noble gesture that has not resonated enough in the African American community where a disproportionate number of people of color are in desperate need of a transplant or transfusions. Even as the numbers of those in need swell, African Americans rank at the bottom of ethnic groups when asked to consent to donation. Bishop Hines, who along with his wife is an “Ambassador for Organ Donation,” opened the program with his per-

“and I personally thank God for the organ donor network. We must spread the word to our congregations about the importance of organ donation.” The pastor of one of Milwaukee’s largest Black churches, Christian Faith COGIC, Bishop Hines said he frequently engages his congregation on the importance of donation, and has sponsored numerous blood drives.

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Donor dad partners with BloodCenter of Wisconsin for National Donate Life Month


pril is National Donate Life Month, a time to honor donors and donor families who have saved lives through organ donation. It’s also a time when BloodCenter of Wisconsin, home to the Wisconsin Donor Network and Wisconsin Tissue Bank, encourages community members to register at to give patients a second chance at life. Fathers like Grady Angeloff of Milwaukee are comforted, knowing their child’s final gift will benefit another child in need. “Riley was a character. He could light up a room when it was pitch black,” said Grady. “He had big brown eyes that, the moment you saw them, you had to fall in love with him.” Riley was born prematurely and weighed just one pound, six ounces. He spent his first six months of life in the hospital, but was able to celebrate his first birthday at home. A few weeks later, however, Riley lost his strength. He passed on March 31, 2013. His parents made the decision to donate Riley’s heart valves so other children might be given a chance at life. “When the doctor asked us if we were willing to donate, really without even thinking about it, I said yes.” Riley’s gift helped two infants, whose hearts are now beating thanks to the valves Riley was able to donate.

Grady-Riley “It made me feel better to know that my son was going to live not only in my memory, but in other children,” Grady said. When African Americans Donate, African Americans Live Nationally, more than 36,000 African Americans are on the waiting list for organ transplants, including more than 500 individuals in Wisconsin. African Americans are encouraged to become donors to give others a second chance at life. To join the registry or for more information, visit

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national news

Over 7.1 Million Enrolled in Obamacare said.


"As messy as it's been sometimes, as contentious as it's been sometimes, it's progress," Obama said.

fter facing a rocky start and chorus of naysayers who declared his health care law a failure, President Barack Obama on Tuesday celebrated a better-than-expected 7.1 million sign-ups for health coverage that he said should end the debate over whether the law should be repealed.

Obama lashed out at critics who still argue that the law should be repealed. "I don't get it," he said. "Why are folks working so hard for people not to have health insurance? Why are they so mad about the idea of folks having health insurance? Many of the tall tales that have been told about this law have been debunked. There are still no death panels. Armageddon has not arrived. Instead, this law is helping millions of Americans, and in the coming years it will help millions more."


Yahoo news

"The Affordable Care Act is here to stay," Obama declared in a feisty Rose Garden speech the day after the deadline for Americans to enroll.

The law is at the center of competitive congressional races across the country. Michael Steel, spokesman for House Speaker John Boehner, R-Ohio, argued that the law was harming the American people.

Obama announced the 7 million threshold that once was seen as unattainable, even as the number still could climb. People who started applying but couldn't finish before the Monday midnight deadline can have extra time, as do potential enrollees whose special circumstances kept them from signing up in time.

President Barack Obama, with Vice President Joe Biden, speaks in the Rose Garden of the White House in Washington, Tuesday, April 1, 2014, about the Affordable Care Act.

Administration officials said they were still compiling data that will be important in determining the ultimate success of the sixmonth enrollment period, such as how many enrollees were previously uninsured and

whether enough younger, healthy people signed up to offset the costs of covering older, sicker consumers. But Obama said after the initial computer problems that plagued the online insurance exchanges where people could sign up, the

Spring 2014 Health Tips (continued on page 12)


Walk More

One of the simplest and best exercises: Walk everywhere. Use a smartphone app such as, moves (, or runkeeper ( to keep track of the distance you've gone. See d-it-read 5.

Bicycling is Great Exercise

Biking is not only great fun and a fantastic means of transportation, it also builds muscle, particularly in your quads, glutes, hamstrings and calves. It's a convenient, inexpensive way to get around town. Parking is always simple, and you can get some exercise while you're running errands. There are some very cool smartphone applications, such as mapmyride (, that help to track how long you ride, and Google maps has a bike route option that helps you find the most efficient path and identifies bike lanes if they exist. Also see: 6.


When you get a great-tasting strawberry, it's hard to believe it's really good for you. Strawberries are loaded with fiber, potassium, vitamin C and folate. And one large strawberry has only six calories (One cup of strawberries has 46 calories; 0.45 g fat; 11 g carbs; 3 g fiber; 1.5 g protein). Research conducted by the UCLA Center for Human Nutrition

at the David Geffen School of Medicine and others has shown that strawberries have potent antioxidant, anti-cancer, anti-atherosclerotic (prevents hardening of the arteries, which leads to heart disease and stroke) and anti-neurodegenerative (leads to Alzheimer's) properties. Pick bright, firm strawberries with vivid red color. The tops should be fresh, green and intact. They will keep in the refrigerator for two to three days. Wash them only when ready to eat. 7.

Green Tea Offerings and Cold Coffee Deals

Dunkin' Donuts ( may not be the best place to hang out if you're on a diet, but they do have some good drink choices. Their flavored coffees are very good: about 20 calories per 10 ounces (without sugar or milk), and they've just added an iced green tea. According to a Dunkin' Donuts spokesperson, they use twice as much ground coffee in their iced coffee as they do in their hot coffee. "By using this double brewing technique, we're able to ensure that our iced coffee has the same signature, smooth taste that our guests have come to know and love from our Dunkin' Donuts hot coffee." But don't go there if you can't resist the doughnuts. 8.

law was working as he had hoped.

Traveling For Spring Break – Avoid Stress

According to Dr. Lisa Gordon, a psychologist at The Family Institute at Northwestern University, vacationing with children can be a challenge

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"The bottom line is this: Under this law, the share of Americans with insurance is up, and the growth of health care costs is down. And that's good for our middle class, and that's good for our fiscal future," the president

"Every promise the president made has been broken: Health care costs are rising, not falling," Steel said. "Americans are losing the doctors and plans that they like — especially seniors suffering under President Obama's Medicare cuts. Small businesses are afraid to hire new workers, hobbling our economic growth. That's why we must replace this fundamentally-flawed law with patient-centered solutions that will actually lower health care costs and help create jobs."

Missed the health insurance deadline? Here are 5 ways to get covered, maybe avoid a fine


t's not too late to get covered. A few routes remain open for those who missed the health care law's big enrolment deadline.

Millions may be eligible for a second chance to sign up for subsidized insurance this year. And people who get coverage after the deadline can still avoid, or at least reduce, the fine for going uninsured. Here are five options for those still without insurance: 1. TAKE ADVANTAGE OF THE GRACE PERIOD This special break was created for anyone who began enrolling in an insurance marketplace by Monday's deadline but didn't finish. That includes people stymied by website outages or overwhelmed phone lines, missing information on applications, and other problems or confusion. Those who started an application on by March 31 should log on and finish it as soon as possible. Federal officials say they will take what time is necessary to work through cases pending. People applying online will have until April 15 to finish, administration spokesman Aaron Albright said Tuesday. Paper applications will be accepted until April 7. Consumers will have to attest that they had tried to enrol by March 31.

Rules vary in the 14 states running their own insurance marketplaces. For most people, going through a marketplace opens the door to lower costs. Those who use the grace period will get coverage starting May 1 and won't owe a fine. 2. USE A SPECIAL ENROLLMENT PERIOD The government also is offering special extensions for a host of problems that might have prevented people from signing up through a marketplace: Natural disasters. Domestic abuse. A serious illness. Mistakes by application counsellors. Errors by insurance companies. To seek a "special enrolment period," contact the federal call centre, at 1-800-318-2596 , or your

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HealthyStart MARCH-APRIL 2014 / / Page 5

Early detection of high cholesterol and hypertension necessitate moderate lifestyle changes


aving high cholesterol or blood pressure is not a death sentence. Nor does it mean a dab diet and an overly regimented lifestyle. Quite the contrary.

by Mikel Holt as $10 a month. Dr. Ahmed cautions his patients not to fall prey to diet fads or commercials advertising

African Americans are disproportionately impacted by high cholesterol and hypertension, a well established and researched fact that prompts those in the medical community to advise early detection through medical examinations.

Unless your cholesterol and hypertension levels are abnormally high, simple adjustments to your diet, regular, moderate exercise and physician prescribed medication is generally the recipe for longevity and a normal life. Dr. Ayed Ahmed, associate dean at the Medical College of Wisconsin and director of the Center for Healthy Communities, says early detection of high cholesterol and hypertension will generally necessitate moderate lifestyle changes that are minimally intrusive, with long-term benefits; the weight generally returns as quickly as it was lost. For African Americans that may mean a change in diet, replacing fatty and salty foods with alternatives. For example, cooking with smoked turkey instead of salt pork or ham hocks. Dr. Ahmed recommends the DASH diet, and moderate exercise five times a week. That may include walking for 30 minutes, or light aerobics. The DASH diet emphasizes eating fruits, vegetables, whole grains, low fat and low sodium products, poultry, fish and nuts. The exercise portion generally involves light aerobics for thirty minutes a day, which may include walking at a brisk pace. Most fitness clubs can arrange a schedule for you. Club membership can run as a low

instead of 10 pounds in a week. Generally those high intensity programs don’t come with long term benefits; the weight comes from quickly.”

products that claim to be quick remedies for high cholesterol or hypertension. The old adage that,”if it sounds too good to be true, it generally is,” is appropriate when it comes to quick fixes. Also beware of intensive exercise programs that guarantee massive weight loss in a short period of time. Instead, those with cholesterol and hypertension should participate in long term and proven health style programs, like the exercise program previously mentioned, along with any prescribed medication. “Remember, it’s a marathon, not a sprint. You goal should be to lose 10 pounds in six months,

“Particularly if you have a family history of high blood pressure,” Dr. Ahmed said. “It’s never too early for African American adults to have their blood pressure checked, or to get a blood test to check their cholesterol. “In far too many cases, hypertension is undetectable by the individual until it reaches a critical stage. That’s why they call it the silent killer.” Education is one of the best prescriptions for better health, Dr. Ahmed says. That goes beyond knowing early warning signs and should entail asking your physicians questions during regular checkups. “Nothing should be off limit as it relates to

questions,” the noted physician said. “Don’t assume, and don’t necessarily believe everything you read or hear. Ask your doctor to verify.” “As much as I love the Internet, some things you find on it is garbage,” he said. Dr. Ahmed encourages his patients to ask questions about any medical concern, including diet programs and new products. “Some people are intimidated by authority figures, including physicians. They should realize that the doctor/patient relationship is a partnership,” he explained. As such, there are no barriers. “The physician has your best interests at heart, but he needs your input into your medical concerns to effectively help you maintain a healthy life.” That includes making recommendations based on the latest medical research. You have to take into consideration that continual research frequently means that different conclusions are reached, he explained. “For example, years ago, eggs were bad for you based on research at that time. Later they offered benefits. New research, which may examine a different group or look at the egg from a different perspective may reach another conclusion.” If in doubt, the physician may tell the patient to look up reliable institutions that maintain the latest research like the American Heart Association, American Diabetes Association or NCEP (National Cholesterol Education Program).

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wisconsin news Recent cases of mumps discovered on UW-Madison campus


wo additional cases of mumps have been reported on the University of WisconsinMadison campus, according to a Thursday article. University Health Services reminded students to take steps to stay healthy and prevent spreading the illness. UHS is working with public health officials to monitor the situation.

By The Daily Cardinal We will continue to update this story as more information becomes available. 4-3-14 ORIGINAL: University Health Services is encouraging students and staff to take preventative measures after three University of Wisconsin-Madison students were diagnosed with mumps, according to Gerald Ryan, UHS director of medical services. Two of the three individuals were diagnosed at their homes over spring break but were exposed while on campus, according to Ryan. Mumps is a viral infection similar to the flu with relatively mild symptoms. Symptoms include fever, sore throat and enlarged salivary glands, unique to mumps. According to Ryan, students can determine if they have mumps by feeling for inflamed parotid glands, located just in front of the


everybody inside,” Ryan added.

While UHS hasn’t heard much about cases in the city of Madison, it is historically more common for outbreaks to occur on university campuses.

Even people immunized as children against viral illnesses such as mumps are not completely immune. People in their late teens and early 20s are particularly susceptible, partially because they are in dense areas, according to Ryan. However, immunized individuals appear to get less sick than others.

Ryan said this is a typical time of the year for outbreaks, as evidenced by the 116 confirmed cases reported Tuesday in Ohio, 93 of which occurred at Ohio State University. “The situation at universities is basically ideal for people to have infectious diseases that are more easily transmitted because you have large numbers of people who are confined into small spaces,” Ryan said. UHS hopes the weather will soon improve so students can get outside and distance themselves from each other, according to Ryan. “Unfortunately, the weather isn’t cooperating, and it’s keeping

“This is the reason why [UHS] talk[s] so much about the importance of having your immunizations up to date,” Ryan said. Ryan reminds students to wash their hands frequently, cough into their elbows and not share beverages or food in order to prevent spreading or contracting the illness. There is no specific treatment for mumps. If you suspect you have mumps, isolate yourself as much as possible for five days after first becoming ill.

Wisconsin Medical Society has mixed reaction to release of Medicare data


he American Medical Association fought the recent release of Medicare data showing how much doctors are paid through the government health program. The Wisconsin Medical Society now says that such transparency is good, but would be helped with fresher, more comprehensive information.

“We want the public to help us with this effort,” said Blum. “We want the press. We want some outside researchers to also mine the data to find outliers.” The Wisconsin Medical Society says releasing the data could help consumers understand health costs and help providers deliver better care. But the public may not take into account why some doctors get more Medicare money. The society's CEO, Rick Abrams, says those doctors may provide more complex care or treat a lot of sick patients.


ov. Scott Walker signed a bill into law Thursday that is designed to lower the cost of chemotherapy drugs that cancer

patients take in pill form, a proposal that passed the Legislature with broad bipartisan support after initially being stymied due to opposition from the insurance industry and a handful of Republicans.

Walker signed the measure at the Froedtert and Medical College of Wisconsin Clinical Cancer Center. The new law, which takes effect in January, requires health insurers to charge the same price for chemotherapy pills, which can be taken at home, as for intravenous treatments, which are administered at hospitals.

sors, Sen. Alberta Darling, of River Hills, and Rep. Pat Strachota, of West Bend. They said the new law will help save lives. Insurance companies typically view the oral drugs as a pharmacy

benefit and the intravenous therapy as a medical treatment, which leads to the price disparity. Patients can often be required to pay half of the pharmacy benefit's cost. The new law caps a patient's copay for the drugs at $100 per month per prescription.

Supporters, including a coalition of 28 patient groups, medical providers, health care institutions and others who have lobbied for years to get the bill passed, say the new law will help more patients afford a more convenient form of treatment. The pills can cost thousands of dollars more than intravenous chemotherapy.

Historically, intravenous treatments have been the predominant route for administering chemotherapy to fight a wide variety of cancers. While chemotherapy in pill form has been available for decades, supporters argued for the new law because more of the new drugs being developed are in pill form.

"Treatment should be based on the disease and not your wallet," said the bill's Republican co-spon-

Wisconsin becomes the 30th state with such a law.

Weston doctor among 6 'Champions' of women's health MADISON — Dr. Adedayo A. Onitilo, an oncology/hematology physician at Marshfield Clinic– Weston Center, is among six people statewide who will be honored by The Wisconsin Women’s Health Foundation at a dinner May 3 in Madison.

By Shamane Mills, Wisconsin Public Radio A year ago the federal government released Medicare data showing a wide variation in how much hospitals charge for common procedures. Now, it's releasing Medicare payments made to doctors in 2012. Jonathan Blum, deputy administrator with the Centers for Medicare and Medicaid Services, says taxpayers paying for Medicare deserve transparency and it may also boost government efforts to reduce fraud in the program.

Wisconsin governor signs Oral Chemotherapy Bill

“We want our physicians, (our other) providers of care, to not only stand behind what they do but also take on the more difficult, albeit more expensive, cases,” said Abrams. “And quite frankly I'm very, very concerned that when we lead with the primary purpose being to ferret out fraud and abuse, it is going to create a chilling effect. The health care industry in the past few years has been moving toward more transparency. For instance, the Affordable Care Act requires pharmaceutical and medical device companies to report payments to.

They will receive the Champion in Women’s Health Award, created by the Wisconsin Women’s Health Foundation in 2002 to honor individuals who have demonstrated extraordinary leadership in women’s health. Recipients are nominated by their peers. Dr. John Mielke and Sally Mielke, Appleton, will be honored with Lifetime Achievment awards. Other Champion award recipients will be Gina Green Harris and Phyllis K. Holder, both of Milwaukee, and Clare Janty, Cameron. After the awards dinner, the Wisconsin Women’s Health Founda-

Dr. Adedayo A. Onitilo tion will host its 15th Annual Spring Gala from 8 p.m. to midnight at the state Capitol, 2 E. Main St., Madison. Tickets are available for purchase at For more information about the Wisconsin Women’s Health Foundation, visit or call 1-800-448-5148 . --wausawdailyherald

HealthyStart 2014 / MARCH-APRIL / Page 7


A Doctor's 'People Skills' Affects Patients' Health doctor's "bedside manner" seems to have a real effect on patients' health, a new research review suggests.

The review, of 13 clinical trials, found that when doctors were given training to hone their people skills, patients typically fared better in their efforts to lose weight, lower their blood pressure or manage pain. Experts said the findings, reported online April 9 in the journal PLOS One, show that the doctor-patient relationship can have an impact on people's health. The effects in these studies were small, but still "impressive," said Alan Christensen, a professor of psychology at the UniversityUniversity of Iowa. Christensen, who was not involved in the research, studies the issue of health care provider-patient relationships. He pointed out that many of the training programs training programs in the studies included in the new review focused on fairly "general" skills - such as maintaining eye contact with patients, and listening without interrupting. So it's encouraging to see that these training programs training translate into specific health benefits at all, according to Christensen.

"It's important to be able to demonstrate that clinicians can learn to change how they interact with patients, and that it affects health outcomes," he said.

By Amy Norton HealthDay Reporter

Dr. Helen Riess, the senior researcher on the new study, agreed. "I think that intuitively, people think that if you have an open, caring relationship with your provider, that's beneficial." But to really know if there are objective health effects, clinical trials are key, said Riess, who directs the empathy and relational science program at Massachusetts General Hospital in Boston. For its review, she said her team chose only rigorous clinical trials that measured "hard outcomes," such as blood pressure changes -as opposed to subjective experiences like patient satisfaction. The researchers ended up with 13 clinical trials from around the world. In each, health providers -- most often doctors -- were randomly assigned to either stick with their

usual care or have some kind of trainingtraining on patient interaction. Some focused on building "warmth" and empathy, Riess said, while others taught providers specific techniques, like "motivational interviewing." In most of the trials, though not all, patients seemed to benefit. Obese and diabetic patients tended to lose more weight, arthritis patients reported less pain, and people with high blood pressure did a better job of lowering their numbers.

Those effects were "modest" overall, Riess and colleagues found. But the magnitude of the benefit was similar to what's been seen in studies testing lowdose aspirin or cholesterol-lowering statins for preventing heart attackpreventing heart attack, according to the new research. "That's important because aspirin and statins are widely prescribed, and everyone agrees they should be used to reduce the risk of heart attack," Riess said. It's not clear, she added, exactly why the trials in this review found benefits: Is it the improved empathy, or the motivational interview technique, for example? And of course, individuals differ in what they consider a "good" relationship with their doctor, Christensen noted.

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Sharing the gospel of organ donation (continued from page 3) Christian Faith COGIC, Bishop Hines said he frequently engages his congregation on the importance of donation, and has sponsored numerous blood drives. Recognizing that many African Americans shun organ donation out of a misinterpretation of scripture (including the belief that they must be ‘whole’ on Judgment Day), Bishop Hines said, “We need to get rid of the (spiritual) fear. As spiritual leaders, we must show that information is life.” Little new information was shared during the luncheon that I hadn’t heard before, although the personal testimonies were emotionally moving and in one case, tearful. As a donor parent, I have worked as an advocate for organ donation for over a decade. It is not only an issue of critical concern to the African American community, both nationally and locally, but also a personal crusade that is dear to my heart. As you read this, there are over 300 local African Americans in desperate need of kidney transplants in Milwaukee. Yet less than 20% of us are on the donor registration list. Nationally, thousands of people of color face unnecessary deaths in part because less than 50% of us are willing to even consider donation. The reasons for that dichotomy have not changed over the years: Religious superstition and false biblical interpretations, distrust of the medical community and a misguided fear that physicians will terminate Black lives prematurely to secure organs are among the most cited reasons African Americans refuse to participate in the life saving program. Ironically, I used to criticize my people for their ignorance or misguided beliefs. That is, until my son died and some of those same superstitions crossed my mind. Fortunately, just prior to Malik’s death, I had authored an article on donation, and the information I had provided to others about the possibility of a life saving gesture flooded my muddled mind as I sorted through the emotional trauma of losing my

oldest child. Donation helped relieve some of the pain of my tragic loss. Malik dedicated his life to education and service to our community; my God spirit told me he would have agreed to that final gesture. I don’t know everyone who benefited from Malik’s donation, but I was told of several, including a little girl who now views the world through his corneas. Hopefully, she can see the world as he did.

presentations was provided by Kitchy Johnson whose son Dominique recently followed in the footsteps of his father, Ray Harmon, and received a heart transplant. Dominique and his father’s “heart” wrenching sojourn (no pun intended) intercepted with my life’s journey at several intersections.

Following Bishop Hines, Bartolotta himself provided an empowering story about how donation impacted his life.

Dominique and I bonded when I served as a teacher’s aide for Malik’s fifth grade class at the Young Leaders Academy for the remainder of the school semester following his death in March of 2003. Malik died on his 27th birthday in a car accident.

Like his father before him, Bartolotta suffered from kidney failure and had to undergo dialysis. He recalled as a child sitting with his father during dialysis and “looking around and seeing many mostly African Americans in the treatment room.

Dominique was a member of what he and his fellow students called, ‘Holt’s Kids of Kemet,’ and like all of Malik’s students, they shared a love for their mentor, and partly because of him, a true appreciation for education and African culture.

“It didn’t dawn on me then why so many of the patients were Black,” he told the audience, “but now I know, and it’s heartbreaking.”

My work in Malik’s classroom served as a mechanism to ease our grief and to continue the Africentric educational paradigm my son had introduced, which earned him the 2002 teacher of the year award. Prior to and after that period, I worked with Ray on several political education projects.

Ironically, 20 plus years later, Bartolotta found himself in an identical situation to his father’s. Whether because of genetics or lifestyle, he faced a life of uncertainty and most assuredly dialysis. He brought up the subject during a family dinner last year, and was surprised when his brother-in-law offered to give him one of his kidneys. Kidneys are one of the few organs that can be transplanted from a live donor. Today, Bartolotta is healthy. And thankful. The experience prompted him to join the Organ Donor Network advisory committee and to volunteer time, energy and resources to promote awareness about organ donation. During his first meeting with the group (I’m also a member), the restaurateur questioned what was being done to educate African Americans on the subject. Even though he was impressed by the marketing and educational strategies being employed, he recognized that much more needs to be done. He immediately volunteered his business for the luncheon and helped organize the discussion with Black leaders. One of the most impactful—and personal--

In 2007, Ray’s personal story of survival against the medical odds garnered national attention. He spent over 360 days in Sinai St. Luke’s Medical Center attached to a Cardio West Total Artificial Heart machine while he waited patiently for a heart transplant. As each day ticked away, his odds of survival diminished. Jay Campbell, long time head of the local organ donor procurement program, told the gathering how his relationship with Ray grew during Ray’s emotionally draining medical sojourn. Ray ultimately received his new heart, but his journey didn’t end there. Several months after leaving the hospital, Ray called Jay to reveal his mother was dying. He wanted to donate her organs when the time came. The story didn’t end there, however. Dominque’s mother told the audience how the young man refused to give up hope and his enthusiasm for life even as he learned

two years ago that he was to follow in his father’s footsteps. Last year he was informed that his deteriorating condition had reached a critical stage. Though his condition threatened his life, Dominque never succumbed to depression. In fact, his most frequently announced complaints were about how his condition derailed his college studies, and his hopes for playing college basketball. After months as a patient at Children’s Hospital (he was the oldest patient in the hospital and often brought laughter to younger patients), he was given the gift of life when a heart was made available. The story of his perserverance and dashed hopes to play college basketball reached the Milwaukee Bucks, and shortly after leaving the hospital, he was invited to a Bucks’ practice where he was given VIP treatment. Dominique has since enrolled at Cardinal Stritch, is working out with plans to play for that college’s basketball team next fall. Sadly, his father won’t get an opportunity to see him play. He died of natural causes at the age of 47. There are dozens of stories like Dominique’s, Joe Bartalotta’s and Bishop Hines’. Unfortunately, there are hundreds that don’t have such happy endings in part because the overwhelming majority of our people don’t understand that when ‘African Americans give, African Americans live.’ That’s the motto that new organ donation outreach marketing manager Alicia Moore is spreading throughout our community. Alicia was introduced at the luncheon, and there was unanimous agreement that she brings a deep-seated passion for her job. That may rest in part on the fact that she once dated Malik and was motivated by his donation. First on Alicia’s agenda is creating a Black network of volunteers, starting with the community leaders and clerics who attended the luncheon. From that core group she hopes to develop additional educational tentacles to reach into every segment of our community. It’s a Herculean job, but the rewards that come with success are greater than any I can think of---the gift of life.

Page 8 / MARCH-APRIL 2014 / HealthyStart

men’s health essential HEALTH SCREENINGS for MEN


AT A GLANCE egular screenings are the best way to protect your health and to detect early signs of major health threats such as heart disease, stroke, cancer, diabetes and osteoporosis. Early detection almost always means simpler, more effective treatment.

Be your own advocate. Help protect yourself from serious health complications with these nine essential health screening tests. 1.

Blood pressure

High blood pressure is a major risk factor for heart disease and stroke. Get your first test at age 20 and repeat every two years or more frequently, if readings are high. 2.


Cholesterol is fatty material in the blood and high levels of cholesterol can increase your risk of heart disease. Get your first test at age 20 and repeat tests as your doctor advises. 3.


Testing your blood sugar level can indicate your risk of developing diabetes. Get your first test at age 45 and every three years or more frequently if you have other risk factors. 4.

Skin exam

Check your entire body every month for asymmetrical, irregular or large spots or moles or any mole changes, which may be an indicator of skin cancer. Self exams should be performed every month from the time you are 20 years old. 5.

Eye exam

Regular eye exams can detect eye diseases in the early stages. If you are 40 or older and have not had a recent eye exam, you should have one immediately. Repeat exams should be done every two to four years until you are 55, every two to four years after age 55 and every one to two years after age 65. 6.

Prostate cancer

The PSA test measures the blood level of prostate-specific antigen (PSA). High levels of PSA may be an indicator of cancer. Get your first prostate exam at age 50 unless you are an African American, in which case you should be screened at age 40. If you have a family history of prostate cancer, you may need to be screened earlier than age 40. Repeat

exams should be performed annually. 7.

Colorectal cancer

There are several ways to test for colorectal cancer, which should be done at age 50, unless you are an African American or have a family history of colorectal cancer, in which case you should have your first exam at age 45. Repeat tests should be done as your doctor advises. 8.

Bone density

An X-ray looking for signs of bone loss or osteoporosis should be performed at age 65, or earlier if you have risk factors for osteoporosis. 9.


If feelings of sadness, loneliness, hopelessness or emptiness persist for more than two weeks, talk to your primary care physician about a series of tests that can determine if you are experiencing depression. --by Methodist

HealthyStart 2014 / MARCH-APRIL / Page 9

women & children P

Aspirin Advised for Women at High Risk for Pregnancy Complication By Dennis Thompson HealthDay Reporter

regnant women at high risk for the serious condition called preeclampsia should take lowdose aspirin every day after their first trimester, according to a new draft recommendation by an influential U.S. panel of experts.

sult with her doctor before beginning a daily aspirin regimen, LeFevre added. “We certainly don’t want women to go out and start taking low-dose aspirin without talking with their prenatal provider about whether they are at high enough risk to begin taking aspirin,” he said. “This is not something women should do on their own. This is something they should do in consultation with their health care provider.”

Daily low-dose aspirin (81 milligrams) in middle and late pregnancy can significantly reduce the occurrence of preeclampsia among these women. And it can lower the risk of preterm birth or low birth weight resulting from the pregnancy-related condition, according to the recommendation by the U.S. Preventive Services Task Force. “Preeclampsia is one of the more common causes of serious health problems for both the expectant mother and their baby,” said Dr. Michael LeFevre, chairman of the task force, and vice chair of family and community medicine at the University of Missouri School of Medicine. “At least for pregnant women at high risk for preeclampsia, a low dose of aspirin taken daily can help prevent the condition and improve the outcome for both mother and child.” The evidence review upon which the recommendations are based was published online April 7 in the journal Annals of Internal Medicine. Preeclampsia is a complex condition that occurs in pregnant women and involves an increase in blood pressure and excess protein in the urine after 20 weeks of pregnancy. About 4 percent of all pregnancies in the United States are affected by preeclampsia, according to information from the journal. It’s important to prevent preeclampsia because the only treatment once it takes hold is delivery, which can pose risks to the baby if performed before 34 weeks of gestation. Preeclampsia is responsible for more than one-third of the serious health problems that occur among pregnant women, and 15 percent of preterm births, the journal noted. Pregnant women who contract preeclampsia can suffer potentially life-threatening organ damage or stroke. Unborn fetuses grow too slowly as the condition robs them of oxygen and nutrients, leading to low birth weight babies, preterm birth or stillbirth, the researchers explained.

The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts that makes evidence-based recommendations about preventive medical services such as health screenings, counseling and medications. The draft recommendation on aspirin treatment for preeclampsia has been posted for public comment at Comments can be submitted from April 8 to May 5. “The baby grows too slowly, so you get a small baby, or you have to deliver the baby early to save the mother’s life because it can lead to stroke,” said Jillian Henderson, lead author of the evidence review and an investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. LeFevre said women at high risk of preeclampsia include those in the following categories: •have had preeclampsia in previous pregnancies, •have high blood pressure or diabetes prior to pregnancy, •are having twins, triplets or even more in a multi-birth pregnancy. A doctor also might recommend daily aspirin use in women who have a combination of two or more moderate risk factors, LeFevre said. These include women who are: •having their first baby, •obese, •older than 35 or black. Daily low-dose aspirin use reduced the risk of preterm birth by 14 percent and of slow fetal growth by 20 percent, according to the new review of the latest medical data. And it led to a 24 percent reduction in the overall

occurrence of preeclampsia, the review found. In addition, there’s no evidence of potential harm in daily low-dose aspirin use for pregnant women at high risk of preeclampsia, study author Henderson said. However, any expectant mother should con-

Henderson said the new review echoes earlier research and evidence reviews that have supported low-dose aspirin to prevent preeclampsia in high-risk mothers. “It’s not a big difference from what’s been found earlier,” she said.

Page 10 / MARCH-APRIL 2014 / HealthyStart


It's All About Familia New center is aimed at enhancing health of local Latino community

hen Marlene Aza heard from a friend that the pediatrics clinic at Johns Hopkins Bayview Medical Center had an outlet for Spanish-speaking mothers to meet, offer feedback on the clinic services, and learn about community resources, she wanted in.

Bayview was the logical place to house the new center, says its director Tina Cheng, because the campus had already established programs such as the family advisory board and an Hispanic community mental health clinic to serve the large Latino population in southeast Baltimore. Not only do Latinos make up roughly a third of the population in the area surrounding Bayview, but more than half of the hospital’s pediatric patients and 45 percent of obstetric patients are Spanishspeaking.

Aza called the clinic to inquire, and soon was invited to join the Latino Family Advisory Board, a group of nine to 12 mothers who meet six evenings a year. Thanks to the board’s feedback, the clinic replaced its carpet with easier-to-clean flooaring, and Latinos are the largest and fastest growing ethnic minority in the The initiative was made possiobtained educational materials ble by a five-year grant from United States, with a total population of 50.5 million in 2010. and children’s books for the Since 2000, the Latino population in Baltimore has grown nearly the Aaron and Lillie Straus waiting area. Volunteers now Foundation, and matching 2.5 times. In Southeast Baltimore, the area served by Bayview, read to children waiting for apfunds provided by leaders from Latinos are 23 to 38 percent of the population. pointments and help parents fill Bayview, the Johns Hopkins Hopkins Medicine Magazine Winter 2014 out paperwork. The clinic also University School of Medicine, started a monthly parenting and the Johns Hopkins Health Now, with the establishment of a Center of class to address issues like behavior manSystem. Excellence for Latino Health at Johns agement in young children, and developed Hopkins Bayview, clinicians hope to ema dental health toolkit for families. Latinos in the Bayview area face a number brace many more families like Aza’s. of health issues, including childhood obeAza, who moved to Baltimore nine years sity and diabetes, dental cavities, and acKnown in Spanish as Centro de Johns ago from Peru, says she loves the group’s cess to health care, says Cheng, a Hopkins para la Salud y Oportunidad de supportive nature, that it offers childcare professor of pediatrics who studies health los Latinos, the center emphasizes a famduring meetings, and that clinicians listen disparities in minority populations. There ily-centered multidisciplinary approach to to her suggestions. Through her participaalso are significant mental health needs health that bridges medicine, pediatrics, tion, she learned about English and exerfor adolescents trying to fit in, and for gynecology and obstetrics, and psychiatry. cise classes and also received important adults feeling economic pressures and isoIt focuses on enhancing the health of Latiinformation about school for her young lation, especially among those trying to nos in Baltimore and beyond, by combinsons. raise money to send to family members ing coordinated clinical care with left behind in other countries. advocacy, education, and research.

Are Milk and Juice Responsible for Your Child’s Weight? Reducing kids’ consumption of liquid calories is an obvious, important way to target childhood obesity. By Yoni Freedhoff, USNews "But it’s milk – she’s supposed to drink lots of it," said the mother of a 100-pound 9-yearold who was drinking an average of four glasses a day. And by no means was that mother’s belief odd or unique, as that’s certainly the message milk has carved out for itself. From the obvious advertising of decades of milk moustaches, to the less obvious but no less impactful recommendations of Food Plates and Pyramids, to school food policies, to governmentsubsidized dairy checkoff programs, there seems to be clarity and consensus in the notion that milk is necessary for building healthy children. While that’s certainly true for infants and toddlers (and a case can also be made for children with poor overall diets), there’s a lot less clarity after age 2, and in the case of children whose weights are a worry, drinking more than 500 daily calories of the stuff (like the daughter of the mom in my office was, with her school-based glass of chocolate milkchocolate milk and three glasses of 2 percent at home), there’s little doubt that as far as health goes, those calories are outweighing even the most hopeful of milk’s theoretical benefits.

And theoretical is the kind way to describe milk’s benefits, in that there simply aren’t robust

and well-designed studies that demonstrate dramatic clinical benefits to its consumption. In fact, looking at those studies designed to examine milk’s most heavily promoted benefit – prevention of osteoporosis – the data are downright disappointing, with researchers failing to link milk intake with fracture prevention. To be fair, it’s important to point out that studies designed to look at the impact of one dietary choice on a particular health outcome are exceedingly challenging. It’s also crucial for me to point out that there aren’t studies directly linking high milk consumption with excess weight in childhood, though if a child is struggling with weight, given we

know they won’t fully reduce the calories they eat from solid foods in response to the calo-

ries they consume from milk, drinking a Big Mac’s worth of milk a day probably isn’t in their best interestbest interest. Of course, it’s not just milk kids are drinking these days. It's juice, too. And while kids drinking four glasses of milk a day, like the little girl in my office, may not be all that common, four combined glasses of milk and juice a day certainly is – and it’s something I have come across regularly working with parents of children with obesity. As far as health goes, juice is a far clearer story than milk, in that juice can be fairly described as flat soda pop with vitamins. Beyond vitamins (which in many cases are added

back to the juice after its processing), there really aren’t any meaningful nutritional difference between the two. So if you don’t think the addition of the identical vitamin and mineral content of orange juice to Coca-Cola would make Coke a healthful beverage, then you should be rethinking your child’s regular juice consumption. As to how much juice is too much, according to the American Academy of Pediatrics, even those small 6ounce juice boxes most likely to be consumed by young children exceed their daily recommended juice maximum of 4 ounces. No doubt there are dozens of contributors to our children’s growing weights, and while there will never be a singular intervention that in turn will fully treat or prevent childhood obesity, reducing kids’ consumption of liquid calories is an easy, obvious and important target.

But, says Cheng, “they also have areas of positive health behavior and health outcomes that we can learn from, like strong families and good birth outcomes.” The center represents a culmination of efforts that began in 2010 with the creation of the Hopkins Organization for Latino Awareness, or HOLA, launched by Kathleen Page and Adriana Andrade, both assistant professors of medicine and infectious disease specialists at Hopkins. HOLA has directed a range of activities, including cultural competency courses for medical students, health seminars at the Bloomberg School of Public Health, and an elective through which trainees in Hopkins’ urban health residency program treat Latino patients at Esperanza Center, a free clinic for immigrants, supervised by HOLA faculty. The new funding allows investigators to strengthen HOLA’s research base, develop interventions to reduce health disparities for Latinos, expand collaborations with other Hopkins and Baltimore City entities, establish a website for community residents, and hire a full-time administrator. Karen Blu. --Hopkins Medicine

NUTRITION & FITNESS have Long Lasting



n a study written by Sharon Palmer, RD, Editor of Environmental Nutrition, she shared that one’s health habits today have long term impact. These findings were from a new German study published in Psychology of Sport and Exercise, January 2014. In the story about 500 men and women were followed from 1992 to 2010. The scientist analyzed many factors that might impact their health status, including socioeconomic status, stress management, social support, physical exercise and nutrition habits. One of the factors that had the greatest effect on health was physical exercise and nutrition. When these habits were acquired at he the beginning of the study they had an impact on heath nearly two decades later. The researchers summarized that acquiring health-promoting habits at an early adult age should be a main focus of disease prevention. It’s encouraging to know that good health habits , daily exercise and eating a balanced diet focusing on lean protein sources, legumes, whole grains, fruits and vegetables can have long lasting results. But it’s also important to remember that it is never too late to gt healthy. previous studies have found that positive changes in fitness and nutrition can reap rewards even when initiated later in life. No matter when you form them, these good habits are linked with long list of worthwhile rewards, including a lower risk of obesity, type 2 diabetes, coronary heart disease, cancer and neurodegenerative diseases. Good habits are an investment that pay out well over time.

HealthyStart 2014 / MARCH-APRIL / Page 11

Is exercise one of the missing links to mental wellness? Real Help. Real Solutions." It is a twoday summit aimed at shattering the stigma associated with psychiatric illnesses. "Mental-wellness issues take a tremendous toll on our community due to the associated stigma, the misunderstanding of the nature of the illnesses and the lack of clarity about how to identify and access available, appropriate services and resources," Hughes said. "The purpose of this summit is to open the discussion and provide resources and solutions that are readily available, because if we don't talk about the problem, we can't get to the solution." Kimberly Garrison is a wellness coach and owner of One on One Ultimate Fitness in Philadelphia.


HE POSITIVE effects of working out extend far beyond the gym. As you might have guessed, physicians, researchers and mental-health practitioners have long discovered the positive relationship between exercise and mental health. More than a decade ago, researchers at Duke University released a groundbreaking study demonstrating that 30 minutes of brisk exercise three times a week is just as effective as drug therapy in relieving the symptoms of major depression in the short term, and also that continued exercise reduces the chances of the depression returning. While that's good news for everybody, that information is particularly good news for the African-American community, which suffers disproportionately from mental-health issues, as well as chronic and life-threatening stress. Given America's history, it should come as no surprise that African-Americans, the most stigmatized group, continue to face chronically high levels of stress, which can lead to both psychological and physiological health problems. Hundreds of years of brutality, chattel enslavement, lynchings, Jim Crow laws, miseducation, implicit and explicit racial bias and other oppressive measures used against African-Americans continue to wreak havoc on the mental and physical health of far too many. In fact, according to the Centers for Disease Control and Prevention, "Health disparities between AfricanAmericans and other racial and ethnic populations are striking and apparent

in life expectancy, death rates, infant mortality and other measures of health status and risk conditions and behaviors." Translation: African-Americans suffer at much greater rates than other Americans from all preventable diseases like heart disease, stroke, cancer, high blood pressure, diabetes, and stress and mental-health-related conditions. One unlikely, though not unsurprising, explanation for this can be found in a recent study published in the New York Times by Inna Gaisler-Salomon, a psychobiology professor at the University of Haifa in Israel, which confirms that not only does stress experienced during a person's lifetime correlate with stress-related psychological health problems, it also shows up in that "person's offspring - and even in the offspring's offspring." Though Gaisler-Salomon's work focuses primarily on Holocaust survivors, it also has indirect implicit significance for African-Americans, too. This stunning research, on the children and grandchildren of Holocaust survivors, demonstrates that they have "greaterthan-average chances of having stressrelated psychiatric illnesses, like post-traumatic stress disorder, even without being exposed to higher levels of stress in their own lives." Undoubtedly, these findings suggest that mental-health conditions and post-traumatic stress disorders are a far greater threat to health than previously known. That's why this weekend state Sen. Vincent Hughes, Temple University's Center for Bioethics, Urban Health and Policy and the Black Women's Health Alliance will present "Breaking the Silence on Mental Wellness: Real Talk.

Spring 2014 (continued from page 2) for many families. The stress of an unfamiliar place, the unpredictability of travel and the overall feelings of newness can affect both parents and their children. In fact, parents and children have very different notions of what makes a "good" or "fun" vacation. Gordon believes that while adults look at vacations as "breaks and revel in their relaxation and newness, children resist that newness and get anxious without activities. Sleeping in a different bed, seeing new television shows and/or schedules, and tasting unfamiliar food can cause stress and anxiety in children, causing them to act out. As a result, sometimes parents face disappointment, and may even think their kids are spoiled or ungrateful." To minimize problems, she suggests the following: •Bring a few "home" belongings. Your kids' favorite snacks, their blanket or a pillow from their bed, which can ease anxiety. •Don't expect perfection. Vacations should be about spending time together, not meeting impossible standards of perfection. •Do expect the unexpected. Planning and budgeting for the unexpected can alleviate stress for parents, and in turn, entire families. Be sure to plan for rainy days and budget for extra room service costs.

(continued on page 12)

Here are 5 ways to get covered, maybe avoid a fine (continued from page 4) state marketplace and explain what went wrong. It's on the honour system. If the extension is approved, that brings another 60 days to enrol. Also, at any time during the year, certain life events — such as changing jobs, getting married or divorced, or becoming a parent — open a 60-day window to sign up for marketplace coverage. 3. SIGN UP FOR MEDICAID Those who qualify can still enroll in Medicaid — there's no deadline. Eligibility is based on income and varies from state to state. About half the states expanded their Medicaid programs. The main beneficiaries of the change are adults earning up to about $16,100 per year, with no children living at home. Previously, Medicaid was limited mostly to poor children and their parents and people with disabilities. 4. BUY INSURANCE OUTSIDE THE MARKETPLACES Buyers can always go directly to an insurance company, but it may be expensive. Plans bought outside the marketplaces don't come with government subsidies that hold down the cost for people with low or mid-level incomes. But they do include the law's consumer protections. For example, insurers can't turn down customers because of pre-existing medical conditions.

Even after the deadline, buying a plan that meets the law's essential coverage standard reduces the penalty owed, which is based on the number of months without coverage. The fine for going uninsured all year is the greater of two formulas: about 1 per cent of household income above the tax-filing threshold of $10,150 or $95 per adult and $47.50 per child under 18, up to $285 per family. It's due to the IRS in April 2015. 5. GET READY FOR NEXT TIME Open enrolment for 2015 is coming later this year. It's scheduled to begin Nov. 15 and run just three months. That's another chance to get covered or switch into a plan with subsidies. Supporters of the law are calling on President Barack Obama to make things easier next time around. The advocacy group Families USA suggested a bunch of improvements Tuesday, including more face-to-face sign-ups, co-ordinatingenrolment with tax-filing season so people better understand the fines, and improving co-ordination with Medicaid programs. Something to think about: The uninsured penalty next year rises to 2 per cent of income or $325 per adult and $162.50 per child. ___ AP writer Ricardo AlonsoZaldivar contributed to this report.

A Doctor's 'People Skills' Affects Patients' Health (continued from page 7) "People clearly differ in how much information they want," he said. "Some people want greater self-management, and see it as having more control. Some people see it as a burden. Some people like being asked about their personal life, beyond their health condition. Some don't." But the bottom line, Christensen and Riess both said, is that the provider-patient relationship matters. "Patients need to understand that it's OK to look for a doctor who meets your preferences and expectations," Christensen said. Or, since finding a new doctor can be tough, Riess suggested talking to your current doctor.

"If you're unhappy, there are polite ways to speak up," she said. "Patients should feel empowered to say, 'I didn't understand that language you used. Can you explain it in laymen's terms?' You can tell (your doctor) if you feel rushed or anxious." And don't worry about offending your doctor, Christensen advised. He said most doctors do care, and say they try to "tailor" how they communicate to individual patients. But if patients don't speak up, Riess noted, a doctor might not realize there's a problem. More information The U.S. Department of Health and Human Services has advice on choosing the right doctor.

Page 12 / MARCH-APRIL 2014 / HealthyStart

Deciphering The FDA's New Nutrition Label


oon it will be much easier to tell whether a packaged food or beverage is actually healthy. The Food and Drug Administration has proposed a major overhaul of the Nutrition Facts panel for the first time since it began requiring it on food labels in 1996. If these changes are approved, the revamped Nutrition Facts will convey accurate, straightforward health information that pertains to how we actually eat and drink and which nutrients we really need–a big improvement over the confusing, out-of-date cryptogram we see today.

carton of milk or a frozen pizza, there will be dual Nutrition Facts panels, one with nutrition info per serving and the other one per container, making it even clearer what you're eating. Second, the Nutrition Facts panel must now disclose how much added sugar is in a prod-

The first major change is serving sizes will become much more realistic. In the current Nutrition Facts panels, you'll often see obscure, small serving sizes such as "one-half of a cookie" or "6 fluid ounces" for a 20ounce bottle of juice. These are misleading – and just plain dumb – because you rarely eat only half a cookie or take just a few swigs of a 20-ouncer. In reality, you consume multiple "serving sizes" in one sitting, which means you get double, or even triple, the calories, sugar, fat, and everything else. With the new Nutrition Facts, a serving size will be the entire cookie or the entire bottle, so you can glance at the panel and easily see what you'll actually consume, without having to do math. For larger items that you eat in multiple sittings or share with others, like a

uct, rather than just listing total sugar content like it does now. Separating out added sugar from naturally occurring sugar (from

Spring 2014 Health Tips •Structure your relaxation. Kids respond well to structure and predictability two things often lacking in a vacation. 9.

Read This Before Gardening

It's getting warmer; the birds are singing more; it's also gardening time. And gardening does burn calories. Spring is often the time when we plant gardens that will reap a summer of lovely flowers and healthy vegetables. In fact, getting on your hands and knees and crawling around pulling weeds can burn about 316 calories per hour. But beware gardening requires a lot of bending, stretching, lifting and moving in ways that we don't typically do. It is important to think about good body mechanics and physical conditioning before you start getting that garden in shape. Paula Kramer, Ph.D., chair and professor of occupational therapy at University of the Sciences in Philadelphia, suggests the following: •Stretch, even for a few days prior, before you begin working in the garden. •Use a fat, rubberized or padded handled trowel made from one piece of metal from top to bottom. This allows for a tight grip under damp conditions, less possibility of breakage in the tool, and less strain on the arms and joints. •Tools, such as shears or clippers, with a spring-action, self-opening feature are helpful to prevent strain on the muscles and joints, but they should be well-oiled to open and close easily. •Sit while working, or take sitting breaks to conserve energy and decrease stress on your back, knees and hips.

(continued from page 11) •When lifting potted plants or bags of mulch and dirt, bend your knees and lift straight up, keeping your back as straight as possible. Concentrate on using the leg muscles rather than the back muscles to lift, and avoid twisting and turning while lifting as this can strain your back. •Do not try to whip your entire garden into shape in one day. This mentality leads to "overdoing it" and sore Monday mornings. 10. Nasty Tick Season Begins The spring starts tick season in many communities. Unfortunately, according to experts, the only sure way to prevent tick-borne diseases like Lyme, Rocky Mountain spotted fever, ehrlichiosis and anaplasmosis is to not get bitten by a tick. Christopher Ohl, M.D., professor of infectious diseases at Wake Forest Baptist Medical Center, offers several key tips to avoid diseases related to ticks: •The longer a tick is embedded in you the greater the risk of infection, so check yourself, or have friend check you, for ticks as soon as you come in from being outdoors. •Shoes, boots and clothing can be treated with a permethrin-based repellant, widely available at sporting goods and outdoors stores, that can provide weeks of protection and last through several washings. •Tuck pants into socks to reduce exposed skin. •When hiking, stay on existing paths and avoid walking in brushy areas or tall grass – favorite haunts of ticks. •If you find a tick, use tweezers to remove it as close to

fruit and dairy ingredients) will be a huge help in determining whether a food is healthy or just sugar-packed junk. Research shows that most Americans eat way too much added sugar – in soda, candy, pastries, even white bread and barbecue sauce – which is causing widespread obesity, heart problems, and even early deaths. Next on the chopping block is "calories from fat," currently listed right after the total calories. The FDA realized that this info is confusing and not really necessary, because research now shows that the type of fat – saturated, unsaturated, trans – is far more important than the amount. In the new format, total calories will be displayed in larger type to stand out better (another nice perk), and fat tallies will fall right below it. You'll see total fat presented both in grams and in percent daily value (how much of your daily target intake this food provides). Then, under total fat, the different types of fat will be broken out, also in grams and percent daily values. The new Nutrition Facts will also emphasize

different individual nutrients than the current panel does. You'll still see iron and calcium (amount and percent daily values), but manufacturers will also be required to list vitamin D and potassium – two nutrients that are crucial to good health and severely lacking in many Americans' diets. The idea is that you'll be able to scan the panel and tell whether a food or beverage is a good source of these key nutrients. Companies will no longer be mandated to list vitamins A and C (although they can if they want), because most of us manage to get enough of these vitamins, according to the FDA. Also say goodbye to that long, confusing footnote at the bottom of the current panel, which attempts to explain percent daily values but fails. The FDA acknowledges that this section is wordy and perplexing and plans to replace it with a much-simpler, briefer statement about percent daily values. These Nutrition Facts changes aren't yet a done deal, but they likely will be soon. The FDA is taking public commentary – suggestions for improvements, criticisms, etc. – until the end of May and then moving forward with a final rule. Food and beverage manufacturers will then have two years to comply with the new panels. But as per usual with new FDA rulings, most manufacturers will jump on the changes immediately to stay ahead of the game. So you could start seeing the new Nutrition Facts as soon as this summer.

Healthy Start Spring 2014  
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