US maternal mortality worse than many other developing nations, shows new study

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US maternal mortality worse than many other developing nations, shows new study

In 2022 there were approximately 22 maternal deaths for every 100,000 live births in the United States

For decades the United States has set global benchmarks, much to the chagrin of many other nations. However a new study has revealed that maternal mortality numbers in that country are far worse than figures for comparable developed nations such as Australia, Switzerland and Korea. 

This, despite the fact that US spends more on healthcare than many developed nations. “In 2022 there were approximately 22 maternal deaths for every 100,000 live births in the United States — far above rates for other high-income countries. U.S. maternal mortality is lowest for Asian American women and highest for Black women. Maternal death rates increased in Australia, Japan, the Netherlands, and the U.S. during the height of the pandemic, between 2020 and 2021. In Chile, Norway, and the U.S., where 2022 data are available, maternal death rates have begun to decline,” revealed a report from the Commonwealth Fund that looked at maternal mortality among 14 rich nations. 

Nearly two of three maternal deaths in the U.S. occur during the postpartum period, up to 42 days following birth. Compared to women in the other countries we studied, U.S. women are the least likely to have supports such as home visits and guaranteed paid leave during this critical time. The analysis also pointed out that the US and Canada have the lowest supply of midwives and obstetricians and gynaecologists. In the U.S., Canada, and Korea, ob-gyns outnumber midwives.

The report also found racial disparities in maternal mortality trends. “For Black women, maternal mortality is exceptionally high. Prior research has found Black people receive worse-quality care than white people on 52 percent of measures, including measures of care process, such as the ability to receive needed care; care outcomes, such as death; and patients’ perceptions of care,” the report pointed out. 

 

Vigorous physical activity can lower cognitive decline risk in people living with hypertension

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Vigorous physical activity can lower cognitive decline risk in people living with hypertension

The research categorised activities that result in sweat, increased heart and breathing rates as vigorous

It is well known that people living with hypertension for a long time are vulnerable to cognitive decline. A new study has shown that vigorous physical activity (VPA) more than once a week can slow down that process. 

The findings by researchers from Wake Forest University School of Medicine have been published online in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. “We know that physical exercise offers many benefits, including lowering blood pressure, improving heart health and potentially delaying cognitive decline,” said Richard Kazibwe, M.D., assistant professor of internal medicine at Wake Forest University School of Medicine and lead author of the study. “However, the amount and the intensity of exercise needed to preserve cognition is unknown.”

The study used data from the  landmark Systolic Blood Pressure Intervention Trial (SPRINT) for the analysis. 

SPRINT was a randomized, controlled, open-label trial that included 9361 nondiabetic U.S. adults at least 50 years of age, at high CVD risk, with hypertension and systolic blood pressure (SBP) between 130 and 180 mmHg at enrollment. It began in the fall of 2009 and included more than 9,300 participants with hypertension ages 50 and older, recruited from about 100 medical centers and clinical practices throughout the United States. 

“Our findings show that individuals who reported engaging in VPA at a frequency of one or more sessions per week had a lower risk of MCI and probable dementia when compared to those who reported engaging in less than one session of VPA per week. Importantly, this association remained significant regardless of the intensity of SBP treatment. The results were also consistent across all the subgroups we included, with some heterogeneity by age and race for both MCI and probable dementia,” the researchers reported.

 

LQBTQ population has a higher risk of cancer, lifestyle to blame, claims US study

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LQBTQ population has a higher risk of cancer, lifestyle to blame, claims US study

The researchers mapped cancer risk with habits such as smoking, drinking and sedentary lifestyle

A new study has found that higher prevalence of lifestyle risk factors such as alcohol consumption and smoking make the LGBTQ population more prone to cancer. 

“People within the LGBTQ+ population have a higher prevalence of smoking, obesity, and alcohol consumption compared to heterosexual and cisgender people, suggesting a higher cancer burden. Health systems have an opportunity to help inform these disparities through the routine collection of information on sexual orientation and gender identity to facilitate cancer surveillance and to mitigate them through education to increase awareness of LGBTQ+ health needs,” researchers reported in the journal of the American Cancer Society. 

The researchers also reported that 16% lesbian, gay, and bisexual adults smoke compared to 12% among heterosexuals. The largest disparity is among bisexual women with 34% bisexual women aged 40–49 years and 24% of those 50 and older smoke compared to 12% and 11%, respectively, of heterosexual women. “Smoking is also elevated among youth who identify as lesbian, gay, or bisexual (4%) or transgender (5%) compared to heterosexual or cisgender (1%). Excess body weight is elevated among lesbian and bisexual women (68% vs. 61% among heterosexual women), largely due to higher obesity prevalence among bisexual women (43% vs. 38% among lesbian women and 33% among heterosexual women),” the researchers reported. 

Bisexual women also have a higher prevalence of no leisure-time physical activity (35% vs. 28% among heterosexual women), as do transgender individuals (30%–31% vs. 21%–25% among cisgender individuals), the paper recorded Heavier alcohol intake among lesbian, gay, and bisexual individuals is confined to bisexual women, with 14% consuming more than 7 drinks/week versus 6% of heterosexual women. In contrast, prevalence of cancer screening and risk reducing vaccinations in LGBTQ+ individuals is similar to or higher than their heterosexual/cisgender counterparts except for lower cervical and colorectal cancer screening among transgender men.

The researchers used US federal data from 2020-2022 for the analysis of the lifestyles of various groups of people.

 

World Environment Day: WHO southeast Asia region records most climate change deaths

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World Environment Day: WHO southeast Asia region records most climate change deaths

The theme this year is “Our land. Our future. We are #GenerationRestoration” with focus on land restoration, halting desertification and building drought resilience

With the WHO southeast Asia region witnessing the most climate change deaths, the WHO SEARO has called for recognising the crucial role of the health sector in in environmental conservation and climate action.

World Environment Day is celebrated annually on June 5th, after it was established at the Stockholm Conference on the Human Environment in 1972. Led by the United Nations Environment Programme, it is the largest global platform for public outreach to raise awareness and taking action on urgent environmental issues – the planet’s most-pressing environmental problems.

This year, World Environment Day (WED) 2024 focuses on land restoration, halting desertification and building drought resilience under the slogan “Our land. Our future. We are #GenerationRestoration.”

In a statement WHO SEARO regional director Dr Saima Wazed said: “Environmental degradation directly impacts human health. Air pollution, water contamination, and climate change contribute to a range of public health problems. WED is not just for those working in the environment sectors – it is a call to action for everyone, including all of us working in public health.The worrying reality is that our Region records the highest number of deaths from climate change annually amongst all WHO regions. Climate change and biodiversity loss already pose major threats to health, the regional economy and livelihoods across our Region.”

The region, she added has prioritized mitigating the impacts of air pollution and hazardous chemicals, building healthcare facilities resilience to climate change, and strengthening the focus on clean and adequate water for drinking, basic sanitation, and hygiene.

 The ‘SEA Regional Plan of Action for the WHO Global Strategy on Health, Environment and Climate Change 2020–2030: Healthy Environments for Healthier Population’ clearly outlines various action points of environmental determinants of health for implementation at regional and country level.

 

 

Pandemic emergency definition among agreed changes in International Health Regulations 

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Pandemic emergency definition among agreed changes in International Health Regulations 

The World Health Assembly saw agreement on several amendments moved by member states based on their COVID19 experience

 

A pandemic emergency definition, a national authorities for the implementation of the International Health Regulations and a commitment to solidariry and enquiry were among amendments to the International Health Regulations that the member states agreed on at the World Health Assembly in Geneva.

These decisions represent two important steps by countries, taken in tandem with one another on the final day of the Seventy-seventh World Health Assembly, to build on lessons learned from several global health emergencies, including the COVID-19 pandemic. The package of amendments to the Regulations will strengthen global preparedness, surveillance and responses to public health emergencies, including pandemics.

It was widely regarded as a momentous achievement. Apurva Chandra, Secretary, Ministry of Health and Family Welfare, government of India, expressed his excitement by stating that “with the revision of the International Health Regulations, an incredible milestone has been reached.” He also said that “this is a further step towards equity and the creation of an umbrella of solidarity that will help protect the world from future pandemic threats. This is a gift to our children and grandchildren.”

The pandemic emergency definition is crucial as one of the triggers for a more effective international collaboration in response to events that are at risk of becoming, or have become, a pandemic. The pandemic emergency definition represents a higher level of alarm that builds on the existing mechanisms of the IHR, including the determination of  public health emergency of international concern. 

Dr Tedros Adhanom Ghebreyesus, WHO Director-General said: “The amendments to the International Health Regulations will bolster countries’ ability to detect and respond to future outbreaks and pandemics by strengthening their own national capacities, and coordination between fellow States, on disease surveillance, information sharing and response. This is built on commitment to equity, an understanding that health threats do not recognize national borders, and that preparedness is a collective endeavor.”

Statins save lives; yet women miss out on statins far more than men do

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Statins save lives; yet women miss out on statins far more than men do

New research recently presented at an international conference show how women are prescribed cholesterol lowering drugs less often than men

Medical science has known for some time now that statins – cholesterol lowering drugs – can be lifesaving. Yet, shockingly, research presented recently at the scientific congress of the European Society of Cardiology (ESC) showed that women are less often treated with statins than men are.

Medical guidelines lay down that statins should be prescribed to all patients who have a history of coronary artery disease and that guidance is gender neutral. Previous studies have shown that while the target “healthy” cholesterol levels for men and women are the same, women are less likely to meet them. The retrospective observational study included 1,037 men and 415 women with a chronic coronary syndrome diagnosed between 2012 and 2020. None of them had ever had a heart attack. 

The median age for men was 68 years and that for women was 70 years. Data on cholesterol levels were obtained from their electronic medical records while the Swedish National Prescribed Drug Registry information was used to chart what medications they were on. Participants were followed up for three years following their diagnosis. The researchers found that at the end of the third year of follow-up, just 54% of women were treated with cholesterol-lowering drugs compared with 74% of men. Additionally, 5% of women were treated with statin plus ezetimibe compared with 8% of men. Factors which may explain the observed sex differences are under further investigation by the research group.

Study author Dr. Nina Johnston of Uppsala University, Sweden said: “Our findings should be a wake-up call about the undertreatment of women with heart disease. Equal prescribing practices are needed so that women receive all recommended therapies and are protected from adverse outcomes.”

Mediterranean diet reduces mortality risk in women, shows new study

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Mediterranean diet reduces mortality risk in women, shows new study

The diet is largely plant based with moderate amounts of chicken and poultry and low amounts of red meat

A new study has found that women who adopt the Mediterranean diet experience a drastic reduction in cardiometabolic risk factors and this shows in a significant drop in their all cause mortality over a period of time.

The study looked at 25 315 participants, with a baseline age of 54.6 years, with 329 (1.3%) Asian women, 406 (1.6%) Black women, 240 (0.9%) Hispanic women, 24 036 (94.9%) White women, and 95 (0.4%) women with other race and ethnicity. It found that there is a 25% reduction overall in all cause mortality. The study was published in Jama Network Open.

The findings are in line with multiple earlier studies that looked at the benefits of switching to a Mediterranean diet. “Our findings of lower risk of all-cause mortality among women with higher adherence to the Mediterranean diet are consistent with the data from prior studies in US populations, which reported that higher Mediterranean diet consumption was associated with 16% reductions in all-cause and CVD mortality, and other cohorts based in the US and non-US populations have reported beneficial effects of the Mediterranean diet. Another meta-analysis of 21 cohort studies, which included 883 878 participants, reported that higher Mediterranean diet adherence was associated with 21% reduced risk of CVD mortality,” the researchers wrote.

Mediterranean diet is rich in green leafy vegetables, nuts, legumes, good fat. Processed foods and alcohol consumption are discouraged. It has been shown to have an effect on body weight while also calming cardiometabolic risk factors such as cholesterol, blood pressure and blood sugar.

In the present study the researchers assigned points for various levels of adherence. “This Mediterranean diet score is commonly used for assessing adherence to the Mediterranean diet and is based on regular intake of 9 dietary components. Higher-than-median intake of vegetables (excluding potatoes), fruits, nuts, whole grains, legumes, and fish and the ratio of monounsaturated-to-saturated fatty acids was given 1 point, while the less-than-median intake of red and processed meat was given 1 point. In addition, participants were given 1 point if their intake of alcohol fell within the range of 5 to 15 g/d (otherwise 0 points were assigned),” they reported.

Mean age of menarche in Indian girls is 13.5 yrs, happens at a younger age in the North East

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Mean age of menarche in Indian girls is 13.5 yrs, happens at a younger age in the North East

In North, Central and South India, a majority of women had attained menarche at the age of 14 years

 

A first of its kind study that looked at the age at which Indian girls have their first menstrual period – menarche – has found that the mean age at which Indian girls attain sexual maturity is 13.5 years.

However there are significant regional variations in the age at which most girls attain maturity. The study also found that the age of menarche has been declining over the six decades of which they had analysed data. 

“In regions like the North (35.1%), Central (36.9%) and South (31.1%), a majority of women had attained menarche at the age of 14 years. On the other hand, in the Eastern (44.4%) and Western (36.4%) parts of the country, the maximum number of women reported experiencing menarche at the age of 13 years. However, in the Northeastern region, nearly 36.1% of women reached menarche at an early age of 12 years,” the researchers wrote in Nature Scientific Reports. An earlier study had reported that the lowest mean age at menarche in the Northeastern states of Assam, Arunachal Pradesh and Sikkim.

The researchers also looked at socioeconomic indicators as these have a bearing on the availability of nutrition and hence the development of the human body from adolescence to adulthood.

“Interestingly, compared to their counterparts, women from economically sound families had a much lower mean age at menarche. Several studies have demonstrated that socioeconomic factors have an impact on the menarcheal onset, with girls growing up in more deprived situations experiencing later menarche as they are unable to get the nutrients they need for proper growth and development in order to attain menarche. Moreover, in the current study, a relatively later age at menarche was reported among women residing in rural areas as compared to urban dwellers.” they wrote. 

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NIMHANS Bangalore receives WHO Nelson Mandela award for health promotion

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NIMHANS Bangalore receives WHO Nelson Mandela award for health promotion

The institute was recognised not just for its work with patients but also for its work with the government on healthcare policy and legislations

 

The National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore was awarded the Nelson mandela award for health promotion during a special ceremony at the Seventy-seventh World Health Assembly in Geneva on Friday.

The institute won the award not just for patient care but also the lead it has taken in supporting the government of various mental healthcare related policies and legislations. The WHO statement announcing the award says that the institute has been “….carrying out training and research as well as involving the communities it serves. It collaborates with central and state governments in framing, informing and implementing national policies and strategies such as the National Mental Health Policy (2014), the Mental Healthcare Act, 2017, and the National Suicide Prevention Strategy (2022). NIMHANS involves young people as change agents within district youth-empowerment centres in order to bridge the gap between young people, their families and an ever-changing society (reaching about 6 million young people). In addition, it is engaged in a national initiative for child protection, mental health and psychosocial care (reaching more than 3 million people).”

It goes on to talk about the other programmes that NIMHANS currently runs, including one on urban mental health and integrating mental health issues arising out of climate change into primary mental health care delivery, as well as training and accrediting community volunteers to deliver mental health first aid.

“We are immensely proud to receive the prestigious Nelson Mandela Award for Health Promotion at this juncture of our institutional journey. This award is not only a recognition of our past and present achievements but also a validation to the enduring legacy and vision that has guided NIMHANS since its inception. It reinforces our resolve to continue our mission of promoting mental health and well-being – making a tangible difference in the lives of those we serve,” said Dr. Pratima Murthy, Director, NIMHANS. 

This accolade arrives at a particularly momentous time for NIMHANS, as the Institute celebrates 50 years of its formation and the 70th anniversary of its precursor, the All India Institute of Mental Health (AIIMH). As NIMHANS marks the dual milestone, the award holds special significance, highlighting the Institute’s rich legacy and continuous evolution in the field of mental health and neurosciences.

Roman Baths could hold key to new antibiotics, shows research coming out of the UK

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Roman Baths could hold key to new antibiotics, shows research coming out of the UK

The Roman Baths from which Bath derives its name are the only hot springs in the United Kingdom

 

As the world battles antimicrobial resistance, research coming out of the University of Plymouth suggests that one of the greatest tourist attractions in the UK – the Roman Baths in the city that derives its name from those structures – could hold potential for developing new antibiotics.The research was carried out by students and academics from the University of Plymouth’s School of Biomedical Sciences and School of Biological and Marine Sciences, working closely with staff at the Roman Baths.

In a paper published in the Journal The Microbe the researchers reported that of the 297 isolates that were purified from various locations within the 2000 year old complex,  15 showed broad spectrum activity against human pathogens. Dr Lee Hutt, Lecturer in Biomedical Sciences at the University of Plymouth and a senior author of the study, said: “This is a really important, and very exciting, piece of research. Antimicrobial resistance is recognised as one of the most significant threats to global health, and the hunt for novel antimicrobial natural products is gathering pace. This study has for the first time demonstrated some of the microorganisms present within the Roman Baths, revealing it as a potential source of novel antimicrobial discovery. There is no small irony in the fact the waters of the Roman Baths have long been regarded for their medicinal properties and now, thanks to advances in modern science, we might be on the verge of discovering the Romans and others since were right.”

An estimated 1.27 million deaths occurred in 2019 due to drug-resistant infections. The number is set to go up as a variety of factors including antibiotic overuse makes more and more pathogens resistant to commonly used antibiotics and the medical fraternity moves on to higher levels of antibiotics. Hot springs around the world are known to harbour substances with antimicrobial potential which is perhaps where their reputation as healing locations, comes from.

Hot springs located in Bath, England, were harnessed by ancient Romans to create the Temple Sulis-Minerva, which still stands today. These waters were famed for their medicinal properties and were sites for socialisation and leisure

 

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