NEWSPREVENTATIVE MEDICINE

What do Elmo and the Republicans have in common? And what’s this got to do with health? Well, first, if you have a toddler in love with the red fuzzy creature adored by millions of preschoolers in North America, brace yourself for the tantrums if the Republicans get their way -- a group of House Republicans called the Republican Study Committee has proposed to axe the Corporation for Public Broadcasting (CPB) as part of the Spending Reduction Act of 2011. The Republicans are angling to kill Elmo and all his furry friends on Sesame Street. And if they do, we’ll lose one of the most successful television programs that has educated and entertained preschool kids since 1969.

Second, when we think health, we rarely remember that access to quality health information plays an important role in helping us build healthier lifestyles. Public broadcasting doesn’t immediately leap to mind when searching for health knowledge in the Internet age. But Google "health" and "public broadcasting" and you’ll discover the CPB supports numerous websites that feature health facts and public health messages for adults and kids alike. This in addition to public broadcasting’s funding of health forums and programs on National Public Radio and its network of affiliate stations across the country, plus health documentaries and features on PBS television.

Who has time to iron anymore? Most weeks, I barely manage to get my laundry done, let alone iron the creases out of my garments. That's why, until now, I've been a huge fan of those clothes advertised as "wrinkle-free." I didn't ask many questions about how clothing manufacturers managed to remove the wrinkle gene (jean?) from their products, only that I could manage to avoid looking like I just rolled out of bed with minimal effort.

But this month, The New York Times published an article revealing the secret ingredient in wrinkle-free clothing: formaldehyde. Yes, formaldehyde, that smelly stuff that kept your frogs preserved for dissection in high school biology class. It's now found in your clothing as a way to keep fabric fibers from moving out of place during washing.

Aside from the ick factor, the major problem with the use of formaldehyde in clothing manufacture is that many people are allergic to it and suffer from contact dermatitis -- itchy skin, rashes, and blisters -- when they wear wrinkle-free clothing. Even scarier, exposure to formaldehyde is a major cause of formaldehyde allergy, so the more you wear, the more likely you are to suffer a reaction.

The United States does not require manufacturers to disclose their use of formaldehyde, or any other chemicals, on clothing labels. So there is no way for those who have a sensitivity to formaldehyde, or those concerned about developing one, to avoid this harmful substance.

It's said that there are two professionals you should always be honest with: your doctor and your lawyer.

But what if you can't be honest with your doctor, for fear of losing your livelihood? Or forgo necessary medical treatment because you don't trust that your history will be kept in confidence? That's the reality for some members of the military, says Kenneth Katz, an Associate Adjunct Professor at the Graduate School of Public Health at San Diego State University.

In a recent article published in the New England Journal of Medicine, Katz states that the military's don't ask, don't tell (DADT) policy for gay, lesbian and bisexual service members means infections go undiagnosed and members don't get the treatment they need and deserve.

Katz describes an active-duty service member who came to his clinic for treatment of a sexually transmitted disease, even though his health care is completely covered for free by the military. So why would did he come to a clinic?  The patient tells Katz that he would not be comfortable discussing his sexual practices or sexual partners with military clinicians. Doing so, the patient tells him, would "jeopardize his military career under DADT."

Cleanliness may be next to godliness, but too much of a good thing can be hazardous to our health. And the overuse of antibacterials in everything from soaps and cutting boards may not only be leading to the development of harmful superbugs, it can also lead to an increase in disease.

A new study by researchers at the University of Michigan School of Public Health showed that young people heavily exposed to the anti-infective product triclosan have an increased incidence of developing allergies. The study contributes to the growing body of research showing that triclosan does more harm than good.

As change.org reported last week, triclosan is found in everything from soaps and face wash to toothpaste and children's toys. Items marked as "antibacterial" may contain the chemical.

A recent report by the CDC found that triclosan was present in the urine of 75 percent of the population it tested. In the Michigan study, researchers measured also urinary triclosan levels, and for those under 18, higher levels were linked to allergies and hay fever.

Most people would rather have a cold or flu than a nasty bacterial infection that's incurable. Unfortunately, this is kind of the choice we're forced to make these days, as more and more research shows our overuse of antibacterial agents -- in consumer products, it's most commonly the ingredient triclosan -- contributes to the development of new "super bugs" that are resistant to antibiotics and antibacterials.

Triclosan is found in everything from Clearasil face wash and Colgate toothpaste to Playskool children's toys. Do we really need that much sterility? It makes sense to keep everything germ-free in a hospital setting where patients have compromised immune systems, but in our daily lives, according to the CDC, antibacterial products can lead to drug resistance, lower immunity and allergies. A recent study by the CDC detected triclosan in the urine of 75 percent of the people they tested.

In April, the FDA issued a statement regarding triclosan's health effects. In it, they note that triclosan alters hormone regulation in laboratory animals and may contribute antibiotic resistant bacteria. Although they state that the chemical does not currently present a health hazard, it does merit "further review" and they are currently reviewing the scientific evidence to determine its safety in consumer products. Some countries have already banned or limited the use of the chemical.

Perhaps most perplexing is why we use the chemical in the first place. Although it's been found to be useful to prevent gingivitis, overall, the FDA statement concludes that it "does not have evidence that triclosan in antibacterial soaps and body washes provides any benefit over washing with regular soap and water."

After the 9/11 attacks, tens of thousands of first responders flooded Lower Manhattan in hopes of rescuing attack victims. The responders came from all 50 states and worked long hours on a massive pile of burning rubble, searching for victims' remains. Numerous toxins filled the air after the attacks, including pulverized concrete, burning plastics, asbestos, heavy metals and irritating gases.

These toxins affected responders and volunteers, as well as local residents, area workers and students, who were brought back to a dust-coated war zone within days of the attacks after the the federal government assured them that the "air was safe to breath." Though the responders' work is long accomplished, health effects of time spent at Ground Zero and the area surrounding it continue to linger.

Doctors initially identified a "World Trade Center Cough," a persistent cough that can require at least four consecutive weeks of medical leave, according to the World Trade Center Medical Monitoring and Treatment Program. As time passed, the cough improved for some responders and residents. For others, it blossomed into asthma, reactive airway disease, recurring bronchitis and a range of respiratory and sinus problems.  A study by the Mount Sinai Medical Center shows that about one quarter of responders had impaired lung function years after their exposures.

As the nation at large navigates the issue of how to honor the rights of homosexual couples (and, indeed, what exactly those rights are), Columbus, Ohio has been a pioneer in extending liberties to domestic partnership. Or at least, it has tried to be.

In 1998, the Columbus City Council attempted to allow municipal employees to share their health insurance benefits with same sex partners. The measure failed, but twelve years later, as reported on change.org's gay rights blog, legislation is coming before the City Council that would enact a form of domestic partnerships for gay city employees, meaning that partners would become eligible for health care benefits. The measure would provide $650,000 in benefits next year to 70 domestic partners of city employees and their 19 children.

This is an important step for LGBT rights in Ohio and in the United States, but it is also a big move toward better health care. As Councilman A. Troy Miller, who heads the Council's human resources committee, said, "To me, this is not about homosexual or heterosexual ... it's about eligible dependents." Regardless of sexual orientation, more people covered by health insurance means more people with access to preventative care, which in turns means less people who will require taxpayer money when the emergency room is their first and only source of medical attention.

Last week, Erie County in New York State, which includes the city of Buffalo, began an initiative to help 200 locally-owned restaurants in the area to list calorie counts, fat content and other nutritional information on their menus as part of a move to fight obesity, the county's biggest public health problem.

Buffalo, known for spicy chicken wings, fishfry and beef on weck, isn't exactly a poster child of eating healthfully. But through a collaboration between the county Health Department and the Western chapter of the New York State Restaurant Association, it is becoming a leader in nutrition labeling.

The program gives health officials and restaurant owners software, called "Menu-Calc," which makes providing complex nutritional information on menu items much easier. The first 200 restaurants to participate will get the software for free.

Although the health care law will require all chain restaurants to post "clear and conspicuous" calorie information once it takes effect in 2011, individual restaurants don't have to list nutrition information, even though they serve dishes loaded with fat, calories, and sodium, too. The Erie County program is the first in the nation in terms of scope and the large-scale way in which the nutrition information will be laid out. Health coordinators are already fielding calls from other municipalities seeking information on the groundbreaking idea.

Alerting consumers of calorie and fat counts can result in healthier choices.

A lung doctor that carries a pack of Camels. An infusion nurse that smells of cigarettes. A cloud of smoke outside a cancer center. These will be scenes of the past for the Massachusetts Hospital Association (MHA), a not-for-profit organization, that announced this month that it will no longer hire individuals who use tobacco products.

"MHA and its members hospitals have long been committed to initiatives that promote the health and welfare of our patients and communities. The negative impact of tobacco use on health is well documented. In Massachusetts alone, smoking is the leading cause of preventable death and disease," they said in a statement on their website.

The move could set a precedent for hospitals -- an other organizations -- nationwide. And Lynn Nicholas, the CEO of the Association, which consists of more than 100 of hospitals in the state, wanted it that way. She decided to take the ban public as a way to raise awareness about the tobacco use, the number one cause of preventable death in the United States.

The hiring ban makes sense for a hospital, whose employees are meant to care for sick and serve, at least in some capacity, as role models for healthy living. In addition, not hiring tobacco users is a savvy way to reduce healthcare costs.

Smokers are not a protected class of workers, so the ban doesn't violate federal law. Police and fire departments in the state stopped hiring smokers in 1997 as part of a change in their pension system. But while MA state law permits the ban, 29 states do have laws discriminating against hiring smokers.

According to a 2010 study by Rutgers University, communities where people walk and bike to work have far lower rates of obesity and diabetes than communities where people use cars as their preferred mode of transportation.

And that is why I love the Park Slope bike lane.

Before the New York City Department of Transportation (DOT) created the lane last summer, biking alone Prospect Park West meant taking your life in your ... spokes. Cars sped down the three-lane street with little regard for the two-wheelers in their midst. Now, however, the two-lane limits for cars keeps drivers to a reasonable speed, and bikers are protected by their own bike lane, separated with a buffer zone.

Biking to work, to run errands, or just for fun has never been easier or more enjoyable.

And that's the whole point behind creating more walkable and bikeable cities and streets -- it makes it easy for people to incorporate activity into their lives. This is a key component of prevention. As Larry Cohen, Executive Director of the Prevention Institute recently wrote in the Huffington Post, "Prevention is a 'significant cost control' because it stops people from getting sick in the first place. 75 percent of current health care costs are the result of preventable chronic diseases."

Cities are realizing that encouraging active transportation can help prevent traffic-related injuries while simultaneously cutting down on chronic diseases.