David Kirkpatrick

August 18, 2009

Study finds foreclosure leads to depression

This isn’t a topic to make light of, but a study finding people whose homes have been foreclosed on show signs of clinical depression should suprise no one.

It does point out the larger picture that the toll of this ongoing economic downturn/recession/financial crisis goes far beyond the economics.

The release:

More than 1/3 of homeowners in foreclosure suffer from major depression, Penn study shows

Findings reveal looming health crisis tied to nation’s housing woes

(PHILADELPHIA) – The nation’s home foreclosure epidemic may be taking its toll on Americans’ health as well as their wallets. Nearly half of people studied while undergoing foreclosure reported depressive symptoms, and 37 percent met screening criteria for major depression, according to new University of Pennsylvania School of Medicine research published online this week in the American Journal of Public Health. Many also reported an inability to afford prescription drugs, and skipping meals. The authors say their findings should serve as a call for policy makers to tie health interventions into their response to the nation’s ongoing housing crisis.

“The foreclosure crisis is also a health crisis,” says lead author Craig E. Pollack, MD, MHS, who conducted the research while working as an internist and Robert Wood Johnson Foundation Clinical Scholar at Penn. “We need to do more to ensure that if people lose their homes, they don’t also lose their health.”

In addition to the high number of participants reporting depression symptoms, the study of 250 Philadelphia homeowners undergoing foreclosure also shed light on other health care problems that may be spurred by difficulties keeping up with housing costs. The study participants were recruited with the Consumer Credit Counseling Service of Delaware Valley, a non-profit, U.S. Housing and Urban Development-approved mortgage counselor. The authors found that compared to a sample of residents in the general public, those in foreclosure were more likely to be uninsured (22 percent compared to 8 percent), though similar health problems were seen among both the insured and uninsured. Nearly 60 percent reported that they had skipped or delayed meals because they couldn’t afford food, and people undergoing foreclosure were also more likely to have forgone filling a prescription because of the expense during the preceding year (48 percent vs. 15 percent). The study also revealed that for 9 percent of respondents, a medical condition in their family was the primary reason for the home foreclosure, and more than a quarter of those surveyed said they had significant unpaid medical bills.

Because the financial hardships of foreclosure may lead homeowners to cut back on health care spending that they consider “discretionary” – preventive care visits, healthy foods or drugs for chronic conditions like hypertension – Pollack theorizes that the prolonged period of time that most homeowners spend in foreclosure could have a serious effect on health outcomes. In addition, the stress of undergoing foreclosure may exacerbate health-undermining behaviors. Among the participants who smoke, for instance, 65 percent said they had been smoking more since they received notice of foreclosure.

The “exceptionally high” rate of depressive symptoms found in the study is especially concerning, Pollack says, compared to previous research showing that only about 12.8 percent of people living in poverty meet criteria for major depressive disorder.

“When people purchase homes, they are buying a piece of the American Dream,” says co-author Julia Lynch, PhD, the Janice and Julian Bers Assistant Professor in the Social Sciences in Penn’s department of political science. “Losing a home can be especially devastating because it means the loss of this dream. When this happens, there is reason to worry not only about the health of the home owner but also that of family members and the broader community they live in.”

The authors say that the data collected in Philadelphia may be only the tip of the iceberg when compared to other cities that have experienced a sharp spike in housing foreclosures. Although foreclosure filings nearly doubled between 2007 and 2008 in Philadelphia, other large cities have higher unemployment and foreclosure rates.

To combat the health problems revealed in the study, Pollack and Lynch suggest that health care workers and mortgage counseling agencies coordinate their efforts to help people at risk of foreclosure access both medical and housing help. Doctors, they suggest, should ask their patients about their housing situation and steer them towards mortgage relief resources. Mortgage counselors, meanwhile, can provide information about how to access safety net health care, enroll in public insurance programs like SCHIP or Medicaid, or apply for nutritional assistance programs for pregnant and nursing mothers and their children. The implications for policy, too, are vast.

“This study raises the stakes of the housing crisis,” Pollack says. “The policy push to get people into mortgage counseling should be combined with health outreach in order to fully help people during this tremendously difficult period in their lives.”

 

###

 

PENN Medicine is a $3.6 billion enterprise dedicated to the related missions of medical education, biomedical research, and excellence in patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System.

Penn’s School of Medicine is currently ranked #3 in the nation in U.S.News & World Report’s survey of top research-oriented medical schools; and, according to the National Institutes of Health, received over $366 million in NIH grants (excluding contracts) in the 2008 fiscal year. Supporting 1,700 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System (UPHS) includes its flagship hospital, the Hospital of the University of Pennsylvania, rated one of the nation’s top ten “Honor Roll” hospitals by U.S.News & World Report; Pennsylvania Hospital, the nation’s first hospital; and Penn Presbyterian Medical Center, named one of the nation’s “100 Top Hospitals” for cardiovascular care by Thomson Reuters. In addition UPHS includes a primary-care provider network; a faculty practice plan; home care, hospice, and nursing home; three multispecialty satellite facilities; as well as the Penn Medicine at Rittenhouse campus, which offers comprehensive inpatient rehabilitation facilities and outpatient services in multiple specialties.

June 26, 2009

FDA oversight to kill big tobacco?

I seriously doubt it since big tobacco is not all that displeased about the new heavy taxation and oversight since it figures all the legislative moves will serve to kill off competition in a marketplace artificially altered by government overreach.

Don’t take a drink before reading this release because you might do a spit take and trash a perfectly fine keyboard:

Experts: Big Tobacco dead by 2047, possibly sooner

MADISON – President Barack Obama’s signature on a bill this week to grant the Food and Drug Administration (FDA) regulatory authority over tobacco was historic, and represents a step in the march to eliminate tobacco use in this country by 2047, two national tobacco experts said today (June 25).

The pair published “Stealing a March in the 21st Century: Accelerating Progress in the 100-Year War Against Tobacco Addiction in the United States” in the July issue of the American Journal of Public Health. Michael Fiore and Timothy Baker, director and associate director of the University of Wisconsin-Madison Center for Tobacco Research and Intervention (UW-CTRI), respectively, chart milestones in beating tobacco addiction and map a battle plan to eradicate tobacco use in the next few decades. The researchers analyzed data from the 1960s, when the first systemic tracking of smoking rates began, until the present.

“Numerous observers have claimed over time that tobacco use has plateaued and progress against its use has stalled,” the authors write. “However, the remarkable decline in rates of tobacco use since the 1960s belies this claim and underscores the remarkable success of tobacco control efforts to date.”

Data from the Centers for Disease Control and Prevention show adults smoking between 1965 and 2007 dropped by an average of one half of one percentage point per year, from 42 percent to the current rate of about 20 percent rate. While this rate of decline hasn’t occurred each year, the overall decrease has been quite steady.

The two researchers urge a nationwide effort designed to accelerate the rate of decline over the next 50 years through:

  • Substantial increases in federal and state tobacco excise taxes.
  • A national clean-indoor air law.
  • Elimination of nicotine from tobacco products.
  • Funds for an aggressive mass media campaign to counter the tide of tobacco industry ads and sponsorships.
  • A ban on tobacco advertising, promotion and sponsorship.
  • Evidence-based counseling and medication for every smoker who wants to quit.

Protecting young people, particularly those 17 and younger, from starting to smoke. Research shows that a major genetic risk for lifelong nicotine dependence can be suppressed if young people avoid daily smoking prior to age 17.

“The progress made in reducing tobacco use over the last 50 years should in no way temper our commitment to further reductions. Nor should that progress be interpreted to mean tobacco use is less toxic or that tobacco companies are now on the ropes. But, if appropriate steps are taken, a tobacco-free nation can be achieved within a few decades,” Fiore says.

Past success has been born of:

  • Tobacco tax increases.
  • Enactment of clean-indoor air laws.
  • Tobacco industry advertising restrictions.
  • Tobacco product-labeling requirements.
  • Policies that restrict youth access to tobacco products.
  • Mass media campaigns.
  • Increased availability and effectiveness of treatments to help current smokers quit.

In their article, Baker and Fiore called for FDA regulation of tobacco products to spur progress. That bill was signed into law on June 22, along with provisions that would further restrict tobacco industry targeting of kids, strengthen health warnings on tobacco packaging, require disclosure about what’s in tobacco products and ban terms like “light” and “mild” to describe cigarettes.

 

###

 

UW-CTRI is a nationally prominent research center established at the University of Wisconsin School of Medicine and Public Health in 1992. The center’s director, Fiore, chaired a panel on behalf of the U.S. Public Health Service to write three successive editions of treatment standards on treating tobacco use and dependence, and chaired the U.S. Department of Health and Human Services Subcommittee on Tobacco Cessation of the Interagency Committee on Smoking and Health that produced a comprehensive plan for promoting tobacco cessation in the United States. Visit http://www.ctri.wisc.edu for more information.