January 8, 2013
A decline in smoking in America has contributed to the decrease in cancer rates across the country, finds a new American Cancer Society report. From Al Jazeera:
The report, an annual forecast of the number of new incidences of cancer and how many people are expected to die of it in the coming year, said that of particular note was figures that suggest black men saw the most dramatic declines in cancer death rates in the last 20 years, with a 55 percent decrease among those between the ages of 40 and 49, and significant drops in every other age group.
Black men have historically fared the worst among all demographic groups in terms of cancer deaths – they die of cancer about twice as often as Asian-Americans, for example. But because many black people picked up the habit of smoking cigarettes and other tobacco products at much lower rates than white people did starting in the late 1970s, they have a much lower prevalence of lung cancer today, according to Rebecca Siegel, an epidemiologist at the American Cancer Society and co-author of the report.
Even so, black Americans still have higher cancer death rates than white Americans do, and that’s likely because of socioeconomic differences, the report suggests.
“Cancer death rates are associated with access to care,” Siegel said. “Individuals who have lower socioeconomic status have much higher death rates than more affluent individuals,” who are more likely to have health insurance, engage in exercise and more easily access healthy foods like fruits and vegetables, all of which decrease cancer risks.
In particular, people who don’t have health insurance or who are on Medicaid are more likely to be diagnosed with advanced cancer, which is much harder to treat than cancer that is detected early. Census data has shown that 20 percent of black Americans are uninsured, as compared to 11 percent of whites.
Vanessa Sheppard, an oncology professor and assistant director for health disparities research at the Georgetown Lombardi Comprehensive Cancer Center, said race-based differences in cancer death rates are caused by a complex mix of behavior, biology and access to health care. “Race is a marker of the experience that one brings,” she said.
For example, black women are less likely to survive breast cancer than white women, a problem that was brought about by a lack of access to health care following advancements in detection. “There was a time in the U.S. where we really didn’t have some of the racial disparities that we see now,” she told Al Jazeera. Before there were screening techniques like mammography, black and white women died of breast cancer at similar rates, she said.
Sheppard said black Americans have also experienced higher cancer death rates because of an increased likelihood of hypertension, heart disease, diabetes and other obesity-related diseases. “We need attention to diet and exercise,” she said. “It is something that’s low cost. You don’t have to get a prescription for it. We need intervention at the policy level and also at the individual level to empower people to make healthy choices for their diets.”
Global Health and Development Beat
CAR - More than 2 million people in the Central African Republic are in need of assistance, accounting for roughly half of the nation’s total population.
HIV/AIDS - The majority of HIV positive mothers in Swaziland do not receive ARV treatments while breastfeeding, putting their children at risk of contracting HIV.
Family Planning - Despite donor funding to advance Myanmar’s healthcare system, experts say more work is needed in life-saving family planning services, which have yet to receive the support they need.
Measles - As the Philippines tries to understand the current measles outbreak, one theory is the displacement of people by Typhoon Haiyan contributed to the spread of the disease.
Nodding Disease - A reported drug shortage in Pader, Uganda for children suffering from Nodding disease.
WFP - WFP and the UNHCR launched an effort to scale up emergency food distribution to thousands of displaced people in the Central African Republic.
UN - Refugees from the Central African Republic have released two UN workers in Cameroon – taken hostage to protest a lack of needed aid.
Save the Children - Joined UNICEF, USAID and other organizations to encourage global leaders to be the champions for the children of Syria and outlined a $1 billion strategy.
USAID - Unveiled its new program to address obstetric fistula, Fistula Care Plus a five-year cooperative agreement with a ceiling of $74.49 million.
Spotlight on PSI
PSI’s own Dr Angus Spiers describes the importance of handwashing for child health. He blogs in Business Fights Poverty:
Working with Unilever Foundation, Lifebuoy (the world’s number one germ protection soap) and the Government of Kenya, PSI implemented behavior change programs in schools and communities promoting handwashing with soap. The ‘School of Five’ program uses Lifebuoy soap products and specially-developed communication materials, enabling teachers and local health workers to help change behavior through fun handwashing programs and activities. Children learn that handwashing is important by making the process fun. Comics, games, handwashing diaries, reward stickers and posters encourage handwashing practice and provide kids with exciting talking points to share at home, at play, and in their communities.
It’s a method that PSI uses across the world – whether you call it ‘edutainment’ or ’social marketing’- it’s using lessons from the traditional marketing of products like a can of soda or a new movie to build interest for new products and services that promote healthy living.
Marketing tactics are used to inform people about the availability of a product, about adopting a new behavior and the difference that a service can make in their lives. Just as with a new bag or a new phone, appealing packaging and catchy messaging builds desire so that health consumers want to consume more.
Instead of just ‘wash your hands because I told you to’, the campaign helps makes handwashing a fun and desirable activity.
We use these techniques because we believe that markets, and the people who live within these markets, are a powerful force in the effort to end poverty. And that children are ideal agents of change (fellow parents, bear in mind the strength of ‘pester power’). Unlike a new bag of sweets, marketing healthy behavior within schools can translate to new knowledge and skills in the household and community-wide. That’s when we start to see real change.
To ensure our work in Kenya is sustainable, the program is part of the national-level school health policy – so there’s strong local ownership. Working within the education system to identify shared interests, exchange expertise, and promote handwashing with soap is critical for success.
Fewer cases of diarrhea and disease due to handwashing means more children reach their fifth birthday – a critical age when kids immune systems become strong. When kids are healthy, they get an education and become productive adults, grow their local economies and ensure those markets remain strong for the future.
Buzzing in the Blogs
Center for Global Development head Nancy Birdsall shares here ten wishes for 2014. Here are a few highlights:
1. Bloomberg, Bono, and Bill Gates team up on tobacco control
Three proven champions of global health and development collaborate on a global anti-smoking initiative. Why does this top the list? Because it’s really big and not hard to fix. Smoking is the leading cause of preventable death in the world, and if current trends continue it will kill one billion people this century, 10 times more than the 100 million it killed last century. Higher tobacco taxes are a proven deterrent to smoking.
While I’m at it, I’m wishing that Jim Kim, the first physician to serve as World Bank president, takes up the cause and forges an agreement among all multilateral development banks that by the end of 2014, fiscal experts advising member countries on revenue mobilization will offer support and encouragement to raise taxes on tobacco, consistent with the WHO Framework Convention on Tobacco Control. The US, unable to lead, at least stays out of the way. (HT: Bill Savedoff, Amanda Glassman; see here for a COD Aid approach)
8. The WHO and the FAO work together to slow resistance to antibiotics
Leaders in the World Health Organization and the Food and Agricultural Organization work with member countries to set global rules for managing use of antibiotics, starting with strengthening and implementing standards for monitoring and reporting antibiotic use in livestock (of the World Organization for Animal Health) in the major livestock producing countries, so that links to antibiotic resistance can be assessed (HT Kim Elliott). (See here on the FAO and global public goods and here on the looming problem of drug resistance and the collaborative efforts needed to overcome it.)
9. International institutions become more legitimate and representative—starting with women
As Garth Luke pointed out in a comment on my call for ideas, “we have been talking about greater gender balance at the UN and in national governments for many years but progress has been too slow.” I also like Garth’s solution: the G-20 members agree that all delegate positions above a certain level will alternate between male and female incumbents. This is not just about gender equity for equity’s sake! There is solid evidence that diversity of any sort encourages smarter decision-making, and that the inclusion of women in particular improves the functioning of deliberative bodies.
While we are at it, let this be the year when the Europeans and the United States announce they will not insist that the next head of the IMF be a European and the next head of the World Bank be an American.
9:00 AM - Stories to Watch 2014 - World Resources Institute
12:00 PM - Beneficiary Feedback—Key to Accountability in International Development
10:00 AM - Humanitarian Crises in 2013: Assessing the Global Response - Brookings
2:00 PM - Subcommittee Hearing: Will there be an African Economic Community? - Congress
By Mark Leon Goldberg and Tom Murphy
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