Category Archives: Politics

A good day to be in Washington!

Not much repenting going on...

Not much repenting going on…

We’re in Washington D.C. for my niece’s wedding on Saturday. When we heard the Supreme Court’s pro-gay marriage ruling this morning we headed over to the Court building from our hotel to check out the reaction. Lots of happy people, justifiably so–and a few not-so-happy hellfire and brimstone folks, too…

Between this and the ruling upholding the Affordable Care Act, it’s been a pretty Supreme week!

Anti-gay marriage or parody? Couldn't tell!

Anti-gay marriage demonstration or performance art? Couldn’t tell!

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Filed under Family, Marriage, Politics

Do we still need polio vaccine?

A thing of the past?

A thing of the past?

I picked up a copy of this week’s Time magazine at my health club today (gotta have something to read in the sauna…) and found an excellent article on global polio eradication.

Only three countries are still considered hotbeds of the disease–Afghanistan, Nigeria, and Pakistan–and money and man-and-woman-power are pouring into those countries in a determined effort to finish off polio, much as smallpox was eradicated in the 1970s.

It’s a remarkable story, and the article is worth a read. Consider this: as recently as 1988 polio killed or paralyzed 350,000 people worldwide, but thanks to an incredible combination of medical know-how, political will, and philanthropy (in particular the Gates Foundation), there were only 215 cases in 2012.

So back to my original question–one that I frequently hear from shot-weary parents–do American kids still need polio vaccine? After all, there hasn’t been an outbreak of wild polio in the U.S. (i.e., person-to-person transmission that wasn’t imported by a foreign traveler or very rare vaccine-related infections) since 1979. And polio epidemics spread via sewage-contaminated drinking water–definitely not a problem here. Yet we still routinely give children four doses of polio vaccine by the time they start kindergarten. This isn’t Afghanistan…can’t we just quit?

There are two main arguments for continuing polio vaccination until the virus is eradicated:

  • The eradication effort in those three final countries is in danger of being derailed by terrorism and war. As reported in the Time article, Pakistan is a particular problem: more than a dozen vaccine workers have been murdered by the Taliban, who believe the eradication effort is really a U.S.-backed spy network.* Since polio can spread quickly, it wouldn’t take much disruption to see the case numbers mount up. And with the ease of modern travel, we could expect infected travelers to appear at least occasionally in the U.S., as has happened in the past.
  • The idea of polio spreading through sewage-contaminated drinking water in the U.S. may seem remote, but as millions learned in the wake of Hurricane Sandy, sewage treatment facilities can fail. An infected traveler in the right place at the wrong time could open a polio Pandora’s box.

Okay, I’ll admit that the reappearance of polio epidemics in the U.S. would take a combination of long-shot coincidences. But given that we’re so close to eliminating polio (and thus polio vaccine) why take a chance? Best to hang in there vaccine-wise until we can do a polio victory dance.

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*The Taliban’s fear of vaccine-worker spies isn’t entirely unfounded. A Pakistani doctor masquerading as a hepatitis-vaccine worker helped confirm Osama Bin Laden’s location just before Bin Laden was killed.

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Filed under Infectious diseases, Politics, Vaccines

School physicians?

School signIn a policy statement just released, the American Academy of Pediatrics recommends that every American school district should have a designated “school physician” to help oversee and coordinate school health programs.

Sure, you may be thinking right about now, in a perfect world that would be great. But most schools can’t afford nurses now…who’s going to pay for doctors?

The statement isn’t so much about doctors getting paid to provide direct services to students as it is about encouraging pediatricians to volunteer as advisors, school board members, team physicians, and such. Larger districts may be able to afford a paid position, but increased involvement by pediatricians in any role can provide valuable service to school districts, and perhaps even save them some money:

School physicians not only bring value to the quality of health services but also may provide a cost savings to districts, with decreased liability from physician oversight of sound school health programs. For example, school physician–coordinated concussion management programs, established climate standards for outdoor activity, or guided anaphylaxis management protocols can potentially save lives, reduce morbidity, improve outcomes, and prevent potential costly litigation against school districts.

A school physician with intimate knowledge of a district and community could be a big help in coordinating health programs in preparation for, and in the wake of disasters, both natural (hurricanes, earthquakes, etc.)  and man-made (Newtown).

I’ve been involved with a variety of school health programs over the years, and it’s very rewarding. It’s nice to see the AAP encourage this in a more formal way.

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Filed under Politics, School

Guns, then and now

FirearmsBrowsing the 1968 World Book Encyclopedia (“F” volume) at my parents-in-law’s house a couple of days ago, I came across an entry titled “Firearms.” Included was the illustration at left, of the types of firearms in circulation then: automatic pistol, revolver, bolt-action rifle, a couple of shotguns. (Not sure how a Howitzer got included on the list, but God bless the old World Book for it’s quirkiness…)

Notice that none of these weapons (including the Howitzer) carried more than a half-dozen or so bullets or cartridges. It’s not that weapons with higher killing power didn’t exist in 1968. We were in the thick of the Vietnam War, after all, with its profusion of pistols, rifles, submachine guns, and the like. But nobody expected to see those weapons out on the street here at home.

Things hadn’t really changed all that much between 1776 and 1968, gun-wise. Whether you were firing your single-shot musket at the British or your “Saturday Night Special” in the middle of a 1960s bar fight, you very quickly ran out of ammunition and were forced to reload. Not so today, when the AR-15 used by the Newtown shooter reportedly had a 100-round magazine.

I was a sophomore in high school in 1968. Had someone opened fire in our lunch-time cafeteria, he might have hit a few of us before having to reload and probably being overpowered. In 2012 he could easily wipe out the whole place.

This madness has to stop.

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Filed under Guns, Politics, Safety, School, Violence

Has it come to this?

crying-childThe American Academy of Pediatrics now offers “Resources to Help Parents, Children and Others Cope in the Aftermath of School Shootings.” It’s important information, of course, but what a comment on American society that we need to have an easily accessible website–like we have for vaccinations and bike safety–ready for “the next time.”

This madness has got to stop.

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Filed under Politics, Safety, School, Violence

My brother was right: Handgun homicides, Seattle and Vancouver, 1988

My brother, John Henry Sloan M.D., was the lead author of a 1988 study in the New England Journal of Medicine that compared Seattle and Vancouver, British Columbia, in terms of rates of specific crimes and, in particular, homicide due to handguns. The two cities were chosen because of their closeness (140 miles), similar demographics, and dramatically different handgun regulations–Vancouver’s laws being far more restrictive.

The study found little difference between the two cities in rates of simple assault, robbery, and burglary. It did find, though, that residents of Seattle were more likely to be victims of homicide, and that the excess risk was entirely due to a 4.8-fold increase in the risk of death by handgun. There was no difference in homicide by any other method.

Their conclusion: “Restricting access to handguns may reduce the rate of homicide in a community.” Wise words that have fallen on politically deaf ears here in the U.S. ever since.

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Filed under Guns, Politics, Safety, Violence

Good news: Fewer teen births, fewer abortions

A welcome trend continues.

Encouraging news on the U.S. teen pregnancy front:

The teen birth rate continues to decrease. It’s now the lowest it’s been since the government began tracking it in 1940.

Ah, a dedicated Planned Parenthood foe might think. Must be all those abortions, right?

Well, no…

Teen abortion rates are the lowest they’ve been since 1972–the year before Roe vs. Wade made abortion legal.

Lower teen birth rates and lower abortion rates?? How is that possible? There’s a straightforward explanation, according to Leslie Kantor, vice president of education for Planned Parenthood Federation of America: more teens are using birth control, and using it properly. Here’s Kantor’s recipe for continued success:

“We can continue this progress by doing what we know works, including expanding access to high-quality sex education and making long-acting types of birth control, such as IUDs and implants, more accessible to teens.”

All of which is politically vulnerable next month, of course…

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Filed under Politics, Sex & Sexuality