Amputations Bad–Public Health Good

If you spend a lot of your working time nagging people to keep their blood sugar under control and to take good care of their feet you will appreciate this. From the Centers for Disease Control…

CDC report finds large decline in lower-limb amputations among U.S. adults with diagnosed diabetes

The rate of leg and foot amputations among U.S. adults aged 40 and older with diagnosed diabetes declined by 65 percent between 1996 and 2008, according to a study by the Centers for Disease Control and Prevention and published today in the journal, Diabetes Care. The age–adjusted rate of nontraumatic lower–limb amputations was 3.9 per 1,000 people with diagnosed diabetes in 2008 compared to 11.2 per 1,000 in 1996. Non–traumatic lower–limb amputations refer to those caused by circulatory problems that are a common complication among people with diabetes rather than amputations caused by injuries.

The study, “Declining Rates of Hospitalization for Nontraumatic Lower–Extremity Amputation in the Diabetic Population Aged 40 years or Older: U.S., 1988–2008,” is published in the current online issue of Diabetes Care.

The study also found that among people with diagnosed diabetes in 2008, men had higher age–adjusted rates of leg and foot amputations than women (6 per 1,000 vs. 1.9), and blacks had higher rates than whites (4.9 per 1,000 vs. 2.9). Adults aged 75 years and older had the highest rate – 6.2 per 1,000 – compared to other age groups.

The study authors note that improvements in blood sugar control, foot care and diabetes management, along with declines in cardiovascular disease, are likely to have contributed to the decline in leg and foot amputations among people with diagnosed diabetes.

Awesome. This kind of progress comes from educating the public, engaging health care workers, and lots of government involvement. And everyone knows that it’s better to have legs than not. I see that up close all the time.

When I started out as an aide in a nursing home, back in the mid-80’s, bedsores were common and the general attitude was just beginning to shift from ‘nothing can be done’ to ‘we’d better do something or Medicare is going to whack us.’ It’s no longer routine or accepted that people get bedsores, and the people I see now who have them tend to be very immobile or paralyzed. It’s a terrible problem that is best prevented. But prevention required a big investment of labor and an attitude adjustment. The payoff comes later.

I gotta run to work, I have lots of people to nag. Have a nice day.

Good News Break

Strange weather. The first snowfall hit while the leaves were still green, and this second one late in January. We could get buried before Spring gets here. The Occupation continues, not much noted in the ProJo, though the Boston Globe has covered the negotiations for a homeless day center. Until the ten-year plan to get housing for everyone is complete, people need to be able to get out of the cold and off the streets.

It’s still the dark of the year, and I need to write about some dark things, but first a little good news–

India is about to mark a year without polio…

India, which was once a major polio hotspot, has reported no new cases of the disease in just over 12 months, ever since a two-year old female case on 13th January, 2011, in the state of West Bengal. According to WHO (World Health Organization), India used to be known as the planet’s “epicenter” of polio.

WHO scientists say that as soon as all remaining lab investigations come back negative, India will be officially recognized as a nation that has stopped indigenous transmission of wild poliovirus, leaving just three countries with existing indigenous transmissions – Pakistan, Nigeria and Afghanistan.

If you’re old enough to have a smallpox vaccine scar, or to have peers who got the worst of polio– paralysis and deafness– then you know what a blessing this is.

Good news in the US as well, homicide has dropped off the list of top 15 causes of death. And that’s not all…

—The infant mortality rate dropped to an all-time low of 6.14 deaths per 1,000 births in 2010. It was 6.39 the year before.

—U.S. life expectancy for a child born in 2010 was about 78 years and 8 months, up about a little more than one month from life expectancy for 2009.

—Heart disease and cancer remain the top killers, accounting for nearly half the nation’s more than 2.4 million deaths in 2010. But the death rates from them continued to decline.

Deaths rates for five other leading causes of death also dropped in 2010, including stroke, chronic lower respiratory diseases, accidents, flu/pneumonia and blood infections.

The American body politic needs a checkup and a gym membership– and we could knock these mortality figures down further. But at least we’re not killing each other off as much, and our infant mortality rate is decreasing. According to the CIA world factbook, In 2011 we were just about even with Croatia, just behind New Caledonia, Hungary and Cuba. Gotta call that progress.

That our country is making improvements in reducing mortality when our economy is such a mess is a sign of hope. Some good people in public health are doing their jobs right. Thanks, guys.

Stephanie Chafee, RN

This looks good for Rhode Island. Our new first lady, Stephanie Chafee, has been involved in public health for her whole career…

PROVIDENCE, R.I. (AP) — Stephanie Chafee was Rhode Island’s first AIDS research nurse and co-founded the state’s only clinic providing free health services to the needy. Now, the multimillionaire wife of former U.S. Sen. Lincoln Chafee is taking on a new role: Rhode Island first lady.

We don’t elect candidate’s spouses, but having a first lady with so much experience in health and public service is a good deal for our state.