- 90% of adults say the United States is experiencing a mental health crisis
- New study examines the effectiveness of colonoscopies
- US breast cancer death rate drops 43% in three decades, but racial disparities remain
- 2021 US firearm homicide and suicide rates were highest since 1990s
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90% of adults say the United States is experiencing a mental health crisis |
An overwhelming majority of adults in the United States think the country is experiencing a mental health crisis, according to a new survey from CNN in partnership with the Kaiser Family Foundation. Nine out of 10 adults surveyed said they believed that there is a mental health crisis in the US today. Asked to rate the severity of six specific mental health concerns, Americans put the opioid epidemic near the top, with more than two-thirds of people identifying it as a crisis rather than merely a problem. More than half identified mental health issues among children and teenagers as a crisis, as well as severe mental illness in adults. When it came to mental health in children, nearly half of parents surveyed (47%) say the pandemic has negatively affected their kids' mental health, with 17% saying it had a major negative impact. The survey also highlighted barriers to accessing mental health services, with more than half of Americans (55%) thinking most children and teenagers in the US aren't able to get the help they need. Americans largely agree that the costs of mental health care and differences in the way insurance companies cover mental health vs. physical health are big problems, with nearly two-thirds seeing the lack of providers who take insurance and stigma around mental health problems as significant challenges. When it came to getting help during a mental health crisis, there was a big question of where people should turn. According to the survey, about 1 in 5 Americans have called 911 because they or a loved one were having a mental or behavioral health crisis. But more than 1 in 4 people surveyed think that calling the emergency line would actually make these situations worse. Pilot programs across the country are trying to help by embedding mental health professionals in emergency services. In Durham, North Carolina, the Holistic Empathetic Assistance Response Team, or HEART, has a licensed mental health clinician who can field calls directly in the 911 call center and determine the best plan of action for the situation, including sending an unarmed response team into the field. "We as clinicians have more training in mental health and just assessing people who are struggling with that," said Jordan Hyler, a licensed mental health clinician and a member of HEART. |
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New study examines the effectiveness of colonoscopies |
Colonoscopies are a dreaded rite of passage for many middle-age adults. The promise has been that if you endure the awkwardness and invasiveness of having a camera travel the length of your large intestine once every decade after age 45, you have the best chance of catching – and perhaps preventing – colorectal cancer. It's the second most common cause of cancer death in the United States. About 15 million colonoscopies are performed in the US each year. Now, a landmark study is looking at the effectiveness of offering colonoscopies. The study marks the first time colonoscopies have been compared head-to-head to no cancer screening in a randomized trial. It found only meager benefits for the group of people invited to get the procedure: an 18% lower risk of getting colorectal cancer and no significant reduction in the risk of cancer death. But many experts say that as good as this study was, it has important limitations, and these results shouldn't deter people from getting colonoscopies. "I think it's just hard to know the value of a screening test when the majority of people in the screening didn't get it done," said Dr. William Dahut, chief scientific officer at the American Cancer Society, who was not involved in the study. Less than half of people invited to get a colonoscopy in the study – just 42% – actually got one. When the study authors restricted the results to the people who actually received colonoscopies – about 12,000 out of the more than 28,000 who were invited to do so – the procedure was found to be more effective. It reduced the risk of colorectal cancer by 31% and cut the risk of dying of that cancer by 50%. Based on the results, then, study researcher Dr. Michael Bretthauer, a gastroenterologist who leads the clinical effectiveness group at the University of Oslo in Norway, expects that screening colonoscopy probably reduces a person's chances of colorectal cancer by 18% to 31% and their risk of death from 0% to as much as 50%. But, he said, even 50% is "on the low end of what I think everybody thought it would be." Other studies have estimated larger benefits for colonoscopies, reporting that these procedures could reduce the risk of dying of colorectal cancer by as much as 68%. |
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US breast cancer death rate drops 43% in three decades, but racial disparities remain |
The breast cancer death rate in the United States has dropped significantly, but Black women continue to be more likely to die from the disease despite having a lower incidence of it, according to a new American Cancer Society report. The study finds that in total, the death rate dropped by 43% within three decades, from 1989 to 2020, translating to 460,000 fewer breast cancer deaths during that time. The researchers found that the incidence of breast cancer has risen slowly since 2004, by about 0.5% per year, driven mostly by diagnosing the disease early and more quickly at a localized stage. In contrast, breast cancer death rates have declined steadily since their peak in 1989, the researchers found, falling 1.9% annually from 2002 to 2011 and then 1.3% annually from 2011 to 2022. When the data were analyzed by race, Black women had a lower incidence rate of breast cancer versus White women, but the death rate was 40% higher in Black women overall. "Death rates are declining in Black women, just like they are in almost every other group, but we're still seeing the same gap," said Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society and senior author of the report. "The evidence is consistent that Black women receive short shrift in the health care system at every point of the breast cancer care continuum, from lower-quality mammography to delays between the time of diagnosis and the beginning of treatment to poor quality treatment when they are diagnosed," Siegel said. "The take-home message is that we really need to take a hard look at how we're treating Black women differently." |
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2021 US firearm homicide and suicide rates were highest since 1990s |
US firearm homicide and suicide rates each increased by more than 8% from 2020 to 2021, according to data published in the US Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report. CDC researchers estimated that there were over 20,000 firearm homicides and over 26,000 firearm suicides in the United States in 2021. The firearm homicide rate was 8.3% higher in 2021 than it was in 2020. There were increases among men and women, and the highest rate tended to be among 25- to 44-year-olds. All racial and ethnic populations in that age group saw increases, and non-Hispanic Black or African American people continued to have the highest firearm homicide rates for every age. Firearm suicide rates among people 10 and older also increased by 8.3% from 2020 to 2021. American Indian or Alaska Native people had the highest firearm suicide rates for people under the age of 45. For those 45 and older, White people had the highest rates. The percentage of homicides attributed to firearm injuries rose from 79% in 2020 to 81% in 2021, the highest in more than 50 years. For suicides attributable to firearm injuries, the percentage rose from 53% in 2020 to 55% in 2021, the highest since 2001. "The overall U.S. firearm homicide and firearm suicide rates in 2021 were the highest documented since 1993 and 1990, respectively," the report says. "Some racial and ethnic groups experienced substantially higher rates in 2021, and among some groups, disparities continued to widen." The researchers note that the analysis can't explain the reasons for increases, but there are "multiple" social and structural conditions that are associated with the risks. "Systemic inequities (e.g., in economic, educational, housing, and employment opportunities) and structural racism have contributed to disparities in outcomes, and the COVID-19 pandemic could have worsened these conditions, especially in some racial and ethnic communities," the report says. |
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| Give your brain a boost and supercharge your frontal cortex when petting a dog. 🐶 |
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Watching NFL games this Sunday felt a little different. Over the weekend, the league – along with the NFL Players Association – agreed to update its concussion protocol, prompted by Miami Dolphins quarterback Tua Tagovailoa's injury on September 25 and in the following game. One of the points of the NFL's concussion protocol that came into question was "gross motor instability," which was on the "no-go" list if it was deemed to be neurologically caused. However, even when I spoke with Dr. Allen Sills, the NFL's chief medical officer, after Tua's injury, he said the process to make that determination can be tricky. But at a news conference over the weekend, SIlls said the new protocols are meant to take a more conservative approach. "Let's just go ahead and assume it is coming from the brain, and we will hold someone out," he said. "Because if we are going to be wrong, we would rather hold someone out who doesn't have a brain injury but we are being cautious than to put someone out who might have a brain injury and we weren't able to diagnose it." The updated protocol now includes ataxia, a lack of coordination caused by poor muscle control, as part of the "no-go" list. "In other words, if a player is diagnosed with 'ataxia' by any club or neutral physician involved in the application of the Concussion Protocol, he will be prohibited from returning to the game, and will receive the follow-up care required by the Protocol," a joint announcement by the NFL and the NFLPA said. If this new protocol had been in place during Tua's September 25 game, he would not have been allowed to continue to play. We have already seen these new protocols in action. This past Sunday, the Dolphins' other quarterback, Teddy Bridgewater, was pulled after taking a blow to the head during his first snap. "Basically, what happened was, a spotter saw [Bridgewater] stumble, and under the new rules and changes, he is ruled out and placed in the protocol," said Mike McDaniel, the Dolphins' head coach. "He doesn't have any symptoms, and he's passed his evaluation, but he'll be now, under the new regulations, in the concussion protocol." I wish these new protocols weren't prompted by the injury of a young, talented player, but I believe they are necessary and will continue to help make a sport that I personally love safer for these admirable athletes. |
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| We're constantly assaulted by "noise" all around us: crowds, vehicles, social media. As quiet spaces around us dwindle, what is it doing to our minds and bodies? |
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