Shoes, Ships, and Sealing Wax

Please do wear red tonight

Wear red to support the American Heart Association's Go Red For Women movement.

Heart disease is still the major cause of death for women in America. Actually, it's the leading cause of death overall in America, and stroke is number three. But the reason the Heart Association pulls a day out of Heart Month to highlight women and heart disease is because the assessment and treatment for women lags behind that of men.

For example:

Cardiac imaging methods such as stress single photon emission computed tomography (SPECT) and stress echocardiography work as well in women as in men to accurately diagnose coronary artery disease (CAD). Women at risk for CAD, however, are less often referred for the right tests, according to a consensus statement from the American Heart Association.

It's a similar story for percutaneous coronary interventions (like balloon angioplasty and stenting to open blocked arteries), which are done in men much more routinely than in women.

And women are less likely than men to receive recommendations from their doctors for preventive therapies such as cholesterol-lowering drugs, aspirin therapy and cardiac rehabilitation to protect them against heart attacks and death.

(Source: AHA press releases, 1 Feb 05)

But the quote from here that really struck with me was this:

In addition, women usually delay seeking treatment, so much so that women who have heart attacks will seek help 30 to 60 minutes later than their male counterparts.

So I'm supporting the Go Red campaign and doing what I can to help get the word out. Women clearly need to be proactive about heart disease. Do you know if you're at risk? Find out. Are you at risk? Mitigate it. Do you know how to recognize a heart attack or stoke? What would you do if you were having one? Read this.

Waiting is not going to do you any good.

World AIDS Day 2004...continued

World AIDS Day 2004: The "Have you heard me today?" campaign from the Joint United Nations Programme on HIV/AIDS.

The World AIDS Day page from the National AIDS Trust in the United Kingdom.

The Australian government's World AIDS Day campaign.

The U.S Health and Human Services World AIDS Day page (and events around the U.S.)

The focus this year is on women and girls. From the AIDS Epidemic Update 2004 from UNAIDS:

The AIDS epidemic is affecting women and girls in increasing numbers. Globally, just under half of all people living with HIV are female. In most regions, an increasing proportion of people living with HIV are women and girls, and that proportion is continuing to grow, particularly in Eastern Europe, Asia and Latin America.

Women and girls make up almost 57% of adults living with HIV in sub-Saharan Africa. Overall, three quarters of all women with HIV worldwide live in that region. According to recent population-based household surveys, adult women in sub-Saharan Africa are up to 1.3 times more likely to be infected with HIV than their male counterparts (UNAIDS, 2004). This unevenness is greatest among young women aged 15–24 years, who are about three times more likely to be infected than young men of the same age.

And in the U.S.:

However, heterosexual intercourse accounts for most HIV diagnoses among women, and there are strong indications that the main risk factor for many women acquiring HIV is the often-undisclosed risk behaviour of their male partners. Recent research in a low-income area of New York City, for example, has shown that women were more than twice as likely to be infected by a husband or steady boyfriend than by casual sex partners.

And more disturbing than big numbers (from this WHO press release):

Violence against women is widespread: estimates suggest that between one in three and one in five women globally have been physically and sexually assaulted by intimate partners in their lifetime. Studies from Rwanda, South Africa and the United Republic of Tanzania show up to three-fold increases in risk of HIV among women who have experienced violence compared to those who have not. Studies also suggest that for many young women, the first sexual encounter is coerced or unwanted. The risk of HIV transmission increases when sex is forced, especially for girls and young women because their vaginal tracts are immature and tear easily.

"Violence against women can not be tolerated at any level," said Dr Peter Piot, UNAIDS Executive Director. "The fear of violence prevents many women from accessing HIV information, from getting testing and seeking treatment. If we want to get ahead of the epidemic we must put women at the heart of the AIDS response."

Violence against women and girls in its different forms increases women's vulnerability to HIV infection and undermines AIDS control efforts. For millions of women, violence and the fear of violence is a daily reality and increasingly, so is AIDS. Women in every culture around the world face violence, most often at the hands of their partners and within the so-called safety of their homes and families.

In the face of all this, what can one person do?

Well, with what you have, in the time you have, in the place you are, you can...

...know your HIV status and encourage others to get tested.

...support HIV/AIDS education and service organizations.

...click on one of those links above and be aware of what's going on in the world.

World AIDS Day 2004

It doesn't seem like a year since I wrote this.

But it has been a year. Tomorrow is December 1, World AIDS Day. The numbers:

39.4 million people with HIV or AIDS
4.9 million new infections this year
3.1 million deaths

Give or take 200,000. These numbers are just too huge for me to comprehend, and fighting a public health battle with numbers this big just seems so...I don't want to say hopeless. But it certainly isn't hopeful.

I just saw an article yesterday about Jim Wooten's new book We Are All The Same. The article opens with the problem of the staggering statistics and closes with this quote:

In contemplative moments, Wooten often recalls a mantra of the wise-beyond-his-years Nkosi Johnson: "Do all you can with what you have in the time you have in the place you are."

More tomorrow.

At it again

It's been awhile since I jumped on the public health soapbox, so here you go:

September is Cholesterol Education Month.

Yeah, yeah. Is there anyone left on the planet who doesn't know the risks of high cholesterol levels, who doesn't understand the links between diet & exercise and cardiovascular health?

I wonder if health educators get burned out. I wonder how often nutritionists feel like tossing their leaflets out a window and saying "Screw it, go have a Big Mac. Have two. You obviously don't care, why should I?"

I'm going to keep at it anyway...I had a pretty unhealthy lifestyle for years even though I knew the damage I could be doing, but something made me clean up my act. Who knows, maybe some random Google searcher will decide that today is his day, and may find these links helpful:

National Cholesterol Education Program's Risk Calculator

Live Healthier, Live Longer

It still kills more women than breast cancer: the Heart Truth for women

Keep the Beat recipes from the National Heart, Lung, and Blood Institute

The Cholesterol Low Down from the American Heart Association

Good fats, bad fats explained by the Harvard School of Public Health

My favorite good fat: avocados...not just for guacamole. (From the California Avocado Commission)

Today is June 27

...and that makes today National HIV Testing Day.

Not Friday, when I first mentioned it. (I dated everything on Friday June 27. Stuff at work, checks, everything. Thanks, Zenchick, for pointing this out..)

The fact remains: anyone with any potential to be infected with HIV should be tested.

Look at this:

The NAMES Project AIDS Memorial Quilt is in town this weekend...well, 1,000 panels of the quilt. There are over 44,000 panels now, panels to memorialize someone who died of AIDS.

In 1988, the year I started working in public health, I became friends with a guy named Paul. He was young and gay but still mostly in the closet, since he'd been estranged from the family he'd told. Paul was the one who introduced me to the Quilt that year, when all 8,288 panels were displayed on the Ellipse.

We have come so far since 1988...but only just so far. With all we have learned, people are still being infected, people are still unaware of their infections and not being treated, and there is still only treatment, no cure. We still have a long way to go in the fight against HIV/AIDS. And the Quilt keeps getting bigger.

Get tested.

Today is National HIV Testing Day.

From the CDC:

CDC estimates that between 850,000 and 950,000 Americans are now living with HIV. This is the greatest number since the epidemic began more than two decades ago. It is estimated that one fourth of the people living with HIV, approximately 180,000 to 280,000 people, remain unaware of their infections. An estimated 40,000 new HIV infections continue to occur in the US each year.

If you have any reason to think it may even be slightly possible that you are infected, you have no excuse. Get tested.

Vitaball

Somebody at work pointed these Vitaballs out to me today. (I think he wanted to see my head explode.)

Vitaballs are candy-coated gumballs with vitamins. They are clearly marketed for children:

Vitaball delivers 100% RDA of 11 essential vitamins but in four flavors selected by kids, and sweetened with a blend of high quality sweeteners for kid-preferred, long-lasting great taste. And, to top it all off, Vitaball is a bubble gum gumball that's fun for kids of all ages.

My head did not explode, but I do have some, shall I say, issues with using this particular dosage form. I'm concerned that blurring the line between "medicine" and "candy" will confuse kids and lead to poisonings and overdoses. The manufacturer addresses the OD question:

The recommended use of Vitaball is one gumball per day, chewed for 5-10 minutes. We strongly advise adults to supervise children's daily intake to prevent over-consumption.

In the event more than one vitamin gumball is consumed, the question of potential toxicity may logically be raised. Vitaball contains both water soluble and fat soluble vitamins. Water soluble vitamins (vitamin C, and the B-vitamins, including thiamin, riboflavin, niacin, B-6, folic acid, B-12, biotin, and pantothenic acid) present no real issues of toxicity. Water-soluble vitamins are not stored in the body in any significant quantity or for any length of time. The body regulates its use of these vitamins and excretes any unneeded amounts though urination and perspiration.

Great, the water-soluble vitamins don't pose a risk, but how about the others? You can overdose on vitamins, and plenty of adults don't understand the dose-response curve. I see a kid getting his yummy gumball. I see him asking for more yummy gumballs and Mommy saying no. I see Mommy maybe, if Mommy actually understands it herself, saying that a certain amount of vitamins are good for you but too many vitamins will make you sick. And then I see the kid climbing up the on the kitchen counter as soon as Mom's back is turned and stuffing his mouth full of as many gumballs as he can hold.

I could go on...I should go on, to make all my points...but I need to go make dinner. So on the subject of food, I'll point out this very useful chart that's also on Vitaball's web page. It's got the vitamins, what they do, and where to find them...vitamin A, for example, is in green and yellow fruits and vegetables. Vitamin E is in cold-pressed vegetables, nuts, seeds, legumes and eggs.

I read the whole chart...it didn't mention candy-coated bubblegum in there at all.

HIV Vaccine Awareness Day

Check it out.