Megan Thielking | Vox

What it would take to rid the world of smoking forever

2019-03-04T15:16:19-05:00

(Jonathan Irish/National Geographic Creative/Corbis)

The massive decline in smoking rates — from 42 percent in 1965 to 19 percent in 2012 — is America’s biggest public health success of the past century.

Tobacco restrictions are estimated to have saved 8 million lives in the 50 years since the first surgeon general’s report on smoking and health in 1964.

This is good — but not good enough, public health experts have begun to argue. The Centers for Disease Control and Prevention set a target of 2020 of getting the country’s smoking rate below 12 percent. An editorial from researchers and public health officials in The Lancet this week called for “a world where over the next 25 years the sales of tobacco are phased out (although not prohibited), and in which fewer than 5 percent of adults use tobacco.”

To achieve that goal, experts think we need to become more dedicated to policy implementation while also tackling the tobacco industry itself.

Smoking rates have both plummeted and spiked worldwide

The prevalence of smoking has fallen considerably in the US and other countries, so industry efforts are moving to where business is booming. (The Lancet)

The proportion of the total global population that smokes decreased 42 percent for women and 25 percent for men between 1980 and 2012. Four countries—Canada, Iceland, Mexico, and Norway—have reduced smoking by more than half in both genders since 1980.

Since 2005, tobacco use has been curbed by the Framework Convention on Tobacco Control, an international treaty that sets guidelines for tobacco sales and consumption. The treaty requires that countries adopt measures such as banning marketing, using detail warning on cigarette packaging, and protecting people from secondhand smoke in public places.

The World Health Organization treaty has been ratified by 180 countries. The US signed it but never ratified it, meaning we’ve acknowledged the importance of it but aren’t technically bound by any of its provisions.

Countries that have ratified the FCTC are legally bound by these provisions, technically speaking. But implementation of the FCTC has been scattered and slow. Despite the change in prevalence, the number of smokers has grown significantly with population growth. In 1980, 720 million people smoked; in 2012, that number was almost 1 billion.

Smoking in the US is at a 50-year low

The CDC has an ambitious goal of getting smoking down to 12 percent in the next five years. (CDC)

Experts credit the numerous policy changes that have helped drive down the smoking rate over the past five decades. In 1965, the federal government began requiring cigarette packages to include warnings of the potential health risks. In 1988, it banned smoking on domestic flights shorter than two hours. By 2002, that ban had been expanded to include smoking on any US airline flight.

Many states have banned smoking in public places since Delaware passed the first such law in 2000. A 2012 study in Circulation found that when smoke-free laws were implemented in a city, there was an average decline of 15 percent in heart attack hospitalizations.

Another 2012 study in Archives of Internal Medicine looked at the impact of smoke-free laws in one Minnesota county over a decade. The study found a 33 percent drop in heart attacks per capita and a 17 percent decrease in the number of deaths from sudden cardiac arrest.

Obamacare makes experts even more hopeful that numbers will continue to fall, as cessation products to help people quit smoking are now covered under federal plans.

There's a growing customer base for tobacco

China has seen a huge boom thanks to aggressive industry marketing and a lack of tobacco control policies. (The Lancet)

As Americans continue to smoke less, citizens of other countries are smoking more — and cigarette sales are increasingly concentrated outside North America. Of the 667 billion cigarettes sold in 2014, 197 billion were sold in the Pacific region (stretching from Mongolia south to New Zealand), and 227 billion were sold in Europe, the Middle East, and Africa. In some countries — including Russia, Indonesia, and Armenia — a majority of men smoke daily. Smoking prevalence for women is above 25 percent in Austria, Chile, and France, and tops 30 percent in Greece. So while smoking seems to be decreasing in the US, there’s still a huge customer base for tobacco — it’s just shifting elsewhere.

Tobacco companies are suing poor countries over smoking regulations

Countries with a GDP much lower than a tobacco company’s revenue have a hard time fighting litigation against tobacco regulation policies. (The Tobacco Atlas)

Tobacco industries are doing three things to contribute to growth of tobacco sales, experts say: marketing their products extensively, manipulating their prices, and lobbying against regulation.

The WHO estimates the tobacco industry spends tens of billions of dollars each year on advertising. Because tobacco sales and advertising are so heavily regulated in countries like the US and Britain, companies have flocked to countries where there’s less regulation and more of an opportunity for a profit.

Particularly in low-income countries, tobacco industries also wield a huge amount of power thanks to their money. The corporations are able to use litigation to their advantage, targeting public health measures that hurt their industry. In poor countries, governments can’t necessarily afford the defense against these types of lawsuits, says Anna Gilmore, a University of Bath researcher who authored one of the articles in The Lancet series.

Uruguay is one such case — the nation is in the middle of a legal battle over its graphic warning labels on cigarette packages. Tobacco giant Philip Morris International claims the labels go against a trade agreement between Uruguay and Switzerland (where PMI’s corporate headquarters are located). Uruguay might not have been able to afford the current litigation, according to Gilmore, if not for the financial support of international NGO Bloomberg Philanthropies, which has stepped in to help. There are other examples of this, as well — big tobacco industries have a hold on many lower-income counties, and it’s a huge problem public health experts are trying to figure out how to solve.

Strong regulations have been proven to dramatically decrease smoking rates

New Zealand is a great example of the impact of a full implementation of FCTC protocols. (Tobacco Control Data Repository)

By all accounts, it seems like many of the practices set forth by the FCTC should work: raising taxes on tobacco products, regulating interactions between lawmakers and the tobacco industry, implementing public protections from smoking, and so on. But the FCTC hasn’t been put into action all that well.

“The implementation has been slow and underwhelming,” says Paul Billings, senior vice president of advocacy and education at the American Lung Association. He’s been working as an advocate for tobacco regulation since 1991, and two and a half decades of effort have shown him what works. To see progress, we have to see action, he says. The ’90s saw a wave of legislation and efforts aimed at both changing tobacco policy and increasing public awareness. The combination is what helped to make a big dent, he says.

“There were smaller steps, but also important steps,” he says, ranging from the EPA’s report on the dangers of secondhand smoke to cities setting a minimum age for purchasing tobacco products. But in recent years, that momentum has dwindled.

We have to speed up the process, Billings says. None of the implementation, in the US or in other countries, has happened fast enough.

“The way to speed it up is by implementing the strategies we know work: raising the taxes, passing the comprehensive smoke-free air laws, regulating the product, providing cessation coverage, funding the comprehensive public education and counter-advertising programs,” he says.

Just a handful of countries have been able to enact many of the FCTC protocols somewhat quickly, but they have seen great success in doing so.

New Zealand — which four years ago set a goal of becoming smoke-free in 2025 — provides one possible roadmap for necessary policies. Cigarette excise taxes have increased 10 percent each year, and legislation to standardize plain packaging for tobacco products to cut down on their appeal is currently being voted on. The work in New Zealand has significantly reduced smoking rates — 21 percent of adults smoked daily in New Zealand in 2006, and in 2013, that number was down to 15 percent.

Some countries actually own their own tobacco companies

The Chinese government is selling a massive number of cigarettes to its own citizens. (The Lancet)

A big problem for countries pledging to rein in tobacco use is that some of them are profiting from it. More than a dozen countries actually own tobacco companies, including Lebanon and China. And that’s a huge contradiction, says Ali Mokdad, global health researcher at the University of Washington.

“A country cannot be saying to the world, ‘I’m going to aggressively go against tobacco’ and at the same time be making money on tobacco,” he says. It’s common sense, says Mokdad — if countries really want to curb use, they can’t also sell tobacco on the side for a profit.

Even in places without such a noticeable tie between legislators and the industry, big tobacco still wields power. Experts think countries in which smoking is on the rise need to be able to swing back at the industry.

“The tobacco industry reigns among the most potent foes. They make a product that addicts people and kills them, but yet they manage to stay in business and make an enormous profit. They’re not to be underestimated,” Billings says.

Gilmore knows there are bigger goals within the concept of a tobacco-free world — like workplaces and pharmacies playing a role in decreasing tobacco use — but those won’t be feasible until the tobacco industry itself is reined in, she says.

But is the goal — that seemingly far-off 5 percent — reachable by 2040?

“Feasible? Yes. But I’m an optimist,” Billings says.

Here’s what happened when Los Angeles banned new fast-food restaurants

2019-03-04T15:13:06-05:00

(Shutterstock)

Back in 2008, new LA zoning regulations restricted fast-food restaurants from opening in certain neighborhoods, and prohibited existing ones from expanding. It was touted as a public-health measure, aimed at curbing obesity rates in some of the city’s poorest neighborhoods.

Now, four years of data shows those restrictions have not lowered obesity rates or changed the neighborhoods’ eating habits, a new study from researchers at RAND finds.

Somewhat surprisingly, obesity rates actually grew faster in the areas with the fast-food restriction.

Obesity rates grew faster in areas with fast-food restrictions

The fast-food ordinance was passed unanimously by the Los Angeles City Council in 2008 and was enacted later that year. It covered regions home to about 700,000 people.

The measure came at a time when the proportion of obese and overweight people was much greater in South Los Angeles than in other areas of the city. But between 2008 and 2012, that gap grew.

Body mass index (a measure of body fat) went up in the area, and so did the percentage of people who were overweight or obese. In areas with the fast-food ban, the number of overweight or obese people jumped from 63 percent in 2007 to 75 percent in 2012. In the rest of the county, that increase was much smaller — just 57 percent to 58 percent.

The researchers did find one positive sign — soft drink consumption fell — but that happened across the whole city, not just in the areas covered by the ordinance.

The restriction didn't apply to many fast-food restaurants

Big chains with drive-thrus aren’t necessarily watering holes for residents of a neighborhood. (Vivido/Flickr)

The researchers say that in large part, the problem with the ordinance is that it didn’t target the right types of restaurants. The zoning regulation only applied to standalone restaurants, which the researchers argue left out many places dishing out unhealthy food, like convenience stores that sell chips and candy. From 2008 to 2012, 17 new fast-food restaurants were actually able to open in the area despite the ordinance, because they weren’t standalone spots (rather, they were in places like strip malls).

The big, chain-style fast-food restaurants, meanwhile, might have been the wrong target. It’s possible, the researchers think, the chains may be more popular with people passing through the neighborhoods (and not residents) because they have drive-thrus and are often located on major roads.

The numbers also might not necessarily come down quickly with any policy, because people form their eating habits over life and could be slow to change them. There isn’t any one way to drastically reduce obesity, the researchers say, but for cities with goals similar to Los Angeles’, policies should take smaller food markets and other types of restaurants into consideration.

WATCH: ‘What’s wrong with food in America’

Why gel manicures probably won’t give you skin cancer

2019-03-04T14:57:31-05:00

Is this hand getting cancer right now? Probably not. | Shutterstock

Gel manicures have grown increasingly popular in the past few years, and for good reason: they chip less easily and last for weeks instead of a few days like normal polish. Industry data says gel manicures account for about 31 percent of all nail salon services.

But people also have concerns about the UV lights used during the process, and there’s worry of potential risks while removing the durable polish. Are gel manicures too good to be true?

Two types of chip-free gel nails

Hard gel manicures seem like the dream: long nails with chip-free color. (Yoko/Flickr)

A gel manicure can be either “hard,” extending the tip of your nail with a fake one, or “soft,” applying gel polish just to the natural nail. Both hard and soft gel manicures stay in place for a few weeks. People love them because they don’t crack or chip easily.

A hard gel manicure uses a gooey polish that, when put under a UV light, toughens up to makes your nails look longer, for an effect similar to acrylic nails. A technician brushes layers of the gel onto your nail and then paints out over a mold placed at the end of your fingertip. Between each layer, the gel is hardened under UV light. The light, through several steps, ends up causing a reaction with the resins in the gel, which releases heat and creates a hard polymer.

For a soft gel manicure, your natural nails are painted with a gel polish and then, again, hardened with UV light. Soft gel manicures give a similar effect to Shellac, a brand of “hybrid” gel-and-traditional polishes released in 2010 by Creative Nail Design.

Concerns about UV lights and cancer

Because these manicures require putting your nails under a UV light, there’s been public concern that gel manicures could increase your risk for skin cancer.

In 2009, researchers reported that two women who developed skin cancer on their hands had used UV lights for manicures (one of the women used them twice a month for years, and the other only eight times). Neither had a family history of the disease. Both underwent surgeries to remove the skin cancer. However, this doesn’t necessarily mean the lights caused their cancer. It’s only a case study of two people, and no one knows if people getting this service are at any higher a rate of cancer than people who don’t, because no one yet has systematically studied it to find out.

In a 2014 study, researchers examined 16 different UV lights in nail salons and found the particular ones studied only posed a small risk, but concluded a wider variety still needed to be tested.

The FDA regulates UV nail lamps just like it regulates the UV lights used in indoor tanning, and the agency hasn’t released any warnings about potential dangers of UV nail lamps. Still, you might want to cut the tips off of photoprotective gloves and wear those during your manicure, or apply sunscreen to your hands before going into the salon.

Taking off gel nails can be tricky, too

You might need something stronger than this. (Joe Mud/Flickr)

Removing gel nails involves soaking them for at least 15 minutes in pure acetone. (Normal nail polish remover is about 95 percent acetone.) Then a nail technician scrapes off the remaining gel.

The acetone dehydrates your nail, so after removal, counter that moisture loss with something like petroleum jelly, according to the American Academy of Dermatology.

Whatever you do, don’t try to peel off your gel nails yourself. They’re really stuck to your nails from the curing process, and picking or peeling them off like normal polish can rip your fingernails.

Go natural once in a while

Nails are made up of keratin, and like your hair, they’re dead. So while nail polish, gel manicures, and acrylics don’t keep your nails from “breathing” (a common misconception), the process can dry them out. So whether you choose to go for gel manicures, acrylics, or standard polish, experts say to be sure to give your nails a break every now and then.

When doctors pick their own birth control, IUDs are the most popular option

2019-03-04T11:37:18-05:00

(Shuttestock)

IUDs are the most effective contraceptive — and the top birth control choice among female women’s health care providers, a new survey shows.

Forty-two percent of doctors say they use a long-acting reversible contraceptive (LARC) method like intrauterine devices (IUDs) and the contraceptive implant. Among the general population, numbers are much lower: separate survey data shows 12 percent of women chose the same option.

“The difference in contraceptive choices between providers and the general population is even higher than we expected,” said Dr. Ashlesha Patel, lead researcher on the study, published Monday in the journal Contraception.

What the researchers found

Researchers surveyed 500 female women’s health care providers between 25 and 44. They found that 67 percent were using contraception. Of those women, 42 percent were using a long-acting reversible contraceptive (LARC) method like intrauterine devices (IUDs) and the contraceptive implant.

The researchers asked the doctors what their biggest consideration was when choosing their birth control method, and half said effective pregnancy prevention.

And for pregnancy prevention, there isn’t really a better option than IUDs. There’s less room for human error with IUD than with a daily contraceptive like the pill. IUDs have less than a 1 percent failure rate, while birth control pills have about a 6 percent failure rate.

The new study backs up similar findings that medical providers prefer IUDs to other forms of birth control. A 2014 study published in Obstetrics and Gynecology found that 40 percent of female family planning providers between the ages of 19 and 44 used IUDs, while only about six percent of women in the general population were using an IUD or similar long-acting reversible contraceptive.

The IUD gap might be closing

There are some signs that the general public is gravitating towards long-acting contraceptives. IUDs are now the third most popular contraceptive choice among American women between the ages of 25 and 44, behind the pill and condoms. Planned Parenthood reports a 91 percent increase over the last five years in the use of IUDs and the birth control implant.

The uptake in IUD use could be, in part, due to a provision in the ACA that gave women with private insurance access to birth control without having to pay anything out-of-pocket. It’s made LARCs more affordable and accessible for more women.

It’s also true that female women’s health care providers may be more likely to use LARCs because they’re generally better informed about the effectiveness of contraceptives than the general public. A 2012 study published in Contraception found how much a woman knows about birth control is correlated to what type she’ll choose – women who chose LARCs were more in the know than other contraceptive users about the efficacy of different methods.

Flats and flip-flops can hurt your feet, too

2019-03-04T14:49:31-05:00

Last year, I developed a painful case of tendonitis (inflammation of the tissue between my muscles and bones) in my feet. My toes wouldn’t uncurl, and I spent the better of a week soaking them in hot water to appease my angry muscles. The culprit, my doctor said, was a combination of weak ankles and my not-very-supportive winter boots.

Winter boots? Yes. It turns out that heels aren’t the only problem.

The Cleveland Clinic has helpfully broken down the best types of shoes for various kinds of foot problems:

(Cleveland Clinic)

Heels increase pressure on both feet and knees

When it comes to heels, chunky heels might be better than stilettos, but not by much, according to one Harvard study. Both significantly increase pressure on your knees (chunky heels by 22 percent, and narrow heels by 26 percent), which can cause pain and potentially strained muscles. High heels, which push your back forward, can also throw your spine and hips out of alignment, which can cause pain.

According to the Spine Health Institute, a one-inch heel increases pressure on your foot by 22 percent, a two-inch heel ups it by 57 percent, and a three-inch heel increases the burden on your foot by a massive 76 percent, which can also cause pain and injure your muscles.

Flats and flip-flops aren't much better

Flats don’t give your arch enough support, which can lead to back, knee, and foot pain, and flip-flops do similar damage. Both can also lead to plantar fasciitis, a painful condition in which the tissue on the bottom of your foot becomes inflamed from supporting your arch without the help of shoes.

When you wear flats or flip-flops, you’re forcing your body to change the way you walk to support itself. One 2008 Auburn study found that people who wore flip-flops took shorter steps than people wearing other types of shoes, and the researchers speculated the change in gait put extra strain on muscles, causing back, foot, and leg pain. People also curl their toes when wearing flip-flops, and that constant flexing of the foot can cause strain, as well.

If you want to wear flats, put in an orthotic insert to give your foot more arch support, experts say, and save flip-flops just for walking on the beach.

WATCH: ‘What happens to your knuckles when you crack them’

Celebrate Pi Day with this heartwarming tale of a WWI sailor and his very important slice of pie

2019-03-04T14:36:11-05:00

A volunteer scrounged up all the ingredients for mince pie in hopes of helping a sailor near death. (Wikimedia) | Wikimedia

A warm, crisp piece of pie is food for the soul, but one injured American sailor during World War I thought a slice of home could actually help heal his wounds. Tended to by a Red Cross committee in the hospital he was staying in in Scotland, the near-dying sailor had one request for getting better: he needed pie.

The story is recounted in, The passing legions: How the American Red Cross met the American army in Great Britain, the gateway to France, a book that details volunteer efforts during the war. And, today being Pi Day, is a good as moment as any to revisit his tale.

And to the injured soldier, there was no sweeter reminder of home than good, warm mince pie.

He was begging for mince pie, a classic comfort dish in the early 20th century, made of a mix of chopped meat, fruits, and spices. And what a comfort the pie was, even just the sight of it — the soldier, too sick to actually eat the pie, found it to be “just the home touch” he needed.

And while mince pie is no longer tops the list of American comfort food — we made the popular switch to “as American as apple pie” decades ago — for this soldier, it was the best reminder of home.

Why you shouldn’t be freaked out by the bacteria in public bathrooms

2019-03-04T14:33:57-05:00

Are there germs here you should really worry about? (Shutterstock) | (Shutterstock)

Public bathrooms just seem like a cesspool of contagion. So many people have used them, and you don’t know where those people have been or what they’ve been spreading around.

But really, there isn’t much reason to be any more grossed out about a public bathroom than about your kitchen or phone or remote control.

Bacteria are in bathrooms, but they're also everywhere else

Research has shown staphylococcus and streptococcus bacteria live on elevator buttons just like they do in bathrooms. (Shutterstock)

Sure, the germs you pick up in the bathroom can make you sick. But so can the bacteria on shopping carts, elevator buttons, restaurant menus, and light switches, which have all been proven to host a whole bunch of bacteria, just like public bathrooms.

Basically, there’s no scientific reason to avoid public bathrooms over any other place. Yes, they have germs, but they’re germs that surround you everywhere pretty much constantly.

“Your keyboard at your desk is loaded with bacteria. It doesn’t mean it’s dangerous,” says Dr. Aaron Glatt, an infectious-disease specialist in New York.

There’s a chance you can get sick from coming into contact with many of these bacteria, and that is concerning. But what makes it dangerous isn’t where you pick it up; it’s how that bacteria could stay on your hands and then — if you don’t thoroughly wash your hands — maybe get onto your food or into your eyes.

These are the bacteria in your average public bathroom

Scientists have surveyed the bacterial residents of public bathrooms and found bugs like E. coli (which can cause kidney damage, urinary infections, or stomach problems), staphylococcus (which causes infections), and streptococcus (the culprit behind strep throat), among others.

The bugs in bathrooms come from a handful of sources:

The bacteria on bathroom surfaces come mainly from these six culprits (everything else is considered an “unknown source”). (“Microbial Biogeography of Public Restroom Surfaces“)

In particular, skin bacteria run rampant in bathrooms because germs that usually live on the skin can survive for long periods of time on inanimate surfaces. Staph and strep bacteria can be transmitted from skin and are most commonly found in places your hands touch, while gut bacteria are (understandably) most dense on toilets. Floors have more bacteria from soil than other places do and are a sneaky spot from which germs spread. Research has found that some women’s purses carried large amounts of bacteria after people had set them down on a public bathroom floor.

The darker the blue, the more bacteria found in that spot in the bathroom. The image on the left shows skin bacteria, and the one on the right points out hotspots for gut bacteria. (“Microbial Biogeography of Public Restroom Surfaces“)

How to minimize your contact with bacteria

Washing your hands the right way can help prevent bathroom bugs from actually making you sick. (Shutterstock)

Some of the advice is common sense and known to work for sure: wash your hands. For real. (One recent study found that 10 percent of people don’t and 33 percent forgo soap.)

When washing your hands, be thorough, says infectious diseases specialist Dr. Lennox Archibald of Malcolm Randall Veterans Affairs Medical Center in Florida. The CDC recommends scrubbing for 20 seconds, making sure to get the backs of your hands, between your fingers, and under your nails.

However, when it’s time to dry your hands, the research isn’t quite in agreement.

The handles on paper towel dispensers are among the dirtier places in bathrooms, likely because they’re touched frequently by people who haven’t scrubbed well enough. That would indicate that you should head to the hand dryer (which Dr. Archibald recommends over paper towels).

But new research suggests hand dryers aren’t great, either. A 2014 University of Leeds study found the amount of bacteria in the air near jet dryers (the really high-speed units) was 27 times higher than the amount of bacteria in the air when using paper towels. And the air bacteria counts near lower-speed hand dryers were five times higher. The bacteria were also found on many spots on people’s bodies after they dried their hands, but mostly the germs from the air landed on their torsos. So it seems like the ideal way to dry off might be to use paper towels from a motion-detected dispenser.

If you have to touch a door handle on your way out, it might be worth it to open it with a paper towel, experts say, or you’ll risk undoing the work you did washing up.

And then wash your hands before you eat. That’s the most important thing, not where you got the bacteria, but whether you give it a good chance of making you sick.

9 myths about PTSD

2019-03-04T04:38:09-05:00

A patient with PTSD speaks with a therapist. Chris Hondros/Getty Images | Chris Hondros/Getty Images

Myth #1: PTSD only affects veterans

Post-traumatic stress disorder, or PTSD, is a condition that affects people who’ve been through a significant trauma. Humans have long been haunted by trauma, but it wasn’t until 1980 that psychologists made PTSD an official diagnosis. Civil War soldiers who were plagued by what we’d now call anxiety and panic attacks, symptoms of PTSD, were diagnosed with “irritable hearts.” Troops in World War I had “shell shock” or “combat fatigue.” The American Psychiatric Association added PTSD to its Diagnostic and Statistical Manual of Mental Disorders after soldiers came back from Vietnam exhibiting symptoms of the condition en masse.

The perception of the disorder has historically been centered on soldiers, but anyone can develop PTSD. Combat, child abuse, a physical assault, or a car crash can cause PTSD to develop. About 7 percent of the US population has PTSD some point in their lives, according to the National Center for PTSD. It’s a small portion of the people who go through a trauma, because most people who experience some sort of significant distress don’t develop PTSD. Women are more than twice as likely to develop PTSD as men, with 10 percent of women and about 4 percent of men having it some point in their lives.

Myth #2: People suffer symptoms of PTSD right after a trauma

Symptoms often show up in the first few months after a traumatic event, but sometimes symptoms don’t appear until years after. It’s different for everyone who develops PTSD.

Many people with PTSD re-experience their traumas through nightmares, flashbacks, or frightened or angry thoughts. They might make a concerted effort to avoid anything that might trigger those recurring feelings of trauma. People with PTSD might feel alienated or lose interest in things they enjoyed before a trauma. They might become more aggressive, self-destructive, or hypervigilant. PTSD is diagnosed when multiple symptoms have lasted for more than a month.

Myth #3: Everyone has some sort of PTSD

Certainly, most people will go through some sort of trauma in their lives. About 60 percent of men and 50 percent of women experience at least one trauma in their lives. But a much smaller percentage of people actually develop PTSD. About 10 percent of women and 4 percent of men develop PTSD at some point.

People who experience a trauma but don’t develop PTSD might still develop a symptom of PTSD. But the American Psychological Association has a strict outline for what qualifies as PTSD. To be diagnosed with the disorder, a person has to have a combination of symptoms that last for over a month. So while it’s common to experience a trauma, it’s relatively rare to develop PTSD.

Myth #4: PTSD isn't treatable

It’s actually quite treatable, even if it isn’t completely curable in everyone. PTSD is frequently treated with drugs, behavioral therapy, and other approaches. Writer P.K. Phillips had PTSD that caused her terrible flashbacks and nightmares and left her unable to sleep alone in her own home. She started taking medication and going through behavioral therapy when she was diagnosed. Now, she says, she has control of her life again.

“For me there is no cure, no final healing. But there are things I can do to ensure that I never have to suffer as I did before being diagnosed with PTSD. I’m no longer at the mercy of my disorder,” she writes.

Several forms of counseling have proven effective in treating PTSD, including talk therapy, exposure therapy, and behavioral therapy. The FDA has also approved two medications to treat PTSD: sertraline and paroxetine (Zoloft and Paxil). They’re both antidepressants, and can help control emotional symptoms of PTSD like sadness, anger, and anxiety. There’s evidence that meditation can help those with PTSD, as well. Treatments are different for everyone, and sometimes people need to try various combinations to find what works.

Myth #5: Symptoms of PTSD go away as a person heals from trauma

Symptoms of PTSD can come and go, and can vary in intensity over time. As with an anxiety disorder, stress can exacerbate a person’s PTSD symptoms. Reminders of the trauma, even many years later, can cause long-dormant symptoms to reappear.

It’s called re-experiencing a trauma, and it’s common in people with PTSD. They might experience the same emotions or even physical sensations they felt during a trauma. People with PTSD commonly cannot control re-experiencing a trauma.

Myth #6: PTSD causes violent behavior

The majority of people with PTSD aren’t dangerous. PTSD is associated with an increased risk of violence, but most people with it have never acted violently. Research shows that when risk factors correlated with PTSD are taken into account, the association between PTSD and violent behavior drops significantly. There’s a wide variety of risk factors, like alcohol abuse, drug misuse, and other psychiatric disorders, that play into the relationship between PTSD and violence.

Myth #7: PTSD is all in a person's head

PTSD is a real condition that causes very real symptoms. Traumatic events can change how the brain functions. PTSD leads to measurable changes in the brain and body after a person has been exposed to a trauma.

Researchers have found three areas of the brain that are different in patients with PTSD than in patients without the disorder: the hippocampus, the amygdala, and the medial prefrontal cortex. The amygdala is where emotions meet reactions, and in people with PTSD, it overreacts to things that have to do with their trauma. In the hippocampus, which controls emotions, research shows that a PTSD patient’s flashbacks might be due to a failure in the brain to control reactions to trauma-related stress.

Myth #8: PTSD only affects weak people

It’s not a question of strength, or of emotional stamina. There are a number of factors that play into whether a person who’s gone through a trauma develops PTSD. A person’s risk of getting PTSD depends, in part, on a combination of risk factors and resilience factors, as researchers call them. Having a history of mental illness, for example, puts people at greater risk to develop PTSD. People with little to no support, such as those who don’t tell anyone about what happened to them, are more likely to develop PTSD.

On the other hand, people who seek support from friends or family after a trauma (considered a resilience factor) are less likely to develop PTSD. Other resilience factors that might stop PTSD from developing include learning how to cope in a healthy way, joining a support group, and feeling good about one’s reaction to the trauma.

Myth #9: It's not an injury, so it doesn't require medical attention

Trauma can be physically damaging, but isn’t always. You don’t have to be physically hurt or wounded to develop PTSD. Many disaster workers who volunteered as part of the rescue crews after 9/11 developed the disorder, though they weren’t physically hurt in the disaster.

Even without a physical wound, PTSD is a sign of an injury, and one that often requires medical attention. Some PTSD symptoms might be acute and subside quickly on their own without help from a professional. But many people with PTSD find their lives disrupted by the symptoms, and require medical attention. It can cause people to lose function as their daily lives are interrupted by symptoms such as panic attacks and sleeplessness. PTSD isn’t something people can necessarily get over by themselves. It often takes time, support, and directed treatment. Seeking medical attention can help people with PTSD regain control over their lives.

To bust this myth, there’s a campaign to end the stigma around PTSD by dropping the D from its name. Army Staff Sergeant Ty Carter has led the movement to change the name to PTS, because he wants people to start seeing it as more of an injury and less of a disorder.

Inside the quiet, state-level push to expand abortion rights

2019-03-04T14:22:32-05:00

(Sylvia McFadden / Flickr)

For decades now, Vermont has had a law on the books that banned abortion.

But nobody thought about it that much: Roe v. Wade, the landmark Supreme Court decision that guarantees a legal right to abortion, has superseded the Vermont law for more than four decades now.

But about a year and a half ago, Vermont State Senator Tim Ashe started to worry. He was thinking about the composition of the United States Supreme Court — and about how the court would rule on a challenge to abortion rights.

“We were increasingly sensing that really at any time the Supreme Court could dramatically alter the landscape of Roe,” he says.

So Ashe decided to do something about it: in January 2014, he introduced a bill to repeal Vermont’s abortion ban. And in March, it passed.

Ashe’s bill is among the four laws to expand abortion rights that passed in 2014 — more than any year since 1990, the year the pro-choice research firm the Guttmacher Institute started keeping track of them. Legislators also introduced 91 other bills that failed to become law.

For much of the late 2000s and early 2010s, states passed barely any pro-choice laws. Nearly all abortion legislation focused on restricting access rather than expanding it. That’s what makes this new crop of four laws in 2014 so interesting. State legislators have pushed forward on pro–abortion rights legislation because, much like Ashe, they worry about the possibility of the Supreme Court revisiting the issue — and using that as an opportunity to overturn Roe.

Pro-choice groups think they also have a chance to capitalize on the many pro-life bills that have passed in the past five years: 231 since 2010, more than in the three decades prior combined.

“When [voters] see the actual facts of the laws that have been passed, they don’t just disagree with it — they are enraged. Incensed. I’ve never seen anything like it when people learn what’s going on,” says Tresa Undem, a pollster at PerryUndem, which has done polling for abortion rights groups.

The makeup of the Supreme Court worries some legislators, pushing them to act

(Shutterstock)

Legislators like Ashe say they’ve started to focus on expanding abortion access now for one big reason: they worry about the current makeup of the Supreme Court and whether the justices might overturn Roe if they take on another abortion case.

The court’s most recent decision came out against abortion rights. That was Gonzalez v. Carhart, a 2007 case in which the Supreme Court upheld the Partial-Birth Abortion Ban Act, a law Congress passed five year prior that prohibits a type of late-term abortion. The decision worries some court watchers that this particular court could use another abortion case to revisit Roe and its guaranteed access to abortion.

There could be an opportunity to do that soon: states have passed dozens of abortion restrictions in recent years, many of which could potentially spur a case that makes it up to the Supreme Court.

Arizona legislators trying to bring back an old law that banned most abortions after 20 weeks of pregnancy attempted to take their case to the Supreme Court, which declined the appeal in early 2014. (A series of similar 20-week bans have centered on the idea that fetuses can feel pain after that point in a pregnancy.)

The court has also gotten involved in Texas abortion restrictions without actually hearing any cases and ruling on them. In October 2014, the Supreme Court issued an emergency ruling staying a law that would have shuttered many Texas abortion clinics.

While that ruling was a positive one for the pro-choice movement, the justices also didn’t vote to block other parts of the Texas law when asked to do so just a year earlier.

So the current makeup of the Supreme Court suggests to some observers that a case relating to women’s reproductive health could swing in either direction. And states are gearing up for that by introducing a staggering number of abortion-related measures.

There was a big jump in the number of provisions that aimed to protect or expand access to abortions

In 2014, legislators introduced 95 different provisions, either bills or parts of bills, that aimed to protect or expand abortion access. It’s the highest number of such measures since 1990. Of these, four passed.

Ashe’s Vermont bill repealed the state’s pre-Roe abortion ban, and a Utah measure scaled back on mandatory counseling in cases where serious problems have been found in a fetus.

Two measures passed establishing buffer zones around abortion clinics in Massachusetts and New Hampshire to keep protesters from harassing clinic patients, but those laws were quickly overturned by the Supreme Court’s decision in June on McCullen v. Coakley, which ruled that buffer zones were too broad a limit on free speech. Four other states considered buffer zone legislation, but did not move forward on the issue.

Other states have looked for different ways to expand abortion access, like loosening parental consent requirements for minors seeking abortions and eliminating the mandatory counseling some states have for victims of rape and incest who are seeking abortions.

And while many of those bills weren’t going to go far — they were, after all, being introduced in the same legislatures that passed restrictions — they sent a message, says Elizabeth Nash of the Guttmacher Institute. “They put folks on notice that not everyone agrees with them,” she says.

Public interest in abortion issues is slowly increasing

(Mirsasha/Flickr)

One reason that abortion legislation might be increasing on both sides of the issue: polls show a growing number of Americans consider it an important issue.

In the mid- to late 2000s, the number of US adults that said they view abortion as a critical issue in society fell significantly, dropping from 28 percent in 2006 to 15 percent in 2009, according to a poll from Pew. But in the years since, that number has crept slowly upward, reaching 18 percent in 2013.

Pro-choice groups also say they’re seeing voters be increasingly interested in getting involved in the conversation about reproductive rights.

Voters are getting more engaged, says Boyer, and the NWLC can see this through the reception of several social media campaigns the group ran to rally people to contact their legislators about abortion policy.

“We have seen social media really reach audiences that have been so far unengaged in these types of issues,” she says. The activists say they’re reaching more millennials but also more health-care providers who are speaking out against legislative interference in the doctor-patient relationship.

Legislators are escalating their efforts, but there are hurdles to doing so

Laws to expand abortion access still face hurdles, and 91 of the 95 measures introduced in 2014 ultimately didn’t get passed.

Assemblyman Tom Abinanti (D-NY) worked on one of those 91 bills. He introduced legislation in 2014 that aimed to establish a buffer zone to protect women entering abortion clinics from harassment.

But his law ultimately failed in the assembly, as the debate over a hot-button issue like abortion led to it stalling. “Somehow this is made out to be an abortion versus anti-abortion issue, but that’s not necessarily the case,” he says. “The issue here is access to reproductive health-care services.”

Pro-choice politicians don’t always make abortion their top issue, either. In New York, Gov. Andrew Cuomo introduced the Women’s Equality Act in early 2013. It would, among other measures, codify Roe v. Wade. But even with the governor’s support, the abortion part of that legislation is still sitting in the state Senate — and, Abinanti argues, taking attention away from other pro-choice bills like his.

“The big battle at the moment is codifying Roe v. Wade, so I’m expecting we’re not going to be able to move this [buffer zone bill] until we resolve that issue,” he says.

Correction: A previous version of this article misstated Tom Abinanti’s title. He is an assemblyman.

Parents know they shouldn’t give their kids Coke, but they do it anyway

2019-03-04T14:20:26-05:00

(Shutterstock)

Parents often buy their kids drinks that they seem to know aren’t healthy, a new University of Connecticut study published in Public Health Nutrition finds.

The online survey polled nearly 1,000 parents of children between the ages of 2 and 17 about what drinks they give their children and how healthy they think they are.

The researchers speculate that a big reason for this gap in what parents buy and what they actually think is the massive marketing campaigns advertising sweet drinks to kids. In 2010, $443 million was spent on promoting sugary beverages, with adolescents seeing an average of 406 TV ads for them each year, according to one study.

Parents might be giving their kids unhealthy drinks without even realizing it. Drinks that seem healthy, or that are marketed to look better for you than they are, often are actually packed with sugar: 20 ounces of Sobe, a flavored water, has about the same amount of sugar as 20 ounces of Coke.

(“Hiding Under a Health Halo“)

Drinks with loads of added sugar have been found to increase a person’s risk for obesity, diabetes, and heart disease, among other problems.