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A Blog from Dr. Jason Eberhart-Phillips, MD
Kansas State Health Officer and Director of Health
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Jason Eberhart-Phillips, MD, MPH, serves as the Health Director of the Kansas Department of Health and Environment (KDHE). In this role, he directs and administers all programs and budgetary activities of the agency's Division of Health. Dr. Eberhart-Phillips also serves as the State Health Officer and as medical advisor to the Department, medical professionals and the public. Prior to his March 2009 appointment as Health Director Dr. Eberhart-Phillips served as the county health officer of El Dorado County, California. He has also served as senior lecturer in the Department of Preventive and Social Medicine at Otago University in Dunedin, New Zealand, the chronic disease director for the Alaska Department of Health and Social Services, as a medical epidemiologist for the ESR Health Communicable Disease Centre in Porirua, New Zealand, and as an Epidemic Intelligence Service officer for the U.S. Centers for Disease Control and Prevention. Dr. Eberhart-Phillips earned his undergraduate degree in journalism from Northwestern University and his medical degree from the University of California San Francisco. He also holds a master's degree in public health from the University of California Berkeley, and a master of divinity degree from the Pacific School of Religion. Before becoming a physician, Dr. Eberhart-Phillips worked as a news reporter in Pennsylvania and Arizona. He has been the lead or principal investigator on a number of research and surveillance activities, and he is a well-published author, writing two books and numerous medical articles.
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Every doctor, nurse and other health care professional knows that the first rule of medical care is "to do no harm."
The ethical obligation to safeguard patients from unintended illness or injury is imbedded in the Hippocratic Oath, the moral compass that has guided the practice of healing arts for more than 2,000 years.
That's why it is so puzzling that about half of all health care professionals today don't bother to protect themselves and their patients against influenza by getting the annual flu vaccine.
Even during last year's flu pandemic – the global outbreak that caused more than 12,000 deaths in the United States – only 37 percent of US health care professionals said they got the additional H1N1 flu vaccine, according to a new report.
What's going on here?  Ask Your Doctors and Nurses to Get the Flu Vaccine This Year
With school starting up again in Kansas, the lazy days of summer for children and adolescents are coming to an abrupt end.
For teenagers who have gotten used to sleeping late during the summer months, the early start times at many of our state's high schools are bound to cause a few rude awakenings. In recent years, more schools than ever have begun requiring their bleary-eyed students to arise before dawn to make it to classes that start at 7 a.m., or even earlier.
Without the help of caring adults, these young people will limp through their school days in a chronic state of sleep deprivation.
Sleep loss is becoming a serious concern for teachers, parents and health professionals who care about the well-being of young people. Recently the American Medical Association House of Delegates voted to identify insufficient sleep and daytime sleepiness among adolescents as a critical public health problem needing more attention.
Evidence is growing that sleep-deprived teenagers suffer from an array of problems related to attention, memory, and control of inappropriate behavior. As a group, drowsy teens are more likely to underperform in school, to drive recklessly on the street, and to miss out on getting the exercise they need to avoid obesity and other health problems. Is Your Teenager Getting Enough Sleep?
Why is the infant mortality problem in Kansas so bad, and why isn't it getting better?
Why have deaths in Kansas among babies less than one year of age increased by 16 percent since 2000, pushing our state's rank to number 40 among the 50 states, according to Kids Count, a report released in late July by the Annie E. Casey Foundation?
Why does the black infant mortality rate in Kansas remain at double the white rate? Why does a black baby born in Kansas today have less chance of surviving to its first birthday than a baby born in the refugee camps of the Palestinian territories in the Middle East?
And finally, why can't the good people living in the heartland of the richest nation on earth solve this problem and do better for our littlest, most vulnerable citizens?
These are tough questions, questions that weigh heavily on the minds of compassionate people from all walks of life who have mobilized in recent years to fight infant mortality all around our state. Looking Deeper into Infant Mortality in Kansas
It's hard not to get fat in Kansas today.
It's an uphill battle to eat right and stay active, to strike a healthy balance between the calories we consume and the calories we burn in physical activity. It's a daily struggle to avoid the temptation to devour more food than we should, and a real challenge to develop an exercise plan and stick with it.
For most of us, the fight against fatness is a battle against an irresistible force - a battle that's just too difficult to imagine winning, even when losing is costing us our lives. For the majority of Kansans today, excess weight is a sad but unavoidable fate, a grim destiny that we just have to accept.
But why does it have to be this way? Why is Kansas now the 16th most obese state in the fattest nation on earth, as shown in a report released last week by the Trust for America's Health?
Why have we seen the level of adult obesity in our state jump from less than 15 percent in the mid-1990s to about 29 percent today? Why are we witnessing an epidemic of diabetes, an incurable and costly disease that ought to be rare, but is now thought to afflict about one in ten adult Kansans? Obesity: It's Everyone's Problem
When Jennifer learned she was HIV-positive, she was dumbfounded. Neither she nor her doctor believed she was at risk of becoming infected with the virus that causes AIDS.
Jennifer, then 24 and living with her parents, got the test at her local health department upon the urging of her new boyfriend. Neither expected a positive result.
"It took three days back then to get confirmation of a positive test," Jennifer said. "Those were the longest three days of my life."
At that time she was dealing with persistently abnormal pap smears, despite treatment. A clinical picture like that can be a sign that a woman is infected with HIV, so Jennifer asked her doctor why she'd never been offered an HIV test.
"You don't fit the bill of someone who would get HIV," her doctor told her. "You come from a good family. You have a decent job. You don't drink. You don't smoke. You don't do drugs. You're a woman living in a small town." Fighting HIV with Knowledge
One of the biggest lies told to sell tobacco is the misleading use of descriptions such as "light," "mild" or "low-tar" in the marketing and packaging of cigarettes.
More than half of the people who smoke so-called "light" brands believe these cigarettes are less harmful than the regular, full-flavored varieties.
In reality, there is no difference in the ways these cigarettes ruin your health. There is nothing "light" or "mild" about the cancer, heart disease or strokes that sooner or later catch up with the people who smoke these cigarettes, in spite of their healthy-sounding names.
For that reason, on Tuesday, June 22, the use of such terms to sell cigarettes will be banned throughout the United States.
The new rule takes effect on the anniversary of the date last year that the federal Food and Drug Administration (FDA) took over regulation of tobacco products. It also comes less than 10 days before the ban on smoking in nearly every indoor public place takes effect in Kansas. The Times are A-Changing for Tobacco
Chances are there is too much salt in your diet, and that salt may be slowly killing you.
So says a report released recently by the Institute of Medicine, which calls for dramatic reductions in American salt consumption over the next few years.
The concern focuses on the dangerous link between dietary salt and high blood pressure, a silent disease that currently affects about one-third of all American adults. Unless it is detected early and effectively treated, high blood pressure can severely damage a person's heart, brain, blood vessels and kidneys, leading eventually to death.
High blood pressure is one of the most common diseases in Kansas, with the number of new cases increasing steadily in the past decade. By age 65, nearly 6 in 10 Kansans are now diagnosed with high blood pressure. Nationally, only about half of those with the disease are able to control it effectively with medications.
Treatment for high blood pressure is starting to improve, but preventing it altogether is the best option for saving lives and keeping health care costs affordable. It's Time to Get Savvy About Sodium
Gonorrhea isn't a topic that is usually brought up in polite company. But maybe it should be.
Today this age-old sexually transmitted infection is making a worrisome comeback after decades of decline. More than 336,000 cases were officially reported in the United States in 2008. The actual count was probably double that number.
Gonorrhea rates in Kansas have mirrored the national trend. After bottoming out in 2006, rates here in 2009 jumped by 10 percent from the previous year.
Gonorrhea can cause many uncomfortable symptoms, but often these infections aren't noticed at all. That's a problem because when gonorrhea is left untreated, it increases a person's risk of HIV infection. Untreated gonorrhea is also a leading cause of infertility.
That's why it is so important for sexually active adults, particularly young women, to be screened for gonorrhea and other common sexually transmitted infections as part of their routine medical care. When screening tests are positive for infection, certain antibiotics can stop gonorrhea dead in its tracks and lower the risk of serious complications. The Next Superbug: Coming Soon to a Community Like Yours?
Life is hard when you're born too young.
Babies born before they've had a full nine months to mature in their mother's womb face a staggering array of medical complications and life-threatening risks. For many, life is a struggle for survival from the moment they are born.
Because their lungs are not fully developed, premature newborns often have serious breathing problems. They also have a higher risk of jaundice, troubles with temperature stability and feeding difficulties.
Even those born just a little too early - between 34 and 36 weeks of gestation as compared to the full term of pregnancy of 37 weeks or more - are vulnerable to serious complications. These so-called "late preterm" babies are much more likely to require intensive medical care in their first days of life, and they are six times as likely to die in their first week as babies who are born full-term.
Sadly, the troubles these children face don't end when they grow out of infancy. Born at the Right Time: The Urgent Need to Prevent Prematurity
One year ago this week the world suddenly woke up to a new threat. A novel flu virus had arrived on the scene.
It was a virus the world had never seen before, one that would later be called H1N1.
At first there were more questions than answers: How serious was the disease this new virus was causing? How fast would it spread between people? Was it treatable with drugs? Could a vaccine be developed to stop it?
The earliest reports said the virus was responsible for widespread disease in Mexico. Laboratory-confirmed cases had also turned up in California and Texas.
And then, just a day after we first heard about the virus, the first American cases away from the border were found right here in Kansas. H1N1 Flu: One Year On
Everyone knows it's a good idea to put away a little money each month to save for retirement, even in tough economic times like this.
Financial experts agree that setting aside a few dollars from your paychecks now, while you're still working, will pay big dividends when you are retired.
But all the money in the world won't make your retirement years golden if you haven't got good health. Acting now to save your health may be an even better investment for a happy retirement than saving large sums of money.
Sadly, Americans who are in their 40s and 50s today are less healthy, as a group, than previous generations were when they were at comparable ages. Middle-aged Americans today report poorer health, more pain and more difficulty with everyday tasks than older Americans did at the same age, according to the National Bureau of Economic Research.
Today's aging Baby Boomers have more trouble with walking, climbing steps or doing other physical tasks than earlier generations did. They are also less likely to report having excellent health than their parents' generation did at the same age. Successful Retirement Planning Begins with Your Health
For people trying to watch their weight, eating out presents a challenge.
For them, each item on the menu amounts to a guessing game: How many calories does the meal I'm considering contain? How much of my daily calorie budget will this or that delicious item on the menu cost me?
Thanks to new federal legislation, help is on the way.
Buried deep in the health reform bill passed this week by the U.S. Congress is a provision requiring chain restaurants with 20 or more outlets to disclose the number of calories on their menus or menu boards. Additional nutrition information will be made available upon request.
Regardless of your views on the overall health reform bill, the arrival of menu-labeling is great news for public health, particularly in the fight against the burden of obesity. Menu-Labeling to Win the Struggle Against Obesity
March 24th marks World Tuberculosis Day, the day in 1882 when the microbiologist Robert Koch revealed to a gathering of scientists in Berlin that he had discovered the bacteria that cause tuberculosis (TB).
At that time, TB was humanity's single largest disease threat.
Known then as "consumption" for the way its victims would waste away, TB struck the young and old, the rich and poor, the famous and obscure throughout the world.
Among the dead were many beloved writers and musicians, such as Henry David Thoreau, Franz Kafka, Robert Louis Stevenson, Steven Foster, D.H. Lawrence, Emily Bronte, Frederic Chopin, John Keats and Anton Chekhov.
Koch and his fellow scientists were sure that his discovery would lead to a cure that one day would rid the world of TB. Remembering the Forgotten Killer: Tuberculosis
Twenty years ago smoking by adults in schools was a common sight. Not surprisingly, so was adolescent tobacco use in the community.
Thankfully, today smoking is unthinkable anywhere in Kansas schools. And adolescent tobacco use is at last showing a steady decline.
This welcome transformation has happened because nearly everyone now agrees that our educational institutions should be places that model health and wellness for our kids.
But with obesity now surpassing tobacco as the biggest threat to health that our kids face, the state's educators and health professionals alike are asking if junk food in school vending machines and school stores is sending young Kansans the wrong message.
These professionals are concerned that obesity rates have doubled among children and have tripled among adolescents since the mid-1980s. In response, they are now rallying in support of Senate Bill 499, which would impose strict standards on the foods and beverages schools sell to students from machines and snack bars. Why It is Important for Schools to Sell Healthy Foods
Ten years ago this month a seat belt saved my life.
I was driving on a gravel road near my farm when I lost control on a curve and slammed my family sedan directly into an oncoming truck. The force of the collision instantly crushed the front half of my car, shattering the windshield and splattering motor oil all over the road.
As my car skidded on the curve, for a split second I could see the approaching truck. I then heard the terrible sound of the impact and felt the shock wave of the crash in my tightly gripped hands. Before I had time to remember anything else, I blacked out.
A moment later, with the truck driver coaxing me on, I was able to pry open the door and step away from the car. Apart from a minor bruise where the shoulder belt had tightened across my chest, I was completely uninjured.
As I stood by the wreckage that was once my car, I was dazed and shaken. But with every scrap of my being I rejoiced: I was alive and unhurt!
I haven't stopped rejoicing since that day. What I Learned First-Hand About Seat Belts
Chances are the teenagers you know aren't thinking much about the far-off future when they will be middle-aged adults. Their attention is probably focused more on the latest hip-hop music than on the prevention of the hip fractures 30 or 40 years from now.
It's up to parents and other grown-ups to think ahead for them, making sure that young people have the best opportunities for good health all through their adult lives.
That's why so many parents, teachers and health professionals are more concerned than ever about what kids are eating today, and how common deficiencies in their diets might be predisposing them to serious health problems in adulthood.
Obviously the enormous intake of high-calorie foods that is typical for many teenagers today puts young people at risk of obesity, a set-up for high blood pressure, diabetes, heart disease and cancer as they grow into adults. Obesity in children and teenagers is now widely recognized as one of our nation's most pressing public health problems.
But another serious dietary risk confronting our teens gets far less attention: It's how our kids' diets – particularly the beverages they are drinking – are putting the future health of their bones at risk. Prevention of Osteoporosis Starts Young
If it is true, as Mahatma Gandhi once said, that "a nation's greatness is measured by how it treats its weakest members," then we Americans – especially we who live in Kansas – need to think hard about how we are treating our youngest citizens, and what we must do better to keep them from death's door.
America's infant mortality rate – the rate by which children under one year of age are dying – is the highest among all industrialized countries. Our country's infant death rate, currently in the range of 6 to 7 deaths for every 1,000 births, is roughly three times higher than world-leading Singapore.
But most alarming for us in Kansas is how many babies are dying in our own state, about 300 each year.
Kansas, which once did better on infant mortality than the United States as a whole, has in recent years been falling further and further back, now posting the 18th worst showing of any state. While the national infant mortality rate has been gradually falling each year, the rate in Kansas – more than 7 per 1,000 – is essentially unchanged from the late 1990s. Infant Mortality: Giving Our Most to the Littlest Kansans
"You have diabetes."
Three words that a doctor never wants to say, and a patient never wants to hear. But every day of every year, someone in Kansas is hearing these words for the first time.
About 170,000 Kansas adults are currently living with a diagnosis of diabetes, of whom about 35,000 have heard the news in just the past five years. Another 113,000 Kansans also have diabetes but don't know it yet, because they haven't been tested.
All told, about one Kansan in 10 now suffers from diabetes, and the numbers are growing fast. In fact, the population with diabetes is now increasing by a million people a year across the United States.
For our friends, neighbors and coworkers being diagnosed with this disease, diabetes presents challenging new responsibilities and sobering new risks. They will discover that on a daily basis diabetes can be a difficult disease to live with and manage. They will also come to realize that by having diabetes they have much higher chances of developing heart disease, kidney failure, foot problems and loss of sight. Tackling the Burden of Diabetes at its Root Causes
What ought to happen in a public health emergency if the number of patients needing acute medical care rapidly exceeds the capacity of hospitals to provide it?
What should be done if the health care needs of the community are suddenly so great that they overwhelm the ability of the health care system to provide care at the usual high standards?
In such a crisis – whether it's due to a natural disaster, a terrorist attack, or a flu pandemic – how should hospitals allocate scarce life-saving resources in the face of crushing patient demand?
These are not easy questions. In fact, they are down right uncomfortable for most people to think about. We Americans aren't used to dealing with shortages, least of all when we need emergency care in a hospital.
But in Kansas we know that good planning means that we think long and hard about tough questions like these, as many other states are doing in the name of preparedness. Making Tough Choices in a Health Emergency
Many Kansas families have been anxiously waiting this month to have their children and themselves vaccinated against the pandemic H1N1 flu virus. Regrettably, makers of the new H1N1 vaccine have found that production of the vaccine's active ingredient in their laboratories is occurring much slower than anyone expected.
As a result, the quantity of H1N1 vaccine produced so far – about 22.4 million doses – is lagging well below anticipated levels. At the same time, the level of disease due to the pandemic – including hospitalizations and deaths – has been steadily rising.
The shortage of vaccine is both frustrating and a bit scary.
The good news is that much larger quantities of H1N1 vaccine will become available during November and beyond. Eventually there will be enough vaccine for everyone in Kansas who wants it.
But in the meantime there is more good news: you can take charge of the situation now and reduce the risk your family faces from H1N1 flu, all without the vaccine.
Aside from the highly publicized importance of frequent and thorough hand washing and respiratory etiquette such as covering one's coughs and sneezes, you have got one other powerful tool to slow the spread of the flu and keep yourself safe. It's called social distancing. While We Wait for the Vaccine: Taking Charge of Your Health
This month marks the start of the largest vaccine deployment in history. As the first shipments of the H1N1 flu vaccine are arriving in Kansas, it's worth noting that a new chapter in humanity's long struggle with influenza viruses has begun.
For the first time ever, people have come together to stop a flu pandemic dead in its tracks by taking away the one thing the virus needs to survive: susceptible human hosts.
As the vaccine induces ever-wider immunity in the population, it promises to bend down the curve of the current epidemic, leaving the H1N1 virus with no place to go.
With all the attention the vaccine is getting, many Kansans are asking good questions about it. Is the vaccine really necessary? Will it work to protect me or my children against illness? How do I know it is safe?
A majority of Kansans have indicated that they will likely obtain the vaccine. For now they need to be patient as we await larger supplies of the vaccine in coming weeks, and as we distribute available doses initially to target groups who are at especially high risk of complications from H1N1 flu infections. What You Should Know About the H1N1 Flu Vaccine
Last week, an editorial in a Kansas newspaper questioned the changes we at the Kansas Department of Health and Environment (KDHE) made in our H1N1 testing procedures.
The editorial called the changes an "about-face on the perspective of the disease" and concluded that based on the changes that the disease is not as serious as we once thought. The editorial implied that if the virus is presenting a serious threat, health officials should continue to be vigilant in tracking cases and keeping the public informed of its activity, pattern of growth and outcomes for patients.
Although the virus does not usually produce severe disease, its rapid global spread shows that it has adapted remarkably well to humans. And this means that many more people will get sick from it than what we typically see with seasonal flu. And, unfortunately, it also means that we will see more deaths. What is also remarkable about this new virus is who it is affecting the most – young children and adults. This is very different than seasonal flu. So I would agree that it is extremely important for us to track the disease and keep the public informed, and in fact I argue, that in our transitioned methods of testing, we are doing just that.
With the assistance of our public health partners across the state we have built a network of approximately 50 outpatient health care facilities to create an enhanced statewide flu surveillance network. In a typical flu season we have maintained a network of approximately 25 sites, but because of the need for additional surveillance related to H1N1 we've created an expanded network of sites. Hospitals throughout the state are also participating in influenza surveillance to help us monitor the impact of this virus. KDHE H1N1 Testing Procedures
As the H1N1 flu epidemic enters its fourth month in Kansas, the lurid headlines and cable news frenzy that marked the early stages of the outbreak are over. Gone are the scenes of subway riders wearing face masks, of school doors closed because of the flu, of bewildered travelers unsure if they should take a vacation in Mexico or New York.
As the springtime alarm about the so-called "swine flu" has given way to summertime complacency, it may seem that the threat is gone, that we Americans have dodged the pandemic bullet.
But in fact the virus has never left us.
Here and around the world the H1N1 pandemic is gaining momentum, and sooner or later it will likely figure big in your life and the life of every Kansan. Collectively we need to start thinking about it again, and get ourselves prepared.
For a completely new organism, the novel H1N1 flu virus has a remarkable capacity to transmit itself among human hosts. In only 100 days it has spread from two countries in one continent to 160 countries in every continent of the world. Forgotten but not gone
By now you are probably aware that an outbreak of swine flu has occurred in Mexico, with a few cases now being reported in the United States. You may be alarmed by what you have heard, or you may be wondering why public health authorities are so concerned.
Many of you are asking good questions about swine flu. At this early stage in the outbreak, some questions don't yet have reliable answers. As each day passes we are learning more, and we are becoming more certain about the advice we give.
As of today, here is what we know: Six Things Every Kansan Should Know About Swine Flu (H1N1 flu)
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