Monday, October 14, 2002

BuyersÕ Market?

The current issue of the Journal of the American Medical Association (JAMA) includes the results of a study about the economic and health consequences of selling a kidney in India. Although selling (or buying) body parts is illegal in India, itÕs an accepted practice, and the average price paid for a human kidney is just over $1000 U.S. dollars.

India and other developing countries do not have the monopoly on kidney commerce. Not long after eBay was launched, it shut down a spate of kidney auctions. Policymakers have even been debating whether to use financial incentives to reduce the kidney shortage. People are asking whether thereÕs anything wrong with a person who needs money selling a kidney to be transplanted into someone whose kidneys have failed.

ThatÕs why itÕs important that the lay media has stepped up to report the kidney-selling research results. JAMA is in the business of providing a prestigious forum for medical researchers to report results to a medical audience. JAMA publishes the results, but they donÕt tell anyone how to interpret them. The medical researchers do that in other forums, such as when mass-media journalists contact them. So JAMAÕs media relations professionals work their tails off to get journalists from the lay media interested in the research results. I donÕt know how difficult it was to get Eric Nagourney of the New York Times interested in the kidney-selling research, but he did a top-notch job telling the story beyond the science in a way that all of us can understand.

The kidney-selling study is a great example of how much can be learned when someone decides to use the scientific method to answer a controversial question. The results are chilling: in addition to the fact that poor people were still poor 3-6 years after selling a kidney, "about 86% of participants reported a deterioration in their health status after nephrectomy." (Live kidney donors in developed countries are much more likely to recover from the kidney removal process with their health intact.) And the mass-media coverage of the results is a great example of journalists doing a terrific job translating important medical information. After this past week of articles like NagourneyÕs and others, I cannot imagine our lawmakers spending too much more time debating the potential advantages of allowing organ sales from live donors.

Thursday, October 10, 2002

Stars, Kids, and Smoking

It's a question that keeps coming up: How much does media influence behavior? My bias: A lot, especially when you're talking about teens. And especially when it comes to teens' health choices. Now, the results of a research project at Dartmouth links smoking in movies to adolescents taking up smoking.

The researchers polled about 5,000 middle school students and found that nearly 32 percent of the students who had seen movies with high smoking rates had tried cigarettes, while just 5 percent of those who had seen films with few smoking sequences said they had ever lit up. The research, funded by the National Cancer Institute at NIH, also found that teens with the most exposure to movie smoking were more than 2.5 times as likely to start smoking as those with minor exposure to movie "smoke scenes."

And donÕt think that the tobacco companies didnÕt figure these connections out decades ago. A few years ago I saw this letter posted to a colleagueÕs door. I thought it was a fake. No such luck. ItÕs real.

Obviously, parents have a role in keeping kids from lighting up by actively disapproving of smoking. But letÕs not fool ourselves into thinking that what kids see on-screen doesnÕt matter. One telling finding from the Dartmouth studies: adolescents whose favorite movie stars smoke on-screen are much more likely to be smokers themselves.

Monday, October 07, 2002

The Politics of Stigma

A friend sent this link to me with the question, "How familiar are you with mental health issues?" Except that this isn't an article about mental health issues. (Which he knew.) It's a compilation of random citations about the most sensational psychiatric conditions, cobbled together by someone who either is so amateurish that she has no idea the harm she's inflicting or is so callous that she doesn't give a damn who she hurts.

From a public health view, it's the sort of imbecilic approach to mental health diagnosis that stigmatizes the discipline, the good practitioners, and especially the individuals and families who will not get help because they are afraid of being mocked in the same way this article mocks mental health issues. Which means that people who need treatment might not get it before they hurt themselves or others.

Saturday, October 05, 2002

Good Drugs, Bad Dudes

I don't know what to do about this. But it should be seen for what it is: greedy idiots doing their greedy idiot thing. Not a reason to slow down delivery of anti-HIV/AIDS drugs to the 28.5 million people living with HIV/AIDS in Sub-Saharan Africa.

U.S. and European pharmaceutical companies arenÕt perfect (more on that another day, Mr. Herbert), and we all know they had to be shamed into it, but in the past year they reduced the price of HIV/AIDS drugs for people living with HIV/AIDS in the poorest countries of the world.

I will be following the coverage of this ring of thieves (and their colluding pharmacists!). And hoping NOT to find anyone arguing that this proves anything other than the need for some tighter controls on how the reduced-price drugs are delivered.

Thursday, October 03, 2002

Malaria Genome Coverage

It's been quite good. The choke-on-your-latte quote for the day has to be this one, from the Washington Post front-page article: "The medical misery inflicted by malaria is matched by its enormous economic toll, having imposed a $100 billion penalty on Africa over the past 30 years alone, said Columbia University economist Jeffrey D. Sachs."

The U.S. Navy absolutely should be patting itself on the back for its part in the malaria genome breakthroughs. But why are their in-house journalists still using the tired old underestimations of the number of deaths caused by malaria each year? All other coverage I've seen and heard uses the updated findings of over two million malaria deaths a year.

Wednesday, October 02, 2002

Cracking the Code

Today two biomedical research groups announced that they had separately mapped the genome of the deadliest malaria parasite and the mosquito that carries that parasite to humans. This is big news because malaria kills over two million people a year, mostly children under 5 in Africa.

The coverage I've seen and heard so far has been right on target. Big points to NPR's Dan Charles for his thorough and clear report of these genetic discoveries and the years of work that it took to reach this day. I'll be watching for tomorrow's print coverage. Hopefully this news will cause Americans to realize that malaria is still a problem, and the United States isn't magically exempt. Two cases of malaria have appeared in my current home state of Virginia in the past few weeks. Malaria is easily carried throughout the world by infected mosquitos via airplanes, it causes problems for U.S. military troops stationed in malaria-endemic areas, and it hurts the global economy because people who are suffering from malaria can't get out of bed to take care of their families or earn wages.

Tuesday, October 01, 2002

About this Site

This weblog will track media coverage of public health issues. Sometimes it will point out that a health issue isn't being covered enough, or that the coverage is missing an important angle. I'm interested in how media coverage impacts which diseases are spread; which conditions are stigmatized; and which are prevented, treated, and sometimes even eradicated.

I believe that the mass media --- television, radio, newspapers, and magazines --- do not tell anyone what to think, but rather tell everyone what to think about, and that means that time and money is spent on health issues that get media attention.