A Yale study estimates that eight million lives have been saved in the United States as a result of anti-smoking measures that began 50 years ago with the pathbreaking report from the Surgeon General outlining the deadly consequences of tobacco use. The Yale School of Public Health-led analysis was published in the Journal of the American Medical Association.

The study used mathematical models to calculate the long-term effect of the seminal report, and subsequent anti-smoking measures, over the past half-century. These cumulative efforts have significantly reshaped public attitudes and behaviors concerning cigarettes and other forms of tobacco, the researchers say.

First author Theodore R. Holford, professor of biostatistics and member of Yale Cancer Center, and six other researchers who are part of the National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network, found that while some 17.6 million Americans have died since 1964 due to smoking-related causes, eight million lives have been saved as a result of increasingly stringent tobacco-control measures that commenced with the report’s 1964 release. 

Of the lives saved, approximately 5.3 million were men and 2.7 million were women. The total number of saved lives translates into an estimated 157 million years of life, a mean of 19.6 years for each beneficiary, report the researchers. 

“An estimated 31 percent of premature deaths were avoided by this effort, but even more encouraging is the steady progress that was achieved over the past half-century, beginning with a modest 11 percent in the first decade to 48 percent of the estimate what we would have seen from 2004 to 2012 in the absence of tobacco control,” said Holford. “Today, a 40-year-old man can expect on average to live 7.8 years longer than he would have in 1964, and 30 percent of that improvement can be attributed to tobacco control. The gains for women have been slightly less, 5.4 years, but tobacco control accounts for 29 percent of that benefit.”

Using data collected by the National Center for Health Statistics from 1965 to 2009, the team recreated smoking life history summaries for groups born each year starting in 1890. These were used along with national mortality statistics and studies that followed large populations to calculate mortality rates by smoking status. This allowed them to estimate the impact of alternative scenarios for what might have occurred had the era of tobacco control never happened.

 NEW HAVEN — New Haven is going on a diet. As part of an initiative to create a healthier Elm City, health professionals, city government and Yale University are challenging city residents to collectively shed 375,000 pounds. That translates into just under three pounds for each of the city’s some 130,000 residents.

The Get Healthy CT weight-loss challenge is a joint initiative of the city, Cornell Scott-Hill Health Center, Yale School of Public Health and Yale-New Haven Hospital.

The weight target coincides (sort of) with New Haven’s 375th anniversary last year. A weight-loss calculator on the Get Healthy CT website (GetHealthyCT.org) will track progress. The website offers tips, exercise programs and events to help people attain their individual goals.

New Haven is marked by wide disparities in health, according to public-health officials, who say that large numbers of residents live in underserved neighborhoods where high rates of obesity, tobacco use and other factors contribute to a range of potentially preventable chronic diseases.

“Prevention is critical. Small lifestyle changes in diet and exercise can have a big impact on your health,” said Jeannette Ickovics, professor of public health at Yale and director of the Community Alliance for Research and Engagement (CARE), a partner in the Get Healthy CT initiative.

Ickovics noted that shedding just five percent of body weight — ten pounds for a 200-pound person — can prevent or delay the onset of diabetes.

 MERIDEN — Last month three MidState Medical Center physicians earned Physician Recognition Awards. Hospitalist Mark Schaner, MD earned the Joseph Goodman Clinical Collaboration and Teamwork Award. Pathologist Mark Ludwig, MD was named recipient of the Daniel Kahn Clinical Quality Award. Also. radiologist Gary Dee, MD was recognized with the David Park Leadership Award.

Nominations for the awards came from the MidState community including colleagues, staff, patients and patients' family members.

 DERBY — The Griffin Hospital Cardiac Rehabilitation Department and Eunice Lisk, MS of Stratford will be honored with the Caring Heart Award at the ninth annual “Women and Heart Disease” program February 6 at Grassy Hill Lodge in Derby. The award recognizes individuals and groups that foster initiatives to promote and improve the general health and well-being of all. This is the sixth year that the award will conferred.

The event is hosted by Griffin Hospital’s Women and Heart Disease Committee, which consists of health-care professionals, heart patients and women from throughout the Valley communities. According to the American Heart Association, heart disease kills nearly twice as many women in the United States as all types of cancer.

Event registration and a silent auction will start at 5 p.m., followed at 6 p.m. by dinner and the awards program. Tickets for the dinner are $35 and the event is open to the public. Proceeds benefit the Women and Heart Disease Fund, which supports heart wellness programs for women in the Valley. Reservations are due January 30. To make a reservation or learn more, call 203-732-7584 or 203-732-1137.

 NEW HAVEN — A rare genetic mutation that disrupts production of histamine in the brain is a cause of the tics and other abnormalities of Tourette syndrome, according to new findings by Yale School of Medicine researchers.

The findings, reported January 8 in the journal Neuron, suggest that existing drugs that target histamine receptors in the brain might be useful in treating the disorder. Tourette syndrome afflicts up to one percent of children, as well as a smaller percentage of adults.

“These findings give us a new window into what’s going on in the brain in people with Tourette. That’s likely to lead us to new treatments,” said Christopher Pittenger, associate professor in the psychiatry and psychology departments and in the Yale Child Study Center, and senior author of the paper.

Histamine is commonly associated with allergy, but it also plays an important role as a signaling molecule in the brain. Interactions with this brain system explain why some allergy medications cause people to feel sleepy. 

Drug companies have developed medications that target brain-specific histamine receptors in an effort to treat schizophrenia and ADHD. While not approved for general use yet, those drugs or others that target histamine receptors should be tested to see whether they can treat symptoms of Tourette syndrome, Pittenger said.

 A new state Web page is intended to streamline resources to help families with insurance coverage and reimbursement for behavioral health and substance-abuse treatment.

The state Department of Insurance’s “Mental Health Parity” Web page is a compilation of free resources, publications and tools that consumers can access through the Insurance Department’s Web site. 

The new site includes the Insurance Department’s Behavioral Health Took Kit, a step-by-step plain-language template that families and providers can use to submit to insurance companies for preauthorization of medically necessary behavioral health services. The Tool Kit was launched in October, the same time the state announced it was dedicating $9 million in federal funds to address the needs of children in schools.

For more information on the new Web page visit the CID Web site, ct.gov/cid.

 BRIDGEPORT — On December 5, federal court Judge Stefan Underhill issued a decision granting members of the Fairfield County Medical Association and Hartford County Medical Association a preliminary injunction preventing UnitedHealthcare from unilaterally cutting hundreds of doctors from the insurer’s Medicare Advantage Network.

 

The two medical associations filed the legal challenge in early November seeking to block UnitedHealthcare from terminating as many as 2,250 physicians, or approximately 20 percent of its entire doctor network in Connecticut.  The associations estimated that as many as 20,000 to 30,000 Medicare patients could be impacted by UnitedHealthcare’s decision to eliminate a significant portion of its physicians in Connecticut.

 

The preliminary injunction order prohibits UnitedHealthcare from terminating any of the Associations’ members from the Medicare Advantage Network, notifying their Medicare Advantage customers/insured that certain providers will be terminated from Medicare Advantage Network as of February 1, 2014; and removing or failing to advertise/market the Association’s affected physicians in UnitedHealthcare’s 2014 directories for the Medicare Advantage Network.

 

“Both the Fairfield and Hartford County Medical Associations took this bold step for our patients and for our member physicians.  We won’t let UnitedHeathcare get away with interfering with the doctor-patient relationship. While this is one huge step in the right direction, the journey is far from over,” said Robin Oshman, MD, president of the Fairfield County Medical Association in response to the judge’s decision.

 

A spokesperson for UnitedHealthcare said the company intends to appeal the ruling.

“We believe the court’s ruling will create unnecessary and harmful confusion and disruption to Medicare beneficiaries in Connecticut,” said Jessica Pappas, a spokeswoman for UnitedHealthcare, in a statement.

 NEW HAVEN — Checking back into the hospital within 30 days of discharge is not only bad news for patients, but also for hospitals, which now face financial penalties for high readmissions. The key to reducing readmissions may be focusing on the whole patient, rather than the specific conditions that caused their hospitalizations, according to a new study by Yale School of Medicine researchers.

Published November 20 in the British Medical Journal, the researchers found that top-performing hospitals — those with the lowest 30-day readmission rates — had fewer readmissions from all diagnoses and time periods after discharge than lower performing hospitals with higher readmissions.

“Our findings suggest that hospitals may best achieve low rates of readmission by employing strategies that lower readmission risk globally rather than for specific diagnoses or time periods after hospitalization,” said lead author Kumar Dharmarajan, MD, a visiting scholar at the Center for Outcomes Research and Evaluation at the Yale School of Medicine and cardiology fellow at Columbia University Medical Center.

Despite the increased national focus on reducing hospital readmissions, Dharmarajan said it had not been clear whether hospitals with the lowest readmission rates have been particularly good at reducing readmissions from specific diagnoses and time periods after hospitalization, or have instead lowered readmissions more generally. To find out, Dharmarajan and colleagues studied more than 4,000 hospitals in the United States caring for older patients hospitalized with heart attacks, heart failure or pneumonia from 2007 through 2009. The authors examined more than 600,000 readmissions occurring within 30 days of hospitalization.