Pregnancy, Health and the Environment- The March of Dimes National Communications Advisory Council Luncheon

Zoe Goldberg is an intern at CHMP.

On June 14th I completed my first official intern assignment in attending the March of Dimes National Communications Advisory Council Luncheon! Held in the Conde Nast building, the topic, “Pregnancy, Health and the Environment,” was discussed by the moderator, Fox and Friends’ Gretchen Carlson, as well as the two speakers: Dr. Maida Galvez from the Mount Sinai School of Medicine and Dr. Frederica Perera from the Columbia Center for Children’s Environmental Health.

Dr. Perera shared insights drawn from multiple research projects. She noted that while environmental problems aren’t the only problem in pregnancies, they are a preventable problem, and therefore worth learning about. She listed the top problematic exposures: PAH/air pollution, pesticides, BPA, phthalates, metals, and water pollutants. The outcomes of these exposures include birth outcomes, neurodevelopment, obesity/metabolic disorders, asthma, and cancer risk markers. Dr. Perera described the process of epigenetic alteration and how these environmental factors can affect the DNA of a fetus when it’s still developing. One cool technique being used to study the effects of environmental factors on pregnancy and children’s health is pregnant women wearing air sampling backpacks, which have shown that many of these harmful environmental factors are present in the air around pregnant women. Chlorpyrifos, a chemical found in most pesticides, can result in low birth weight, low head circumference, developmental deficits, and attention problems, and was found in 70-75% of the women monitored. Once this statistic was exposed, the US Environmental Protection Agency banned the residential use of chlorpyrifos in 2001 and the positive effects were seen immediately, showing that while many of these statistics are disheartening, change can be made and we should not give up on trying to fix these problems.

Dr. Galvez spoke next and provided the attendees with a constructive approach to addressing the problem. She said that the biggest piece of advice she gives to new or soon-to-be parents is to use common sense and try to find evidence-based information. She also urges people to err on the side of caution. Dr. Galvez taught us about safe and unsafe plastics– #’s 1, 2, 4, and 5 are safe, #’s 3, 6, and 7 can contain phthalates or BPA. She showed us some online resources that can serve as a guide for which fish are safe and which contain lots of mercury. However, Dr. Galvez explained that tobacco is still the biggest and deadliest among harmful environmental factors. She concluded by urging the attendees to take whatever action we can in urging the government to pass the Safe Chemicals Act, which would require all chemicals to be proven safe for children before being sold.

These two experts provided me with lots of knowledge and awareness about this important topic that affects babies- my favorite kind of people.

Zoe Goldberg

Photos: Zoe Goldberg

Zoe Goldberg is an intern at CHMP. On

CHMP National Advisory Council Member Ivan Oransky’s TEDMED Are we over-medicalized?

All of us at CHMP congratulate Ivan Oransky, a member of our National Advisory Council, for his TEDMED appearance in Washington DC. His presentation is featured on the TED website today. As of 10:42 PM it had over 69,000 views.

“Reuters health editor Ivan Oransky warns that we’re suffering from an epidemic of preposterous preconditions — pre-diabetes, pre-cancer, and many more. In this engaging talk from TEDMED he shows how health care can find a solution… by taking an important lesson from baseball.

Ivan Oransky is the executive editor of Reuters Health, and has done pioneering work in covering scientific retractions.” Watch it here.

All of us at CHMP congratulate Ivan

mHealth, Patient Empowerment, and Physician Control

Are smartphones the new care managers?

There are some 96 million mobile phones in the US and Pew Research reports that a majority of American adults (53%) own smartphones. According to Nielsen, that’s a 38 percent jump in just one year.

Smartphones can be an ideal tool to deliver health information to end users, remind them to take medicine on time, monitor their weight or blood pressure, record blood sugar levels, and collect and transmit that data to providers. So it’s no wonder that there are thousands of health-related apps available, with more continually in the works. A recent report by PriceWaterhouse Coopers (PWC) predicts 40 to 250 million global health app downloads in 2012.

Mobile, or mHealth, could be the go-to platform to help providers deliver high quality care, save money, and improve outcomes.

Payers see this as a boon to profits. The PWC report, Emerging Health: Paths for Growth revealed that 42 percent of payers think patients should allow doctors to monitor their health with smartphones and other mobile devices. However, only one quarter of physicians surveyed think this is a good idea. Many of them (42 percent) are “concerned” that patients might be getting “too independent” by using mHealth. In fact, 13 percent of doctors actively discourage patient self-monitoring via mobile health apps.

The report concludes that widespread adoption of mHealth by providers will grow slowly because physicians and other care providers are looking out for their interests –  even though PWC points out that mobile health encourages patient-centered care, fosters prevention and improves chronic disease management. Other experts agree that for mHealth to be truly successful, it must be a collaborative effort among patients, providers and payers.

Mobile health presents real opportunities to improve care delivery and health outcomes.  It is increasingly embraced by consumers for its convenience, ability to take greater control of their own health, and time-saving features. Physicians, however, freely admitted they did not like the idea of a shift in control towards the patient. “Patient independence” is not a term most are fond of.

Ironically, the PWC report reveals that 30 percent of physicians already own an iPad or similar device and almost as many expect to purchase one in the coming year. They’re finding it easier to monitor compliance, communicate with patients, and access various clinical and decision support support data. Provider-patient communication is cited by many (43 percent) as a key use for mHealth.

Huffington Post columnist John Burns recently commented that mHealth initiatives and applications have the potential to build a bridge to better health care for all communities. “Innovative wireless technologies provide new and more substantive opportunities for better health and better health education than ever before.“ He specifically singled out men from minority groups as prime targets for this type of initiative.

Practitioners need to look at the overall health benefits of using smartphones, not just worry about the control issue. mHealth creates new lines of communication, captures critical data, provides positive reinforcement and encourages patients to take ownership of their health. Physicians need to accept the reality that patients like using mobile health apps. Rather than fight it, they should embrace technology and work with their patients to improve outcomes.

My question, as always, is what happens those poor, homebound, elderly patients, who do not have access to or the means to acquire this technology? Who is going to buy the $600 iPad or pay for the data plan on a Galaxy Nexus? The digital divide keeps widening.

mHealth might be the solution to improved