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Why C-Section Babies May Be at Higher Risk for a Food Allergy

Fri, 30 Apr 2021 12:13:46 GMT

FRIDAY, April 30, 2021 (HealthDay News) -- Could there be a link between having a C-section and your baby's chances of developing a peanut allergy?

Yes, a team of Canadian researchers warns.

Their new study found that babies born via cesarean section appear to have relatively low levels of so-called Bacteroides, a specific form of bacteria that is key to the proper development of a child's immune system.

The finding follows an analysis of bacterial content found in more than 1,400 Canadian infants, both when they hit 3-4 months of age and again when they turned 1 year.

Follow-up allergy tests -- conducted at age 1 and age 3 -- confirmed that, on average, babies with low Bacteroides levels were three times more likely to develop peanut sensitivity by age 3.

"We found a causal link between cesarean section birth, persistently low Bacteroides in the first year of life, and peanut sensitivity in infants," noted study author Hein Tun, an assistant professor in the school of public health at the University of Hong Kong.

That's a problem, said Tun, because "as the gut microbiota are developing so is the gut's immune system, training the gut to react to pathogens and to be tolerant of the food that we require."

In fact, low Bacteroides levels linked to C-section deliveries is really only part of the concern, Tun's team noted, because low Bacteroides levels also tend to be accompanied by low levels of sphingolipids, proteins that are key to healthy immune system development, further undermining food tolerance.

"[And] the effect is more pronounced in children of Asian descent than others," Tun added. He and his colleagues found that low Bacteroides levels in Asian infants were linked to an eight-times higher risk for developing a peanut allergy.

Tun deemed that later finding "a bit of a surprise," though he attributed the stark increase in risk to the fact that many of the Asian infants in question had immigrated to Canada.

"[So] it's likely related to a change in diet and environment that lead to the Westernization of [their] gut microbiota," Tun said, though he acknowledged that more research is needed to confirm the hypothesis.

Still, the general finding of a C-section link to peanut allergies comes as little surprise to Lona Sandon, program director of the department of clinical nutrition with the school of health profession at the University of Texas Southwestern Medical Center at Dallas.

The link between C-sections and immune system issues among infants "is fairly common knowledge and consensus within the pediatric and nutrition world," Sandon said.

"A C-section results in less exposure to germs or bacteria upon birth. Same with lack of breastfeeding," she noted.

"This lack of exposure affects the immune system's ability to mature and adapt to life outside the womb. This lack of exposure and maturity is also associated with inappropriate immune reactions such as food allergies."

All of that can give rise to more than just a peanut allergy, Tun's team warned. That's because babies who develop food allergies are known to face a higher long-term risk for also developing asthma, wheezing, eczema and/or allergic rhinitis, he said.

So what are expectant mothers to do?

Since C-sections are one of the principal triggers for low Bacteroides levels among infants, "avoiding C-sections when possible is recommended," Tun said.

At the same time, he acknowledged that sometimes a C-section is unavoidable. In that case, Tun advises parents to find creative ways to enhance their infant's exposure to more diverse microbial environments.

Some potential solutions -- such as giving C-section babies probiotics or swabbing them with their mother's vaginal bacteria -- "have not been as successful as hoped," he noted.

But other measures -- such as introducing furry pets into the home environment -- "could increase Bacteroides abundance in babies," Tun said.

Meanwhile, "Asian mothers in Western countries should pay special attention to the possibility of developing peanut allergy in their children," said Tun, even if they don't have a family history of developing food allergies.

As a practical matter, he suggested that such mothers consider rearing their offspring on traditional Asian diets as "one way to maintain their Asian gut microbiome when they are living in non-Asian environments."

Tun led the investigation while a postdoctoral fellow at the University of Alberta. The findings were published recently in the journal Gastroenterology.

More information

There's more information on food allergies at the U.S. Centers for Disease Control and Prevention .

SOURCES: Hein Tun, PhD, assistant professor, School of Public Health and HKUâ€Pasteur Research Pole, faculty of medicine, The University of Hong Kong; Lona Sandon, PhD, assistant professor, department of clinical nutrition, school of health professions, University of Texas Southwestern Medical Center at Dallas; Gastroenterology, March 15, 2021

CBD: How Much Pain Relief Is Real and How Much Is Placebo?

Thu, 29 Apr 2021 12:51:42 GMT

THURSDAY, April 29, 2021 (HealthDay News) -- CBD is all the rage, and millions of people are turning to it for a host of reasons, including pain relief.

But despite CBD's popularity and widespread use, new research finds it's actual benefits are less clear.

The bottom line? CBD -- and your expectations about whether it will help (the "placebo effect") -- can make pain feel less bothersome, but it doesn't appear to reduce pain intensity.

"CBD-induced pain relief is not just driven by psychological placebo effects, but also pharmacological action," explained study author Martin De Vita, a researcher in the psychology department at Syracuse University, in New York. "It's a little bit of both."

CBD, or cannabidiol, is usually derived from hemp, a cousin of the marijuana plant, but unlike THC (delta-9-tetrahydrocannabinol) â€” the active ingredient in marijuana â€” CBD won't get you high.

In the new study, 15 healthy, pain-free volunteers participated in experiments involving their response to heat before and after receiving pure CBD oil. To tease apart the real versus placebo effect, the researchers told participants that they got CBD when they actually got a placebo, or vice versa, and conducted the experiments again.

"CBD and expectancies reduced the emotional component of pain, or how 'unpleasant' it felt," De Vita said. "Although the pain sensation was not completely eliminated, participants felt that it was less bothersome."

The body's central nervous system has its own processes to dampen pain based on information about when (temporal processing) and where (spatial processing) the pain is happening, he explained. "Expectancies alone enhanced temporal pain inhibition, and CBD and expectancies both enhanced the spatial pain inhibition independently, but not when combined," De Vita said.

Now, the researchers hope to look at how CBD affects pain perception in people with different pain conditions, he noted.

The study was published online recently in Experimental and Clinical Psychopharmacology.

The researchers chose a pure CBD oil for the study. "Commercially available CBD products differ in their content and purity, so results might be different for different CBD products, depending on what other compounds they may or may not contain," De Vita stressed.

Kevin Boehnke, a research investigator in the anesthesiology department and the Chronic Pain and Fatigue Research Center at the University of Michigan, in Ann Arbor, agreed.

It's buyer beware when it comes to choosing CBD products. "If you live in a state where marijuana is legal, medical dispensaries often have pure CBD products," Boehnke said. "If not, choose a brand from a reputable company with a third-party seal of approval that willingly shares their Certificate of Analysis (COA)." This document provides results of any testing of the supplements, he explained.

Unfortunately, the flood gates are already open when it comes to CBD, and science has a lot of catching up to do, said Boehnke, who was not involved in the new study.

"This is an interesting small pilot study that does show that both placebo and drug effects are playing a role in how CBD affects pain," he said. Still, Boehnke cautioned, this study was conducted in healthy volunteers so it can't tell us much about how or if CBD affects people with actual pain disorders.

More information

Learn more about the risks and potential benefits of CBD at the U.S. Food and Drug Administration .

SOURCES: Martin De Vita, researcher, psychology, Syracuse University College of Arts and Sciences, Syracuse, N.Y.; Kevin Boehnke, PhD, research investigator, department of anesthesiology and Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor; Experimental and Clinical Psychopharmacology, April 22, 2021, online

Who Is Using Herbal Kratom?

Thu, 29 Apr 2021 12:32:46 GMT

THURSDAY, April 29, 2021 (HealthDay News) -- Herbal kratom is used by less than 1% of the U.S. population, but the rate is much higher among those who misuse opioid painkillers, a new study finds.

Kratom is used to manage pain and opioid withdrawal. However, it carries the risk of addiction and harmful side effects, which has led the U.S. Food and Drug Administration and the Drug Enforcement Administration to identify kratom as a "drug of concern."

The plant-based substance, while legal, has been linked to thousands of poisonings and hundreds of deaths in the United States, most also involving the use of other drugs, especially opioids.

In the new study, researchers examined data collected from more than 56,000 U.S. teens and adults during the 2019 National Survey on Drug Use and Health.

Overall, 0.7% of respondents used kratom in the past year, but use was more common among people who used other drugs, including cannabis, stimulants and cocaine.

Kratom use was especially high among those who misuse prescription opioids, and highest (10%) among those with opioid use disorder, the findings showed.

Men, white people and those with depression and serious mental illness were also more likely to report using kratom. Teens and adults over 50 were less likely to report use, according to the study published April 29 in the American Journal of Preventive Medicine.

"This study adds to our understanding of kratom's prevalence and its connection to opioid misuse," said study author Joseph Palamar. He's an associate professor of population health at NYU Grossman School of Medicine.

"More research is needed to determine the substance's effectiveness in treating opioid withdrawal, and more research is needed to determine how safe this substance is when combined with other drugs," Palamar said in an NYU news release. .

More information

The U.S. National Institute on Drug Abuse has more about kratom .

SOURCE: New York University, news release, April 29, 2021

Poll Reveals Who's Most Vaccine-Hesitant in America and Why

Thu, 29 Apr 2021 12:18:54 GMT

THURSDAY, April 29, 2021 (HealthDay News) -- U.S. resistance to getting a COVID-19 vaccine is slowly diminishing, a new online survey finds, but it still exists and at especially high rates in some blue-collar jobs.

For adults under age 65 who are hesitant, reluctance is mainly driven by concerns about safety, side effects and distrust in government, the poll found. It's also largely linked to people's line of work.

The bottom line: "Vaccine hesitancy is emerging as a key barrier to ending the COVID-19 pandemic," said lead author Wendy King, associate professor of epidemiology in the University of Pittsburgh Graduate School of Public Health.

Identifying occupations with a high rate of vaccine hesitancy and understanding the reasons for it might help public health workers address concerns, she said.

"Our study indicates that messaging about COVID-19 vaccine safety and addressing trust are paramount," King said in a university news release.

King and researchers from the Delphi Group at nearby Carnegie Mellon University analyzed results from its ongoing COVID-19 survey in collaboration with the Facebook Data for Good group. About 1.2 million U.S. residents in Facebook's active user database complete the survey each month.

In January, the survey added a question about willingness to receive the vaccine.

This study was limited to working-age adults, because workplace outbreaks and spread of infection from workers to customers are public health threats. Many working-age adults also are more hesitant about getting a shot than older Americans.

While resistance persists, there was some encouraging news: Vaccine hesitancy fell from 27.5% in January to 22% in March, according to the survey.

The March survey included 732,308 people (median age: 35 to 44, meaning half were older, half younger). About 45% were male, 77% had some college education and 64% were white.

Nearly 48% of those who reported vaccine hesitancy expressed concern about side effects. More than one-third didn't think they needed the shot, didn't trust the government, were waiting to see if the vaccine was safe or didn't trust COVID-19 vaccines specifically. And 14.5% said they didn't like vaccines in general.

Workers in some occupations were more reluctant than others to take the jab. Hesitancy ranged from 9.6% among educators and people in life, physical or social sciences to a high of 46% among workers in construction, oil and gas extraction and mining. Hesitancy was nearly as high among workers in installation, maintenance, repair, farming, fishing or forestry.

In health care fields, pharmacists were the least hesitant at 8.5%. The highest hesitancy, 20.5%, was among medical assistants, emergency medical technicians and home health, nursing, psychiatric or personal-care aides.

"The survey has grown to collect data on symptoms, illness, treatment, testing, behaviors like masking and distancing, and mental health," said senior author Robin Mejia, from Carnegie Mellon's Dietrich College of Humanities and Social Sciences. "And it's continuing to evolve as new policy questions arise."

The survey results were posted April 24 on the preprint server medRxiv and have not been peer-reviewed.

More information

The U.S. Centers for Disease Control and Prevention has more information on COVID-19 and vaccinations .

SOURCE: University of Pittsburgh, news release, April 28, 2021

FDA Poised to Ban Menthol Cigarettes

Thu, 29 Apr 2021 12:17:17 GMT

THURSDAY, April 29, 2021 (HealthDay News) -- The U.S. Food and Drug Administration on Thursday proposed a ban on menthol cigarettes, a move that the agency has tried before and one that public health experts and civil rights groups have pushed for years.

Menthol cigarettes have been marketed aggressively to Black Americans for decades: About 85% of Black smokers use menthol brands, the FDA said, and research shows menthol cigarettes are harder to quit than plain tobacco products.

The agency said it will also seek to ban menthol and other flavors in mass-produced cigars, including small cigars popular with young people.

The action will "address health disparities experienced by communities of color, low-income populations and LGBTQ individuals, all of whom are far more likely to use these tobacco products," Acting FDA Commissioner Dr. Janet Woodcock said during a morning media briefing on the proposed ban.

And "flavored tobacco, including flavors found in some cigars and cigarillos, makes smoking more appealing by reducing initial aversive responses, particularly for young people," she added.

Mitch Zeller, director of the FDA's Center for Tobacco Products, said during the briefing that the health costs of menthol cigarettes has been particularly punishing for Black Americans.

"For far too long, certain populations have been targeted and disproportionately impacted by tobacco use. Furthermore, 85% of all Black smokers use menthol cigarettes, compared to just 30% of white smokers," Zeller said.

"One study showed that from 1980 to 2018, menthol cigarette smoking was linked to 378,000 premature deaths, 3 million life-years lost, and 10.1 million new smokers," he added. "Another study suggests that banning menthol cigarettes in the United States would lead an additional 923,000 smokers to quit â€” including 230,000 African Americans â€” in the first 13 to 17 months after a ban goes into effect."

Anti-smoking and civil rights advocates alike applauded the move.

"Banning menthol would be an important step in reducing the initiation of smoking and increasing smoking cessation attempts," said Patricia Folan, director of the Center for Tobacco Control at Northwell Health, in Great Neck, N.Y. "This proposal will help protect Black health and save lives. There is overwhelming evidence documenting the immense harm caused by the marketing and sale of menthol tobacco products. I hope this long anticipated ban takes effect."

Delmonte Jefferson, executive director of the Center for Black Health and Equity, called the decision a victory for all people of color.

"This has been a long time coming," Jefferson told The New York Times. "We've been fighting this fight, since back in the 1980s. We told the industry then, we didn't want those cigarettes in our communities."

Advocacy groups support ban

Matthew Myers, president of Campaign for Tobacco-Free Kids, noted that menthol and other flavors also appeal widely to teenagers.

"The Administration's new policy has the potential to be the strongest action our nation has ever taken to drive down the number of kids who start smoking and the number of Americans who are sickened and killed by tobacco," Myers said in a statement.

"It will crack down on the tobacco industry's most pernicious tactic for luring and addicting kids â€” the marketing of flavored products like menthol cigarettes and flavored cigars. And it will end the industry's predatory targeting of Black communities with menthol cigarettes â€” a form of institutional racism that has taken a devastating toll on Black lives and health, is a major cause of health disparities, and must be stopped once and for all," he continued.

"This decision is supported by overwhelming scientific evidence. As the FDA itself concluded in a 2013 scientific

report, menthol cigarettes are easier for kids to start smoking, more addictive and harder for smokers to quit. Half of all kids who ever try smoking start with menthol cigarettes. And because of the tobacco industry's targeted marketing, 85% of Black smokers now smoke menthol cigarettes, compared to less than 10% in the 1950s. Menthol cigarettes are a major reason why Black Americans have a harder time quitting smoking and are more likely to die from tobacco-related diseases like lung cancer, heart disease and stroke," Myers added.

According to Nancy Brown, CEO of the American Heart Association, "A prohibition on menthol cigarettes and flavored cigars would mark a historic turning point in the decades-long battle against tobacco use and the epidemic of tobacco-related disease.

"The FDA's announcement today will begin a process intended to prohibit products that for decades have enticed tobacco users into a lifetime of nicotine addiction and condemned a disproportionate number of Black smokers to serious illness and premature death," Brown said in a statement.

"We commend the FDA for moving, at long last, to prevent tobacco companies from targeting Black communities, youth and others with menthol cigarettes that make smoking easier to start and harder to quit," Brown added.

But Steven Callahan, a spokesman for Altria, which owns Philip Morris USA, told the Times that the company remained opposed to a menthol ban.

"We share the common goal of moving adult smokers from cigarettes to potentially less harmful alternatives, but prohibition does not work," Callahan said.

An April 29 court deadline is forcing the FDA to act on a citizens' petition to ban menthol, but the proposed ban is expected to face a lengthy legal challenge from tobacco companies, the Washington Post reported.

The ban would not apply to electronic cigarettes, which are currently considered tools to help smokers of regular menthol cigarettes quit. Most e-cigarette brands, including Juul, are undergoing an FDA review that will determine whether they are sufficiently beneficial to public health to be allowed to stay on the market, the Times reported.

Dr. Scott Gottlieb, President Donald Trump's first FDA commissioner, proposed a similar menthol ban three years ago, but the Trump administration backed down after intense resistance from tobacco state lawmakers, the Times reported.

But pressure to resurrect the effort has been building since President Joe Biden's election, and as the coronavirus pandemic and the Black Lives Matter movement further exposed sharp racial disparities in the country's public health and medical systems.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on the dangers of menthol cigarettes .

SOURCES: April 29, 2021, media briefing with: Janet Woodcock, MD, Acting U.S. Food and Drug Administration Commissioner, and Mitch Zeller, director, FDA's Center for Tobacco Products; Patricia Folan, director, Center for Tobacco Control, Northwell Health, Great Neck, N.Y.; Matthew Myers, president, Campaign for Tobacco-Free Kids, statement, April 29, 2021; Nancy Brown, CEO, American Heart Association, statement, April 29, 2021; Washington Post, The New York Times

'Light Therapy' Could Help Brain-Injured Veterans Struggling With PTSD

Wed, 28 Apr 2021 12:54:35 GMT

WEDNESDAY, April 28, 2021 (HealthDay News) -- A popular treatment for the seasonal depression that strikes during dark winter months may also benefit veterans with traumatic brain injuries and post-traumatic stress disorder, a small pilot study suggests.

Results from 16 older veterans found that bright light therapy alongside traditional treatments for these problems improved physical and mental symptoms.

The therapy, in which participants sat in front of a device called a lightbox that mimics outdoor light, may help by altering brain chemicals involved in sleep and mood, according to researchers at Oregon Health & Science University (OHSU) and the VA Portland Health Care System.

"We kind of take a top-down approach in terms of we're trying to improve sleep, and by way of or through increased sleep, also show that we can also improve cognitive function, depression, symptom severity elsewhere," said study co-author Jonathan Elliott, an assistant professor of neurology at OHSU, in Portland.

Participants in the study suffered brain injuries long ago and were being treated for problems with thinking and remembering. All but two also had post-traumatic stress disorder (PTSD), a mental health condition triggered by a past trauma. PTSD is common among military veterans, especially those with brain injuries.

Over eight weeks, the 16 vets participated in group-based cognitive rehabilitation therapy (CRT), a standard treatment to address memory, attention, thinking and judgment issues after brain injury.

Half received CRT alone, while the other half also spent an hour each morning for eight weeks in front of a lightbox. The lightbox sessions were done within two hours of waking.

Veterans who used the lightbox said their thinking, sleep and mood had improved, while those on CRT alone reported no such gains. The researchers noted the outcomes were subjective, based on veterans' self-reported answers on questionnaires.

Elliott said it's not clear whether light therapy played a direct role improving all of the measures investigated. It may be that exposure to the bright light in the morning led to better sleep, which then boosted participants' mood and thinking skills, he said.

Dr. Raymond Lam, a professor of psychiatry at the University of British Columbia in Vancouver, Canada, reviewed the preliminary findings.

Noting that the only well-established use of light therapy is as depression treatment, Lam suggested that the bright light might have eased depression among participants, leading to the reported gains.

"The more depressed you are, the more cognitive complaints that you have because there's a recognized association between depression and cognition," he said.

Lam noted that the preliminary findings don't indicate how much depression the group had at the outset, although depression is associated with traumatic brain injury.

While he called this novel use for light therapy interesting, Lam said much more extensive research is needed to support these findings.

He also pointed out that the average age of the study participants was 65 to 70 years old. Veterans in this age group might have thinking, memory and mood problems related to their age, such as dementia, rather than their history of brain injury. These could affect the study outcome, Lam said.

Study co-author Elliott said his team would like to double or triple the size of the study group before publishing their findings. They are seeking a grant to fund a full-scale clinical trial.

One advantage of light therapy is that a person receiving it can do other things at the same time.

"You can drink your coffee, read the newspaper, or eat breakfast," said Allison Keil, a research assistant at the Portland Veterans Affairs Health Care System. "We just ask participants to stay within roughly two-feet of the lightbox and have it set to the highest setting."

Lightboxes can be costly and recommendations for use may depend on the device and its purpose, the researchers noted, so it is important to consult a medical professional for advice.

The researchers were scheduled to present their findings Tuesday at an online meeting of the American Physiological Society.

Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

More information

There's more about light therapy at the U.S. National Library of Medicine .

SOURCES: Jonathan Elliott, PhD, assistant professor, neurology, Oregon Health & Science University, and research physiologist, VA Portland Health Care System, Portland, Ore.; Raymond Lam, MD, professor, associate head for research, department of psychiatry, University of British Columbia, Vancouver, Canada; Allison Keil, research assistant, VA Portland Health Care System, Portland, Ore.; American Physiological Society, online meeting, April 27, 2021

Head Injury, Alzheimer's Appear to Affect Brain in Similar Ways

Tue, 27 Apr 2021 12:56:09 GMT

TUESDAY, April 27, 2021 (HealthDay News) -- Alzheimer's disease and traumatic brain injury appear to affect the brain in similar ways, according to a study that may point to new ways to identify people at high risk for Alzheimer's.

"These findings are the first to suggest that cognitive impairment following a traumatic brain injury is useful for predicting the magnitude of Alzheimer's-like brain degradation," said study author Andrei Irimia. He is an assistant professor of gerontology, neuroscience and biomedical engineering at the University of Southern California, in Los Angeles.

More than 1.7 million Americans a year suffer a traumatic brain injury (TBI), which is often followed by changes in brain structure and function, as well as thinking and memory struggles.

Concussion, which is a mild TBI, is a known risk factor for Alzheimer's, but similarities in brain changes caused by the two conditions haven't been investigated before.

This study included 33 people who suffered TBIs in falls; 66 people with Alzheimer's; and a control group of 81 healthy people without TBI or Alzheimer's.

Compared to the control group, the TBI and Alzheimer's patients had more cortical thinning, the researchers found.

Cortical thinning is often associated with declines in attention, memory and speech, as well as impaired ability to make decisions, integrate new information and adapt behavior to new situations.

Using MRI scans, the researchers also found significant similarities between Alzheimer's disease and how the brain's gray and white matter deteriorate after TBI.

In gray matter, the most extensive similarities were in areas involved in memory and decision-making. In white matter, there were similar patterns of degeneration in structures such as the fornix (involved in memory); corpus callosum (which facilitates information exchange between brain hemispheres); and corona radiata (involved in movement of limbs).

The findings were published April 26 in the journal GeroScience.

"The results may help health professionals to identify TBI victims who are at greater risk for Alzheimer's disease," Irimia said in a university news release.

While the findings do not establish a cause-and-effect relationship between TBI and Alzheimer's, the researchers said they add to evidence that the two conditions share common trajectories.

At least 15% of Americans have a history of TBI.

More information

The American Academy of Family Physicians has more on traumatic brain injury .

SOURCE: University of Southern California, news release, April 26, 2021

Lullaby Effect: Music Can Speed Your Way to Sleep, Study Finds

Mon, 26 Apr 2021 12:59:12 GMT

MONDAY, April 26, 2021 (HealthDay News) -- Music hath charms to soothe you off to slumber, new research suggests.

The study found that calming tunes at bedtime seem to help older people struggling with insomnia.

"We found music therapy was effective for older adults with sleep disturbance," said study co-author Yen-Chin Chen, an associate professor of nursing at National Cheng Kung University in Tainan, Taiwan.

That's one of three takeaways from the study.

"Second, listening to sedative music is more effective than listening to rhythmic music," Chen said. "And listening to music for longer than four weeks is more effective for older adults with sleep disturbance."

Getting enough sleep can improve a person's thinking and memory function, as well as energy levels, Chen said.

The findings were published online April 20 in the Journal of the American Geriatrics Society.

The study authors noted that adults aged 60 and up appear to sleep better when they listen to music for 30 minutes to an hour at a time, and that they see the greatest benefit by trying tunes for at least a month.

For the review, the researchers looked at five studies with 288 participants.

About half of the participants listened to bedtime music. The rest either had other treatments for their sleep problems or none at all. The research compared different treatments to music, and rhythmic music to calming music.

Listening to calming music, which has a slower tempo and smoother melody, resulted in better sleep, the investigators found. By slowing your heart rate and breathing, and lowering your blood pressure, calming music can lower your stress and anxiety, the researchers theorized.

Older adults need seven to nine hours of sleep each night, according to the U.S. National Institute on Aging.

About 40% to 70% of older adults have sleep problems, and about 40% experience insomnia, waking often during the night or too early in the morning, the study authors noted in the report.

Sleep problems can contribute to irritability and depression, cause memory problems, and lead to falls and accidents.

Dr. Alayne Markland, an associate professor of medicine in the division of gerontology, geriatrics, and palliative care at the University of Alabama, Birmingham, reviewed the findings.

"I think this is novel work," she said, adding that more work remains, especially with older adults who have thinking and memory issues. The study did not include people with Alzheimer's disease, Parkinson's disease or other neurologic conditions.

"This could be a good thing to try â€” we just don't have that data," Markland said. Music could be a very effective sleep aid for some folks, as long as they don't leave it on all night long, she added.

Sleep is an important driver of metabolism, activity levels, social interaction and mental health for seniors, so getting recommended amounts is important, Markland stressed.

It's hard to say based on these findings alone who might be better suited to other strategies, such as cognitive behavioral therapy for insomnia (CBTI) with a trained professional, Markland said. CBTI can target behaviors around falling asleep and staying asleep.

According to a research summary from the American Geriatrics Society, one limitation of the study was that people who listened to music received more attention from researchers, which could be why their sleep improved. Also, all of the study participants had similar sleep problems, so this music strategy many not help folks who are struggling with sleep for other reasons.

Dr. Rafael Pelayo, a sleep specialist at Stanford Sleep Medicine Center in California, noted that most older people who are healthy don't have any sleep issues at all. Some have poor sleep as a result of other medical conditions, he added.

For example, someone with cataracts may sleep poorly because less light goes into their eyes, which can influence their sleep-wake cycles, he explained. Menopause, depression, sleep apnea, thyroid issues or iron deficiency can also cause sleep issues.

And over time, poor sleep can become a habit, Pelayo pointed out.

People who experience chronic pain or post-traumatic stress disorder have particular sleep challenges, but there are tools to help with even those sleep issues, according to Pelayo.

"There are many reasons an older person may sleep poorly," he said. "Having said that, most of the conditions will improve when addressed correctly."

Pelayo sees the greatest potential for music as a sleep aid in those whose sleep issues are stress-related. The predictability of music can help these folks get into the right state of mind and promote serenity, he said.

"People should go to bed, feeling safe, comfortable and loved. That's the state of mind you want to be in: safe, comfortable and loved," Pelayo said. "That's how our children sleep and that's what we hope to provide our kids and you need to provide for yourself. If you go to bed thinking 'How bad will it be tonight?' that will make you sleep lighter."

More information

The Sleep Foundation offers more suggestions for seniors and sleep .

SOURCES: Yen-Chin Chen, PhD, associate professor, nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Alayne Markland, DO, MSc, associate professor, medicine, division of gerontology, geriatrics and palliative care, University of Alabama at Birmingham, and clinician-researcher, Birmingham VA Medical Center, and director, clinical programs, Birmingham/Atlanta Geriatric Research, Education, and Clinic Center; Rafael Pelayo, MD, sleep specialist, Stanford Sleep Medicine Center, Redwood City, Calif.; Journal of the American Geriatrics Society, April 20, 2021, online

Low Risk of Mom Passing COVID to Newborn

Mon, 26 Apr 2021 12:57:29 GMT

MONDAY, April 26, 2021 (HealthDay News) -- The risk of mother-to-newborn transmission of COVID-19 is low, but the illness in pregnant women can trigger preterm birth, researchers say.

The new study looked at 255 babies born in Massachusetts last year to mothers with a recent positive test for COVID-19.

Only about 2% of the 88% of babies who were tested for COVID-19 had a positive result.

But worsening COVID-19 illness in mothers-to-be accounted for about three-quarters of preterm births in the study group. Preterm birth increases the risk of short- and long-term complications in infants, including respiratory distress, chronic health problems and developmental disabilities.

The study was published online April 23 in JAMA Network Open.

"We found that of babies born to mothers with COVID-19, very few babies tested positive," senior author Dr. Mandy Brown Belfort said in a Beth Israel Deaconess Medical Center news release.

"Instead, the adverse health impact of maternal COVID-19 on the newborn was from preterm delivery, usually prompted by a mother's worsening illness. Our findings support the need for thoughtful and collaborative decision-making around delivery timing in the setting of maternal COVID-19 illness," added Belfort, an associate professor of pediatrics at Harvard Medical School, in Boston.

The study also found that newborns of "socially vulnerable mothers" â€” those from poorer neighborhoods â€” had an increased risk for testing positive for COVID-19. This might be because these mothers have less access to care and face discrimination from health care providers, according to the researchers.

Discrimination may also cause chronic stress, which can reduce the immune system's ability to fight viruses, they noted.

Study co-author Dr. Asimenia Angelidou said, "We expected the mode of delivery and/or the degree of maternal illness to increase the risk of newborn infection, but were surprised to find that this was not the case." Angelidou is a neonatologist at Beth Israel Deaconess Medical Center.

"While the low rates of neonatal infection we observed are reassuring, it is important that providers remain vigilant," she added. "Even during public health emergencies like the ongoing pandemic, providers need to carefully monitor newborns for atypical signs of the illness, while also trying to avoid unnecessary premature deliveries that pose inherent risks for both mother and child."

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19 and pregnancy .

SOURCE: Beth Israel Deaconess Medical Center, news release, April 23, 2021

CDC Decision on Johnson & Johnson Vaccine Pause Expected Friday

Fri, 23 Apr 2021 13:02:05 GMT

FRIDAY, April 23, 2021 (HealthDay News) -- More than a week after pressing "pause" on the rollout of the Johnson & Johnson COVID-19 vaccine, experts convened by the U.S. Centers for Disease Control and Prevention are scheduled to meet again Friday with an eye toward a decision on moving forward with the shot.

According to CNN, the CDC's Advisory Committee on Immunization Practices (ACIP) will reconvene from 11 a.m. to 5 p.m. (ET) on Friday to vote on updated recommendations on the vaccine.

The pause in use of the one-dose vaccine came after six U.S. reports, one fatal, of a rare but severe form of blood clot tied to use of the J&J shot, all occurring in women. On Thursday, Oregon health officials said they were investigating one more case, this time fatal, in a woman in her 50s who developed a clot soon after receiving the J&J vaccine, CNN reported.

Federal health officials are stressing the extreme rarity of the clots -- seven potential cases in more than 7 million doses of the J&J vaccine deployed so far in the United States.

ACIP is calling the rare clots thrombosis with thrombocytopenia syndrome (TTS). TTS is characterized by a rare form of clot in the brain (and possibly elsewhere in the body) that occur in tandem with a low level of blood clotting cells called platelets.

According to CNN, some blood specialists believe the clots could stem from an unusual immune reaction targeting platelets, which causes the platelets to clump together to form a clot.

Last week, ACIP members said they did not have enough information or time to recommend how to proceed.

"I continue to feel like we're in a race against time and the variants, but we need to [move forward] in the safest possible way," CDC adviser Dr. Grace Lee, of Stanford University, told the Associated Press last week. She was among those seeking to postpone a vote on the vaccine, the AP reported.

Authorities have studied the clots for only a few days and have little information to judge the shot, said fellow CDC adviser Dr. Beth Bell, from the University of Washington, the AP reported.

"I don't want to send the message [that] there is something fundamentally wrong with this vaccine," Bell said. "It's a very rare event. Nothing in life is risk-free. But I want to be able to understand and defend the decision I've made based on a reasonable amount of data."

One of the most worrying things about the clots is that they are atypical and require different treatment. They occur in unusual places, such as in veins that drain blood from the brain, the AP reported. The six cases raised an alarm bell because that number is at least three times more than experts would have expected to see of more typical clots, said the CDC's Dr. Tom Shimabukuro.

"What we have here is a picture of clots forming in large vessels where we have low platelets," Shimabukuro explained to the AP. "This usually doesn't happen," but it is similar to European reports of clotting with the AstraZeneca vaccine.

According to CNN, Johns Hopkins University blood specialist Dr. Michael Streiff will brief the ACIP panel on treatments for TTS. Blood thinners -- with the notable exception of heparin -- can typically be used to dissolve the clots, and an immune product called IVIG can also help dampen the erroneous immune response.

The J&J clotting cases in the United States were all among women younger than 60. In Europe, most but not all cases following AstraZeneca vaccinations have been among women under 60, leading different countries to deploy that vaccine in more limited ways.

Biden pushes businesses on employee vaccinations.

In the meantime, with demand for COVID-19 vaccination in the United States showing signs of declining, President Joe Biden on Wednesday offered businesses new incentives to help more workers get their shots.

He asked -- but did not mandate -- that businesses give employees paid time off to get vaccinated, and even offered special tax credits to businesses employing under 500 people, to help cover any costs.

According to The New York Times, Biden said that "no working American should lose a single dollar from their paycheck because they chose to fill their patriotic duty to get vaccinated."

The President spoke during a White House briefing to announce that 200 million Americans had now gotten at least one dose of COVID-19 vaccine. That milestone means Biden has already met a target he set for his 100th day in office, which is still a week away.

But even harder work may lie ahead: Most of those Americans who were already eager to get a vaccine have already done so, and in the weeks ahead convincing the vaccine-hesitant to line up for a shot will be a harder sell.

Michael Carney is the senior vice president for emerging issues at the U.S. Chamber of Commerce Foundation. Speaking with the Times, he said, "If you think of this as a war, we're about to enter the hand-to-hand combat phase of the war."

Paid time off could be a major weapon in that battle. According to the Times, officials say that about 30% of unvaccinated workers said it could help convince them to get immunized. Some businesses are also contemplating their own vaccination education campaigns and immunization clinics.

Reaching the unvaccinated will be crucial to boosting immunization rates to the 70% to 90% scientists believe is needed for herd immunity. Right now about 40% of American adults have gotten at least one dose of vaccine, the Times said, but rates vary widely between states.

'Tipping point' soon

Since the first COVID-19 vaccine was approved in December, millions of Americans have eagerly sought to find and receive one. But a new report finds that that could change over the next few weeks, as the pool of eager recipients shrinks and only the vaccine-hesitant remain.

"While timing may differ by state, we estimate that across the U.S. as a whole we will likely reach a tipping point on vaccine enthusiasm in the next two to four weeks," researchers from the Kaiser Family Foundation (KFF) explained in a report released April 20.

"Once this happens, efforts to encourage vaccination will become much harder, presenting a challenge to reaching the levels of herd immunity that are expected to be needed," concluded KFF researchers Jennifer Kates, Larry Levitt and Josh Michaud.

According to Kaiser's own polling data, the percentage of American adults who have either received one COVID-19 vaccine dose or want to get vaccinated as soon as they can has steadily risen -- from 55% in late February to 61% expressing "vaccine enthusiasm" by March 21.

"If we use 61% as a current 'outer edge' of vaccine enthusiasm, it translates into about 157 million adults," the authors of the report said. With the CDC announcing Monday that more than half the adult population -- 131 million people -- have already received at least one dose of vaccine, "that leaves an additional 27 million adults to go before we hit up against the 'enthusiasm limit,'" the team said.

At current rates of vaccination, those last "enthusiastic" vaccine-seekers will have gotten their shots "in about 15 days," the authors noted, and "of course if the pace of vaccination picks up, it could be sooner."

There is the possibility that enthusiasm in the vaccine increases again, to say, 66%, and in that case the "tipping point" where supply exceeds demand could be reached in three to four weeks from now, according to the Kaiser report.

But once that tipping point hits, finding willing arms to receive vaccines gets a lot harder.

"It will take a concerted effort to reach a sufficient level of vaccination for herd immunity," the researchers added.

"Federal, state and local officials, and the private sector, will face the challenge of having to figure out how to increase willingness to get vaccinated among those still on the fence, and ideally among the one-fifth of adults who have consistently said they would not get vaccinated or would do so only if required."

Speaking with CNN on Tuesday, Dr. Rob Davidson, an emergency room physician in Spring Lake, Mich., said that local officials are becoming worried already. "We have slots going unfilled, I know in West Michigan and other parts, particularly in rural Michigan," he said.

And Kristy Fryman, the emergency response coordinator and public information officer for the Mercer County Health District in Ohio, told CNN she's seeing a slowdown in vaccination appointments as well.

"We've been going back to the drawing board trying to figure out how to get more people vaccinated but ... we can only do so much," she said.

Other polls suggest acceptance of the vaccines may still be on the rise, however. According to an Associated Press-NORC Center for Public Affairs poll conducted in January, 67% of Americans said they'd be willing to get a COVID-19 vaccine, but that number had risen to 75% in the latest AP-NORC poll.

The U.S. coronavirus case count neared 32 million on Friday, while the death toll topped 570,000, according to a tally from Johns Hopkins University. Worldwide, nearly 145 million cases had been reported by Friday, with nearly 3.1 million people dead from COVID-19.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

SOURCES: CNN; The New York Times; Associated Press

Brain Study Suggests Autism Develops Differently in Girls Than Boys

Thu, 22 Apr 2021 13:08:54 GMT

THURSDAY, April 22, 2021 (HealthDay News) -- Autism appears to develop differently in girls and boys, so the findings of research conducted mainly with boys might not apply to girls, a new study suggests.

Autism spectrum disorder is four times more common in boys, which may help explain why there's far less research about autism in girls.

"This new study provides us with a roadmap for understanding how to better match current and future evidenced-based interventions to underlying brain and genetic profiles, so that we can get the right treatment to the right individual," said lead investigator Kevin Pelphrey. He is an autism expert at the University of Virginia's School of Medicine and Brain Institute.

"This advances our understanding of autism broadly by revealing that there may well be different causes for boys versus girls," Pelphrey added in a university news release.

For the study, the researchers combined brain imaging with genetic investigation to learn more about autism in girls.

Functional MRI was used to examine brain activity during social interactions. It showed that girls with autism use different sections of their brains than girls without autism.

The difference between girls with and without autism was not the same as the difference between boys with and without autism, meaning that brain mechanisms involved in autism vary depending on gender, according to the study authors.

The investigators also found that girls with autism had much larger numbers of rare variants of genes active during early development of a brain region called the striatum. A section of the striatum is believed to be involved in interpreting social interaction and language.

The findings were published April 16 in the journal Brain.

Ultimately, Pelphrey said, the team hopes to use the findings to generate new autism treatment strategies tailored to girls.

More information

The American Academy of Pediatrics has more on autism .

SOURCE: University of Virginia, news release, April 20, 2021

Wildfire Smoke Can Trigger Eczema, Study Finds

Thu, 22 Apr 2021 13:07:43 GMT

THURSDAY, April 22, 2021 (HealthDay News) -- When wildfires choked the air and turned the skies orange throughout the American West in recent years, they caused a variety of health problems from coughs and runny noses to life-threatening heart attacks and strokes.

But eczema and other skin issues were a result of the wildfires, too, according to researchers from the University of California, San Francisco (UCSF), and the University of California, Berkeley.

"Existing research on air pollution and health outcomes has focused primarily on cardiac and respiratory health outcomes, and understandably so. But there is a gap in the research connecting air pollution and skin health," study co-author Raj Fadadu said in a UCSF news release.

"Skin is the largest organ of the human body, and it's in constant interaction with the external environment. So, it makes sense that changes in the external environment, such as increases or decreases in air pollution, could affect our skin health," added Fadadu, a student in the UC Berkeley-UCSF Joint Medical Program.

Eczema, also known as atopic dermatitis, and general itch were among the skin symptoms that health clinics in San Francisco saw more of during the two weeks that the "Camp Fire" wreaked havoc in November 2018. Researchers compared those dates to the same time of year in 2015 and 2016.

The findings suggest even short-term exposure to hazardous air quality from wildfire smoke can harm skin health, the study authors said.

For the study, the research team examined data from more than 8,000 visits to dermatology clinics between October and February for the years 2015, 2016 and 2018.

During the Camp Fire, clinic visits for atopic dermatitis and general itch increased significantly for both adults and children. The study also found increased rates of prescribed medications, such as steroids, during times of high air pollution.

Study senior author Dr. Maria Wei, a dermatologist at UCSF, said that "89% of the patients that had itch during the time of the Camp Fire did not have a known diagnosis of atopic dermatitis, suggesting that folks with normal skin also experienced irritation and/or absorption of toxins within a very short period of time."

Air pollution from wildfires includes fine particulate matter, polycyclic aromatic hydrocarbons and gases. These pollutants can slip through skin barriers, penetrate cells and cause inflammation, trigger oxidative stress and other negative effects, the researchers said.

"Skin is a very excellent physical barrier that separates us and protects us from the environment," Wei said.

"However, there are certain skin disorders, such as atopic dermatitis, in which the barrier is not fully functional. It's not normal even when you don't have a rash. So, it would make sense that when exposed to significant air pollution, people with this condition might see an effect on the skin."

You can protect your skin during wildfire season by staying indoors, wearing clothing that covers the skin if you go outside and using emollients, such as petroleum jelly, to strengthen the skin's barrier, the researchers suggested.

The findings were published online April 21 in JAMA Dermatology.

More information

The American Lung Association has more on how wildfires affect your health.

SOURCE: University of California, San Francisco, news release, April 21, 2021

'Disrupted' Sleep Could Be Seriously Affecting Your Health

Thu, 22 Apr 2021 13:05:46 GMT

THURSDAY, April 22, 2021 (HealthDay News) -- Waking up briefly throughout the night may do more than leave you feeling grumpy and tired in the morning.

Disrupted sleep may actually increase your odds of dying early from heart disease or any other cause, and women seem to be harder hit by these effects than men.

"The data underscores all the more reasons why we need to be screening people about whether or not they feel refreshed and how much sleep they're getting each night," said Dr. Andrea Matsumura, a spokeswoman for the American Academy of Sleep Medicine, who reviewed the findings.

Nighttime arousals are caused by noise, temperature, pain or pauses in breathing as a result of sleep apnea. They are brief, and you're often unaware they are happening unless they're strong enough to wake you or your bed partner notices. When these arousals become frequent, however, they may take a toll on your health.

For the new study, researchers analyzed data from sleep monitors worn by participants in three studies. In all, 8,000 men and women were followed for an average of six to 11 years.

Women who experienced more nightly sleep disruptions over longer time periods had nearly double the risk of dying from heart disease and were also more likely to die early from all other causes, compared to women who slept more soundly, the study showed.

Men with more frequent nighttime sleep disruptions were about 25% more likely to die early from heart disease compared to men who got sounder sleep, the investigators found.

The triggers for sleep arousal or the body's response to it may be different in women than in men, said study author Dominik Linz, an associate professor of cardiology at Maastricht University Medical Center in the Netherlands.

"Women and men may have different compensatory mechanisms for coping with the detrimental effects of arousal," Linz said.

Exactly how â€” or even if â€” disrupted sleep leads to increased risk of early death is not fully understood, and the new study wasn't designed to show cause and effect.

But the authors of an editorial that accompanied the findings have a few theories.

"Many people with frequent arousals and poor sleep have other risks for heart disease, including obesity, high blood pressure, diabetes and lung disease," said editorial writer Dr. Valentin Fuster, director of Mount Sinai Heart in New York City.

Anxiety and stress can also rob you of sleep and are known to have harmful health effects.

"During short or interrupted sleep, activation of the sympathetic nervous system and inflammation may play a more direct role," Fuster said.

When activated, the sympathetic nervous system triggers release of stress hormones that can increase heart rate and blood pressure, which can raise your risk for heart disease over time.

Linz said the best way to improve sleep and reduce nighttime disruptions is to eliminate any arousal triggers.

Consider sound machines to filter out noise, and make sure the temperature in your bedroom is comfortable. If you are overweight or may have sleep apnea, treating these can help head off episodes of "unconscious wakefulness," Linz said.

Fuster offered some other strategies that can add years to your life: Reducing stress with relaxation techniques, such as yoga, and making sure any heart disease risks are under control.

The new study did have some limitations. It didn't take into account medication use that can affect sleep.

Monitoring took place on just one night, while readings from sleep monitoring tend to fluctuate from night to night. In addition, most participants were white people and older, so the findings may not hold in different populations.

The study and the editorial were published April 20 in the European Heart Journal.

The new findings should serve as a wakeup call, said Matsumura, who is also a sleep medicine physician at the Oregon Clinic in Portland.

"When people don't feel good and wake up feeling unrefreshed, many don't realize they need to be evaluated by a sleep specialist," she said.

Taking steps to improve sleep quality is also important, Matsumura added.

"Consider developing a nightly routine that evokes calm and relaxation, which may include reading, journaling or meditating," she suggested. "Limit noise and distractions by making your bedroom quiet, dark and a little bit cool â€“ and only use the bed for sleeping, not watching TV or reading."

Limiting alcohol, caffeine and large meals before bedtime will also help you get a better night's sleep, Matsumura said.

More information

Learn more about healthy sleep habits at the American Academy of Sleep Medicine .

SOURCES: Dominik Linz, PhD, associate professor, cardiology, Maastricht University Medical Center, Maastricht, the Netherlands; Valentin Fuster, MD, PhD, director, Mount Sinai Heart, and physician-in-chief, Mount Sinai Hospital, New York City; Andrea Matsumura, MS, MD, sleep medicine physician, Oregon Clinic, Portland; European Heart Journal, April 20, 2021

AHA News: How to Make Sure Everyone Gets a Fair Shot at the COVID-19 Vaccine

Thu, 22 Apr 2021 13:04:09 GMT

THURSDAY, April 22, 2021 (American Heart Association News) -- Getting vaccinated may be everyone's best protection against COVID-19. But giving everyone fair access to vaccines will take more than just providing needles and vials, community health experts say.

Vaccines have not been reaching everyone equally, statistics show. Overall, Black and Hispanic people have been receiving smaller shares of vaccinations relative to their population and their portion of COVID-19 cases and deaths, according to a Kaiser Family Foundation analysis from mid-April. Levels of disparity vary by region, but overall, white people have received a disproportionately high number of vaccines. Asian people in most states have received doses that tracked with their levels of cases and deaths.

"The populations hardest hit by the pandemic, which unfortunately are communities of color, were not prioritized at the forefront of the vaccine distribution and resource allocation," said Dr. LaPrincess Brewer, a preventive cardiologist and health disparities researcher in the department of cardiovascular medicine at the Mayo Clinic in Rochester, Minnesota.

Solving the problem, Brewer and other experts say, will require taking down obstacles that keep people from understanding, signing up for and receiving vaccinations. It will take partnerships between medical experts and people who know their communities. And, they say, it will take trust.

The roots of the structural inequities that cause the problem are complex, said Brewer, who also is an assistant professor within Mayo Clinic College of Medicine. But she dispelled the idea that such groups should be labeled "hard to reach" with vaccines.

"Communities of color are not necessarily hard to reach," she said. "We oftentimes have not tried hard enough to reach them."

Such communities have to be addressed in culturally appropriate ways, she said. And vaccines have to be made available in ways that do not create inadvertent barriers.

Isabel Becerra has seen such barriers. She's chief executive officer for the Coalition of Orange County Community Health Centers based in Santa Ana, California. Her county has a large percentage of Hispanic and Asian American residents, but Hispanic people have been vaccinated at much lower rates than others.

Among the most affected communities were the cities of Santa Ana and Anaheim, which are predominantly Hispanic. One of Orange County's initial vaccination efforts was in Anaheim, at Disneyland. Becerra said it was a well-intentioned idea.

"But it's such a massive site," she said. To get there, people needed transportation. To get an appointment, they needed an app, which meant they needed internet access. And initially, the app was available only in English.

Becerra said things began to improve once vaccines were available through her group's community clinics, which are in medically underserved areas. But the clinics could not do it alone, she said. They relied on others who specialized in driving people to vaccination sites. Other groups served as trusted links to the community.

Latino Health Access of Santa Ana was such a group. It helped set up, staff and spread the word about several vaccine events. Gloria Giraldo, the group's COVID-19 education and field coordinator, said the organization is built on a network of neighborhood health workers, or promotores.

They not only help educate the community, they offer crucial feedback. They suggested, for example, that local high schools would be convenient vaccination locations. The Anaheim and Santa Ana school districts worked with Latino Health Access to open school gyms, and now eagerly line up early on weekend mornings to get their shots.

"We are very prone to listen to experts" who have lots of letters behind their names, Giraldo said. But the people who need help also have expertise, she said. "In their communities, they are experts in what works."

Geography is not the only barrier. Some people don't understand vaccines, while the politics of immigration has driven others away from the health care system, said Giraldo, who has a doctorate in public health and has done field work, literally, to help with that.

To reach workers in Orange County's strawberry fields, she worked with their employer to speak with them during a break. She was told interest was low, and that only eight had expressed interest in the vaccine.

But she went. And at the end of her talk, about 80 workers signed up for a shot. That led to a vaccination event that drew more than 160 agricultural workers.

In Minnesota, Clarence Jones also has served as a connector between people and experts. He's a community health strategist with the Hue-MAN Partnership, where he's worked closely with Brewer and Mayo Clinic on health programs in Black churches around Minneapolis-St. Paul and Rochester.

Black Americans know the health care system has a long history of racism, neglect and abuse, he and Brewer said. Through a Mayo Clinic project called FAITH! (Fostering African-American Improvement in Total Health), Brewer has built ties with more than 100 churches.

She first approached Jones and his group as a potential partner several years ago. "We vetted her for about a year and a half," Jones said. "And we asked her to vet us. Because one of the things that we have in our community is a real distrust about academics and researchers."

The partnership between Mayo Clinic researchers and local churches was well-established when the pandemic broke out. Brewer said communication has been key to solving problems. FAITH! has, for example, surveyed churchgoers and made regular phone calls to leaders to learn their vaccine concerns.

"Throughout the pandemic, we have simply asked our partnering congregations, 'How can we work together?' and 'What do you need?'" she said. Guided by the answers, Mayo Clinic created relevant information. FAITH! also participated in a virtual "Barbershop Talk" forum hosted by a local pastor that let people ask physicians of color about the vaccine.

"Because we were a trusted and reliable source of information, our community members instilled their trust in us about the COVID-19 vaccine," Brewer said.

Jones said large organizations can't provide instant trust. But they can start by looking for community partners and approaching them honestly about their shared goals.

Giraldo said a similar attitude has helped her group throughout its history.

"We're not saviors," she said. "We're not here to do anything that is not in partnership."

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Michael Merschel

Little Progress in Boosting Numbers of Black American Doctors

Wed, 21 Apr 2021 13:10:39 GMT

WEDNESDAY, April 21, 2021 (HealthDay News) -- The percentage of U.S. doctors who are Black has barely risen in the past 120 years, and there's still a wide pay gap between white and Black physicians, a new study finds.

The analysis of U.S. Census Bureau data from 1900 to 2018 included about 150,000 physicians, with about 3,300 Black male physicians and 1,600 Black female physicians.

The study "findings demonstrate how slow progress has been, and how far and fast we have to go, if we care about the diversity of the physician workforce and the health benefits such diversity brings to patients, particularly minority patients," said study author Dr. Dan Ly. He's an assistant professor of medicine at the University of California, Los Angeles (UCLA).

In 1900, almost 12% of the U.S. population was Black, but only 1.3% of physicians were Black. In 1940, nearly 10% of the population was Black, but less than 3% of physicians were Black. Of those, 2.7% were men and 0.1% were women, the study found.

In 2018, about 13% of the U.S. population was Black, but only 5.4% of physicians were Black. Of those 2.6% were men and 2.8% were women.

While the percentage of Black women physicians increased almost 3 percentage points between 1940 and 2018, the proportion of physicians who are Black men remained essentially unchanged in that time, according to the study.

The study also found that, adjusted for inflation, the difference in median income between Black and white male physicians was about $68,000 in 1960. That wage gap narrowed slightly by 2018, to $50,000, but remains worryingly large, said Ly.

That pay disparity could be due to a combination of pay discrimination and unequal access for physicians to pursue careers in better-paying medical specialties, he suggested.

"If medical leadership is serious about making the physician workforce more representative of the general population, much more effective policies need to be conceptualized and implemented," Ly said in a UCLA news release.

The findings were published April 19 in the Journal of General Internal Medicine.

More information

The RAND Corporation has more on diversity in U.S. health care .

SOURCE: University of California, Los Angeles, news release, April 19, 2021