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Health Capsules: March 13

Coming shortage of primary care may impact Americans’ longevity

As a shortage of primary care doctors looms in the U.S., new research shows their importance to the longevity of Americans.

The Association of American Medical Colleges estimates that by 2030, the U.S. will see a dramatic shortfall in the number of primary care physicians necessary to tend to Americans’ day-to-day health care and help catch illnesses like cancer and cardiovascular disease in their early stages. Recent reports predict a shortage of up to 49,300 primary care doctors by the end of the next decade.

At the same time, new research shows just how important primary care physicians are in prolonging American lives: Every 10 additional primary care physicians per 100,000 people in the U.S. was associated with about a 52-day increase in life expectancy during the decade from 2005 to 2015, according to a study led by researchers at the Stanford University School of Medicine and Harvard Medical School.

By comparison, the researchers found that an increase of 10 specialists per 100,000 corresponded to only a 19.2-day increase.

The main reason cited for the worsening shortage is the significant disparity in pay for primary care doctors compared to specialists. “There are few incentives to go into primary care among U.S. medical school graduates,” said Sanjay Basu, M.D., Ph.D., assistant professor of medicine and of health research and policy at Stanford. “Pay tends to be lower, burnout rates higher and prestige lower.”

People in rural areas, who are already experiencing a decrease in the number of primary care physicians available, will be especially hard-hit by the shortage, the report said.

By identifying the extent to which the number of primary care physicians might impact overall mortality, the researchers hope to encourage U.S. policymakers to consider the importance of encouraging more medical students to become primary care physicians.

“The passionate students who care about population health really want to go into primary care, but they also have serious education debts and are looking at the paychecks for fields like dermatology, ophthalmology or urology,” Basu said. “I think the problem comes down to money. We pay less for prevention than treatment – and the former is where primary care lives.”

Frequent weigh-ins, food diaries are simple weight loss ‘hacks’

Stepping on the scale frequently and regularly has been shown to be an effective way to lose pounds and keep them off.

Before embarking on the latest fad diet or jumping on the newest exercise bandwagon to lose weight, there’s something extremely simple you can do that also may be effective: stepping on the scale regularly.  

An analysis of 17 studies conducted in 2015 found that this simple but effective habit helped people lose weight and keep it off. Similarly, researchers from the University of Pittsburgh and the University of California – San Francisco recently found that regular weigh-ins not only keep weight loss goals top of mind, but also allow people to recognize fairly quickly what health habits are most effective – in other words, which specific changes in diet, exercise or other routines are working for them. 

“The overall evidence suggests regular self-weighing can enhance weight loss, particularly if the self-weighing is regular and continues,” said Dr. Rachel Tabak, a registered dietitian and research associate professor at the Brown School at Washington University in St. Louis. Overall, it’s currently unclear what an optimal weighing schedule is, Tabak added, but some newer studies “suggest that more frequent weighing, daily rather than weekly, is associated with better weight loss outcomes.”

Scales don’t have to be high-tech or expensive to be accurate, so getting started is easy. Keeping a log of weight changes over time also is helpful, being mindful that everyone’s weight may fluctuate a few pounds from day to day and from morning to evening. 

The most important thing is to set a schedule for weighing and stick to it, Tabak said. 

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Similarly, keeping a written log of what you eat throughout the day, recording both fat and calorie intake, is also a good predictor of whether you can successfully meet weight loss goals. 

But because dietary self-monitoring is viewed by many people as cumbersome and time-consuming, they can’t commit to it.

However, new research published in the March issue of Obesity suggests that the reality of dietary self-monitoring may be far simpler than the perception. The study, conducted by researchers at the University of Vermont and the University of South Carolina, is the first to measure how long dietary self-monitoring actually takes for those who successfully lose weight.

Researchers examined the dietary self-monitoring habits of 142 participants in an online behavioral weight control intervention – for six months, the participants met weekly for an online group session led by a trained dietitian. They also logged their daily food intake online, recording in the process how much time they spent doing so and how often they logged in.

The most successful participants, those who lost 10 percent of their body weight, spent an average of about 23 minutes per day on self-monitoring during the first month. By the sixth month, their recording time had dropped to just 14.6 minutes daily.

“Those who self-monitored three or more times per day, and were consistent day after day, were the most successful,” said Jean Harvey, Ph.D., the study’s lead author. “It seems to be the act of self-monitoring itself that makes the difference – not the time spent or the details included.”

With online dietary monitoring apps like LoseIt, Calorie King and My Fitness Pal widely available, Harvey said she hopes the study results motivate more people to adopt food diaries as a weight-loss strategy.

What causes most teen car crashes?

Reaching for objects or otherwise taking their eyes off the road increases teen drivers’ risk of a crash sevenfold, new research shows.

New research from the National Institutes of Health [NIH] shows that reaching for objects while driving – such as food, makeup or a cell phone – increases new teen drivers’ risk of being in a car crash by an alarming seven times. Dialing, texting or surfing the internet on a phone while driving was shown to double a teen’s crash risk.

The data came from real-time monitoring, via cameras and GPS technology, of new teenage drivers in Virginia. The study was the first to actually record their behavior behind the wheel, in an effort to quantify exactly how these distractions contribute to crash risk.

The teens who participated in the experiment consented to drive the monitored cars for a year. After that period, just over 52 percent of the drivers had not experienced a crash, while 30 percent had been involved in one crash and 17 percent had two or more crashes. Using six-second videos of each driver’s behavior before a crash took place, researchers calculated that for every second a teen’s eyes were off the road, the risk of a crash increased by 28 percent regardless of the type of distraction. Teens who manually used a cell phone doubled their odds of crashing, and teens who reached for something while driving increased their risk nearly sevenfold. Researchers attributed this large increase in crash risk to the combined effects of both taking their eyes off the road and their hands off the wheel.

On the calendar

BJC St. Louis Children’s Hospital sponsors Babysitting 101 on Saturday, March 16 from 9 a.m.-1 p.m. at the Children’s Specialty Care Center, 13001 N. Outer Forty Road in Town & Country, in the third floor conference room. Topics covered include the business of babysitting, child development, safety and first aid, and fun and games. A snack will be served. The course fee is $30. Registration is required and is available online at https://classes-events.bjc.org. 

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The American Red Cross sponsors a community blood drive on Monday, March 18 from 2-6 p.m. at the St. Louis County Library Grand Glaize Branch, 1010 Meramec Station Road in Manchester. To schedule an appointment time, visit redcrossblood.org.

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St. Luke’s Hospital sponsors You Can Manage It – Prevent Diabetes from Controlling Your Life on Tuesday, March 19 from 6:30-8 p.m. at the Desloge Outpatient Center, 11 St. Luke’s Center Drive in Chesterfield, in Building A. The goal of this program is to provide the information and resources needed for a successful diabetes self-management plan. Attendance is free. Register online at stlukes-stl.com.

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St. Louis Children’s Hospital offers a Young Athlete Center Bridge Program on Tuesday and Thursday, March 19 and 21 from 6:30-7:30 p.m. at its Young Athlete Center located in the Children’s Specialty Care Center, 13001 N. Outer Forty Road in Town & Country, Suite 350. This workout class is designed to target muscle groups commonly associated with injuries among younger athletes. The class is led by physical therapists and athletic trainers from the Young Athlete Center. The fee is $25 per child, per class; register online using the child’s name at https://classes-events.bjc.org.

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St. Luke’s Hospital and Dierbergs Markets co-sponsor Learn to Shop for a Healthier You on Wednesday, March 27 from 10-11:30 a.m. at Dierbergs Des Peres, 1080 Lindemann Road. Join a St. Luke’s dietitian for a store tour that will focus on how to make better choices, read labels and plan meals. Tour will meet at the store’s School of Cooking. The cost is $5, but all participants will receive a $5 Dierbergs gift card at the end of the tour. To register, visit Dierbergs.com or call (314) 238-0440.

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BJC St. Louis Children’s Hospital sponsors Family and Friends CPR on Wednesday, March 27 from 6:30-9 p.m. at Missouri Baptist Medical Center’s Clinical Learning Institute, 3015 N. Ballas Road. Learn adult hands-only CPR; infant and child CPR with breaths; introduction to adult and child AED use, and relief of choking, using the American Heart Association curriculum. Participants under 15 must be accompanied by an adult; the cost is $25 per person. Register online at https://classes-events.bjc.org.

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