NEWS BLOG from UPMC and the University of Pittsburgh Schools of the Health Sciences

Archive for January, 2017

Mortality Rates Predict Presidential Voting Patterns

As public health researchers, we track and analyze data on the health status of Americans. Our database on every death in the United States for the past 50 years (Mortality Information and Research Analytics) allows us to examine geographic patterns of mortality. Using this data system, we noticed state-by-state associations between mortality rates and the percent of support for the major party presidential candidates in the 2016 Presidential Election.

Analyzing data from all 50 states, we found a strong association between all-cause mortality rates (data from 2014, the most recent data available) and the percent of votes for President Donald Trump in the 2016 general election.

The 16 states with the highest mortality rates all voted for Trump in the election, while 15 of the 18 states with lowest mortality voted for Hillary Clinton. In a more detailed analysis, we found that the death rates among whites (both males and females) were better predictors of votes for Trump than death rates among other races/ethnicities. Although the association of mortality and voting preference is very strong, it’s not perfect. Interestingly, a cluster of seven north central states all showed a greater voting preference for Trump than might be expected, based on mortality rates alone.

Much has been written about why Trump won the election. This data suggests Trump voters were expressing dissatisfaction with real problems that included shorter lives and less healthy living conditions. We hope that the new administration will work to improve health and longevity for all Americans.

Buchanich is deputy director of the Center for Occupational Biostatistics and Epidemiology at the University of Pittsburgh Graduate School of Public HealthWoolley is a doctoral candidate at Pitt Public Health, and Burke is dean of Pitt Public Health.

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Tips to Improve Problem-Solving Skills and Reduce Stress

The ability to solve problems can be improved and related stress reduced by understanding its physical and emotional impact and taking active steps to cope or remove the problem.

“No one leads a charmed life,” says psychiatrist Joseph Antonowicz, medical director of UPMC Altoona Behavioral Health Services. “No one gets out alive and no one escapes without scars. It’s part of being human. We all experience disappointments, pain, and lost dreams. We learn to live with it and manage it.”

Some cope with life challenges and stressors better than others, he said, defining stress as “a reaction to adverse things around you,” because each person perceives and interprets stress/pain uniquely. For example, one person may find getting a traffic ticket extremely upsetting. For another, it’s a minor inconvenience.

“One study looked at the levels of morphine required by soldiers who received shrapnel wounds in World War II and compared it to patients who had their gall bladder taken out,” Antonowicz said. “The study showed that the soldiers required less morphine, because in the context of war, being taken to a hospital away from the front where you are being shot at and shooting at people, was less stressful.” (more…)

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UPMC Reaches Lung Transplant Milestone

Growing up with cystic fibrosis, Michael Keller’s parents always encouraged him to lead as normal and active life as he could.

He joined the swim and soccer teams, ran track, graduated from high school, earned his college degree, and got married. It wasn’t until about seven years ago that his cystic fibrosis worsened, forcing him first to use supplemental oxygen at night to eventually requiring it 24 hours a day.

“My quality of life and longevity thus far can most definitely be attributed to my family pushing me to not let cystic fibrosis hold me back,” said Keller, of Bellefonte, Pennsylvania. “A lot of milestones normal people would set, I set for myself.”

As the 32-year-old’s condition continued to deteriorate, his doctors in Hershey, Pennsylvania, encouraged him to establish a relationship with the UPMC Lung Transplant Program. Cystic fibrosis is a condition with no cure that damages the lungs, and a transplant eventually would be necessary. (more…)

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The Benefits of Mindfulness-Based Meditation

We asked Deanna Burkett, registered yoga teacher at UPMC Center for Integrative Medicine, for tips on practicing mindfulness-based meditation in the New Year.

What is mindfulness?

A. One of the most referenced definitions is Jon Kabat-Zinn’s description of mindfulness as an attentional quality, that is – intentional, present-moment and non-judgmental. Mindfulness is also defined as “to hold something in mind.” Mindfulness, in its non-secular context, communicates an element of remembering what to do with the present moment. This practice stitches the present moments together and helps us aim them toward our goals and resolutions.  

What are the benefits of mindfulness?

A. Mindfulness-based meditation teaches us how to relate differently to stress in our lives, and the results are wonderfully unpredictable.  One of the greatest benefits I’ve seen in my own life is in my relationships – my reactivity decreased, and this benefit translates into personal and professional arenas. For me, less difficulty and regret in relationships means less anxiety, sadness and rumination. Other researched benefits of mindfulness-based practices include decreases in depression and anxiety, reduced pain, greater ability to meet pain, better sleep and increased feelings of well-being.

What’s the best way to begin practicing mindfulness?

A. It’s helpful to have a teacher and a group to practice with regularly. If that isn’t available, there are applications, books, videos and online courses. At the UPMC Center for Integrative Medicine, I teach a weekly yoga class that has mindfulness as its context. Live situations like this give students a chance to ask questions and get personal feedback.

What would you suggest to people who say they are too busy for meditation?

A. I understand where they’re coming from, but I would ask them to make space for the idea that some time-consuming activities are simply habits that don’t offer us much in return. What would happen if we could learn new mental habits to help us live life differently, more skillfully and more intentionally? This isn’t a matter of meditation being “one more thing to do.” Meditation means setting out to learn a new habit, a new mental training that we can apply to our lives outside of meditation.

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Shulkin: Unusual Residency, Presidential Appointment

Dr. David Shulkin, announced today as President-elect Donald Trump’s pick for Secretary of Veterans Affairs, was a resident at the University of Pittsburgh School of Medicine. In its Winter 2016 issue, Pitt Med Magazine gave a peek into Shulkin’s time at Pitt. The article below was written by Nick Keppler.

The VA’s Under Secretary for Health, David Shulkin (center) and VA Secretary Robert McDonald (flanking him on the right) visited Pitt in November 2015. Credit: Mike Drazdzinski/CIDDE.

General medicine residents spend their days seeing patients, mastering clinical skills, absorbing a ton of information, and developing a bedside manner. When David Shulkin (Res ’89, Fel ’90) trained at Pitt, he also spent a lot of time going through stacks of file folders.

Shulkin, who had followed his wife-to-be, Merle Bari (Res ’90), to Pitt, where she pursued her dermatology residency, asked his advisors to allow him to study care costs at insurer Blue Cross of Western Pennsylvania. It was the first time a resident had made such a request, Shulkin recalls. “They were amazingly open to allowing me to explore my interests and my desire to understand how [the business of ] health care works.”

Shulkin would go on to manage huge health care systems, including one of the nation’s largest: the U.S. Department of Veterans Affairs.

That early Pittsburgh study on health care costs was so fascinating and promising, Shulkin stayed on an extra year as a general medicine fellow to complete the project

His findings, published in the Annals of Internal Medicine and covered on the front page of the Pittsburgh Post-Gazette, showed that doctors largely had no knowledge of the cost of the care they provided. This was leading to the rise of a managed care industry to keep costs in check—yet the increase in administrative costs was also raising the price of health care. “We were at the beginning of a trend showing health care costs were set to explode,” he recalls, “and as we now know, that’s become a fundamental issue in health care design.”

Shulkin would later spend four years as president and CEO of New York’s Beth Israel Medical Center and serve as the president of the New Jersey–based Morristown Medical Center. He also founded DoctorQuality, an early informational Web site for health care consumers. (more…)

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