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‘Tsunami’ Of Alzheimer’s Cases Among Latinos Raises Concerns Over Costs, Caregiving

SACRAMENTO, Calif. — Florence Marquez liked to describe herself as a cannery worker, even though she was best known in her heavily Latino East San Jose neighborhood as a community activist.

She strode alongside Cesar Chavez in the farmworker movement during the 1960s and 70s. She helped build affordable housing for poor families near her local church.

But eight years ago, Florence, now 86, couldn’t find her way to the house she had lived in for 50 years. “That’s when we knew she needed 24-hour care,” said her oldest daughter, Barbara Marquez, 61.

Florence was diagnosed with Alzheimer’s disease, which robbed her of her memory and her fierce independence. Across the United States, stories like hers are becoming more common, particularly among Latinos — the fastest growing minority in the country.

With no cure in sight, the number of U.S. Latinos with Alzheimer’s is expected rise by more than eight times by 2060, to 3.5 million, according to a report by the USC Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network.

Advanced age is the leading risk factor for Alzheimer’s disease and the likelihood of developing Alzheimer’s doubles about every five years after age 65. As a group, Latinos are at least 50 percent more likely than whites to have Alzheimer’s, in part because they tend to live longer, the report notes.

“This is an incoming tsunami,” said Dr. William Vega, one of the report’s authors and the Roybal Institute’s executive director. “If we don’t find breakthrough medication, we are going to be facing a terrible financial crisis.”

That tidal wave of Alzheimer’s cases is prompting some tough conversations in Latino families, who often pride themselves on caring for elders at home, rather than placing them in nursing homes.

Those talks come with a lot of guilt, Barbara said. Until recently, Barbara was her mother’s primary caregiver. Her sister and brother helped out.

“But it was more than I could have anticipated,” Barbara said, recalling sleepless nights as she tried to make sure Florence didn’t get up and wander off. “It impacts your health, it impacts your marriage. So we looked for help.”

About 1.8 million Latino families nationwide care for someone with Alzheimer’s and other types of dementia. And while the Roybal report shows that Latino families are less likely than whites to use formal care services, such as nursing home care, institutionalized care is becoming more common among these families.

Between 1999 and 2008, the number of elderly Latinos living in U.S. nursing homes grew by about 55 percent, a rate that outpaced the growth of the overall Latino population during that time, according to research published in July 2011 in Health Affairs.

That can be costly. Nationwide, the average cost for basic services in an assisted living facility is $43,200 per year, according to the Alzheimer’s Association. Yearly nursing home care now averages more than twice that, at slightly more than $92,000.

For many Latino families, getting outside help isn’t an option. It’s often too expensive for seniors who aren’t eligible for Medi-Cal, California’s version of the Medicaid program for low-income people, which generally pays for nursing home care. Immigrants who are in the country unlawfully do not qualify for it, nor do people whose incomes are too high.

Florence’s children decided to take their mother out of her house in San Jose, and they brought her to live with her daughter Barbara in Fair Oaks, just outside Sacramento. They sold the San Jose house, thinking it would help pay for institutionalized care should their mom need it down the road.

She did not qualify for Medi-Cal, so she lived with Barbara for about three years. But after trying out a senior day care program outside of the house at a cost of about $78 a day, Barbara and her family placed Florence in a senior home in the Sacramento suburb of Carmichael, where she has been living for the past year.

Dwindling Resources

The decision to institutionalize Florence Marquez left her children feeling both guilty and overwhelmed by the steep expense. Her care now costs $3,000 to $4,000 per month, they said. They pay extra for specialized services.

They had the proceeds from the sale of Florence’s house, “but those resources are dwindling,” Barbara said. “What do we do when that money is gone?”

The Roybal study estimates that the cumulative economic impact of Alzheimer’s among Latinos will hit $2.35 trillion by 2060. That figure includes the costs of medical and long-term care, as well as the lost earnings of family members who provide unpaid in-home care, and of the Alzheimer’s victims themselves, according to the study.

Gustavo Lopez of Chicago cares for his mother, Agustina Lopez, 76, who was diagnosed with Alzheimer’s disease seven years ago.

Gustavo, 48, and his four siblings looked into assisted living but couldn’t afford it. Agustina, after moving between her children’s homes, eventually landed with Gustavo, her youngest.

When Gustavo first took on the role of primary caregiver, his mother still did most things on her own, he said. But she now relies on him to help her eat, bathe, dress and take her medication.

So Gustavo needs a job with flexible hours. He’s worked mostly as a waiter. Other employment opportunities have come his way, some with better pay, but caring for his mother comes first, he said.

Asking For Help

Gustavo does get some help from family friends who check in on his mom while he is at work. He also found Casa Cultural in Chicago, a social service agency that offers a day program for seniors. He can drop his mom off at the center for a few hours, giving him a respite.

Free or low-cost programs like these are available in many communities, but families need to do research and ask for help, said Constantina Mizis, president of the Chicago-based Latino Alzheimer’s and Memory Disorders Alliance.

The alliance, formed in 2009, focuses on family members who are primary caregivers. Mizis said she has met many caregivers who are near their breaking point. The nonprofit offers training for them, helps find resources to boost their own well-being and puts on community events for families.

When seeking support, the best place to start is at a local community group or center — a church, a nonprofit, a United Way office, or the local Alzheimer’s Association chapter, for example, Mizis said. These groups will most likely refer caregivers to a county’s Agency on Aging or a state’s Department of Aging.

There, families are assigned a social worker who can discuss what benefits are available. If an Alzheimer’s patient qualifies for Medicaid, these benefits could include caregiver training and payment through programs such as California’s In-Home Supportive Services. But benefits and eligibility vary by state.

In 2010, the Social Security Administration recognized early-onset Alzheimer’s as a medical condition eligible for disability income. That could help people whose Alzheimer’s disease is diagnosed before the age of 65, but many Latino families aren’t aware the program exists, Mizis said.

A Push For Awareness

Because Latinos are more likely to use informal and more affordable care options, the Roybal report calls for improving training and resources for families in both English and Spanish.

Among the caregivers who opt to keep a parent with Alzheimer’s at home is Julia Garcia, of Houston, Texas. She rotates with her three daughters to watch her mother, Marcela Barberena, 85, who was diagnosed with the disease last year.

Julia, who had been unfamiliar with Alzheimer’s, initially thought her mother’s forgetfulness and childlike behavior was due to age.

“Too often people will see Alzheimer’s as a result of old age, but this brain-deteriorating disease is not natural,” said Vega, co-author of the report.

Julia Garcia said she realized it was something more serious when her mother took a shuttle bus from Houston’s international airport without knowing her destination.

“We had agreed I’d pick her up, but she left on her own,” Julia said. “She ended up downtown. It was the scariest moment of my life.”

As a new caregiver, Julia reached out to her local Alzheimer’s Association chapter for information. While some resources are available in Spanish in the Houston chapter, Julia noticed very few Latinos attending the informational workshops or classes.

Spanish-language media provided little information about the disease. “You rarely hear anything about it on TV or the radio,” she said.

In addition, many Latinos, including the Marquez, Lopez and Garcia families, are often unaware of clinical trials through which families can gain access to experimental therapies and medications at little or no cost.

Latinos are underrepresented in clinical trials sponsored by the National Institutes of Health: They account for 17 percent of the U.S. population but only 7.5 percent of participants at the 32 NIH-funded Alzheimer’s research centers across the country, according to the Roybal study.

Latino volunteers for these trials are important in helping researchers develop Alzheimer’s treatments that work for all ethnic groups, the report says.

“This is why it is so important to invest in the education of these communities,” Mizis said.

Her group helps train promotoras, or community health educators, in regions with large Latino communities — including San Francisco, Los Angeles, Baltimore and New York. Going door-to-door, promotoras educate families about the disease.

“I see firsthand everyday how much help our communities need,” Mizis said. “And this need keeps growing.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

El “tsunami” de casos de Alzheimer entre latinos plantea inquietudes sobre el cuidado y los costos

SACRAMENTO, Calif. — A Florence Márquez le gustaba describirse a ella misma como una trabajadora de fábrica de conservas, a pesar que era conocida en su latinísimo vecindario del este de San José como una activista comunitaria.

Ella caminó junto a César Chávez en el movimiento de trabajadores agrícolas durante los años 60 y 70. Ayudó a construir viviendas asequibles para familias pobres cerca de su iglesia local.

Pero hace ocho años, Florence, ahora de 86, no pudo encontrar su camino a la casa en la que había vivido durante 50 años. “Fue cuando supimos que necesitaba atención las 24 horas”, dijo su hija mayor, Barbara Márquez, de 61 años.

Florence fue diagnosticada con la enfermedad de Alzheimer, que le robó su memoria y su feroz independencia. A lo largo de los Estados Unidos, historias como Florence Márquez se están convirtiendo en más comunes, particularmente entre los latinos, la minoría de más rápido crecimiento en el país.

Sin una cura a la vista, se espera que el número de latinos con Alzheimer aumente más de ocho veces para 2060, a 3.5 millones, según un informe del Edward R. Roybal Institute on Aging de la Universidad del Sur de California (USC) y de la red Latinos Against Alzheimer.

La edad avanzada es el principal factor de riesgo para la enfermedad de Alzheimer y la posibilidad de desarrollar el mal se duplica cada cinco años después de los 65. Los latinos son al menos 50% más propensos que los blancos no hispanos a tener Alzheimer, en parte porque viven vidas más largas, destaca el informe.

“Este es un tsunami en marcha”, dijo el doctor William Vega, uno de los autores del informe y director ejecutivo del Roybal Institute. “Si no encontramos medicamentos innovadores, vamos a enfrentar una terrible crisis financiera”.

Esa marea de casos de Alzheimer está provocando algunas conversaciones difíciles en las familias latinas, que a menudo se enorgullecen de cuidar a sus ancianos en casa, en lugar de ponerlos en hogares para adultos mayores.

Esas charlas se presentan con mucha culpa, dijo Barbara Márquez. Hasta hace poco, Barbara era la principal cuidadora de su madre. Su hermana y su hermano ayudaban.

“Pero fue más de lo que yo podría haber previsto”, dijo Barbara, recordando las noches sin dormir mientras intentaba asegurarse de que Florence no se levantara y escapara. “Afecta tu salud, tu matrimonio. Así que buscamos ayuda”.

Alrededor de 1,8 millones de familias latinas en todo el país cuidan a alguien con Alzheimer y otros tipos de demencia, y mientras que el informe de la USC muestra que las familias latinas tienen menos probabilidades que los blancos no hispanos de usar servicios de atención formales, como un hogar, el cuidado institucionalizado se está convirtiendo en una opción más popular entre estas familias.

Entre 1999 y 2008, el número de latinos seniors que vivían en hogares aumentó un 55%, una tasa que superó el crecimiento de la población latina en general durante ese período de tiempo, según una investigación publicada en julio de 2011 en Health Affairs.

A nivel nacional, el costo promedio de los servicios básicos en un centro de asistencia es de $43,200 al año, según la Asociación de Alzheimer. Los cuidados anuales en hogares de ancianos son, en promedio, unos $92,000, más del doble.

Para muchas familias latinas, obtener ayuda externa no es ni siquiera una opción. A menudo es demasiado costoso para las personas mayores que no son elegibles para el Medi-Cal, la versión de California del Medicaid para personas de bajos ingresos, que generalmente paga por el cuidado de enfermería en hogares de ancianos. Los inmigrantes que están en el país ilegalmente no califican, ni tampoco las personas cuyos ingresos son demasiado altos.

Después de probar un programa de cuidado de ancianos fuera de la casa a unos $78 al día, Barbara y su familia pusieron a Florence en una residencia para ancianos de la zona de Sacramento, donde ha estado viviendo durante el último año.

 Recursos en baja

La decisión de institucionalizar a Florence Márquez dejó a sus hijos no sólo sintiéndose culpables, sino también con una economía tambaleante por los elevados gastos. El cuidado de su mamá ahora cuesta de $3,000 a $4,000 por mes, dijeron. Pagan extra por servicios especializados.

Florence actualmente no califica para el Medi-Cal, por lo que la familia Márquez vendió la casa de su madre en San José para pagar por su atención. “Pero esos recursos están disminuyendo”, dijo Barbara. “¿Qué vamos a hacer cuando se acabe el dinero?”.

El informe de la USC estima que el impacto económico acumulado de la enfermedad de Alzheimer entre los latinos llegará a $ 2,35 mil billones en 2060. Esta cifra incluye los costos de atención médica y de largo plazo, así como la pérdida de ingresos de los miembros de la familia, y de las propias víctimas del Alzheimer, según el estudio.

Gustavo López, de Chicago, se preocupa por su madre, Agustina López, de 76 años, diagnosticada con la enfermedad de Alzheimer hace siete años.

Gustavo, de 48 años, y sus cuatro hermanos buscaron un centro de asistencia, pero no pudieron solventarlo. Agustina, después de vivir en las casas de todos sus hijos, eventualmente se quedó con Gustavo, el más joven.

Cuando Gustavo asumió por primera vez el papel de cuidador principal, su madre todavía hacía la mayoría de las cosas por su cuenta, dijo. Pero ahora depende de él para comer, bañarse, vestirse y tomar su medicación.

Así que Gustavo necesita un empleo con horario flexible. Ha estado trabajando principalmente como camarero. Han aparecido otras oportunidades de empleo, algunos con mejor salario, pero el cuidado de su madre está primero, dijo.

 Pidiendo ayuda

Gustavo recibe ayuda de amigos de la familia que vigilan a su madre mientras está en el trabajo. También encontró Casa Cultural en Chicago, una agencia de servicios sociales que ofrece un programa de día para personas mayores. Puede dejar a su mamá en el centro por unas horas, lo que le da un respiro.

Programas gratuitos o de bajo costo como éstos están disponibles en muchas comunidades, pero las familias necesitan investigar y pedir ayuda, dijo Constantina Mizis, presidenta de la Latino Alzheimer’s and Memory Disorders Alliance, con sede en Chicago.

La alianza, formada en 2009, se centra en los miembros de la familia que son los principales cuidadores. Mizis dijo que ha conocido a muchos cuidadores que están al borde de quebrarse. La organización sin fines de lucro les ofrece capacitación, ayuda para encontrar recursos para impulsar su propio bienestar, y participación en eventos comunitarios para las familias.

Al buscar apoyo, el mejor lugar para comenzar es en un grupo o centro comunitario local: una iglesia, una organización sin fines de lucro, una oficina de United Way o el capítulo local de la Asociación de Alzheimer, por ejemplo, dijo Mizis. Es probable que estos grupos refieran a los cuidadores a la Agencia de Envejecimiento del condado o al Departamento de Envejecimiento del estado.

Allí, se les asigna a las familias un trabajador social que puede discutir qué beneficios están disponibles. Si un paciente de Alzheimer califica para Medicaid [Medi-Cal en California], estos beneficios podrían incluir capacitación para cuidadores y pago a través de programas de “efectivo y consejería”. Los Servicios de Apoyo en el Hogar de California es uno de esos programas. Sin embargo, los beneficios y la elegibilidad varían según el estado.

En 2010, la Administración del Seguro Social reconoció al Alzheimer de inicio temprano como una condición médica elegible para los ingresos por discapacidad. Eso podría ayudar a las personas cuya enfermedad de Alzheimer se diagnostica antes de los 65 años, pero muchas familias latinas no son conscientes de esto, dijo Mizis.

Un impulso para la concientización

Debido a que los latinos son más propensos a usar opciones de atención informales y más asequibles, el informe de la USC pide mejorar la capacitación y los recursos para las familias, tanto en inglés como en español.

Entre los cuidadores que optan por mantener a un padre con Alzheimer en casa está Julia García, de Houston, Texas. Ella se rota con sus tres hijas adolescentes y adultas para cuidar a su madre, Marcela Barberena, de 85 años, quien fue diagnosticada con la enfermedad el año pasado.

Julia, que no estaba familiarizada con el Alzheimer, pensó que el olvido y el comportamiento infantil de su madre se debían a la edad.

“Demasiado a menudo la gente ve al Alzheimer como resultado de la vejez, pero la enfermedad que deteriora el cerebro no es natural”, dijo Vega, coautor del informe de la USC.

Julia García dijo que se dio cuenta de que era algo más serio cuando su madre tomó un micro desde el aeropuerto internacional de Houston sin saber su destino.

“Habíamos acordado que la recogería, pero ella se fue por su cuenta”, dijo Julia. “Terminó en el centro de la ciudad. Fue el momento más espantoso de mi vida”.

Como nueva cuidadora, Julia se acercó a la sede local de la Asociación de Alzheimer para obtener información. Aunque algunos recursos están disponibles en español en el capítulo de Houston, Julia notó que muy pocos latinos asistían a los talleres informativos o a las clases.

Lo mismo ocurre con los medios en español, que proporcionan poca información sobre la enfermedad. “Rara vez se oye nada en la televisión o en la radio”, dijo.

Muchos latinos, incluyendo las familias de Márquez, López y García, no saben sobre los ensayos clínicos y cómo pueden ayudar a sus seres queridos.

Los latinos están subrepresentados en los ensayos clínicos patrocinados por los Institutos Nacionales de Salud: representan el 17 por ciento de la población de los Estados Unidos, pero sólo el 7,5 por ciento de los participantes en los 32 centros de investigación de Alzheimer financiados por los INS en todo el país, según el informe de Roybal.

Los voluntarios latinos son importantes para ayudar a los investigadores a desarrollar tratamientos para el Alzheimer que funcionen para todos los grupos étnicos, según el informe de USC.

“Por eso es tan importante invertir en la educación de estas comunidades”, dijo Mizis.

Su grupo ayuda a entrenar promotoras o educadores comunitarios de salud en regiones con grandes comunidades latinas, incluyendo San Francisco, Los Ángeles, Baltimore y Nueva York. Al ir de puerta en puerta, las promotoras educan a las familias sobre la enfermedad.

“Veo de primera mano cuánto necesitan ayuda nuestras comunidades”, dijo Mizis. “Y esta necesidad sigue creciendo”.

Esta historia fue producida por Kaiser Health News, que publica California Healthline, un servicio editorial independiente de la California Health Care Foundation.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

The 6 Biggest Surprises That Came With Losing 280 Pounds

To say that losing weight is difficult is a huge understatement… especially in a country where Dollar Menu items are much easier and cheaper to acquire than anything that’s remotely healthy. Even after losing more than 280 pounds over 10 years, I’m still battling with obesity issues. While it’s been hard losing the weight and keeping it off, I’ve learned where my overeating stems from, have overcome many of the issues that brought me into this, and have finally gained control of my own body. But the journey has been a long one, and there have been many surprises along the way.

1. You have to learn to think incrementally.

Even if you are hundreds of pounds over your goal, every ten pounds lost matters. I like to think about my weight-loss journey like a tightrope walker trying to cross a gap. I want to maintain the balance of a fitness lifestyle while being wary of falling into the abyss of my obesity issues. Having faith in myself is the wind blowing (or staying blessedly still) in the middle of my high wire act.

2. The rewards trickle in daily… and they’re not always what you expect.

During my battle with obesity, I’ve discovered countless upsides to being in control of my disorder. I’d anticipated some of them—like being able to walk upstairs without shortness of breath and agonizing knee and back pain—but there were other sheer joys I hadn’t even thought to expect. For instance, when I no longer had to face the embarrassment of asking a first date to move to the table instead of the booth so my gut could fit… that was a pretty miraculous day.

You might also like {{displayTitle}} READ 3. Emotionally charged backslides happen—and they hurt.

Even with all the rewards, this process is emotionally complicated and requires you to take a full life inventory. When I fell off my tightrope, some of the most painful parts of my life resurfaced—I realized that at the core of my food addiction was a desire for more time with my father, who had passed away when I was in high school. This realization drove my addiction to food into hyperspeed, and I began to overeat again—sometimes it felt like I was eating more than any other human had ever eaten before. But I regained control and felt proud of my first 100-pound weight loss, which marked the anniversary of my father’s death.

4. Your goals will change.

Even now, as I maintain a healthy weight on the other side of grief, I still battle with emotionally charged eating, but I now have the drive to make the rest of my life the best of my life. However, I still face the anxiety that comes with getting older and the challenges of weight management. By 2014, I had lost 220 pounds, but the last 60 pounds I lost came just as I turned 30 years old. When I realized my own mortality, I began working even harder.

5. You have to relearn to see yourself… over and over again.

I should view my excess skin as a medal of honor; it serves as a daily reminder of who I used to be and how far I’ve come. But seeing yourself this way can be difficult, especially in the fitness industry, where looks feel like they’re everything. Our current fitness culture, which is so dependent on social media, can feel like the opposite of love, acceptance, and appreciation for who you are. I’ve learned to cope by helping other people identify their disorder and start the process of becoming who they want to be.

6. The worst parts can become the best.

I remember the embarrassment I felt when I first walked past the gym veterans to the far back of the cardio deck. While it was originally a big source of anxiety, cardio—along with strength training—really helped me build self-esteem. I’m currently on the other side of that battle; now I’m the gym vet with a new view from the front of the cardio deck. Of course, I still struggle with my self-image, but I have peace of mind knowing I am learning to be happy with me.

Vinson Smith is the cofounder of HardBody Fitness Personal Training Group and player development coach at Mallard Creek High School in Charlotte, NC. Follow him on Twitter, Instagram, and Facebook @VinsonSmithCLT.

A 25-Minute TRX Workout for When You Have No Idea What to Do at the Gym

In order to see results, you have to switch up your usual routine. This 25-minute workout utilizes a suspension trainer like TRX to transform the basic bodyweight moves you know and love to make them even more effective.

You might also like {{displayTitle}} READ

Using a suspension trainer forces you to activate your stabilizing muscles (the muscles that help you balance) during every exercise, so you'll challenge your upper body, core, and lower body in ways you never knew possible. Have no idea WTH to do with those straps? Don't worry. Instructor Kelly Lee offers detailed directions to guide you through each move. So grab a TRX and press play to get started.

To recap: You'll need a suspension trainer like TRX for this workout.

Looking for more short and effective at-home workouts? Grokker has thousands of routines, so you’ll never get bored. Bonus: For a limited time, Greatist readers get 40 percent off Grokker Premium (just $9 per month) and their first 14 days free. Sign up now!

Veteran Teaches Therapists How To Talk About Gun Safety When Suicide’s A Risk

Jay Zimmerman got his first BB gun when he was 7, and his first shotgun when he was 10.

“Growing up in Appalachia, you look forward to getting your first firearm,” he said, “probably more so than your first car.”

His grandfather taught him to hunt squirrels and quail. Zimmerman, who lives in Elizabethton, Tenn., said pretty much everyone he knows has a gun. It’s just part of the culture.

“When I went into the military, that culture was reinforced,” he said. “Your weapon is almost another appendage. It’s part of who you are.”

Zimmerman served as a medic in the Army in the late 1990s and early 2000s, with stints in Bosnia, Africa and the Middle East. Since he came home, he’s struggled with PTSD and depression. It reached a crisis point a few years ago, when his best friend — the guy who had saved his life in a combat zone — killed himself. Zimmerman decided his time was up, too.

“I decided that I would have one more birthday with my daughter, one more Christmas with my daughter,” he said. “I had devised my own exit strategy for 16 February 2013.”

But then he bumped into a woman who used to ride the same school bus when they were kids. His exit date came and went. They’re married now.

Zimmerman still gets depressed, but now he’s a peer counselor at the Mountain Home VA Medical Center in Johnson City, Tenn. He also travels to conferences all over the country, sharing his story with therapists and with other vets, encouraging them to ask for help when they need it.

Even today, he explains at these conferences, if he’s not doing well, he disassembles his guns and stores them separately from ammunition, so he can’t make any rash decisions. And if things get really bad, Zimmerman has a special arrangement with a few friends.

“I call them and say, ‘Look, I’m feeling like it’s not safe for me to have firearms in my home. Can you store them for me for a couple days till I feel like I’m OK to have them back?’ ”

Suicide is often an impulsive act. Nearly half the people who survive an attempt say the time between their first thought of suicide and the attempt itself was less than 10 minutes. But the method can mean the difference between life and death: People who take pills have time to change their minds, or may still be alive when discovered. That’s not the case with guns.

Almost 70 percent of veterans who commit suicide do so with a gun, which prompted President Barack Obama to order the VA to talk to vets about gun safety and storage options like the ones Zimmerman uses.

But here’s the trouble: Most therapists aren’t gun people. They don’t know how to talk about guns and so they don’t.

“One obvious reason for that is that no one has taught them how,” explained Megan McCarthy, a psychologist and National Deputy Director in the Office for Suicide Prevention in the U.S. Department of Veterans Affairs.

McCarthy was invited to speak recently at a suicide prevention conference in San Francisco, aimed at therapists who work with vets.

“How many of you would say you feel really comfortable having a conversation with any of the people you work with about limiting access to all lethal means?” she asked the roomful of therapists.

Hardly anyone raised their hand.

“OK, so that’s why we’re here today,” she said.

Researchers recommend starting with a field trip to a shooting range. There, therapists can learn about different kinds of firearms, as well as gun locks, and get an introduction to gun culture.

When counseling vets, therapists have to ask more questions and be less directive, McCarthy said.

“We often conceive of ourselves as experts — as people who impart information to clients,” she said. But with vets, “it may take time to build trust. Telling them what to do the first time you’ve met them is probably not going to be a very effective approach.”

McCarthy presented a case study at the conference: A 28-year old, unmarried Army veteran who fought in Iraq told his VA psychiatrist that he had an argument with his girlfriend last week. He drove to an empty parking lot and sat with his loaded handgun in his lap, intending to kill himself.

He didn’t do it. A week later, the man told his psychiatrist things were still tense with his girlfriend. But he didn’t want to talk about suicide or storing his gun.

McCarthy asked the clinicians in the audience what they would do next, if they were this man’s psychiatrist.

“Why did he not do it? That would be my question,” one therapist said.

“I would want to see this individual again, within the same week,” said another. “I believe in strong intervention.”

Jay Zimmerman, the former army medic and peer counselor, stood up and explained his different perspective.

“Chances are the reason he’s not talking to you is because he’s afraid he’s going to lose his gun that he carries pretty much all the time,” Zimmerman said. “My buddies are the same way. We all carry — all the time.”

A lot of veterans would sometimes rather confide in a fellow vet than someone in a white coat, Zimmerman said. And that was an unusual takeaway for the professional counselors: Sometimes their role is not to intervene at all, but to be a facilitator. To make sure vets have someone to talk to outside the therapy office.

This story is part of a partnership that includes KQED, NPR and Kaiser Health News.

Congressman’s Ties To Foreign Biotech Draw Criticism

When a small Australian biotechnology company, Innate Immunotherapeutics, needed a clinical trial for an experimental drug it hoped to turn into a huge moneymaker, the company landed a U.S. partner where it had high-level connections: Roswell Park Cancer Institute in Buffalo, N.Y.

The company is partly owned by Rep. Chris Collins, a wealthy Republican entrepreneur from Buffalo, whose enthusiasm for Innate helped persuade others to invest. Former Rep. Tom Price, now secretary of Health and Human Services, bought Innate stock after Collins told him about it, Price said at his Senate confirmation hearing. Other shareholders include Collins’ campaign supporters, some of whom are key figures in Buffalo’s medical corridor, company and government documents reveal.

Federal money is in play, too: National Cancer Institute funds are being used to test an application for Innate’s drug that could make the company more attractive to potential buyers. Innate has said in presentations to investors that it hopes to sell itself to a major pharma company by the end of 2017.

The Roswell clinical trial, which could start this month, will investigate whether MIS416 might have an application as an ingredient in a vaccine for ovarian cancer. Innate’s primary strategy, however, is to develop the drug for advanced multiple sclerosis and it has told investors that the results of early-stage human trials in Australia and New Zealand against MS will be reported by this fall.

With its tangled web of medicine, politics and money, Innate’s story has proven irresistible for U.S. news media, whose initial reports in December that Price received discounts on Innate stock purchases helped place the secretary on the hot seat as he won confirmation. Now, the story is exploding half a world away, and the focus is shifting to Collins. The Australian newspaper’s website reported Feb. 6 that a former securities regulator there alleged Collins may have violated disclosure requirements in the country’s securities laws in acquiring his Innate stake and also by not reporting his close relationships with other large shareholders. The Australian government’s Takeovers Panel said Feb. 15 that it has not decided whether to convene a panel to investigate the allegations.

Innate CEO Simon Wilkinson said in a statement that company financial documents “fully informed” financial markets about Collins’ investments. The company was “not in the slightest bit concerned” about the allegations, which “are politically motivated and have been peddled by hack journalism,” he said.

Compared with Price, the potential conflicts could run even deeper for Collins who — along with two children — owns more than 21 percent of Innate’s shares. He is its largest shareholder, company reports show.

Collins, who is ranked by the Center for Responsive Politics as the 14th-wealthiest member of Congress, sits on the health subcommittee of the Energy and Commerce Committee, where he helps oversee health care funding. He was a member of President Donald Trump’s transition team and is a liaison between the new administration and Capitol Hill.

Congressional ethics rules do not prohibit Collins and other members from investing in companies whose businesses overlap with the committees they serve on and the government agencies those committees oversee, legal experts said. Even so, they added, members must take care to disclose possible conflicts of interest because they can erode the public’s trust in government.

“Members should not have large holdings in health care stocks while serving on committees that oversee health policy,” said Richard Painter, former chief ethics lawyer for President George W. Bush.

Collins’ spokesman said his boss has done nothing improper.

“Congressman Collins is not going to apologize because a company he has a relationship with is attempting to help conquer cancer,” said Collins communications director Michael McAdams. “It’s sad the media is attempting to launch partisan attacks insinuating otherwise.”

‘I Talk About It All The Time’

Collins has been candid about his promotional efforts on Innate’s behalf.

In an interview with CNN, Collins said he often talks to people about Innate. “I talk about it all the time, just as you would talk about your children,” he said.

Last month, Collins was overheard by reporters boasting on a cellphone call just off the House floor about the “many millionaires” he had made talking up Innate, according to Politico.

Innate’s drug is an immune response stimulator discovered in the 1990s that had initially been developed as a potential treatment for HIV/AIDS or to boost the efficacy of childhood vaccines.

Founded in 2000, the company later tried MIS416 in a number of medical uses, but never found a marketable niche, Innate’s financial reports and news reports show.

Collins’ ties to Innate go back to 2005 — seven years before he was first elected to Congress — when the successful Buffalo businessman decided to invest after meeting Wilkinson while the CEO was in the U.S. seeking investors, Wilkinson said.

Collins joined the board in 2006 and the company first sold shares to the public in 2013. From 2013 to 2016, he bought Innate shares then worth between $3.5 million and $16 million and has not sold any, according to his congressional disclosure statements. Collins now owns nearly 38 million shares of the company, worth about $25 million based on the stock’s recent closing prices on the Australian stock exchange. That price peaked at $1.35 a share on Jan. 25 and is now under $1.

Innate has never had a revenue-producing product and has relied mainly on investor capital for funds. The congressman made four personal loans to Innate in 2012 and 2013 totaling $1.3 million that were later converted to shares and options to buy more shares at discounted prices, according to company financial reports.

Collins also promoted Innate among people in his professional and social circles, drawing investors whose share purchases have helped keep the company afloat.

Americans own 44 percent of Innate, according to a company-funded research report on its website. Many of those shareholders seem to come from an interconnected circle of prominent Buffalo investors with Collins at the center, based on company documents, congressional disclosure statements and political contributions reported in Federal Election Commission filings.

Investors who bought stock in two private placements by Innate have contributed at least $105,000 to Collins’ congressional campaigns, according to the Public Accountability Initiative in Buffalo, a nonprofit that investigates politics and government, which compared an Innate shareholders’ document with FEC filings.

One was Glenn Arthurs, an executive in the Buffalo office of UBS, the Swiss financial services giant. Another was Paul Harder, who runs a private investment firm in Buffalo, CHEP II. Arthurs and CHEP II both ranked among Innate’s top 20 shareholders last year, according to the company’s annual report. Both have also contributed to Collins since 1998, the year of his first — and unsuccessful — congressional campaign, FEC records show.

Collins’ congressional chief of staff, Michael Hook, who began working for Collins early last year, bought shares of Innate 28 times last year, according to his disclosure statements. Sometimes he purchased thousands of dollars of stock multiple times in a single day, those filings show.

Bill Paxon, a former congressman from Buffalo and a lobbyist whose clients include PhRMA, the major drug makers’ trade group, has invested in Innate. So has Lindy Ruff, the former coach of the Buffalo Sabres hockey team, who is now head coach of the Dallas Stars. Both were identified in a public company document for shareholders.

Ruff declined to comment on his Innate investment. Paxon, Arthurs, Harder and Hook did not reply to repeated requests from KHN for comment.

Mark Lema, Roswell’s head of anesthesiology, told The Buffalo News recently that he became an Innate investor after overhearing Collins discussing it at a meeting for Buffalo visitors that Collins hosted in Washington, D.C. But he’s never discussed Innate or MIS416 with study researchers at Roswell, he said in a subsequent interview with KHN.

A Complaint In Australia

Recent published reports in the U.S. detailing Collins’ ties with Innate are what provoked Sydney lawyer — and Innate shareholder — James Wheeldon to question Collins’ adherence to Australian securities laws, according to the 10-page letter that he sent Feb. 3 to Innate and the Australian Securities and Investment Commission.

Wheeldon alleged that Collins failed to disclose his large holdings in Innate to the Australian Securities Exchange within two business days of becoming a substantial stockholder, as the country’s law requires.

Stating that Collins owned more than 15 percent of the company before Innate went public in December 2013, Wheeldon alleged that Collins did not inform the exchange how much he owned until almost 18 months later.

Wheeldon also said that published reports about Collins’ “family, professional, political and financial relationships” with other Innate shareholders like Price had never been disclosed to the Australian financial market to his knowledge, “but rather has only come to light as a consequence of these press reports.”

Collins, his children, political allies and his donors control at least 27.25 percent of the company — giving Collins greater influence over the company than has been disclosed to shareholders, Wheeldon wrote.

“Mr. Collins duty is not to enrich the business and political elite of Buffalo, New York. His overarching duty is to the company,” read Wheeldon’s letter.

The stakes may be high, but the data from the Roswell study might not produce strong conclusions. Twelve people will be in the study, which is to be completed in August 2018, according a listing on clinicaltrials.gov. The start of the trial has been postponed five times since July and is now scheduled for this month. Recruiting for participants has not started yet, according to the listing.

Innate and Roswell began collaborating in 2009 and as both sides tell the story, Collins — the man who first connected the Australian biotech firm to Buffalo — had nothing to do with it. According to Roswell, the doctor running the trial, Kunle Odunsi, learned about MIS416 that year when Wilkinson, the CEO, pitched the drug at a presentation in Buffalo to prospective collaborators. Roswell researchers have been testing the vaccine in mice with tumors since first receiving the National Cancer Institute grant in 2011.

The trial is called an “investigator-initiated” trial, meaning that Odunsi has an agreement with Innate to explore the use of MIS416 for a cancer vaccine for free. Innate donates the drug, Roswell sponsors for the trial and if it’s successful, researchers could approach a medical journal to publish the results.

“A publication by a reputable clinical center (e.g., Roswell) in a prestigious journal […] would almost certainly increase off-label usage, thus increasing sales,” Kenneth Kaitin, director of the Tufts Center for the Study of Drug Development, wrote in an email.

Wilkinson said Collins has played no role in lining up the clinical trial at Roswell or getting the NCI funds to pay for it. McAdams, Collins’ spokesman, said Collins had “zero involvement” in the grant.

12 Heart-Smart Tips You Haven't Heard

When I flip my calendar to February, two things usually come to my mind. One, I’m getting tired of the cold and snowy winter, and two, Valentine’s Day is coming. Now, I don’t know how you feel about this “holiday," but I like it. Red happens to be my favorite color, and I love seeing all the decorations in stores. I look forward to reading the articles in magazines about celebrating our relationships, and how best to tell those who mean the most to you that you care. And even though baking is not my thing, I find it fun to read the Valentine’s Day recipes and see the heart-shaped cakes and cupcakes in the bakeries. Regardless of how you feel about Valentine’s Day, hearts are everywhere, and February is also American Heart Month. Although we think of the heart as the vehicle of emotions, that job really belongs to our minds. The heart’s job is to keep us alive by pumping vital oxygen-enriched blood to every cell of our body, doing all the jobs that keep us functioning. With such an important role, it’s essential to do all we can to keep our hearts healthy and strong. There is a common misconception that heart attacks only occur in men, but in fact, heart disease afects 6.5 million women. Many believe that cardiovascular disease has such a strong genetic component, that there is little you can do to prevent the inevitable. Please don’t fall into this faulty thinking. There is an old expression that states: “Genetics loads the gun, but lifestyle pulls the trigger.” We cannot underscore the importance of good nutrition and exercise. The heart is a muscle, and the more it works, the stronger it gets. A heart-healthy diet is one filled with fruits, vegetables, whole grains, nuts, legumes, low-fat protein, and healthy monounsaturated fats and omega-3 fatty acids. It happens to be the same diet that is recommended to reduce the risk of so many other diseases, such as hypertension, diabetes, obesity, high cholesterol, high triglycerides and vascular diseases, which of course, all raise your risk of heart disease. Although exercise and a healthy diet top this list, here are twelve interventions you should embrace to protect your heart. Some will be familiar and serve as a good reminder, and others will surprise you. You owe it to yourself and your loved ones to take the best possible care of yourself. Begin with strengthening the most important muscle in your body, your heart.

  • Adhere to a consistent exercise program and follow a heart-healthy diet. If you need help, talk to your doctor, hire a personal trainer, and/or enlist the services of a dietitian or certified wellness coach. Do whatever it takes.  
  • Lose excess weight safely, which means slowly. Maintaining a healthy body weight is known to reduce your risk of heart disease. However, crash dieting repeatedly, very-low calories diets (VLCD), cleansings and fasts have all been shown to weaken the immune system and damage heart muscles, thus increasing the threat of developing heart disease.  
  • Develop a robust circle of friends and loved ones and nurture those relationships. Studies have shown that people who lack a strong network of friends and family are at a greater risk of developing and dying from heart disease. If loneliness plagues you, developing good relationships will not only increase your happiness, but will make you healthier. Consider signing up for volunteer work. Take a class that interests you. Meetup.com is a great website that lists interest groups by geographic areas and has so many groups that you are sure to find a new social circle.  
  • Brush, floss and rinse everyday. It’s not just about sweet-smelling breath and pearly whites: Gum disease has been linked to heart problems. Make sure you keep on top of professional cleanings at your dentist’s office twice a year.  
  • Get a good night's sleep. Researchers have found that the chronically sleep-deprived increase their likelihood of developing heart disease. Aim for a minimum of seven hours a night.  
  • Reduce your intake of sodium by reading food labels and choosing lower-sodium items. Avoiding the salt shaker will only make a small dent in your daily sodium intake, since the majority of salt we consume comes from processed foods we purchase. Consistently exceeding the recommended daily sodium threshold of 2,400 milligrams raises the danger of developing high blood pressure, often a precursor to heart disease.  
  • Don’t smoke cigarettes, or do everything in your power to stop, if you do. Although we tend to associate smoking with lung problems and cancer, it also plays a role in cardiovascular disease. Smoking is a major cause of atherosclerosis, which is the build up of fatty substances on the arteries. This narrowing results in a decrease of oxygen-rich blood flow to the heart muscle. Over time, if one or more of the arteries that lead to the heart get totally blocked, a heart attack may occur.  
  • Talk to your doctor about antioxidant vitamin supplements and/or baby aspirin as a defense against heart disease and heart attack. However, no matter what your doctor may recommend, vitamins won't prevent the development of heart disease if you don't control your other risk factors, such as poor diet, lack of physical activity, smoking, high cholesterol and diabetes.  
  • Adopt a pet. Individuals who own animals have a live-in, stress-reducing pal and often have lower blood pressures. If that pet happens to be a dog, you also have a great exercise buddy.  
  • Learn and practice stress management skills. If you find yourself saying, “this stress is killing me!” you may not be exaggerating. Chronic stress has been linked with decreasing the immune system, and increasing the risk of heart attacks and cardiovascular disease. Daily meditation, exercise, journaling and “me” time have all been shown to considerably reduce the amount and intensity of daily stress.  
  • Drink green tea and treat yourself to dark chocolate on Valentine’s Day, or any day. Antioxidants in green tea improve blood vessel function, and eating a small amount of dark chocolate can lower blood pressure and reduce the inflammation that leads to cardiovascular disease.  
  • Decrease daily negativity and increase your positivity. Mountains of research exist to show that an abundance of negative emotions such as anger and stress affect cardiovascular health, and positive emotions such as joy, gratitude and love boost our immune systems. By remaining positive, you’ll not only make life more fun, you’ll be taking care of your heart.

 

Sources American Heart Association Circulation. "Antioxidant Vitamin Supplements and Cardiovascular Disease," accessed January 2012. http://circ.ahajournals.org. Cleveland Clinic. "Heart and Vascular Health and Prevention," accessed January 2012. www.my.clevelandclinic.org. Fredrickson, Barbara. 2009. Positivity. New York: Crown Publishers. American Medical Association. 2008. Guide to Preventing Heart Disease. New Jersey: John Riley & Sons, Inc. Harvard Health Publications. "Gender Matters: Heart Disease Risk in Women," accessed January 2012. http://www.health.harvard.edu. Article Source: http://www.sparkpeople.com/resource/wellness_articles.asp?id=1716

Finding Time for Healthy Living

You've made the decision to get in shape, lose weight or just live a healthier lifestyle. But you're worried about how you'll manage to find the time to get to the gym, shop and cook healthy foods, or even how you'll keep your goals in mind with so many other things already on it. Your concerns are certainly valid. As a matter of fact, one of the most common statements I hear from colleagues and friends is, "When things calm down, I really need to start taking better care of myself." Here's the thing: If you are living a full and happy life, it is more often busy than not. And when you have so much to do, doesn't it make sense to take care of yourself and feel well? There's no debating that you will need to dedicate some time to self-care, but it shouldn't mean you will have to drop your friends, ignore your family or neglect your business. Here are some suggestions of how to create more time for healthy living. Eating well for good health and/or weight loss requires you to have nutritious foods available and make wise choices when eating out. Here are some ways to make the most of your meals when you're short on time. Take a few minutes at the beginning of the week to think through your upcoming schedule. How many days will you be home for dinner, and what will you prepare? Do Monday morning meetings always last through lunch? If so, it makes sense to bring a brown bag lunch that day. Will you head to the gym straight from the office and need to bring a healthy snack to fuel you through your workout and hold you over until dinner? Once you have a picture of your week, create your grocery list and plan when you'll head to the store. This extra step will save you tons of time by avoiding multiple trips to the market, or standing in line at the take-out eateries on your way home. At the market, consider purchasing healthy convenience foods. There are so many to choose from these days. Fresh vegetables, salad greens and fruit are available pre-cleaned and cut. Old-fashioned frozen dinners have been recreated to be low-cal, low- sodium, even vegetarian or gluten-free. Check the labels and know which ones to keep in your freezer for nights when you don't have the time to cook. Although you may think these options cost more, they are less expensive than eating in restaurants, buying take-out, or high blood pressure and high cholesterol medicines that often are required after years of unhealthy choices. If you prefer to avoid the expense of pre-cut fruits and vegetables, invest in crisper storage containers. Spend a little bit of time washing and cutting produce on the weekends, in order to save loads of prep time during the week. Call your local supermarket in advance of your visit and give the deli, meat and fish counter your order over the phone. They'll have everything ready and packaged for you, saving you time from waiting in line. If you really don't have the time to shop, many supermarkets now have online ordering and delivery options. Not only will they save your weekly shopping list so you can go back to check off your frequently purchased options, they'll let you know which of your favorites are on sale. Check out online food co-ops, produce and dairy markets. Many have memberships that will deliver fresh and/or organic goods on a scheduled basis. Equip your kitchen with time-saving devices. A slow cooker allows you to quickly throw together ingredients the night before. Plug it in to cook in the morning and a hot prepared dinner is ready when you return home. A microwave will reheat leftovers or frozen healthy choices. An immersion blender quickly makes soups from frozen veggies or smoothies out of frozen fruit. When you do cook, double the recipes. Keep old take out containers or purchase freezer-to-oven pans and create your own TV dinners or a second meal for the following week. On days when you have a meal out, keep in mind that the average restaurant serves two to three times the appropriate portion size. Ask for a take-out container and pack away half for lunch or dinner at another time. Now you've kept to a healthy portion size and you don't need to take time out to prepare another meal the next day. Fitting in movement and exercise requires the same proactive thinking as eating healthy. If you are going to join a gym, make sure it is conveniently located near your home or office. No matter how fabulous the gym in the next town is, if it takes too long to get to, you won't go when you're pressed for time. Home exercise equipment is the best investment for the truly time pressed or those who simply dislike the gym atmosphere. You won't waste time traveling back and forth, and could pair your daily sessions with another activity you enjoy. Addicted to the evening sitcoms or news? Do your exercise while watching. You know you would take the time to get that one episode in anyway, what a great way to multitask! Need to catch up on trade journals? All cardio equipment today is equipped with a reading stand. When squeezing in a formalized exercise session still seems impossible to do, know that several short bursts of activity has been shown to add up to great benefit. Whenever possible, take the stairs rather than the elevator, walk to your co-worker's office to deliver messages rather than emailing. Use the restrooms on another floor. Purchase and wear a pedometer. Measuring the number of steps you take each day can be highly motivating. Without even thinking about "taking the time out to exercise" you might just reach the 10,000 steps a day to achieve health benefits. Suggest business meetings at the local walking track rather than the boardroom. Your colleagues may be delighted to squeeze in their activity as well, plus fresh air and being in nature has been proven to improve mood and creativity. Combine exercise with family time. Rather than an outing to the movies, consider the roller or ice skating rink, miniature golf course, park or town pool. You and the kids will both get your exercise and quality time together. You don't have to sacrifice time with your friends to get in a workout. Suggest an active happy hour after work rather than heading to the local bar. Go bowling, or join a baseball, basketball or soccer team. For the really ambitious, train together for an upcoming race. Let go of your "all or nothing" exercise attitude. If you think a 10 or 15 minute workout is "pointless" when you don't have time for a full hour, think again. Every minute counts toward improving your fitness level, reducing stress and strengthening your heart and muscles. Plus a minute spent exercising always beats a minute spent sedentary. Stress reduction and sleep are important to self-care and a healthy lifestyle, but too often neglected when life is frantic. Deep breathing is one of the best ways to ease stress and takes a mere 30 seconds. Begin to notice the physical signs you experience when stress is mounting. Neck tension, back pain, and queasy stomach are common. Stop what ever you are doing and take a few deep, cleansing breaths. A mantra such as "breathe" or "stay calm" may help. Stress leads to inefficiency and mistakes that then take more time to redo and correct. Chronic stress can weaken the immune system, exacerbate illness and injuries and lead to lots of time spent at the doctor's office or home in bed. Take time regularly to manage your stress to avoid massive loss of time later. Experiment with what works best for you. Ten minutes of daily meditation, a weekly massage or just an evening out each week with your honey can go a long way to keeping you healthy. When you find yourself thinking "I don't have time for this" remind yourself how time consumed being sick or depressed is! Many people believe they can gain more time by skimping on sleep. I hope you are not one of them! Just as too much stress will lead to more mistakes, inefficiency, depressed immune system and increased injury and illness, so will lack of sleep. Although an occasional night of reduced sleep won't have long lasting effects, a constant diet of sleep deprivation will. Trying to function on too little sleep will end up causing you to waste time rather than save it. Chronic stress and sleep deprivation have also been proven to hinder weight loss. So if you are in hurry to see the pounds melt away, get your sleep and take time to relax, unwind and rejuvenate. With some proactive thinking and creativity, creating time for healthy living should not be an insurmountable problem. Self-care can compliment and fit seamlessly into your lifestyle. Sources: American Heart Association. Clarkson Potter Publishers, New York. "Fitting in Fitness: Hundreds of Simple Ways to Put More Physical Activity into Your Life." IL: Human Kinetics. Tribole E. "Eating on the Run—Third Edition." Journal of Clinical Sleep Medicine. Siobhan Banks, Ph.D. and David F. Dinges, Ph.D. Banks S, Dinges DF. "Behavioral and Physiological Consequences of Sleep Restriction," Accessed August 2011. www.ncbi.nlm.nih.gov.Article Source: http://www.sparkpeople.com/resource/wellness_articles.asp?id=1664

Why Getting Outside is So Good for You

John Keats once wrote, "The poetry of the earth is never dead." Poet or not, almost all of us have been awestruck by nature at one time or another. Whether it's running at sunset on a sandy white beach, walking alongside a cool trickling stream, watching sunset over a mountain ridge, or even hearing the wind blow through the trees in the morning, being outdoors and aware of the world's beauty can make you feel energized and alive. Recently, much research has focused on the so-called "nature connection," and how it affects our health, outlook and overall life. Nature's Healing Powers It seems that just being out in nature does your body, mind and soul some good. According to a 2009 study published in the Journal of Epidemiology and Community Health, the closer you live to nature, the healthier you're likely to be. The study took an objective look at 345,143 Dutch people's medical records, assessing health status for 24 conditions, including cardiovascular, respiratory and neurological diseases. The records were then correlated with how much green space was located within 1 kilometer and 3 kilometers of a person's postal code. And what did researchers find? People who lived within 1 kilometer of a park or a wooded area experienced less anxiety and depression than those who lived farther away from green space. Additionally, people living in urban environments had a higher prevalence of 15 of the 24 conditions, with the relationship strongest for anxiety disorder and depression. It's interesting to note that the green space's health benefits were only found when they were within a kilometer (not 3 kilometers away), except for anxiety disorders, gastrointestinal digestive disorders and other medically unexplained physical symptoms, according to the research. Live in a city with no green space nearby? No worries! Other studies by researchers in England and Sweden have found that joggers who exercise in a natural green setting with trees, foliage and landscape views, feel more restored, and less anxious, angry and depressed than those runners who burn the same amount of calories in gyms or other urban settings. So even if you have to drive a few miles to find a little green, it's worth it! Why Does Nature Do the Body So Good? So what is it about nature that makes us so much healthier? And what is about outdoor exercise that is better than working out in a gym? While there are many theories as to why being in nature makes us healthier, one leading hypothesis is that being outside increases our Vitamin D intake. We just keep learning more and more about how important vitamin D is for health, including preventing cancer, hormonal problems, obesity, and inflammation, and having a strong immune system. Because sunlight is a natural source of vitamin D, it only seems logical that spending more time in outside would increase your vitamin D intake. Being in a natural setting can also help increase your quality of sleep, as studies show that natural sunlight helps set the body's internal clock that tells us when to eat and sleep, and normalizes hormonal functions that occur at specific times of the day. And we all know how important sleep is not just for our health, but even for our weight loss! Enjoying the outdoors also gives us a break from technology and the on-the-run lifestyle to which we're all so accustomed. When we're outside, we have a clearer, more focused mindset to hang out with friends, or spend some quiet time alone or even play with a pet.  (Remember: Pets can decrease your blood pressure, cholesterol levels, triglyceride levels and feelings of loneliness, according to the Centers for Disease Control and Prevention). When we're outside, we can also learn and enjoy a new skill or physical activity. And perhaps most important of all, we get a chance to turn off—or better, leave behind—our cell phones to clear our heads and break from the stress we all have each and every day. How Much Green Exercise Is Enough? So how much green time do you need? Not much, recent research says. According to the American Chemical Society's journal Environmental Science & Technology, as little as five minutes exercising in a park, working in a backyard garden, hiking on a nature trail, or even sitting in a plant-filled setting will benefit your mental health. From researchers' analysis of 1,252 people of different ages, genders and mental health status performing walking, gardening, cycling, fishing, boating, horse-riding and farming, the greatest health changes occurred in the young and the mentally ill, although people of all ages and social groups benefited. All natural environments benefited study participants, including parks in urban settings. However, green areas with water were especially beneficial, as were environments that were both green and blue (think of a green tree on a bright blue sky). Fun Ways to Get Outside Ready to get out there? Here are seven easy ways to enjoy the benefits of nature!

  1. Make being outside a ritual. Go for a morning or evening walk every day. And if you have one, bring your pooch—outdoor exercise is good for Fido, too.
  2. Try gardening. From a planting vegetable garden to planting a few flowers, both activities get you outside regularly and communing with nature.
  3. Take vacations in beautiful places. For your next scheduled break, visit a state or national park or go to a beautiful beach—whatever landscape speaks to you!
  4. Find a trail. Whether hiking or biking is your speed, there are trails around the country for you to explore. Find one near you at trails.com.
  5. Sit outside. We're always so on-the-go. The next time you need a break, try sitting outside quietly and just appreciate the natural beauty around you! Notice the scents, sights and sounds as you sit quietly and focus on the moment.
  6. Go to a local park. Ask others in your neighborhood which park is their favorite to visit. Then the next time the weather is good, trade your usual gym workout for an outdoor one!
  7. Commit to the outdoors, rain or shine. When you're layered properly, you can enjoy the outdoors in any season, cold, wet or hot. Don't forget about the fun and healthy outdoor activities available during the rainy or cold months—these are the times that we have even less outdoor interaction, but may be when we need it the most!  
So the next time you have the opportunity to get outside for a brisk walk or a workout, take the chance to soak in that Mother Nature! What's your favorite exercise to do outside? How does it make you feel?   Sources Gardner, Amanda. "Being Near Nature Improves Physical, Mental Health," accessed May 2011. www.usatoday.com.   Louv, Richard. "The Powerful Link Between Conserving Land and Preserving Health," accessed May 2011. www.childrenandnature.org.   National Institute of Neurological Disorders and Sleep. "Brain Basics: Understanding Sleep," accessed May 2011. www.ninds.nih.gov.   National Centers for Infectious Diseases. "Health Benefits of Pets," accessed May 2011. www.cdc.org.   Science Daily. "In the Green of Health: Just 5 Minutes of 'Green Exercise' Optimal for Good Mental Health," accessed May 2011. www.sciencedaily.org.  Article Source: http://www.sparkpeople.com/resource/wellness_articles.asp?id=1680

10 Signs You're Watching Too Much Television

Many people claim that they don't have time to work out or cook healthy meals, yet they do find the time to park themselves in front of the TV. In fact, the average American watches 31.5 hours of TV per week, according to a 2010 Nielsen report. That's almost as many hours as most of us spend working! That's a lot of hours that could be spent shopping for and preparing nutritious meals, hitting the gym or even taking up a new hobby. If you think your loyalty to your favorite TV shows could be interfering with your life—or your pursuit of health—then read on. 10 Signs You're Watching Too Much TV 1. You've turned into a hermit. If you can't commit to a night out with your friends because you don't want to miss the latest episode of your favorite show—or even one of your top 10 favorite shows—you may have an addiction to TV. Hanging out with friends can combat loneliness and put you in a better mood. Plus, time with buddies may even help you live longer, according to the Journal of Epidemiology & Community Health. So don't banish your buddies just because you love that show about people who fish with their bare hands. Set the DVR—or if you're old-fashioned, program the VCR—and head out with your friends. Even better: Go for a walk with your pals to get your heart pumping. 2. There's a dent in your couch where your butt usually goes. If your couch is looking increasingly lopsided, it might be a sign that you're spending too much time parked on its cushions. Don't just flip them over or switch your position to fix the problem—get off the couch! There are numerous exercises that can be done with little or no equipment while you watch TV—think jumping jacks, push-ups, sit-ups, squats and lunges—or you can crank up your treadmill while you catch up on the latest episode of Real Housewives. Choose an hourlong show to get moving to, or if you'll be camped out for a while watching a marathon, get moving during commercial breaks instead of heading to the kitchen for that snack. 3. Your dog jumps onto the couch and looks at you with sad puppy dog eyes when you don't join her. If even your dog has gotten used to your nightly routine of snuggling on the couch while watching Animal Planet, it may be time to break away from the boob tube. Take your faithful furry friend for a long walk—you'll both benefit from the exercise and the change of scenery! 4. You find yourself ordering out so you have more time to veg. If you're calling for pizza delivery or stopping to get takeout on the way home so that you won't have to bother with groceries or cooking, it might be a red flag. Skip a show or two so you'll have time to make that healthy meal before getting comfortable for an evening in. Healthy cooking can even be quick and easy! 5. Your TV tray has a permanent spot in your living room. If you eat all of your meals in front of the television, it might mean you're a little too addicted to cable. Not only does TV make it easier to zone out and overeat, but you're not interacting with the family or friends during meals (invite them over if you're living the single life). 6. You lift up the couch cushions, and popcorn and crumbs have multiplied. This is another sign that you're vegging out too much—and eating mindlessly while you do. When you don't even realize that a bucket of popcorn has fallen onto the couch, how can you keep track of how much you're actually consuming? 7. You get up from the TV after hours and have no idea what you've been watching. We're all guilty of this sometimes. You flip around mindlessly, channel surfing until something catches your attention. You stop there until a commercial sends you on your merry way and you repeat this process for hours on end. If you find yourself doing this and you're the type that doesn't feel like they have time to eat right or exercise, you need to prioritize. Be honest with yourself and pick your top three can't-miss television shows and schedule workouts with the importance previously given to your show schedule. Or set a daily limit for yourself—two hours of TV and then it's on to something new. Set a timer if you have to! 8. Commercials have become your culinary inspiration. If you're craving fast food because you saw that Burger King commercial, it might be a sign that you're saturating your brain with advertisements! When you don't watch TV, you'll see far fewer fast food ads. Although most people claim that advertising "doesn't work" on them, marketers know better. You'll think about fries, seasonal shakes, and new must-try gut-busting burgers far less if you aren't exposed to their TV ads. 9. You find yourself thinking that you could star in your own reality TV show. News flash: There are about a million reality shows flooding the market already, and I've yet to see one starring someone who camps out in front of the TV all day! If you want to be a show worth making, go on a get-healthy streak à la The Biggest Loser or plan big, like running a marathon or trying a vegetable for every letter of the alphabet. Hey, I'd watch. 10. You don't have time to exercise, but you do make time to sit on the couch. That stat mentioned above about the 31.5 hours of TV per week is staggering. That's like another full-time job! If you have time to watch even 30 minutes of TV per night, then you have time to exercise—it's just that you are prioritizing the TV viewing higher on your list. Put down the remote and try to go TV-free for a couple of weeks, and use that time to get active and healthy. You'll feel so much better that we doubt you'll trade working out for couch surfing ever again! If you recognize yourself in this list—whether it's one or all 10—it may be time to admit you have a problem. Luckily, the TV habit can be broken and your life will get a lot healthier. TV definitely has its place in the modern world, but so do healthy habits! Sources: Nielsen. "2010 Media Industry Fact Sheet," Accessed September 2011. www.blog.nielsen.com. Journal of Epidemiology & Community Health. Giles LC, Glonek GF, Luszcz MA, Andrews GR. "Effect of social networks on 10 year survival in very old Australians: the Australian longitudinal study of aging," Accessed September 2011. www.jech.bmj.com.Article Source: http://www.sparkpeople.com/resource/wellness_articles.asp?id=1666

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