New contraceptive methods change birth control patterns

The birth control pill and sterilization are still the most common forms of contraception, but new federal data released Thursday show that long-acting methods are gaining ground while condom use for birth control is declining.

The report from the National Center for Health Statistics is based on data from a national sample of 12,279 women ages 15-44 in 2006-2010 compared with a sample of 10,847 women those ages in 1995. Findings show that sterilization and the pill were used by either 27% or 28% of women in both sets of data, (28% in 1995 and 27% in 2006-10 for sterilization and 27% in 1995 and 28% in 2006-10 for the pill), but condoms as the most effective method of birth control declined from 20% to 16%. That decline was offset by a 75% increase in the use of other hormonal methods such as the patch or ring (from 4% to 7%) and a sevenfold increase (0.8% to 5.6%) in the intrauterine device (IUD). Such methods are among those deemed "long-acting" since they do not require daily or weekly attention.

"There is some shift toward more effective contraception. The shift is also toward methods that require less user intervention," says Lawrence Finer, director of domestic research at the New York City non-profit Guttmacher Institute, which studies sexual and reproductive health.

Finer is lead author of research published this month in the journal Fertility and Sterility, which focused on long-acting contraception. The study found the proportion of women using such methods "increased significantly" since 2002 and occurred among women in almost every age, race, education and income group.

Experts say these other hormonal methods and the long-acting methods are becoming more popular because they are reliable and convenient. Many were not available during the first data collection. In addition, implants can last three years and some IUDs don't need replacing for five or 10 years.

However, the report notes that contraceptive method use varies depending on insurance coverage and income.

"Many of the newer methods require physician visits to receive either the method itself like the IUD or a prescription," says Jo Jones, the report's lead author.

But that's not the only obstacle to greater growth of these newer methods, suggests nurse practitioner Linda Dominguez, of Albuquerque.

"There's a whole generation of physician providers who were not trained in the use of IUDs and implants," says Dominguez, board chairwoman of the Association of Reproductive Health Professionals, which is providing such training.

Among other findings:

-- 62% of women ages 15-44 use contraception; 38% do not (includes those who are pregnant or trying to get pregnant; those who haven't ever had sexual intercourse or had sex in the past three months of the survey).

-- Of teens ages 15-19, about 31% were using contraception; 59% either had never had intercourse or had not had intercourse in the prior three months.

-- More white women (66%) were using contraception compared with Hispanic (60%) or black (54%) women.

-- The use of other hormonal contraceptive methods increased in all age groups, but was greater among women under age 30.

Multivitamins may lower cancer risk in men

Taking a daily multivitamin could slightly decrease men's risk of cancer, according to a large new study being presented at the annual meeting of the American Association for Cancer Research and published in the Journal of the American Medical Association.

The study, conducted by researchers at Brigham and Women’s Hospital, is based on 14,641 male doctors ages 50 and older who participated in the Physicians' Health Study II. Some of the men were randomly assigned to take a daily multivitamin between 1997 and 2011, while others were assigned not to.

By the end of the study period, 2,669 new cases of cancer had developed, of which 1,373 cases were of prostate cancer and 210 cases were of colorectal cancer.

Overall, researchers found that the men who were assigned to take a daily multivitamin had an 8 percent lower cancer occurrence compared with those who didn't take the multivitamin.

Specifically, researchers didn't find that multivitamin use had any effect on the men's prostate cancer risk (even though prostate cancer was the most common cancer to affect them on a whole). However, multivitamin use was associated with a 12 percent lower risk of developing other cancers in the study.
Researchers also found that the risk of dying from cancer was 12 percent lower among men who took the daily multivitamins, but they said that this decreased risk was not statistically significant.

"This study suggests, at least for men, that there might be benefits to taking multivitamins in terms of cancer as well," study researcher Dr. John Michael Gaziano, M.D., the chief of the Division of Aging at Brigham and Women’s Hospital, said in a statement. However, they did note that the observed benefits were modest, and more research is needed to see how multivitamin use impacts men over a longer period of time, as well as whether multivitamin use has any effect in women's cancer risk.

Balz Frei, a professor and director of the Linus Pauling Institute at Oregon State University who was not involved in the research, said in a statement commenting on the study that percent decrease in cancer risk is "not small."

"Given that more than 1.6 million new cancer cases are diagnosed in the U.S. each year, this translates into about 130,000 cancers prevented every year, and with it all the health care costs and human suffering," Frei said in the statement.

Multivitamins are extremely pervasive in American culture, with one in three U.S. adults taking one every day, Next Avenue reported.

Past research on multivitamins has been mixed. For example, an Archives of Internal Medicine study last year of more than 38,000 women showed that supplement use was linked with a 2.4 percent higher risk of death during a 19-year-period, MyHealthNewsDaily reported.

Specifically for multivitamins, 40.8 percent of women who took a multivitamin every day died by the end of the study period, compared with 39.8 percent of women who did not take a daily multivitamin, according to MyHealthNewsDaily.

"Our study, as well as other similar studies, have provided very little evidence that commonly used dietary supplements would help to prevent chronic diseases," study researcher Jaakko Mursu, an epidemiologist at the University of Minnesota School of Public Health, told MyHealthNewsDaily. "We would advise people to reconsider whether they need to use supplements, and put more emphasis on a healthy diet instead."

And a 2010 study in the American Journal of Clinical Nutrition actually found an increased risk of cancer among women who took a daily multivitamin, CNN reported. That study included 35,000 women in Sweden (between ages 49 and 83), and showed that breast cancer risk was 19 percent higher among women who took a daily multivitamin compared with women who didn't by the end of the 10-year study.

U.S. News reported that the U.S. Preventive Services Task Force doesn't have a recommendation one way or another on multivitamin use -- it neither recommends them, nor recommends against them. However, there's still a lot to know, and experts generally recommend talking to your doctor to see if you need to take a multivitamin or another daily supplement due to deficiencies.

UK recession affecting mental health of men

THE FEAR of unemployment has led to a significant fall in the quality of mental health of English men since the start of the economic crisis four years ago, according to the results of a major survey published yesterday.

The Health Survey for England has tracked health issues among over 100,000 people aged between 25 and 65 in England since 1991 and was analysed in depth by researchers.

Neither losing a job nor falling household income can be blamed for the fall; rather it is the threat of losing their jobs and the anxiety that is caused by that threat that has affected men’s mental health.

“The onset of the global economic downturn, heralded by the collapse of Lehman Brothers in September 2008, can therefore be considered as a potential threat to public health,” according to the research, published by the medical journal, BMJ Open, an online-only general medical information publication run by the British Medical Association.

The analysis shows that poor mental health results were highest between 1991 and 1993, when the United Kingdom was in a deep recession. Afterwards, mental health results steadily improved as the economy prospered, though they began to disimprove gradually from 2004 until 2008. Subsequently, they disimproved sharply.

In 2008, when the global economic downturn began, the prevalence of mental ill-health recorded by the survey was 13.7 per cent. It rose sharply a year later to 16.4 per cent, before falling back to 15.5 per cent in 2010.

Over most of the period under study, the researchers stress that more women than men reported poor mental health. But during periods of recession the sharpest rises in the prevalence of mental ill-health occurred among men.

Furthermore, they warn that women’s mental health in England is likely to have disimproved since 2010, because they have been more affected than men by the loss of nearly 500,000 jobs in the public sector.

But the study only examined changes in mental health up to 2010, and women may have been affected more severely after this time, particularly given subsequent changes in public sector employment, say the authors.
Justine Schneider, professor of mental health and social care at the University of Nottingham, said that the impact on mental health of job insecurity was worse than joblessness had long been recognised.

Prof Nick Manning, director of the institute of mental health, University of Nottingham, who carried out research in Russia after the collapse of communism, said the results did not surprise.

“Men who found themselves without their jobs and the prospect of new work were less able to cope than women. They suffered a catastrophic rise in morbidity and mortality,” he said.

Boosting breastfeeding rates saves lives and money: Unicef

Improving breastfeeding rates in Britain could save hundreds of lives by preventing breast cancer in mothers and hospital admissions in babies, Unicef has calculated. 

The risk of a raft of diseases in mothers and their babies can be reduced through breastfeeding, including breast cancer, respiratory diseases, stomach upsets and ear infections.

Experts calculated what effect increasing breastfeeding rates in Britain would have on these conditions and the consequent savings for the NHS.

Britain has one of the lowest breastfeeding rates in Western Europe with a third of women never feeding naturally, a third feeding for up to six months of their lifetime which may be spread across two or three children and one in six feeding for between seven and 18 months.

If the number of women who breastfeed for up to 18 months of their life increased from half to to two thirds, then there would be 865 fewer cases of breast cancer over their lifetime, it was calculated.

The report from Unicef found that only taking the benefits for a handful of conditions would mean the NHS could save £40m a year.

The report said if 45 per cent of babies were exclusively breastfed for four months, and if three quarters of babies in neonatal units were breastfed at discharge, each year there would be; 3,285 fewer babies admitted to hospital with gastroenteritis and 10,637 fewer GP consultations, saving more than £3.6 million.

The increase would also result in 5,916 fewer babies admitted to hospital with respiratory illness, and 22,248 fewer GP consultations, saving around £6.7 million.

There would also be 21,045 fewer GP visits for ear infection, saving £750,000 and 361 fewer cases of the potentially fatal disease necrotising enterocolitis, saving more than £6 million.

Anita Tiessen, Deputy Executive Director of Unicef UK, said: “As a society we are failing mothers and babies, and this new report shows that low breastfeeding rates in the UK are costing the NHS millions of pounds each year – as well as causing untold distress and suffering for families.

“We want to see breastfeeding recognised as a major public health issue from government level through to local children’s centres, and appropriate investment and legislation put in place to give mothers a better experience of breastfeeding.

"The good news for commissioners is that our research shows that money invested to help women breastfeed for longer would provide a rapid financial return
.
“Enabling women to breastfeed for as long as they choose is a health issue where the interests of the mother, baby and health service all align.”

The report, entitled Preventing Disease and Saving Resources: potential contribution of increasing  breastfeeding rates in the UK, was carried out academics at Universities of Dundee, Oxford, York, Brunel and St George’s, University of London, as well as the National Childbirth Trust.

The team also calculated that boosting the number of babies who receive any breastmilk by one per cent could lead to an increase in average IQ of the population, increasing productivity by £278m a year.

Cot deaths and childhood obesity could also be reduced and increasing breastfeeding may have an impact on diabetes, heart disease, ovarian cancer, asthma, leukaemia, coeliac disease and sepsis rates in babies, although the data is not robust enough to calculate the exact effect for these disease, the report said.

Professor Mary Renfrew, from Dundee University, who led the group, said: “This research shines a spotlight on the profound protective effects which breastfeeding has on both mother and child.

“It shows that the NHS could save money in different ways, both from the immediate costs of treating acute infant diseases, and longer term savings from reduced incidence of breast cancer. Larger scale savings from chronic diseases are also likely, although the evidence was not in form required for calculating costs. There would also be considerable health gains for both mothers and babies.

“It is clear that putting resources into supporting women to breastfeed successfully would be hugely cost effective to the NHS, as well as preventing the distress and pain felt by a mother who has a bad experience of breastfeeding.”

Cathy Warwick, chief executive of the Royal College of Midwives, said: “This report adds weight to the arguments that have been made for many years; investing in supporting breastfeeding can have positive impacts on the health of mothers and their babies. This is also a very good example of the fact that delivering the highest quality care does not mean increasing cost, indeed it can save money.

“We know, because women tell us, that many of them do not get the support and help they need in the early postnatal period from midwives. There are many strategies that can be put in place to improve breast feeding rates including increasing support from other women.

“However, if we are to deliver both the potential health and economic benefits that increased breast feeding will bring, we must ensure there are enough midwives and trained support workers to give women the help and advice they need throughout and beyond pregnancy.”

Health Minister Dr Dan Poulter said: "I welcome the UNICEF report. Breastfeeding has huge health benefits, as well as benefits in helping to promote a strong bond between mum and baby. We recommend babies are breastfed for the first six months where possible.

"Breastfeeding rates in England have steadily increased over recent years, and we are doing everything we can to support women who choose to breastfeed.

"We have pledged to have an extra 4,200 health visitors by 2015. Health visitors support new mums and help them get through any problems they are having with breastfeeding."

Cow's milk 'too salty for babies'

Babies under a year old should not be given cow's milk because it is much too salty for them, nutritionists have warned. 

It is almost four times as salty as breast milk, say researchers who have found that those fed cow's milk before 12 months tended to have the highest salt diets.

Dr Pauline Emmett and Vicky Cribb, nutritionists from Bristol University, found that seven in 10 babies had too much salt in their diets.

The study, published in the European Journal of Clinical Nutrition, looked at almost 1,200 eight-month-olds born in 1991 or 1992.

Cow's milk, they noted, contains 55mg of salt per 100ml, almost four times that found in breast milk (15mg / 100ml). Concentrations in formula milk vary from 15 to 30mg / 100ml.

A baby consuming 700ml of cow's milk daily (or 25 fluid ounces) would be getting 385mg of salt from that source alone - almost half the recommended maximum (one gram) for a baby up to a year old. One in eight of the children studied were fed only cow's milk, as opposed to breast or formula.

The researchers warned: "These findings show that salt intakes need to be substantially reduced in children of this age group.

"Infants need foods specifically prepared for them without added salt, so it is important to adapt the family diet.

"This research suggests that clear advice is needed for parents about what foods are suitable for infants.

"This should be given to all parents and carers, and should include the important advice not to use cows' milk as a main drink before 12 months of age."

The researchers also found that those fed cow's milk tended to be given other foodstuffs relatively high in salt, including processed foods like baked beans and tinned spaghetti.

They went on: "Given that three-quarters of salt in the diet comes from processed adult foods, successful salt-reduction strategies can only be achieved with the co-operation of the food industry.

"Manufacturers have a responsibility to reduce the salt content of food products.

"This process has already started in UK but much more needs to be done."

Giving babies too much salt in their diets can encourage a liking for the flavour that lasts a lifetime.

That can lead to health problems. Only last week experts reiterated the dangers of taking in too much salt, which is known to increase blood pressure. More than 4,000 deaths a year could be prevented it British adults reduced their mean daily intake from 8.6g to 6g, they said.

Giving far too much salt to small children can also damage their kidneys.

The Department of Health recommends avoiding giving cow's milk as a drink until a baby is a year old.

The NHS Choices website explains: "This is because it doesn't contain the right balance of nutrients to meet your baby’s needs."

Stigma and Discrimination

People with mental health problems say that the social stigma attached to mental ill health and the discrimination they experience can make their difficulties worse and make it harder to recover.

Mental illness is common. It affects thousands of people in the UK, and their friends, families, work colleagues and society in general.

• One in four people will experience a mental health problem at some point in their lives.
• Around one in ten children experience mental health problems. 
• Depression affects around one in 12 of the whole population.
• Rates of self-harm in the UK are the highest in Europe at 400 per 100,000.
• 450 million people world-wide have a mental health problem.

Most people who experience mental health problems recover fully, or are able to live with and manage them, especially if they get help early on.

But even though so many people are affected, there is a strong social stigma attached to mental ill health, and people with mental health problems can experience discrimination in all aspects of their lives.
Many people’s problems are made worse by the stigma and discrimination they experience – from society, but also from families, friends and employers.

Nearly nine out of ten people with mental health problems say that stigma and discrimination have a negative effect on their lives.

We know that people with mental health problems are amongst the least likely of any group with a long-term health condition or disability to:

• find work
• be in a steady, long-term relationship
• live in decent housing 
• be socially included in mainstream society.

This is because society in general has stereotyped views about mental illness and how it affects people. Many people believe that people with mental ill health are violent and dangerous, when in fact they are more at risk of being attacked or harming themselves than harming other people.

Stigma and discrimination can also worsen someone’s mental health problems, and delay or impede their getting help and treatment, and their recovery. Social isolation, poor housing, unemployment and poverty are all linked to mental ill health. So stigma and discrimination can trap people in a cycle of illness.

The situation is exacerbated by the media. Media reports often link mental illness with violence, or portray people with mental health problems as dangerous, criminal, evil, or very disabled and unable to live normal, fulfilled lives.

This is far from the case.

Research shows that the best way to challenge these stereotypes is through firsthand contact with people with experience of mental health problems.

A number of national and local campaigns are trying to change public attitudes to mental illness. These include the national voluntary sector campaign Time to Change.

The Equality Act 2010 makes it illegal to discriminate directly or indirectly against people with mental health problems in public services and functions, access to premises, work, education, associations and transport.

Stigma of mental ill health is 'worse than the illness'

It is the single biggest cause of disability in the Western world but many sufferers say the stigma attached to it is worse than the illness itself, according to researchers.

While celebrity sufferers who speak out about their depression are hailed as heroes, ordinary citizens are shunned, taunted and abused.

An international study of more than 1,000 sufferers in 35 countries has found that three quarters said they had been ostracised by other people leading them to avoid relationships, applying for jobs and contacting friends.

Discrimination is leading many to put off seeking treatment with a subsequent worsening of their condition.
Drugs and psychotherapy can help 60-80 per cent of people with depression but only half get treatment and only 10 per cent receive treatment that is effective – at the right dose, for long enough and with the right kind of therapy.

The international study published in The Lancet found that levels of discrimination were similar to those for schizophrenia revealed in a similar study three years ago.

Professor Graham Thornicroft, head of health service and population research at the Institute of Psychiatry said: "We have a major problem here. Non-disclosure is an extra barrier – it means people don't seek treatment and don't get help."

While public confessions of depression by well known people including the tennis champion Serena Williams, the US actress Kir-sten Dunst and chat-show host Stephen Fry were increasing, abuse of sufferers was also widespread.

The Norwegian Prime Minister, Kjell Bondevik, attracted worldwide approval when he relinquished power for three weeks to his deputy in 1998 while he recovered from an episode of depression. He was subsequently re-elected.

In contrast, Professor Thornicroft described the case of a woman who had dog faeces posted through her door because neighbours wanted her out and another in which police halted an interview with a man whose flat had been burgled when they learnt that he had been in psychiatric hospital.

"Our findings show discrimination is widespread and almost certainly acts as a barrier to an active social life and having a fair chance to get and keep a job," he said.

The Government's Time to Change campaign launched in 2008 aimed at reducing discrimination against people with mental illness had proved to have had a "modest but significant" impact, he added.

In a separate study, researchers have found that the 2008 economic crash led to a deterioration in the mental health of men – but not women.

Anxiety and depression increased markedly among men in the three years following the crash, but women escaped largely unscathed.

Rising unemployment and falling income are not to blame, the researchers say. Instead, job insecurity is thought to be the cause.

Mental ill health among men rose from 13.7 per cent in 2008 to 16.4 per cent in 2009 before falling back to 15.5 per cent in 2010, according to the study published in the journal BMJ Open.

Men derive much of their social status from their occupation and are still the main wage earners in most families. They are becoming more mentally unstable because of the fear of losing their jobs in the recession.
The authors from the Social and Public Health Sciences Unit in Glas-gow, say that while women's mental health appeared to change little in the period it may have deteriorated since due to job cuts in the public sector.