(WASHINGTON) — The U.S. Food and Drug Administration on Wednesday approved the first RSV vaccine in the U.S.
Scientists have been trying to develop an RSV vaccine for decades after previous high-profile attempts failed.
The vaccine, made by the pharmaceutical company GSK, is for older adults. Pfizer and Moderna are also developing similar RSV vaccines.
The Centers for Disease Control and Prevention still needs to weigh in with specific recommendations, which is expected in June. GSK anticipates it will have enough vaccine to meet demand in time for the fall and winter respiratory illness season.
GSK said it has “millions of doses ready to be shipped.”
Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement: “Older adults, in particular those with underlying health conditions, such as heart or lung disease or weakened immune systems, are at high risk for severe disease caused by RSV. Today’s approval of the first RSV vaccine is an important public health achievement to prevent a disease which can be life-threatening and reflects the FDA’s continued commitment to facilitating the development of safe and effective vaccines for use in the United States.”
RSV is a viral infection that leads to mild illness for most people; however, it can be dangerous for older adults and some young children. RSV is a common cause of lower respiratory tract disease (LRTD), which affects the lungs and can cause life-threatening pneumonia and bronchiolitis, according to the FDA.
Each year between 60,000 and 120,000 older adults are hospitalized due to RSV.
RSV circulation is seasonal, typically starting in the fall and peaking in the winter. Pharmaceutical companies are also working on RSV vaccines that are targeted at young children.
(NEW YORK) — The rate of drug overdose deaths linked to fentanyl in the United States has skyrocketed over the last five years, new federal data showed.
The rate of overdose deaths involving fentanyl spiked by 279% between 2016 and 2021 from 5.7 per 100,000 to 21.6 per 100,000, according to a report published early Wednesday by the National Center for Health Statistics’ National Vital Statistics System — which looked at death certificate records.
“We are always hoping we won’t see a rise in fentanyl deaths, but this really highlights that this is continuing to be the public health problem,” Merianne Spencer, a co-author of the report and a researcher at the Centers for Disease Control and Prevention, told ABC News.
Although the rate of overdose deaths linked to other drugs also saw increases, they were more modest rises and did not reach the levels of fentanyl.
Deaths linked to methamphetamine quadrupled from 2.1 per 100,000 in 2016 to 9.6 per 100,000 in 2021 and deaths due to cocaine more than doubled from 3.5 per 100,000 to 7.9 per 100,000 over the same period.
“When it comes to overdose, really the biggest driver is folks who are really struggling with addiction primarily on street drugs, which fentanyl is primarily found in terms of the street drug supply rather than a prescription medication,” Dr. Allison Lin, an addiction psychiatrist at University of Michigan Medical School, who was not involved in the report, told ABC News.
“And it’s primarily folks who are struggling with addiction to multiple substances, so oftentimes, folks who are using not only fentanyl, but fentanyl plus cocaine or fentanyl plus methamphetamine,” she said.
Meanwhile, drugs that used to make up the majority of overdose deaths — heroin and oxycodone — saw declines in their rates of death.
Rates of heroin overdose fatalities fell from 4.9 per 100,000 to 2.9 per 100,000 while oxycodone overdose death rates fell slightly from 1.9 per 100,000 to 1.5 per 100,000.
Researchers have noted there has been a marked increase in fentanyl use, and subsequently fentanyl overdoses, as heroin overdoses have fallen.
From 2019 to 2020 alone, the rate of fentanyl deaths linked to fentanyl rose by 55% and by 24.1% from 2020 to 2021, according to the report. The Department of Justice and the FBI announced on Tuesday that 300 people were arrested after a year-long operation tracking the trafficking of fentanyl and opioids on the dark web.
There has been a shift from a heroin-based market to a fentanyl-based market, according to the DOJ’s Drug Enforcement Administration.
“The vast majority of our folks or patients with substance use disorders, even if they don’t know it, they’re primarily using the drug supply that’s primarily fentanyl,” Lin said. “So, the folks who were using heroin previously are the folks who are also using fentanyl now. It’s just that the supply of opioids and other drugs in our communities are primarily supplies that are predominantly fentanyl because of all the characteristics of it, how inexpensive it is, how easy it is to cut with other substances, other factors.”
However, the CDC said the decrease in heroin-related deaths is also linked to increased treatments for people who use heroin, as well as increased access to naloxone, which reverses opioid overdoses.
Data showed that, for all five drugs analyzed in 2021, men had higher rates of death than women. The widest gap was when it came to rates of death due to heroin with men having a rate nearly three times higher at 4.2 per 100,000 compared to 1.5 per 100,000 for women.
In 2021, among all age groups, fentanyl was the drug with the highest overdose death rates. However, rates were highest among those aged 35 to 44 at 43.5 per 100,000 and those aged 25 to 34 at 40.8 per 100,000.
For Americans between ages 45 and 64, while the rates were highest for fentanyl, the rates were similar to deaths involving cocaine and methamphetamine.
Meanwhile, for those aged 24 younger and those aged 65 and older, death rates were highest for fentanyl but not significantly different from deaths due to methamphetamine, cocaine, heroin and oxycodone.
Similarly, while fentanyl has the highest death rate across every racial/ethnic group, some groups have been affected by different drugs.
American Indians/Alaska Natives saw a fentanyl overdose death rate of 33.1 per 100,000 in 2021, but it was closely followed by methamphetamine at 27.4 per 100,000. Black Americans had a fentanyl death rate of 31.3 per 100,000 closely followed by a cocaine rate of 20.6 per 100,000.
Drug cartels have specifically targeted Native American reservations, leading to higher use of methamphetamine among this population than any other group, according to the Department of Justice. Additionally, Black Americans and African Americans have been disproportionately affected by use of crack cocaine.
“The fact that for American Indians/Alaskan Natives, it was fentanyl followed by meth and for non-Hispanic Black Americans and African Americans it was fentanyl followed by cocaine, that’s an important highlight,” Spencer said. “Within each group, the drug ranking varies slightly.”
Lin said this is evidence that even if fentanyl is now the primary drug of focus, the epidemic related to cocaine and meth has not disappeared.
“There are going to be different substances, different factors that affect different groups,” she said. “Unfortunately, we see death rates and overdose rates rise across all of these groups, because of the factor of fentanyl.”
Lin added, “It doesn’t mean that we’ve ever addressed the crack epidemic, I would say, and we also have a rising meth epidemic in the country as well and everything is just made worse [because] these are not just single substance that people are using anymore. They’re really oftentimes combined with fentanyl.”
(NEW YORK) — The U.S. Surgeon General released an advisory on Tuesday calling attention to the public health crisis of loneliness, isolation and lack of connection in the United States.
“Lacking connection increases the risk for premature death to more than 60%. Put simply, this social disconnection increases the risk for premature death to the same levels as smoking up to 15 cigarettes a day,” U.S. Surgeon General Dr. Vivek Murthy said in a statement.
The report cites recent research showing that approximately half of U.S. adults experienced loneliness daily, even before the onset of the COVID-19 pandemic.
It highlights that a lack of social connection can present significant health risks, as loneliness can increase risk of premature death by 26% and social isolation by 29%, according to a meta-analysis cited in the advisory.
According to the report, insufficient social connection has also been linked to an increased risk of heart disease, stroke, anxiety, depression and dementia.
Additionally, loneliness was reported among the primary motivations for self-harm, according to a systematic review cited in the advisory.
“Given the profound consequences of loneliness and isolation, we have an opportunity, an obligation, to make the same investments in addressing social connection that we have made in addressing tobacco use, obesity and the addiction crisis,” Murthy said.
Social connection can reduce the health risks associated with isolation and loneliness. One study found that frequently confiding in others is associated with up to 15% reduced odds of developing depression among people who are at higher risk due to a history of traumatic or adverse life experiences.
The advisory lays out a framework for a National Strategy to Advance Social Connection, which provides recommendations for individuals, governments, workplaces, health systems and community organizations that aim to increase social connection and improve overall health. This type of strategy has never been implemented before in the United States.
These recommendations include infrastructure changes, such as developing parks and libraries that enhance social connection, policy changes allowing for paid family leave and accessible public transportation, and more research to efficiently address social isolation.
The framework also includes training for healthcare providers to allow for intervention if a patient is at risk for loneliness and its significant health consequences. It also notes that digital environments should be further evaluated, particularly how online interactions can potentially hinder meaningful connections.
Lastly, the recommendations call for the cultivation of a culture of connection, stating that the informal interactions of everyday life can significantly influence social connection.
“By taking small steps every day to strengthen our relationships, we can rise to meet this moment together… And we can ensure our country and the world are better posed than ever to take on the challenges that lay ahead,” Murthy said.
There are some immediate steps you can take to reduce loneliness and increase social connection, such as reaching out to a friend or family member.
“People often incorrectly assume that disclosing painful truths or emotions with a trusted other will be a turn off or perceived as a burden. Quite the opposite typically occurs,” Justin Baker, the clinical director of the Suicide and Trauma Reduction Initiative (STRIVE), told ABC News.
“Instead of feeling like a burden, sharing a common struggle typically brings people together and strengthens the existing relationship,” Baker said.
If you are experiencing suicidal thoughts, substance use or other mental health crises please call or text 988. Trained crisis counselors are available for free, 24 hours a day, seven days a week.
(CLARK COUNTY, Nev.) — Health officials are investigating an increase of a rare brain infection occurring in kids in Nevada, according to the U.S. Centers for Disease Control and Prevention.
The Southern Nevada Health District (SNHD) reported in October a “higher than expected” number of pediatric patients in Clark County who have intracranial abscesses.
There were 18 cases of intracranial abscesses found in children in 2022, up from about four cases per year between 2015 and 2021, which is more than triple the amount, according to SNHD.
According to the report, there were an average of seven cases during 2020 and 2021, at the height of the COVID-19 pandemic.
A cerebral abscess is a pus-filled pocket of an infection in your brain, according to Johns Hopkins Medicine.
The abscess can cause swelling in the brain, which places harmful pressure on brain tissue and can prevent blood from flowing to parts of the brain, according to Johns Hopkins.
“A cerebral abscess usually occurs when bacteria or fungi make their way into your brain, either through your bloodstream or from an infected area in your head, such as your ears or sinuses,” John Hopkins Medicine said on its site. “An injury to your head or head surgery can also let in germs that can cause an abscess.”
Headaches, fevers, chills, nausea, vomiting and seizures are some symptoms caused by the brain abscess, according to Johns Hopkins Medicine.
According to the Southern Nevada Health District’s findings, most of the cases occurred in males with a median age of 12 years old. The most common bacterial pathogen was Streptococcus intermedius, found in 33% of patients. Fifteen out of the 18 patients required craniotomies, according to the report.
No deaths were reported, according to SNHD. However, death is possible if left untreated, according to Johns Hopkins.
Medical professionals can treat cerebral abscesses with strong antibiotics and other medications, such as steroids and drugs to prevent seizures, according to John Hopkins Medicine.
Author Jancee Dunn talks about her new book, “Hot and Bothered: What no one tells you about menopause,” on ABC’s “Good Morning America,” May 1, 2023. — ABC News
(NEW YORK) — As more women pull back the curtain on their journeys with menopause — a topic that previously felt taboo to discuss openly — Jancee Dunn dives into the subject in her new book, Hot and Bothered: What No One Tells You About Menopause.
For Dunn, the first signs of menopause started when she turned 45.
“I had no idea what it was. I wasn’t in that space at all,” she told Good Morning America.
While there were plenty of pregnancy books on the shelves, Dunn said she found just one outdated book on menopause from the ’90s. So she set out to change that, spoke with experts in the field and wrote the book she wished she’d had.
“I really wanted to write a book where there was humor in it and not make it so dire,” she said.
Her book instead offers simple advice on how she handled some of the common symptoms, like hot flashes. “I breathe in, count of five, hold it for eight count, then breathe out. There’s something about giving yourself control,” she said.
Other symptoms she outlined include brain fog, mood change, irregular periods, thinning hair and dry skin.
“[Skin is] probably going to get dryer and more sensitive and your go-to products might not work any more,” Dunn explained from her personal experience. “You want something that gets rid of that dry outer layer. Gentle retinol products can help.”
Dunn also shared her message to women struggling with menopause: “Normalize this transition by talking as much as possible to everyone you know about it. The more we talk about it, the more normal it is. Less scary it is.”
ABC News Chief Medical Correspondent and OB-GYN Dr. Jennifer Ashton shared her expertise to further shed light on the topic and help women better understand the phase of time and transition.
When does menopause begin?
“The average age of menopause in this country is 51. It can start as early as 45 or even earlier,” Ashton said. “Perimenopause can start 10 years before menopause actually begins.”
What is perimenopause?
“Our definition is one year without a menstrual period,” Ashton said.
What are the perimenopause symptoms?
The head-to-toe symptoms, as Ashton called it, include “bleeding patterns can change, mood swings, skin changes, hair change [and] weight changes.”
“It is so pervasive and so distinctive woman to woman that we tend to say to a woman 40 and up, ‘If you are experiencing something new, something different, think hormonal, think perimenopause or menopause first.’ That’s how diverse and broad the signs and symptoms are,” Ashton said.
Recommendations for menopause symptoms
“The first thing we have to remember is that hormone replacement therapy is and should be an option on the table for the vast majority of women,” Ashton said, adding that “women should talk to their gynecologist about that.”
When it comes to hot flashes specifically, Ashton said, “There are numerous non-hormonal prescription medications that work very effectively.”
Additionally, she said wellness behaviors can help, such as getting exercise and avoiding alcohol, caffeine and spicy foods, which, she says, can trigger the onset of a hot flash.
What to know about hormone replacement therapy
“Women have to discuss this with their gynecologist,” she encouraged.
While some are weary of the treatment, Ashton pointed to the 2002 Women’s Health Initiative trial, in which “data was boiled down to a misleading headline: ‘Hormones bad, hormones dangerous.’ Now, there are oncologists who actually, in evaluating the data both past and present, really find that most data suggests and shows conclusively that estrogen does not increase the risk of breast cancer.”
When it comes to other conditions that affect women, Ashton said, “Heart disease, osteoporosis and dementia cause more deaths than breast cancer and there are some real benefits to hormones.”
(NEW YORK) — Four types of Gold Medal all-purpose flour, bleached and unbleached, have been recalled due to possible salmonella contamination.
General Mills announced a voluntary recall with the U.S. Food and Drug Administration on Friday.
According to the recall, the strain was “discovered during sampling of the five-pound bag product.”
The affected products included two date codes of Gold Medal Unbleached All Purpose Flour in 5- and 10-pound bags, as well as two date codes of Gold Medal Bleached All Purpose Flour in the 2- and 5-pound bags. The recalled bags of flour have a “better if used by” date of March 27, 2024, and March 28, 2024.
No other types of Gold Medal Flour were affected by this recall.
General Mills urged customers to check their pantries at home and asked them to discard any of the affected products.
The FDA and the Centers for Disease Control and Prevention warned consumers to refrain from consuming any uncooked products made with Gold Medal flour.
The agency wrote, “Salmonella Infantisis [is] killed by heat through baking, frying, sautéing or boiling products made with flour. All surfaces, hands and utensils should be properly cleaned after contact with flour or dough.”
(NEW YORK) — Rachel Simner, the mom of a 13-year-old child in Illinois, said she took her child to a local emergency room last September at the urging of her child’s school officials, who had done a suicide risk assessment.
Simner, a mom of two, told Good Morning America that when her child was discharged from the emergency room several hours later, her only guidance was a list of pediatric mental health providers that were said to specialize in autism, a condition with which her child has been diagnosed.
“It turns out a lot of them weren’t pediatric or they didn’t deal with autism or they had waitlists, so it took a while to find anybody and this is a kid who was suicidal, so it was urgent,” Simner said. “Four or five days later I went to the mental health hospital itself instead of the ER to try to get them admitted directly, and we were turned away again.”
Simner said her child, who also uses they/them pronouns, has for the past several months relied on a patchwork of providers and an at-home tutor provided by the school district while she and her husband continue to search for a more permanent treatment plan.
“We get bad information. The providers aren’t adequately trained. There’s such a shortage of space and beds for inpatient treatment,” Simner said. “In the meantime, my child is falling through the cracks and not getting the help that they need.”
Several states away, in the Washington, D.C., area, Ann, a mom of two, estimates that she and her husband have spent hundreds of thousands of dollars to get mental health care for their oldest child, a high school student.
“We’ve been paying basically out-of-pocket since she was in third grade for weekly therapy,” Ann, who asked that her last name not be used, told GMA, noting that is even with her family being lucky enough to have health insurance.
Around eighth grade, Ann said her child, who uses they/them pronouns, began to self-harm and experience suicidal thoughts, which led to years of searching for and bouncing between inpatient and outpatient treatment programs.
“At one point I switched to half-time in my job to take care of my child because we were too scared to leave them alone physically,” Ann said, adding of the financial toll, “We’ve spent anything that they had for college, and possibly everything that their sibling had for college and possibly our retirement, just so that they could do all of this so that they could survive enough to decide what they wanted to do after high school.”
In addition to the financial burden, Ann said the logistical burden of finding treatment for their child has fallen squarely on her and her husband.
After one 10-hour stay at a local emergency room following their child’s suicide threat, Ann said they left with little more than a list of mental health care providers to try to call for an appointment.
“Everyone is just trained to say, ‘Call 911,’ and then you get discharged from the hospital and you’re like, what do I do now?” Ann said. “It’s like a state of crisis for a parent to be constantly like, how do I manage that someone will be home 24/7 with my child and still work and still be able to pay our bills and still have another child who is supposed to be able to function like a normal person?”
A mental health crisis of care for kids
Mental health experts say what Simner and Ann described experiencing is part of a larger crisis across the country, where a record number of kids in need of mental health care are crashing up against a lack of access to care.
“I think out of the 100,000 psychologists [in the U.S.], there are around 4,000 adolescent clinicians, and most of those are in urban areas,” Robin Gurwitch, Ph.D. , professor of psychiatry and behavioral sciences at Duke University School of Medicine, told GMA. “You tell a family, ‘Here’s what you need to do,’ but then what? If you’ve got a six-month waiting list, that isn’t helpful for a family in crisis, particularly for a child in crisis.”
The American Academy of Child and Adolescent Psychiatry estimates that when it comes to child and adolescent psychiatrists — medical doctors who are able to prescribe medicine — there are just over 10,000 currently practicing in the U.S., at a ratio of 14 per 100,000 children.
Two years ago, the AACAP joined with the American Academy of Pediatrics and the Children’s Hospital Association — which collectively represent more than 77,000 physicians and over 200 children’s hospitals — in declaring children’s mental health a “national emergency.”
Last year, a report from U.S. Surgeon General Dr. Vivek H. Murthy warned of a growing mental health crisis among young people. The report, issued during the coronavirus pandemic, cited statistics including a 50%-plus-increase in emergency room visits for suspected suicide attempts among girls and a doubling of anxiety and depression symptoms reported across genders.
On Thursday, a new report from the U.S. Centers for Disease Control and Prevention painted an even starker picture: According to the agency, the number of high school female students seriously considering suicide jumped from 24% in 2019 to 30% in 2021.
The percentage of those who made a suicide plan increased from 19.9% to 23.6% in that same time frame. There was also an increase in suicide attempts, from 11% to 13.3%, according to the CDC.
“So many people that I’ve worked with have had to make the choice where they know that their child is imminently suicidal, and they just can’t afford to bring them somewhere to get treatment,” said Mitch Prinstein, Ph.D. , chief science officer for the American Psychological Association, noting that many parents struggle to find treatment at all. “So they come home every day from work, hoping and praying that their child is still alive.”
Prinstein described kids as moving targets who develop so quickly that a delay of any time in mental health treatment can set them on a different life course.
“If a kid has to wait six months until they get an evaluation or they get better, that means they’re missing, potentially, a significant portion of their school year,” Prinstein said. “When they are able to start functioning again, they’re now on a whole new trajectory and where they end up might be miles away from where they would have been had they been able to get minimal disruption where they did not lose a school year and they did not have major conflicts with teachers, parents and peers.”
Prinstein and other experts point to data showing the mental health crises among kids has been a long time coming, and was both exacerbated and highlighted by the pandemic, a time when kids faced everything from loss and isolation to economic uncertainty at home.
A new report by the National Academies of Sciences, Engineering, and Medicine, a policy-focused nonprofit organization, determined that in the absence of a “focused strategy” for help post-pandemic, “a generation of young people will enter adulthood with worse mental health,” particularly those in low-income communities.
“Just because [COVID] is not like it was three years ago, doesn’t mean that it has completely disappeared from the lives of our children,” said Gurwitch. “Those concerns that arose during COVID — those that were often coupled with grief and loss issues, with changes in their family due to housing or food or job insecurity — we couldn’t just turn those off and put them back into the learning environment.”
Gurwitch said a silver lining of the increased focus on mental health care post-pandemic is the expansion of the government-backed 988 Suicide & Crisis Lifeline, which people can call or text 24/7 for help. A federal funding bill passed in January included $506.1 million to support and expand services provided by the lifeline.
Both Gurwitch and Prinstein said the lasting impacts of COVID are piled on top of what is an already stressful time to be a child in America. Kids today, they said, feel the weight of school shootings, natural disasters like hurricanes and tornadoes, economic uncertainty, social justice, climate change and war, on top of social media and academic pressures.
At the same time, according to Prinstein, they are not prepared emotionally to cope, despite a renewed public discourse on mental health that came out of the pandemic.
“We have basically an almost complete lack of any prevention right now,” Prinstein said. “When it comes to physical health, there’s all kinds of prevention that we teach kids about — how to eat well and exercise and avoid unhealthy practices — but there’s just remarkably little prevention that’s built into the way that we raise kids or that we talk about at the family and community level.”
‘We need a mental health moonshot’
Prinstein said if the U.S. wants to make any significant progress towards ending the mental health crisis among kids, there needs to be substantial change.
“We made a big investment in building a whole mental health infrastructure in our country after World War II, for the veterans, but we’ve made no meaningful changes to the mental health infrastructure in this country since that time 70 years ago, and that system already was built for adults, not for kids,” he said. “So we’re just sitting on a whole bunch of solutions that could work if we developed a system that reflected the science.”
He added, “All of that is just going to waste because everyone is making these tiny, incremental, ultimately meaningless changes that don’t address the heart of the issue.”
Just as President Joe Biden last year outlined a new “American Moonshot ” aimed at eradicating cancer, Prinstein said the U.S. needs a “mental health moonshot.”
“We should be thinking about mental health in the exact same way we do physical health. People should be aware of their options, they should know about the scientific approaches to treatment that are likely to work and they should be able to access that treatment,” he said. “We should be building mental health resilience and competencies into every kid, K-12, in every community.”
Prinstein applauded the Biden administration’s $1 billion in funding to increase the number of school-based health professionals, but described that effort and others as “tiny band-aids” being placed on the problem, instead of a necessary “systemic fix.”
“Right now, the government pays billions of dollars every year to make sure as a national priority that we have a sufficient number of physicians with the right specialties in the right parts of the country so that everyone has access. There is no such effort being made for mental health care providers,” he said. “It really is that substantial and that big of a concern that we’re talking about the need for a major, systemic federal commitment, and we haven’t been doing that for decades.”
Last year, when the Biden administration’s funding increase was announced, Education Department Assistant Secretary for Planning, Evaluation, and Policy Development, Roberto Rodríguez, told ABC News there’s never been an effort of this magnitude by the federal government to distribute mental health professionals to schools. The recent spending, according to Rodríguez, also helps President Biden inch closer to his goal of “doubling” school-based mental health practitioners.
“We are making a big bet on supporting, attracting, developing and retaining our school psychologists, social workers, [and] counselors to really work in support of our students,” Rodríguez said.
Anne, a mom from Rockville, Maryland, who asked that her last name not be used, said she wonders what would have happened with her own 16-year-old child if mental health was treated differently in the U.S.
In one instance, the child — whom Anne asked not be named — experienced suicidal ideation, and Anne said they waited several days in a local hospital’s emergency department trying to be admitted to a mental health treatment center.
“Immediately, you are depersonalized, put in a space that has nothing that can be used as a hazard and you sit there, and you sit there, waiting to be assessed,” Anne said of her family’s experience in the ER.
“Ultimately, the psychiatrist, in meeting with my child, she determined that there was a lot of a lot of stuff my kid was having to deal with, and the thought of suicide and the plans for suicide were the only things that my child knew to go to, to cope, because they hadn’t learned coping strategies anywhere.”
Training pediatricians to be first responders for children’s mental health
With schools also facing a stark shortage of mental health professionals — at a ratio of 1,162 to 1 compared to the 500 to 1 ratio recommended by the National Association of School Psychologists — one organization is working to train another population that reaches children daily: pediatricians.
To date, the REACH Institute, a New York-based nonprofit organization, has trained more than 6,000 pediatricians and primary care providers in delivering scientifically proven mental health care, according to Lisa Hunter Romanelli , Ph.D., CEO of REACH and a licensed clinical psychologist.
“Unfortunately, the typical pediatrician, through medical school and their training, they don’t get a lot of training on mental health, but increasingly, because of the children’s mental health crisis, that’s where families are turning,” Hunter Romanelli told GMA. “So REACH’s training program aims to increase the knowledge and comfort of pediatricians so that they are able to to spot early signs of children’s mental health illness and manage and help those kids within the scope of their pediatric practices.”
The scope of REACH’s training, according to Hunter Romanelli, extends from learning to identify mental health struggles in kids to treating them, whether by helping the patient and family learn different skills to alleviate symptoms or, if indicated, prescribing medication.
“We’re not trying to turn [pediatricians] into therapists,” Hunter Romanelli said, adding, “Our training empowers them to do something that they are already being asked to do and gives them more comfort and confidence in being able to help the kids in their practice.”
Hunter Romanelli said REACH, which is funded by donations as well as grants and fees for its training programs, estimates that training one pediatrician can help 250 kids with mental health issues, meaning the need is still great.
“Today, our impact has been that we’ve trained 6,000 pediatricians, which means they are helping 1.5 million kids, which is good, but there’s still a crisis,” Hunter Romanelli said. “We’d love to make sure that every pediatrician has gone through our training program because obviously that would make a dramatic impact on the number of kids to have access to to mental health services.”
What parents can do now
Hunter Romanelli, as well as Prinstein and Gurwitch, stressed that there are steps parents can take to try to protect their child’s mental health.
First, parents should know that they have the right to ask questions of providers about the mental health treatment their child is receiving, according to Prinstein.
“It’s really, really important that folks, when they go to get help, that they’re looking for a licensed professional and also asking, ‘Did you go to an accredited institution,?’ and, ‘What is the kind of therapy that you’re providing? Is there science to demonstrate that therapy works,?'” he said. “Parents have every right to ask.”
Second, parents should be sounding boards for their kids, and be proactive in speaking to them about mental health, including suicide, according to Prinstein.
“Talk with your kids about suicide because there is a big misconception that we’re going to somehow put an idea in our kids’ heads and it’s going to make them more likely to do something risky or bad. That is absolutely incorrect,” he said. “You’re not putting an idea in their head, but what you are doing is communicating when they talk with you about it, they’re going to feel safe and they’re going to feel like they can open up to you.”
Gurwitch echoed Prinstein’s advice, saying simply, “Talk to your kids.”
“Check in with them about how they’re doing when events happen,” she said. “Whether it is another shooting, whether it’s a disaster, whether it’s the impact of climate change, whether it’s the war in Ukraine, check with your kids about how they’re doing and they can know that you’re available to talk to about the tough things.”
Likewise, Gurwitch said parents should feel comfortable talking to their child’s pediatrician and school officials about mental health.
“You know your child better than anybody else, so if you see a change in their behaviors and their functioning and how they’re doing in school or with peers or with you, talk to somebody to see, ‘Should I be concerned?'” she said. “Children don’t come with a manual, so it’s unfair [for parents] to think, ‘I know what to do.'”
If you or someone you know are experiencing suicidal, substance use or other mental health crises please call or text 988. You will reach a trained crisis counselor for free, 24 hours a day, seven days a week. You can also go to 988lifeline.org or dial the current toll free number 800-273-8255 [TALK].
ABC News’ Arthur Jones II and Kelly Livingston contributed to this report.
(NEW YORK) — Weeks of shoulder pain landed a reluctant Whitney Nichols in urgent care. As a previously healthy 24-year-old Black woman, she pleaded for additional testing to uncover the cause of her pain. As a last resort, the doctor ordered a CT scan of her chest. The result, blood clots in both of her lungs.
Even after this seemingly scary diagnosis and after being transferred to a hospital, Nichols said she felt dismissed when a doctor told her she would be fine.
Nichols, now 29 and a graduating medical student, reflected that these interactions with dismissive doctors made her feel “so alone in that space” and unsafe.
But Nichols said that night, everything changed when a Black physician, Dr. Erika Walker, walked into the room. Walker explained the blood clots were serious but treatable. Walker advised Nichols to stop taking her estrogen-based birth control, which can increase the risk of blood clots, and prescribed medication that would break up the clots.
She said it was great ” … just seeing somebody that I felt like I could be comfortable with.”
Black people make up 13% of the U.S. population, but Black doctors are not equally represented. For example, only 7% of primary care physicians are Black, according to a study from the Journal of the American Medical Association. Amid a growing recognition that Black Americans experience disparities in health and medical care, new research suggests that Black patients are more likely to live longer and healthier lives when their primary care doctors are also Black.
Michael Dill, director of Workforce Studies at the Association of American Medical Colleges team, analyzed the relationship of Black primary care physicians and the health outcome of the people who lived in those same areas, evaluating 1,600 U.S. counties. Dill and his colleagues found that a 10% increase in Black primary care doctor representation was associated with an extra month of life expectancy for Black patients.
The higher the representation of black physicians in the workforce per county was associated less death of any cause for county residents, Black and White patients. Thus, even people not actively being treated by Black physicians benefitted from their presence like the results published in the Journal of the American Medical Association in April of 2023.
“We found that diversifying the physician workforce … is important for improving public health,” Dill told ABC News.
Dr. Bobby Mukkamala, past chair of the American Medical Association Board of Trustees, said the data was “shocking” but “in a motivational way.” Mukkamala said this data can be used to advocate for equitable hiring practices at hospitals and health care systems so that doctors and staff look like the communities they serve.
Researchers said when doctors have similar cultures and lived experiences to the patients, they may be more likely to take their concerns seriously, which results in better life expectancy.
For over 150 years ago, Historically Black Colleges and Universities (HBCU) were established to provide Black students the opportunities to advance their education when they were unwelcome at existing public and private institutions of higher education. Traditionally HBCUs are a large producer of Black physicians.
Dr. Erica Sutton, associate dean at Morehouse School of Medicine said, “feeling heard, perhaps listening as well, and then translating that into patient centered care patient driven treatment plans,” is the essence of why Black physicians can impact their patients’ health.
Dill said there is no shortcut to increasing workforce diversity. “This is not a problem we can fix in a couple of years,” Dill said. “This is the work of generations.”
Mukkamala, Sutton, and Whitney are involved in programs that aim to increase and inspire young children of diverse backgrounds to pursue careers in science, education, technology and math, including The American Medical Association’s Back to School Program, Morehouse’s health careers programs and Student National Medical Association.
“This isn’t something that you can tell somebody in college to convince them to [pursue medicine],” Mukkamala told ABC News. “Those seeds get planted early on in grade school.”
Sutton is hopeful for the future.
“I think that one of the things that we’ve seen recently in this country is a renewed interest in inclusivity belongingness … we definitely try to teach at HBCUs is that these [less diverse] communities do include you,” Sutton told ABC News. “It’s not us and them…that community is enriched by your presence.”
Danielle Craigg, MD is a senior General Preventive Medicine & Public Health Resident at Renaissance School of Medicine at Stony Brook University and a member of the ABC News Medical Unit.
Sotonye Douglas, MS is a graduating medical student from Quinnipiac University, Frank H Netter Medical School, beginning General Surgery Residency in June 2023, and a member of the ABC News Medical Unit.
(NEW YORK) — A new report released this week by the Environmental Protection Agency projects the devastating health impact of climate change on children.
Effects include higher rates of respiratory disease, reduced academic achievement, higher rates of infections and risk of housing insecurity in coastal cities.
“Children have unique vulnerabilities,” Jeremy Martinich, chief of EPA’s Science and Impacts Branch and a co-author of the report, told ABC News. “This report is really intended to provide a new level of specificity about some of these risks.”
One major risk is extreme heat waves, which can have a negative impact on children’s health and education.
Children are more vulnerable to heat-related events such as lightheadedness, fainting, coma or even death in rare cases.
Based on data extrapolated from the Healthcare Cost and Utilization Project’s Kids’ Inpatient Database , for each 1 degree Fahrenheit increase between May and September, the number of emergency department visits at U.S. children’s hospitals could increase by 113 visits per day.
“When exposed to higher temperatures, children have more difficulty concentrating and learning in the classroom,” Martinich said.
Studies show a 4% to 7% reduction in academic achievement associated with temperature increases of 2 to 4 degrees Celsius. This reduction translates to decreased future income for graduating students, which could be as much as $18.3 billion.
While installing air conditioning in educational facilities can help, this may not be an option for economically disadvantaged schools.
Stable housing is also a critical factor in children’s health and development. Increasing frequency of flooding due to the rising sea levels places children in coastal cities at high risk for temporary or permanent displacement from their homes.
The EPA estimates that if we do not adapt to the increased flooding risk, 17.2 million children, or 23% of all children in the U.S, are at risk for housing displacement. Children are also at risk of drowning, disease, and post-traumatic stress disorder from flooding events.
“Under each different level of future rising sea level there’s a whole new population that has been exposed [to flooding] in some parts of the country,” said Martinich.
Playing outdoors is crucial for children’s mental and physical development, however, the effects of climate change will significantly limit their ability to be outside. Warm seasons are getting longer, which leads to increased duration and severity of pollen allergies. Prolonged exposure to pollen has been associated with higher rates of asthma, eczema, hay fever, and even ADHD, or attention-deficit/hyperactivity disorder.
Air quality has also sharply decreased due to rising pollution, increasing temperature and wildfires. Infants and children have developing lungs and are more sensitive to toxic exposures than adults. Chronic exposure to pollution is also linked with cardiovascular disease and poor lung function in adulthood. Babies born to mothers exposed to severe air pollution are at risk of being born early or with low birth weight, which can lead to lifelong challenges with growth and development.
The EPA report does not say parents should not let their kids go outside, according to Martinich.
“We’re trying to empower caregivers and parents to be more aware of the risks,” he said, “just like you tell your kids about being careful when crossing the street.”
Parents can monitor daily air quality reports on AirNow.gov, which can be important for kids with asthma. The CDC has tips and resources on preventing toxic exposures for kids.
Similar to the findings of the State of the Air report released last week by the American Lung Association, communities of color face a disproportionate risk of impact. For these communities, the EPA report confirmed much of what they already know.
“It’s alarming, but it’s not surprising,” Courtney Hanson, deputy director of People for Community Recovery, an environmental justice organization on the South Side of Chicago, told ABC News. “[People for Community Recovery] has been advocating and raising the alarm bells about these issues for decades.”
The EPA report represents a key step in political advocacy, according to Gabrielle Browning, director and co-founder of Mom’s Clean Air Force.
“We are really excited about this report because it is the culmination of messaging on the vulnerability of children to climate change,” Browning told ABC News. “For the first time really in history, we have a lot of opportunities to get some things across the finish line.”
Parents can get involved in several ways, experts say.
“[Future generations of children] are going to inherit the world that we’re giving them,” said Martinich. “Let’s give them a safer future. That’s what this report is trying to inform.”
Browning suggests signing a petition that will be delivered to Congress, or calling the local school board to discuss current plans for sustainability.
“Doing something means that you can look your children in the eyes in a decade and say, ‘Yeah I did what I could do. We really tried hard,'” Browning said.
Hanson emphasized community engagement. “Visit the frontline neighborhoods in the city,” she said. “Learning about what’s going on in your own backyard … tends to be very impactful.”
Nisarg Bakshi, D.O., is a pediatrics resident at University of Chicago Comer Children’s Hospital and a member of the ABC News Medical Unit.
(NEW YORK) — The American Heart Association released a report Thursday that ranked the top 10 diets according to their guidelines for heart-healthy eating. Researchers found that some of the most popular diets – like keto and Paleo — ranked lower for heart health.
Nutritionist Maya Feller spoke to Good Morning America about the results of the study and what heart-healthy habits to keep in mind.
Feller said that researchers used the American Heart Association (AHA) criteria for heart-healthy eating patterns as the basis of the rating system, which includes nutrition requirements based on limited fat, saturated fats, cholesterol, trans fat or sodium.
“What they found was that these diets that were very low in carbohydrates like Atkins or diets that were very high in fat like keto actually scored lower,” Feller explained. “In the short term, there was some weight loss and there was some improvement in lipids as well as blood sugar. However, in the long term, it really can raise the risk for LDL [or] high cholesterol. That’s the bad cholesterol and that is a risk factor for heart disease.”
The very low carbohydrate diets and high-fat diets, like the ketogenic and Paleolithic diets, scored the lowest on the AHA scale.
“Restrictions on fruits, whole grains and legumes may result in reduced fiber intake. Additionally, these diets are high in fat without limiting saturated fat. Consuming high levels of saturated fat and low levels of fiber are both linked to the development of cardiovascular disease,” the AHA said in a statement.
The report also took other factors into consideration like diet flexibility, cultural relevance, personal preference and affordability.
The DASH diet, Mediterranean diet, pescatarian diet and vegetarian diet were among the top-scoring diets. The first two diets aid in managing hypertension, a known risk for heart disease.
“What we see when we’re looking at the top rated diets is there’s tons and tons of seafood. There’s legumes, there’s really nice carbohydrates, ones that have fiber,” Feller noted. “Across the board, we see these patterns of eating that are really rich in fruits, vegetables, lean proteins, as the way to think about bolstering your cardiovascular health.”
The AHA’s top-ranked diets often include vegetables, seafood, lean proteins, nuts, seeds and potassium-rich foods.
While people do not have to cut carbohydrates and fats completely out of their diet, Feller said that the best course of action is finding a pattern of eating that works best for the individual while just staying mindful.
“Carbohydrate literacy is key. We need carbohydrates as fuel and energy for our brain,” she said. “In terms of fat, replacing saturated and synthetic fats with mono and polyunsaturated fatty acids found in nuts, seeds and some fruits like olive and avocado can be a heart-healthy choice.”
