April 23, 2015

 

Our esteemed colleague Joe Paduda is hosting the current edition of Health Wonk Review over at Managed Care Matters: The Everything-PPACA edition of Health Wonk Review

We have a tiny cavil with the title of Joe's post though because although Affordable Care Act issues are prominent in this edition, there are numerous other health policy topics included too -- so it's more accurate billing would be: The Everything-PPACA edition PLUS. Grab a coffee and check it out!

Hats off to Joe, who is the founder and sponsor of Health Wonk Review, which has been going strong since 2006. Thanks also to the many participants who have submitted thoughtful posts over the years and to the regulars who have borne the not insignificant work of hosting. Check out the impressive Health Wonk Review archives for the all-star cast.

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April 22, 2015

 
"Between 2003 and 2010, a total of 1,719 people died by suicide in the workplace. Workplace suicide rates generally decreased until 2007 and then sharply increased. This is in contrast with non-workplace suicides, which increased over the study period. Workplace suicide rates were highest for men (2.7 per 1,000,000); workers aged 65-74 years (2.4 per 1,000,000); those in protective service occupations (5.3 per 1,000,000); and those in farming, fishing, and forestry (5.1 per 1,000,000)."

From the recent study of workplace suicides between 2003 and 2010, published in the American Journal of Preventive Medicine, Suicide in U.S Workplaces, 2003-2010:

Aimee Swartz looks at the study data and the issue of suicide in Workplace Suicides Are on the Rise in a recent issue of The Atlantic, noting that In 2013, the last year for which data are available, 270 people in the U.S. committed suicide at work - a 12 percent increase over the prior year.

There are many factors that contribute to the rise. Mental health experts caution that potential causal factors can't be generalized based on occupation, but that job factors may present additional stressors that tip the balance. Individual factors such as depression, financial losses, mental and physical health issues play a role.

Swartz looks at potential contributing job factors in each of the highest professions. In law enforcement, trauma is high and a "macho" culture means that people often are reluctant to share or deal with feelings of stress that may be perceived as weakness, Plus, ease of access to a methodology may come into play: 84% of law enforcement suicides involved a firearm. In farming, isolation and financial losses are contributing factors. In the auto repair industry, many think that long-term exposure to chemical solvents may be linked to depressive symptoms.

Mental Health Daily looks at 15 common causes of suicide, as well as the Top 11 Professions with Highest Suicide Rates

  • Medical Doctors 1:87
  • Dentists 1:67
  • Police Officers 1:54
  • Veterinarians 1:54
  • Financial Services 1:51
  • Real estate 1:38
  • Electricians 1:36
  • Lawyers 1:33
  • Farmers 1:32
  • Pharmacists 1:29
  • Chemists 1:28

Farmer suicides on the rise
Madeleine Thomas of Grist takes a deeper look at farmer suicides in her excellent article How can we stop farmer suicides? Thomas says that "farmer suicides tend to increase when farm economics falter." Rates were high during the farm crisis of the 1980s, when more than 900 farmers took their own lives. Many mental health experts fear that current hardships may lead to an increase in farmer suicides. Calls to hotlines are spiking, with droughts, cold, heavy snow and other climactic woes taking a deep financial toll.

Other factors include the isolated, insular nature of rural farming and easy access to weapons. When the business of farming falters for family farms, it can be ruinous for families, and farmers are often unprepared for other professions.

Experts say that behavioral health in farming populations is an underfunded and often ignored public health issue, particularly in an era when funds for the CDC and the National Institute of Occupational Safety and Health are scarce and funding priorities compete.

"Behavioral health is the area of healthcare that agricultural people understand the least well," says Michael Rosmann, a licensed clinical psychologist specializing in agricultural behavioral health and one of the field's leading researchers. "It is the area that probably is in most need of research and clarification so that we improve the understanding and treatment of behavioral health issues." Rosmann and other experts believe the country's rural agricultural population should be classified as a health disparity group, which according to the CDC, would mean that farmers consistently face greater barriers to proper healthcare due to the unique environmental, cultural, and economic factors. If farmers and rural America were more widely recognized as a health disparity, more government funding could be directed toward addressing the issue."

National Suicide Prevention Lifeline (U.S.) 1-800-273-8255


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March 26, 2015

 

Grab a coffee and head on over to Wing of Zock. Jennifer Salopek has a freshly-posted Health Wonk Review, Spring Break Edition awaiting your perusal. The wonks are covering a wide range of policy topics and issues today - don't miss out.

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March 24, 2015

 

A decade after the BP Texas City explosion that killed 15 and injured 180, U.S. refineries are nearly as deadly as ever, according to Blood Lessons, an investigative journalism report by Houston Chronicle and Texas Tribune that looks at the aftermath of the tragedy at the facility itself and the industry at large. The report shows that serious risks remain unaddressed; survivors of the terrible event are distressed that even seemingly simple lessons haven't been learned, such as locating flimsy break tents close to the refineries. The fatalities a decade ago largely occurred in just such temporary shelters.

In fact, it would appear that refineries are not a lot safer than they were then:

"No single refinery accident has matched Texas City's devastation, but at least 58 people have died at American refineries since the BP blast, according to data compiled from Occupational Safety and Health Administration records, news accounts, lawsuits and union reports. There were at least 64 deaths in the 10 years before the accident.
The Department of Energy has tracked almost 350 fires at refineries in the past eight years - nearly one every week. There are about 140 refineries across the United States. Members of the United Steelworkers union like Ambrose have been out on strike, protesting at 15 locations. They're worried, among other things, about safety, claiming that old refineries are routinely pushed far beyond safe operating limits, that fires occur too frequently and that trailers and tents remain in harm's way."

While OSHA stepped up inspections through a nationwide refinery emphasis program, it discontinued the highly labor-intensive program and lacks staff to enforce existing rules.

For other chapters in the report see:

Anatomy of a Disaster, which includes an animated video of what caused the BP explosion.

Survivors Remember, interviews and videos with survivors.

A deadly industry - Assembled data shows how and where refinery workers continue to die.

In other remembrances, Chemical Safety Board (CSB) Chairperson Rafael Moure-Eraso addresses the 10th Anniversary of the BP disaster in a brief video:

He faults organizational and safety deficiencies at all levels of BP for the disaster, citing
a weak safety culture, a deficient process safety management program, and obsolete equipment. These problems have continued in the refinery industry in decade since. He cites two large incidents, one being the 2010 Tesoro blast that killed 7 workers in Anacortes, Washington.

The CSB notes that current federal and state regulations are not strong enough on preventive measures and say that more regulatory oversight is required to strengthen prevention.

Related: The extended CSB report on the BP investigation, issued about one year after the tragedy.


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