August 8, 2008
NIH Podcast Episode #0064
Balintfy: Welcome to the 64th episode of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health--the nation's medical research agency. I'm your host Joe Balintfy. Coming up in this episode, what researchers are looking for in terms of Cancer Health Disparities; and an interview about how to avoid heat-related illnesses. But first, how smokers who stick together, quit together. That's next on NIH Research Radio.
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Smokers Stick Together and Quit Together
Balintfy: A recent study looked at how social networks – families, friends, coworkers – influenced the decision to quit smoking. Here’s Wally Akinso with a report.
Akinso: For smokers, kicking the habit is a hard thing to do. Though odds are smokers are not alone in making the move.
Suzman: The clusters of people who were friends, siblings, spouses, co-workers tended to quit together when they quit.
Akinso: Dr. Richard Suzman is the Director of the Social and Behavioral Research Program at the National Institute on Aging.
Suzman: It looked at the impacted of social relationships on smoking and specifically on quitting smoking.
Akinso: The decision to quit smoking often tunnels through social networks, with entire clusters of spouses, friends, siblings and co-workers giving up the habit roughly in tandem according to a NIA study. Researchers analyzing changes in smoking behavior over the past three decades within a large social network found smokers quit in groups and not as isolated individuals. Dr. Suzman talks about some of the interesting findings amongst the various social networks.
Suzman: When a husband and wife quits it reduces the chance of the other spouse smoking by 67 percent, for a sibling 25 percent. A friend quitting decreases the chance of smoking by 36 percent among their friends. And in small firms co-worker quitting could cut smoking amongst his or her peers by 34 percent but not in larger firms. Neighbors didn't seem to be influenced by each others smoking habits.
Akinso: Dr. Suzman delivers an important message dealing with the social context of kicking the habit.
Suzman: What any one person does, really effects people other than themselves.Akinso: Dr. Suzman says that the public health message of the study is that no one is an island-one's health is partially determined by their social networks and those around them. This is Wally Akinso at the National Institutes of Health, Bethesda, Maryland.
2008 Cancer Health Disparities Summit
Balintfy: You know smoking leads to cancer. Well here’s another report from Wally Akinso on cancer, in particular, cancer disparities.
Akinso: The National Cancer Institute's Center to Reduce Cancer Health Disparities hosted the 2008 Cancer Health Disparities Summit. Dr. Donald Warne is the Health Policy Research Director for Intertribal Council of Arizona and a NCI grantee.
Warne: The theme this year is eliminating cancer health disparities through science, training, and community.
Akinso: Dr. Willie Underwood is an Assistant Professor in the Department of Urology at Wayne State University of Medicine and also a NCI grantee.
Underwood: Most of the topics discussed are around the top 5 cancers that have the highest disparity issues. One is prostate cancer, secondly is lung and bronchus cancer, breast cancer, colorectal cancer, and pancreatic cancer.
Akinso: The Summit was held from July 14th–July 16th. It highlighted the science of the programs and grantees funded through the Center to Reduce Cancer Health Disparities. Dr. Underwood talks about the impact of cancer health disparities in the African American community.
Underwood: We know that deaths from all cancers combined for both men and women are high among blacks. African American women who are diagnosed with breast cancer are less likely than white women to survive five years after diagnosis. The rate among African American women is 71 percent compared to 86 percent and that's for survival of breast cancer for whites. African American males have far higher death rates of prostate cancer, 2.4 times higher. The incidences of colorectal cancer among African American women are higher than that among whites. Lung cancer is the leading cause of death for African Americans when you look at cancers death.
Akinso: Dr. Warne talks about how it impacts the Native American community.
Warne: If you look nationally our most common cancers are lung, bronchus cancer, but also prostate, colon rectum cancer, kidney and renal pelvis cancer and stomach cancer. But we see tremendous variation. Some regions of the country have much lower rates of one cancer than others primarily due the rates of cigarette smoking.
Akinso: Dr. Warne explains how this summit benefits Native Americans and other groups.
Warne: One of the major benefits of the summit is to find out what other populations are doing. I think that projects like ours-that is a community network program. We will benefit tremendously by learning what other programs are doing, what other populations are doing, what other communities are doing. And when we share information in a forum like this we learn from each other and perhaps there's templates of projects or even ideas that we haven't though about that we can try to implement in Indian country.
Akinso: Both Dr. Warne and Dr. Underwood cite that the goal of the summit was to enhance mutually beneficial interactions among the Center to Reduce Cancer Health Disparities programs by sharing scientific knowledge, encouraging junior investigators, and broadening community participation. This is Wally Akinso at the National Institutes of Health Bethesda, Maryland.Balintfy: Coming up, how to handle heat. Stay tuned…
(BREAK FOR PUBLIC SERVICE ANNOUNCEMENT)
Balintfy: The month of August may have plenty of heat left dish out this summer, which could result in heat-related illnesses. Another term for that is hyperthermia:
Guralnik: Yeah, Hyper-thrermia is actually a set of conditions that relate to being exposed to very hot weather in the summer time and it’s a range of conditions that goes from fairly mild conditions of having cramps of having some fatigue, all the way up through heat stroke which is a very serious and sometimes life threatening condition.
Balintfy: We’re talking to Dr. Jack Guralnik, Chief of the Libratory of Epidemiology, Demography and Biometry at the National Institute on Aging. What are some of those conditions?
Guralnik: There are several. I’ll start at kind of the mildest ones. There’s heat cramps, which are simply cramps of the muscles of the abdomen, arms or legs that relate to becoming somewhat dehydrated and over heated. We also have swelling, what’s been termed heat edema which can also be from becoming mildly overheated. Heat syncope is a condition where people actually feel faint or pass out related to exposure to prolonged and high temperatures. Heat exhaustion is kind of the next worst step – where people become quite fatigued, may sweat profusely, may become confused, have headaches – and while in itself, it doesn’t lead to very poor outcomes, it may be a sign that you’re headed toward heat stroke which is really the thing that you absolutely want to avoid.
Balintfy: What exactly is heat stroke?
Guralnik: Yeah, heat stroke is a condition where your body has essentially lost the ability to control body temperature. When we exercise, and even in daily life we generate a certain amount of heat and the body has a variety of ways of getting rid of that heat. Of course the most obvious is sweating or perspiration. When you develop heat stroke, your temperature rises and you loose the ability to sweat and control your body temperature. So what you get into is a situation where basically your body temperature starts to soar. And heat stroke has been defined as having a temperature above 104 degrees. The other symptoms include fainting, which can sometimes be the first sign of stroke, changing behavior, people will become confused, be grumpy and irritable, they may start acting strangely, they may loose control of their bodies and they may stagger or fall, their skin may be dry and flushed rather than perspiring, and finally if you take their pulse, they may have a strong rapid pulse, or a slow and weak pulse.
Balintfy: Are there populations that are especially at risk for hyperthermia?
Guralnik: Young infants are at risk, older people, especially older people who have chronic conditions -- conditions like heart disease and high blood pressure -- some of this is related to the disease and some of it’s related to medications that people take. Certain medications for instance diuretics may reduce your ability to perspire. Also in terms of younger people, athletes are at risk and we here stories of football players training in the summer and dying of heat stroke, even very healthy highly trained athletes who are at risk. And even people who work outside in the heat -- construction workers, gardeners -- are at risk of heat stroke if they don’t pay some attention to keeping their body temperature down.
Balintfy: How do you know when to call a health professional?
Guralnik: Well certainly if an older person has fainted due to the heat, or if it’s serious and they don’t regain consciousness quickly, absolutely you should be calling 911 because it could be a medical emergency. Certainly if their temperature is elevated and rising, that absolutely is a medical emergency.
Balintfy: What are some tips to prevent heat-related illnesses?
Guralnik: Well the most obvious tip is to try to stay in a cool place and this is a tip particularly for older people. If you have air conditioning, you should use it. If you don’t have air conditioning, it’s important to try to ventilate your home, keep the shades down during the day; at night when it cools off open the windows to get some circulation, use fans. On particularly hot days it’s important particularly for older people to try to get to, who don’t have air conditioning, to try to get someplace where there is air conditioning where they can cool off for several hours. And there are a number of agencies that make these kinds of places available. Or even going to the shopping mall or the movies can give you relief in the middle of the day. It’s important to drink plenty of fluids during the day, to wear light loose fitting clothing. Sometimes older people get in the habit of wearing certain kind of clothing and they don’t modify it adequately when the temperature goes up. It’s important to pay attention to the weather forecasting when it’s going to be particularly hot and humid, when the air pollution levels are going up; older people should really try not to be out of doors during the peak hours of heat during the middle of the day.
Balintfy: Are there other tips to remember as the temperatures climb?
Guralnik: Yes, it is important to drink plenty of fluids. There are experts who recommending drinking six or eight glasses of water or fruit juice a day. One important consideration is that when you are at risk of hyperthermia or heat related conditions, you should avoid alcoholic beverages and even avoid drinking an excessive amount of coffee or tea which also can impair your ability to regulate your temperature when the temperature goes quite high.
Balintfy: Is that because of the temperature of the drink itself or is it is the caffeine which is associated with it?
Guralnik: It is the caffeine itself that has that effect. So iced tea with caffeine in it will also have that effect.
Balintfy: To wrap things up, what are some resources available to combat heat?
Guralnik: Yeah, there are several resources people should know about. If people don’t have air conditioners, there’s an organization called the Area Agency on Aging that at times is able to provide window air conditioners to people. These days, there may be people who have air conditioners who simply can’t afford to run them especially during the hottest weather. There are agencies that provide support for people who are having problems with their electric bills. For instance, there’s an organization called the Low Income Home Energy Assistance Program. And if you call your Area Agency on Aging, they can direct you towards that program. Also for any questions related to hyperthermia, the National Institute on Aging can answer your questions and direct you to people who can help you locally.
Balintfy: Thank you Dr. Jack Guralnik of the National Institute on Aging. Again here are some of those resources: You can call the National Association of Area Agencies on Aging, their Eldercare Locator, toll free at 1-800-677-1116, or the Low-Income Home Energy Assistance Program, again, toll free at 1-866-674-6327. For these numbers and more information from the National Institute on Aging, you can also visit www.nia.nih.gov.
Balintfy: That's it for this episode of NIH Research Radio. Please join us again on Friday, August 22 when our next edition will be available for download. I'm your host, Joe Balintfy. Thanks for listening.
NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.