New Online Health Care Tool Now Available to Consumers

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The U.S. Department of Health and Human Services (HHS) unveiled an innovative new online tool on July 1, 2010, which will help consumers take control of their health care by connecting them to new information and resources that will help them access quality, affordable health care coverage. Called for by the Affordable Care Act, 

HealthCare.gov is the first Web site to provide consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool. This site has a central database of health coverage options, combining information about public programs, from Medicare to the new Pre-Existing Conditions Insurance Plan, with information from more than 1,000 private insurance plans.

"HealthCare.gov helps consumers take control of their health care and make the choices that are right for them, by putting the power of information at their fingertips," said HHS Secretary Kathleen Sebelius. "For too long, the insurance market has been confusing and hard to navigate. HealthCare.gov makes it easy for consumers and small businesses to compare health insurance plans in both the public and the private sector and find other important health care information."

As the health care market transforms, so will HealthCare.gov. In October 2010, price estimates for health insurance plans will be available online and, moving forward, new information on preventing disease and illness and improving the quality of health care for all Americans also will be posted.

"People need to see what choices are offered, what options cost, and how coverage works in practice," said Karen Pollitz, Deputy Director for Consumer Support, Office of Consumer Information and Insurance Oversight. "Today, HealthCare.gov takes an important first step in that direction. In the coming months and years, we will add pricing and plan performance information so that consumers can see and understand and make meaningful choices about their health coverage."

Visit www.healthcare.gov.

Glucosamine Fails to Ease Aching Backs from MedPage Today

By Michael Smith, North American Correspondent, MedPage Today

Although it is widely used, glucosamine has no effect on chronic low back pain and degenerative lumbar osteoarthritis, researchers said.

In a large randomized double-blind trial, patients getting both glucosamine and placebo had similar changes in pain-related disability after six months of treatment and six months of follow-up, according to Philip Wilkens, MChiro, of Oslo University Hospital in Norway, and colleagues.

There was also no difference in pain itself, health-related quality of life, and the use of other medications or therapies for pain, Wilkens and colleagues said in the July 7 issue of the Journal of the American Medical Association.

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USPSTF Expands Osteoporosis Guidelines from MedPage Today

By Todd Neale, Staff Writer, MedPage Today

Postmenopausal women of any age with a 10-year fracture risk equal to or greater than that of a 65-year-old woman and no other osteoporosis risk factors should be screened for the disease, according to draft guidelines from the U.S. Preventive Services Task Force (USPSTF).

The 2002 USPSTF guidelines recommended routine screening only for women ages 65 and older, as well as women ages 60 to 64 with an increased risk for osteoporotic fractures. The current guidelines contain no recommendation for or against screening in younger women.

An additional change from the 2002 guidelines is a mention of men, albeit only to say that evidence is insufficient to assess the balance of benefits and harms of screening in older men. The updated guidance is still in draft form and will be available on the Agency for Healthcare Research and Quality's website for four weeks to receive public comments. After consideration of feedback, the final recommendations will be released.
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How to Encourage Repeat Mammograms? Are Interventions Worth the Effort, Money?

by Nick Mulcahy

A meta-analysis of public health interventions that promote repeat mammography was unable to identify which interventions were most effective.

The interventions to encourage women to regularly receive screening on a 1- or 2-year schedule include reminder systems, educational outreach, and intensive counseling.

An editorial accompanying the analysis, both of which were published online June 29 in the Journal of the National Cancer Institute, described the results as "sobering."

"Behavioral interventions only increase rates by a small to moderate amount, and there is insufficient evidence to know which approaches are most effective," write editorialists Jeanne Mandelblatt, MD, MPH, and Diana Buist, PhD, from the Cancer Control Program at Georgetown University Medical Center in Washington, DC.
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Colonoscopy Should Be Targeted at High-Risk Patients

by Becky McCall

Surveillance colonoscopy should target individuals with high risk for colorectal cancer who are most likely to benefit, according to a new study published in Gastroenterology.

Headed by Sameer Dev Saini, MD, MS, clinical lecturer in the Department of Internal Medicine, University of Michigan, the study examined the cost-effectiveness of various surveillance strategies and concluded that overuse of colonoscopy as a surveillance tool aimed at decreasing the burden of colorectal cancer can be excessively costly, and even harmful.

The American College of Gastroenterologists currently recommends that patients with colonic adenomas undergo surveillance colonoscopy every 5 to 10 years, but Dr. Saini questioned whether this strategy made health-economic sense.
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Celebrating the Life of Dr. Robert Butler

The Administration on Aging joins Secretary Sebelius and others throughout the world  in celebrating the life of Dr. Robert Butler, who passed away on the 4th of July. 

Dr. Butler's absence leaves a void that will not soon be filled in the corridors of geriatrics, medicine, research, science, education, literature and advocacy.  Much will be said about Dr. Butler over the next several days and weeks, but perhaps it is his own words that will help us through this difficult time. In his Pulitzer Prize winning book called "Why Survive: Being Old In America," he wrote,  "After one has lived a life of meaning, death may lose much of its terror, for what we fear most is not really death, but a meaningless and absurd life." For those of us fortunate enough to have known Dr. Butler and his work, the phrase "lived a life of meaning" could not be more appropriate. 

Please read Secretary Sebelius' statement below:

Statement from Secretary Sebelius on the Death of Dr. Robert Butler

I join the rest of the country in mourning the death of Dr. Robert Butler, one of America’s greatest champions for the health and wellbeing of older Americans.  As the first director of the National Institute of Aging, the founder of the country’s first geriatrics department, and in a decades-long career as a physician and policy advisor, Dr. Butler brought critical new public attention and medical resources to improving the health of our seniors.

He made great contributions as a researcher, playing a key role in the discovery that some of the debilitating conditions associated with old age could actually be prevented with the right care.  But he made an even bigger impact as an advocate.  He coined the term “ageism” and then became its most determined critic, helping to transform a culture that too often acted as if people’s contributions to society ended on their 65th birthday.

Dr. Butler’s own career showed just how wrong that view was, as he continued to be an international leader in geriatrics right up until his death at age 83.  For his trailblazing work to help seniors live rich and healthy lives – to not just survive, but thrive – all Americans, young and old, owe him an enormous debt.  We will miss him dearly.   

'Father of modern gerontology' Robert N. Butler dies at 83

By Emma Brown Washington Post Staff Writer

Robert N. Butler, 83, a Pulitzer Prize-winning author, psychiatrist and expert on aging who helped illuminate the "quiet despair, deprivation, desolation and muted rage" that he said characterized the act of growing old in America, and who co-wrote a best-selling sex manual for senior citizens, died July 4 at Mount Sinai Medical Center in New York. He had leukemia.


For more than half a century, Dr. Butler was a leading advocate in academic and policy circles for the dignified treatment and care of the elderly. He coined the term "ageism" to describe systematic discrimination against older people and challenged lawmakers, scientists and medical students to consider how to create a health-care system in which Americans could grow old gracefully.
Read More About Dr Butler and His Accomplishments

Photo Credit: Larry Barns/mount Sinai Medical Center

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In the D.C. area and across the U.S., scams against senior citizens are on the rise

By Dan Morse Washington Post Staff Writer

Murders and violent crimes are down around the Washington region and the country, but one kind of crime is rising steadily: scams against the elderly.

Senior citizens lose at least $2.6 billion a year to thieves, many of whom are in their own families, according to a study last year by the MetLife Mature Market Institute. And that estimate is conservative, MetLife says, given the schemes left unreported.

As the nation ages, the number of targets increases. By 2030, the United States will be home to 34 million people older than 75.

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Vital Signs: Colorectal Cancer Screening Among Adults Aged 50--75 Years --- United States, 2008

ABSTRACT  Background: Colorectal cancer (CRC) remains the second leading cause of cancer deaths in the United States and the leading cause of cancer deaths among nonsmokers. Statistical modeling indicates that, if current trends in health behaviors, screening, and treatment continue, U.S. residents can expect to see a 36% decrease in the CRC mortality rate by 2020, compared with 2000.

Methods: Every 2 years, CDC uses Behavioral Risk Factor Surveillance System data to estimate up-to-date CRC screening prevalence in the United States. Adults aged ≥50 years were considered to be up-to-date with CRC screening if they reported having a fecal occult blood test (FOBT) within the past year or lower endoscopy (i.e., sigmoidoscopy or colonoscopy) within the preceding 10 years. Prevalence was calculated for adults aged 50--75 years based on current U.S. Preventive Services Task Force recommendations.

Results: For 2008, the overall age-adjusted CRC screening prevalence for the United States was 62.9% among adult respondents aged 50--75 years, increased from 51.9% in 2002. Among the lowest screening prevalences were those reported by persons aged 50--59 years (53.9%), Hispanics (49.8%), persons with lower income (47.6%), those with less than a high school education (46.1%), and those without health insurance (35.6%).

Conclusions: CRC screening rates continue to increase in the United States. Underscreening persists for certain racial/ethnic groups, lower socioeconomic groups, and the uninsured.

Implications for Public Health Practice: Health reform is anticipated to reduce financial barriers to CRC screening, but many factors influence CRC screening. The public health and medical communities should use methods, including client and provider reminders, to ensure test completion and receipt of follow-up care. Public health surveillance should be expanded and communication efforts enhanced to help the public understand the benefits of CRC screening.
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Vital Signs: Breast Cancer Screening Among Women Aged 50--74 Years --- United States, 2008

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Breast cancer remains the most commonly diagnosed cancer and the second leading cause of cancer deaths among women in the United States. In 2006 (the most recent data available), approximately 191,410 women were diagnosed with invasive breast cancer, and 40,820 women died (1). The incidence and mortality have been declining since 1996 at a rate of approximately 2% per year (2), possibly as a result of widespread screening with mammography and the development of more effective therapies (3). Mammography use declined slightly in 2004, but rose again in 2006 (4,5). This Vital Signs report updates mammography screening prevalence in the United States, using data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS).
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TIME GOES BY | Reverse Mortgages – Part 2: The Basics

by Ronni Bennet

Because there are many small details to know about reverse mortgages and enough individual questions to fill a book, I am going to start broadly and drill down in subsequent posts so that we can absorb the needed information in bites (bytes?) we can easily digest.

Let's start today with a definition.

At least once in their lives, the majority of U.S. grownups go through the process of getting a traditional mortgage to pay for the purchase of a home. We pretty much understand what it is: a bank lends the money to pay for the property; the borrower repays the loan at an agreed-upon interest rate over a set period of years.

It is not much more complicated than that.

Although there are different requirements and more caveats associated with a reverse mortgage, at its most basic level, it is just that – the reverse of a traditional (“forward”) mortgage: a bank loan, secured by your home, that gives you regular payments or a lump sum based on the value of your home at the time the reverse mortgage is made.

Interest is charged on the outstanding balance which continues to grow, due to continuing interest, even when you do not take out additional funds. But you owe nothing, make no payments until the loan is due when you permanently move out of the home through a sale or death.

Eligibility Requirements

You (or the youngest borrower, if more than one) must be at least 62 years old.

You must have sufficient equity in your home to pay off any traditional mortgage with the proceeds of the reverse mortgage, a requirement to obtaining the reverse mortgage.

That's it. Income, health, credit rating or score are not considered.

Your Obligations

You are required to keep homeowners insurance and property taxes paid and to keep the property in good repair. Failure to do so can result in the loan being called due.

Remember, you continue to hold the title to your home and no matter what rumors you've heard or what others have told you, as long as you keep up those three obligations, you cannot be thrown out of your home. Also, you pay nothing until you sell or move out and you will never owe more than the value of your home.

Types of Reverse Mortgages

Reverse mortgages come with various interest rates and differing up-front costs. Some fees may he high, but the interest low and vice versa. One kind, called proprietary, is designed for people with extremely high-value homes offered by a few banks and other lending institutions. If you are rich enough to qualify for one of these, you're on your own. In this series, I am concerned only with HECMs because that is the type I am considering.

About 95 percent of all reverse mortgages are HECMs (pronounced HECK um by those in the business), the acronym for Home Equity Conversion Mortgages – administered by the Department of Housing and Urban Development (HUD) and insured by the FHA.

The FHA insurance protects the lender if the sale price of a home (when you move out) does not cover balance of the loan. It also protects you, the borrower, so that if the lending institution that holds your reverse mortgage files for bankruptcy or otherwise stops servicing your loan, your reverse mortgage will not be affected.

HECMs are as safe and secure as traditional mortgages and you should not be afraid of them. There was a time, early in the program, when large lenders with many kinds of financial products could give you a reverse mortgage with one hand and lock you into an inappropriate annuity, for example, with the other. But that is no longer allowed.

Problems today are not with the mortgage lenders, but with how people use the proceeds from the reverse mortgages. We'll talk about this in a future installment.

Benefits of a Reverse Mortgage

These are the five most common reasons people give for taking out reverse mortgages:

1. To pay for ongoing medical treatments, prescription drugs or a large, one-time medical bill


2. To make home improvements, modify a home for aging needs or pay off a traditional mortgage


3. To pay off large, high-interest debts


4. To take a long-awaited, lavish, dream vacation


5. To supplement Social Security and/or other monthly income

Number four seems a frivolous reason to take on large, expensive debt, but who is to say what is important to each of us.

Number five is my reason. As I explained in Part 1, the financial collapse of 2008 took a huge chunk of my savings and I don't have the stomach now to reinvest what remains, so my income is uncomfortably reduced.

For me, a reverse mortgage will provide a cushion to pay for future medical or other unforeseen needs and therefore return some of the peace of mind I lost in the 2008 crash. It also will give me some breathing room around normal expenses and, maybe, allow for some modest travel now and then which I can't otherwise afford. I don't have expensive needs so mostly, it's that peace of mind I'm going for.

Disadvantages of a Reverse Mortgage

There are good reasons to think very carefully before taking out a reverse mortgage.

If you were planning on leaving your home to the kids or grandchildren, they may not be able to afford to pay off the HECM after you die.

If you live alone and need to stay in a rehab, assisted living or nursing home for more than a year, you are required to pay off the mortgage.

Costs are high. They include all the fees you paid when you purchasedd your home (title search and insurance, FHA appraisal, document preparation, flood certification, credit report, etc.) plus an origination fee to the lender based on the appraisal of your home. The least it can be is $2,500 and there is an upper cap of $6,000. And there is the MIP - mortgage insurance premium - for the FHA mortgage insurance which is two percent of the amount of the reverse mortgage up front and, annually thereafter, one-half of one percent of the loan amount.

Usually, closing costs and fees are tacked onto the mortgage, but keep in mind that you pay interest on that money throughout the life of the loan in addition to the lender's ongoing service fe which is $30 or $35 per month.

Recently, lenders have been offering reverse mortgages with low or no origination fees and lower service fees. I'll look into this and let you know details as this series proceeds.

This is a general overview, the basic information needed to think clearly and rationally about a reverse mortgage. More next week. If I have been unclear, please leave questions in the comments. You can leave other questions too that you would like answered in future installments.

Reverse Mortgage Series
Part 1: One Reason For a Reverse Mortgage

TIME GOES BY | Reverse Mortgages – Part 2: The Basics

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When I’m 164 - The New Old Age Blog - NYTimes.com

by Paula Span

My theory is that the more intensely involved we are with caring for the very old and sick, the less appealing the notion of ever-longer lifespans becomes.

I can practically hear legions of New Old Age readers — hip-deep in elder tasks, in decisions and tussles and exhausting responsibilities — chorusing, “More years of this? Please, no.” A number of older readers have expressed similar sentiments here themselves.

But what if longevity didn’t involve an extended period of managing chronic illnesses and coping with frailty and disability, as so often happens now? What if we were talking about years of health and vigor, decades or even centuries in which we barely felt the impact of age? About not merely (merely!) defeating killers like Parkinson’s or Alzheimer’s, but achieving near-immortality?

Such visions, and the emerging science that might make them possible, have intrigued Jonathan Weiner, a Pulitzer Prize-winning author, for years.
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No Place Like Home - The New Old Age Blog - NYTimes.com

by Paula Span

Mary Wareheim suffers from a long list of health problems. She’s an amputee who uses a wheelchair. She has diabetes, heart disease, high blood pressure and an irregular heartbeat; she takes 11 prescription drugs. At 83, she leaves home infrequently, perhaps twice a year.

Yet she’s been the hospital just once in six years, probably because she’s had excellent medical care and monitoring. Though she’s essentially homebound, doctors come to her, in the Baltimore house she shares with her daughter, son-in-law and a Great Dane named Murphy, through the Johns Hopkins Elder House Call Program.

“My mother would absolutely make excuses not to go to a doctor,” said her daughter Chris Ricko, 49. “Now she doesn’t have an excuse.”

House calls aren’t a new idea, of course. Johns Hopkins has been sending attending physicians and residents out to see frail, elderly patients in their homes for 30 years. (I remember our family doctor coming to see me, black bag in hand, when I had the measles in my long-ago youth, so I wouldn’t infect everyone in his waiting room.)
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Losing Independence - The New Old Age Blog - NYTimes.com

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by Paula Span

Thoughts occasioned by fireworks, barbecues and flags: Why are we so surprised and dismayed, those of us who take care of older Americans, when they resist the help we want to provide? Or torpedo the plans we’ve so carefully researched?

Their intransigence can madden their families. We see a parent fall three times, and we want to intervene, to retrofit his house or move him into what seems a safer environment. But he insists that no, he’s fine at home. We notice that a relative is losing weight, either because she forgets to eat or can’t easily get to a market and cook, and we want to arrange for a home care aide or to fill her freezer or to sign her up for Meals on Wheels. She says she doesn’t don’t need any help, thanks.
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The Looming Challenge of Dementia in Corrections

by John Wilson, PhD, and Sharen Barboza, PhD in CorrectCare journal

As the inmate population ages, dementia will become increasingly common in our jails and prisons. In the community, the rate of new cases of dementia is expected to double in the next four decades. Although we don’t really know what the prevalence of dementia is among inmates, there is no reason to think it is less than in the community.

In fact, there is reason to think it may be two to three times more frequent in corrections than in the community: Inmates have fewer protective factors and more risk factors; increasing numbers are being incarcerated into late age or for life; and inmates may grow physiologically older faster than people in the community due to high risk lifestyles and poor health care prior to incarceration. Base rates for serious mental disorders are two to four times greater in corrections than in the community. Dementia is unlikely to be an exception.

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Brown to Whitman: Respect your elders - Andy Barr - POLITICO.com

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By ANDY BARR

California Democratic gubernatorial nominee Jerry Brown on Wednesday criticized Republican rival Meg Whitman for running an ad highlighting his age.

Whitman began running a ‘60s-themed television ad last week tracking Brown’s five-decade career in politics. It starts with pictures of a younger Brown during his first campaign for governor in the 1960s and ends with an aging Brown in his current spot as state attorney general.

Brown, 72, was asked about the spot during an interview Wednesday morning with “Good Day L.A.” "'60s, '70s, '80s, '90s, I’ve been around a long time,” he said. “I know stuff. Knowing is better than not knowing.

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Stem Cell Treatments Restore Sight After 60 Years! - Justin Gardner - Political Pulse - True/Slant

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by Justin Gardner

In what can only be considered a miracle of modern science, patients receiving stem cell treatments have had their sight restored after being blind in one eye for a number of years.
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Cross-State Risk Pooling Under Health Care Reform: An Analytic Review of the Provisions in the House and Senate Bills

by Linda J. Blumberg and Karen Pollitz

How health care risk is pooled is of defining importance to health care systems. This paper explores provisions in the House and Senate health reform bills that could pool risk across state lines. These provisions include options for states to jointly operate insurance exchanges and enter into interstate health insurance compacts, as well as the development of national health plan offerings. Using available literature and discussions with an array of experts in the fields of health policy, insurance, regulation, and purchasing pools, the paper summarizes the potential for cross-state pooling and the challenges faced in implementation of the specific strategies.
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Health Insurance Benefits Protection for Employees with Disabilities: The Role of the Family and Medical Leave Act

by Pamela J. Loprest, Elaine Maag

Workers experiencing serious health problems that temporarily make continuing work difficult face not only loss of earnings, but potentially loss of health insurance coverage. The Family and Medical Leave Act (FMLA), passed in 1993, helps to mitigate these losses by mandating employers provide temporary unpaid leave, continuation of health benefits during the leave, and the right to return to work in the same or similar job for eligible workers. This paper reviews earlier research with respect to how important a role health insurance continuation under the FMLA is for employees with disabilities.
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Study Shows Age Doesn't Necessarily Affect Decisions

from Medical News Today

Many people believe that getting older means losing a mental edge, leading to poor decision-making. But a new study from North Carolina State University shows that when it comes to making intuitive decisions - using your "gut instincts" - older adults fare as well as their juniors.

The researchers tested groups of young adults (aged 17-28) and community-dwelling older adults (aged 60-86) - meaning they live in the community, rather than in a nursing home - to see how they fared when making decisions based on intuitive evaluation. For example, study participants were asked to choose from a list of apartments based on each apartment's overall positive attributes. Under such conditions, young and older adults were equally adept at making decisions.

"But not every decision can be made that way," says Dr. Thomas Hess, a professor of psychology at NC State and co-author of the study. "Some decisions require more active deliberation. For example, those decisions that require people to distinguish pieces of information that are important from those that are unimportant to the decision at hand." And when it comes to more complex decision-making, Hess says, older adults face more challenges than their younger counterparts.

In one portion of the study, participants were given a list of specific criteria to use in selecting an apartment. That list was then taken away, and each participant had to rely on his or her memory to incorporate the criteria into their decision-making.

However, there was considerable variation among the older adults who participated in the study - some did very well at the complex decision-making. "Older adults with a higher education did a better job of remembering specific criteria and utilizing them when they made decisions," says lead author Tara Queen, a psychology Ph.D. student at NC State. "Ultimately, they made better choices."

"This tells us that the effects of age on decision-making are not universal," Hess says. "When it comes to making intuitive decisions, like choosing a dish to order from a menu, young and old are similar. Age differences are more likely to crop up when it comes to complex decision-making, such as choosing a health-care plan based on a complex array of information. But even then, it appears that any negative effects of aging will be more evident in those with lower levels of education."

The research can be used to change the way we present information to older adults, Hess adds. Queen explains that "presenting older adults with overwhelming amounts of information is less beneficial to them. For example, different people have different priorities. Information can be broken down into categories. People could then decide which categories are most important to them, and dig down for additional information as needed."

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Lawmakers Urge Swifter Launch Of Home Health Care Demo

From Medical News Today

Democratic lawmakers are pushing the Obama administration to launch a Medicare home health demonstration project as soon as possible.

"The so-called Independence at Home (IAH) program, included as part of the Democrats' new health reform law, is scheduled to take effect no later than Jan. 1, 2012, but Sen. Ron Wyden (D-Ore.) and Rep. Edward Markey (D-Mass.) warn that waiting that long would threaten the health of one of the country's most vulnerable populations," The Hill reports. "The lawmakers are pressing the Centers for Medicare and Medicaid Services (CMS) to install the program 'sooner rather than later,' with a target launch within six months." The push may also have a political incentive. "With many seniors wary of the Medicare cuts contained in the Democrats' new health reform law, party leaders are eager to prove that those cuts won't harm the quality of care... It was CMS that, leery of potential complications surrounding implementation, had pushed lawmakers to delay the required launch of the IAH program until 2012" (Lillis, 6/29).

Congressional Quarterly: "Under the three-year demonstration project, people with chronic conditions such as Alzheimer's disease would have primary care provided in their home by teams of providers directed by physicians and nurse practitioners. Seniors with chronic conditions account for 85 percent of Medicare spending and often receive disjointed and badly managed care through the current Medicare system, Wyden and Markey said" in a letter to Medicare administrators. "Organizations that contract to participate are held accountable for producing 5 percent savings in the cost of the beneficiaries' care, but at the same time improving the quality of care and satisfying family members and caregivers. In return, the organization gets a share of the savings beyond 5 percent" (Norman, 6/29).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

Lawmakers Urge Swifter Launch Of Home Health Care Demo

Low Vitamin D Linked To The Metabolic Syndrome In Elderly People

from Medical News Today

A new study adds to the mounting evidence that older adults commonly have low vitamin D levels and that vitamin D inadequacy may be a risk factor for the metabolic syndrome, a condition that affects one in four adults. The results were presented at The Endocrine Society's 92nd Annual Meeting in San Diego.

"Because the metabolic syndrome increases the risk of diabetes and cardiovascular disease, an adequate vitamin D level in the body might be important in the prevention of these diseases," said study co-author Marelise Eekhoff, MD, PhD, of VU University Medical Center, Amsterdam.

The researchers found a 48 percent prevalence of vitamin D deficiency. The study consisted of a representative sample of the older Dutch population: nearly 1,300 white men and women ages 65 and older.

Nearly 37 percent of the total sample had the metabolic syndrome, a clustering of high blood pressure, abdominal obesity, abnormal cholesterol profile and high blood sugar.

Subjects with blood levels of vitamin D (serum 25-hydroxyvitamin D) lower than 50 nanomoles per liter, considered vitamin D insufficiency, were likelier to have the metabolic syndrome than those whose vitamin D levels exceeded 50. That increased risk especially stemmed from the presence of two risk factors for the metabolic syndrome: low HDL, or "good" cholesterol, and a large waistline.

There was no difference in risk between men and women, the authors noted.

The study included subjects who were participating in the Longitudinal Aging Study Amsterdam. Although the data were from 1995 and 1996, Eekhoff said they expect that vitamin D inadequacy remains prevalent among whites in the Netherlands.
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A Day of a Person With Quadriplegia

by Tom Babinszki

Tied up with an invisible chain -- you’d probably think this to yourself if you suddenly found out that you can’t walk, move, lift your arms, or even just curl your fingers.

This could easily be anyone’s reaction if they’ve had a spinal cord injury and is left paralyzed from the neck down. But this doesn’t have to be so. For the many people living with quadriplegia, life doesn’t have to slip away from them even if it had slipped away from their limbs.

This is exactly what our friend will show us as he invites us to a day in his life. We will see the daily challenges that he has to face and how assistive technology and adaptive tools are helping him to overcome them.
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Disability.gov: Countdown to the 20th Anniversary of the ADA: Day 24 - Anniversary of the Civil Rights Act of 1964

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By Guest Blogger Patrick Cokley, Office of Disability Employment Policy, U.S. Department of Labor


Today is the Anniversary of the Civil Rights Act of 1964 (CRA 64).






The passing of this groundbreaking legislation still exists in the living memory of many Americans. Our society continues to be steeped in the ramifications of Jim Crow segregation and the impacts of “separate but equal,” but because of CRA 64, separate lunch counters and Whites Only bathrooms have become history.

As a student of the American policy-making process, the Civil Rights Act of 1964 is what I would call one of two gold standards in my personal civil rights, the other being the Americans with Disabilities Act of 1990 (ADA). Being an African American and a person with a disability, there are few things that affect me more with regard to my personal civil rights in my day to day life.


Like most Americans, I base my concept of hardships on what is happening in my time and place in history, and compare them with the past. That being said – I had to wonder…in a policy grudge match between the ADA and CRA 64, taking place in the Freedom Ring of Constitution Hall in front of spectators, fans and representatives from the ACLU, which would come out the victor? I couldn’t resist the opportunity to play out in writing what that battle might look like.

Now before the two contenders even step into the ring, there is an obvious age difference. CRA 64 was developed in a time where breaking down segregationist barriers was a day to day struggle. Though there had been a significant series of prior civil rights acts, in many ways the methods that CRA 64 created were untested. The passing of CRA 64 formed a brand new America, and thus CRA has the advantage of years of experience. By contrast, the ADA had the benefits of all of the legislation that came before it – the Architectural Barriers Act, the Voting Rights Acts, the Rehabilitation Act, as well as the Civil Rights Act of 1964. So it had the prior knowledge these acts brought - the “training,” if you will.

For those of you who do not carry a copy of the text of CRA 64 or the ADA in your wallet (or written on your heart), here is a quick rundown of their stats:

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Disability.gov: A New Federal/Private Model Promotes Financial Well Being for Americans with Disabilities

By Guest Blogger Dr. Johnette Hartnett, Director of Strategic Partnership Development, The National Disability Institute’s Real Economic Impact Tour and Burton Blatt Institute, Syracuse University

Imagine an unlikely partnership between federal agencies, private sector partners, universities and nonprofits, collectively championing the rights of taxpayers with disabilities.

Now, what at first seemed improbable has become reality. Over the past six years, the National Disability Institute’s Real Economic Impact Tour has established a groundbreaking federal/private model for promoting tax education and financial well-being to Americans with disabilities nationwide.

Thanks to key sponsors like Bank of America, AT&T, Walmart, Acorda Therapeutics, Inc. and others, we've delivered funding and asset-building programs to cities in all 50 states. Since 2005, our partnerships with the IRS and 100 community-based organizations have resulted in free tax filing assistance for more than 650,000 taxpayers with disabilities – representing more than $600 million in returns and more than $120 million in saved preparer fees.

Yet, while we’re pleased to celebrate the above milestones as part of the 20th Anniversary of the ADA, we know there’s much work ahead to ensure that all Americans with disabilities have access to the economic mainstream. Especially considering the following:

• 37 million Americans live in poverty, and 13 million are children less than 18 years of age
• 38 million Americans subsist on food stamps
• 50 million Americans, in any given month, are on Medicaid
• 57 percent of unemployed Americans receive unemployment compensation compared to 40 percent before the recession
• 61 percent is the increase in homelessness in America since December 2007
• 40 percent of Americans accessing food shelters and pantries are people on Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)
• 65 percent of Americans experiencing long-term poverty (greater than a year) are persons with disabilities

The above 65 percent translates into more than 54 million Americans – clearly, not a niche market. In fact, it's a market larger than the United States’ African-American, Latino and Gay markets combined; a market that wields 17 times the spending power of tweens 8-12 years old. It's a market not to be ignored.
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Disability.gov: Countdown to the 20th Anniversary of the ADA: Day 25 - Disability Statistics

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By Guest Blogger Cherise J. Hunter, Research Analyst, Office of Disability Employment Policy, U.S. Department of Labor

Did you know that a VERY important announcement is made the first Friday of EVERY month? It is publicized on virtually every news network and is often viewed as a major indicator of the status of the U.S. economy by politicians, researchers, economists and everyday citizens alike. It is the release of the nation’s unemployment rate - which, by the way, currently stands at 9.9 percent. It is released by the Bureau of Labor Statistics (BLS) and represents the most comprehensive measure of national employment and unemployment. These measures are obtained from a survey called the Current Population Survey (CPS), conducted monthly by the U.S. Census Bureau for the BLS.


Unfortunately, the CPS was not originally designed to capture whether or not the person being surveyed has a disability (although certain questions address the issue). However, since June 2008, the Census Bureau has asked six new questions, the purpose of which is to identify whether the person who is surveyed has a disability and the nature of the disability. The six survey questions are:

• Is {person} deaf or does {person} have serious difficulty hearing?
• Is {person} blind or does {person} have serious difficulty seeing even when wearing glasses
• Because of a physical, mental or emotional condition, does {person} have serious difficulty concentrating, remembering or making decisions?
• Does {person} have serious walking or climbing stairs?
• Does {person} have difficulty dressing or bathing?
• Because of a physical, mental or emotional condition, does {person} have difficulty doing errands alone such as visiting a doctor's office or shopping?

This information is vital for the disability community because it provides a primary source of data on employment status and characteristics of the labor force, emerging trends and changes in the employment rate of individuals with disabilities. What do the current numbers reveal? Well, according to the April 2010 CPS (not seasonally adjusted), the employment rate of the civilian noninstitutional population with disabilities, ages 16 to 64, was 28.9 percent compared to 70.0 percent for persons without disabilities. The unemployment rate for individuals with disabilities was 15.5. One of the most striking statistics involves the participation rate. Only 34.5 percent of individuals with disabilities ages 16 to 64 are participating in the labor force compared to 77.3 percent of persons with no disability!

Evaluating and researching this data will take time. But stay tuned! In addition, to the disability labor force status data released every month at http://www.bls.gov/news.release/empsit.t06.htm, a CPS supplement is currently being planned by the Department of Labor’s Office of Disability Employment Policy (ODEP) and BLS to delve further into disability employment data in order to better explain what these numbers really mean for people with disabilities and employers.

For More Information
To learn more about the CPS disability statistics, visit
http://www.bls.gov/cps/cpsdisability.htm. To find data from June 2008 through May 2010, visit http://www.bls.gov/webapps/legacy/cpsatab6.htm and select one or more questions from the data table on the page, then scroll down to click the "Retrieve data" button.

New Fiscal Year Brings More Grief for State Budgets, Putting Economic Recovery at Risk — Center on Budget and Policy Priorities

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By Erica Williams, Phil Oliff, Ashali Singham and Nicholas Johnson

Dismal state revenue collections caused by the severe recession are setting the stage for a new round of state budget cuts as fiscal year 2011 begins in most states on July 1. The states’ cumulative budget shortfall will likely reach $140 billion in the coming year, the largest shortfall yet in a string of huge annual gaps that date back to the beginning of the recession. Closing it will have severe effects on services and jobs.

In many states, the new fiscal year will bring immediate cuts to programs and services that are facing unprecedented demand. As of July 1, 10,000 families in Arizona will lose eligibility for temporary cash assistance; Georgia will lay off as many as 284 workers who help low-income families enroll for food stamp, Medicaid and TANF benefits; and Kansas will cut off nearly 2,800 individuals with a disability from independent living services. Education, health care, and other priority areas will also face new cuts in the coming fiscal year — on top of extensive cuts that at least 45 states have enacted over the last two years.

States are raising taxes as well for 2011. Effective July 1, Kansas and New Mexico increase their sales taxes; Hawaii, New Mexico, New York, South Carolina, and Utah increase their tax on tobacco products; Washington begins taxing soda, and Oklahoma is temporarily suspending various business and energy tax credits. Other changes have already taken effect or will take effect later in fiscal year 2011. Since 2008, more than 30 states have raised taxes or tax-like fees.

Separate and apart from dismal revenue collections, the budget situation for states just got worse. Last week, the U.S. Senate failed to pass jobs legislation that would have extended an enhanced federal match for the Medicaid program that 30 states were counting on to balance their budgets. Without these funds, states will make even deeper spending cuts and more tax increases than previously planned.
These state actions, while necessary to meet state balanced-budget requirements, will nevertheless slow the economic recovery and raise the risk that the nation will fall back into recession as the loss of Americans’ spending power ripples through the economy. States’ actions to close their $140 billion gap without more federal aid could cost the economy up to 900,000 public- and private-sector jobs.

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Unlimited Estate Tax Exemption For Farm Estates Is Unnecessary and Likely Harmful — Center on Budget and Policy Priorities

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By Gillian Brunet and Chye-Ching Huang

Proponents of repealing the estate tax have made farmers, along with small business, the face of their cause, driving some policymakers to push for special preferences for farms in estate tax law. One of the most radical of these proposed changes is an unlimited estate tax exemption for farmland, recently introduced by Rep. Mike Thompson (D-CA) in H.R. 5475. This approach is seriously misguided, for three basic reasons.
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