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Daily Archives: March 31, 2022

Charts: U.S. Nominal Income and Spending Rose Slightly in February 2022

The inflation indicator Headline PCE Deflator surged to the highest since 1982

Source : Bloomberg

Chart: 13 U.S. Recessions Since World War II

Source : NBER

Music Video: Everyday People

Sly & The Family Stone

Watch video at You Tube (2:28 minutes) . . . .

The Surprising Link Between COVID-19 Deaths and … Internet Access

Keren Landman wrote . . . . . . . . .

Two years into the pandemic, researchers are still trying to understand what makes some people more likely than others to die from Covid-19. Although we know some of the risk factors — like age and underlying disease — others are less obvious. Identifying them could ease our current pain, protect communities from future epidemics, and point us toward some of the societal fractures we should most urgently try to mend.

One of the more surprising answers to this question is one that appears to have a relatively straightforward solution: internet access.

This March, researchers at the University of Chicago published a study in the journal JAMA Network Open that showed one of the factors most consistently associated with a high risk of death due to Covid-19 in the US was the lack of internet access, whether broadband, dial-up, or cellular. This was regardless of other demographic risk factors like socioeconomic status, education, age, disability, rent burden, health insurance coverage, or immigration status.

The study authors estimated that for every additional 1 percent of residents in a county who have internet access, between 2.4 and six deaths per 100,000 people could be prevented, depending on the makeup of the region.

The findings held more surprises. The trend held true not just in rural areas with sparse internet access, but also in urban areas, where most homes can be wired for broadband internet. That is, people who could get internet access in cities but either don’t or can’t are also at increased risk of dying from Covid-19.

“We believe this finding suggests that more awareness is needed,” the study authors wrote in the paper. “Populations with limited internet access remain understudied and are often excluded in pandemic research.”

Still, questions remain. Why does internet access seem to be protective? And would increasing it yield meaningful improvements in public health?

The answers to those questions matter because while the American marketplace has generally treated internet access as a luxury, the Covid-19 pandemic has revealed that the ability to get online might be a matter of life or death.

America’s internet inequality, explained

Internet access has been inequitable for almost as long as there’s been an internet.

In 2000, when the Pew Research Center first began gathering data on Americans’ internet use, its researchers found large gaps: older Americans, low-income people, minorities, people with less education, and those who live in rural areas were less likely to be online.

While some of those gaps have since narrowed, most of them stubbornly remain. More than a quarter of Americans still don’t have home broadband internet, and the proportion without access is twice as high for those without any college education and those who earn less than $30,000 a year. Only 63 percent of rural homes have broadband access, as do about half of those living on tribal lands — even if they have a computer.

These inequities were not created by chance. In the US, private internet service providers developed the infrastructure for broadband internet access where it was profitable. As a consequence, many of the country’s most marginalized communities have the fewest, most expensive, and lowest-quality choices when it comes to an internet service provider.

As those access gaps persisted over the years, more and more health services came online. That left those without access unable to use telemedicine, or even easily look up information about health conditions. Over the last few years, researchers have started to see internet access, and in particular high-speed broadband, as a critical component of health — something vital for connecting people not only with health care, but also with food, housing, education, and income, all of which are considered social determinants of health.

Then, as Covid-19 pushed routine health care provider visits into the telehealth space, people without internet access — many of them already medically underserved — found health care even harder to access. Home broadband drew a sharper line than ever before between haves and have-nots; access to internet bandwidth suddenly determined access to educational instruction, economic stability, food pantry sign-ups, vaccine availability and safety information, human contact, and so many other resources.

Before the pandemic, broadband internet access was only occasionally described as a social determinant of health, but over the past two years, its centrality has crystallized. “Broadband internet access acts as a gateway to information and services,” said Natalie Benda, a health care informatics researcher who co-authored an editorial on the subject in the American Journal of Public Health.

Having broadband internet access means having access to education and financial stability, which on their own contribute to our well-being. The connections are so strong, Benda said, that the Federal Communications Commission is now framing broadband internet access as a “super” determinant of health.

There’s a huge amount of observational data showing broadband internet access tracks with other factors that predict health, like income, race, and education. However, there is almost no experimental data linking internet access with health outcomes themselves.

The pandemic provided an opportunity to accelerate our understanding of just how internet access is related to health because it exacerbated many of the existing inequalities underlying health disparities.

Linking internet access to Covid-19 mortality

Prior to the pandemic, the investigators might not have thought to include internet access as a variable, said Qinyun Lin, one of the study’s co-authors. However, another study had linked home broadband internet to Chicago-area Covid-19 mortality; that finding, combined with the team’s own pandemic experiences of retreating to life online, led them to consider internet access as essential in the Covid-19 context. The authors drew on census data on households without access to any form of internet, whether broadband, dial-up, satellite, or cellular. (Note: The study does not directly compare the impact of having broadband versus dial-up or any other category.)

In Lin’s study, internet access was the only factor associated with higher mortality rates in rural, urban, and suburban areas (the study also included measures of socioeconomic status, education, age, and other demographic risk factors). The effect was strong: In rural areas, a 1 percent decrease in a county’s internet access was associated with 2.4 deaths per 100,000 people. But the effect was even stronger in urban areas, where the same difference in access was associated with nearly six deaths per 100,000 people.

The investigators weren’t surprised to find that low internet access was associated with high death rates, said study coordinator and co-author Susan Paykin. But they were surprised by how strong the association was, and surprised by its presence in both rural and urban areas.

None of the other demographic variables the team examined — including socioeconomic status — were significant across all three types of communities, said Paykin. There’s a lot of attention and research put into broadband gaps in rural areas, “but I think that misses a lot of what’s clearly going on in suburban and urban communities,” she said. That means lack of internet access isn’t just a rural infrastructure problem. It’s likely a problem of affordability in cities as well.

Questions remain about the why of it all

Internet access doesn’t boost your immune system or filter your air — so what’s the mechanism explaining the robust relationship between low digital connectivity and high Covid-19 death rates?

The absence of internet access in a household can signify a variety of other factors that are known to increase the risk of dying from Covid-19: old age, housing problems, or difficulty accessing quality health care. But Lin’s study accounted for these characteristics in the analysis, suggesting the lack of internet access was the real source of risk.

Lin hypothesizes that it’s all about lacking information. “If they have limited access to the internet, they rely more on their personal network or their local network to get Covid-19-related information,” she said. That may lead to being influenced by low-quality information sowing distrust in vaccines, for example. But her study wasn’t designed to show why Covid-19 deaths were more common in counties where internet access was more scarce, she says, and more research is needed to answer this question.

New funding for broadband expansion will solve some access problems but not the root cause of them

The good news here is that internet access is a problem the US government has actually allocated money to solve.

In November, Congress passed an infrastructure bill that included $65 billion in funding for broadband internet expansion. Two-thirds of the funding will support the creation of infrastructure, largely in rural parts of each state, and an additional large chunk will pay for $30 monthly subsidies to help low-income households pay for internet access.

Smaller amounts have been earmarked for programs to teach new users the tech skills they need to use the internet, programs to expand access in tribal communities, and other initiatives.

That means a lot of the new money “gets funneled toward rural areas without access to what we consider basic broadband today,” said Ry Marcattilio-McCracken, a senior researcher with the Institute for Local Self-Reliance’s Community Broadband Networks Initiative.

In many ways, that’s a good thing: Because rural communities have not been profitable areas of development for the telecommunications monopolies that serve them, infrastructure to support rural access to even the lowest-speed broadband internet has been woefully underdeveloped.

But the bill doesn’t do as much to address disparities in areas that have good infrastructure but low affordability, said Marcattilio-McCracken. Residents of many cities cannot afford an $80 monthly bill for broadband internet, even with the $30 subsidies the new funding would provide. And because the bill disincentivizes competition, urban residents will not have new internet service providers to choose from any time soon.

One of the most promising solutions to urban internet insecurity — and one the Biden administration initially wrote into the bill — is the creation of cooperative community networks. These municipally run internet service providers are able to provide higher download speeds, lower prices, and better service to city residents — plus, they are relatively uncomplicated to set up, and as easy to sign up for as, say, city-run electrical utilities, Marcattilio-McCracken said.

They do require startup funding, he said, but ultimately, these providers prioritize access over profit. “They’ve got a whole different set of motives in building an operating infrastructure, and it means building more resilient communities,” Marcattilio-McCracken said.

“Broadband internet access should be a public utility,” Benda said, especially considering the research linking access to health. It’s a need, not a privilege; that means making it as accessible and adjustable as water or electricity use, she said.

Will expanding access improve health? It’s an experiment worth conducting.

Researchers know the lack of internet access is associated with poor health outcomes, but one thing still remains to be seen: Does expanding access work as an intervention to improve health?

In the coming years, the expansion of broadband will at least provide a natural experiment to test this question. Regardless, the pandemic has shown that increasing access is essential for so many reasons.

Improving internet access now would have positive effects that last beyond the pandemic, Paykin said. Telehealth and online learning for children and adults are likely here to stay. “This almost surely won’t be our last pandemic,” she said, nor our last public health emergency. Whatever challenges may come, increased broadband internet access seems likely to help people through them.


Source : Vox

After COVID-19, Experts Say Watch for These Potential Heart and Brain Problems

Michael Merschel wrote . . . . . . . . .

COVID-19 was full of surprises early on, causing mild problems in the short term for some people and serious complications for others.

Long term, it may be just as capricious.

Studies are spotting potential heart and brain problems up to a year after infection with SARS-CoV-2, even in people who had mild COVID-19.

The possible long-term effects include “a myriad of symptoms affecting different organs,” said Dr. José Biller, director of the COVID-19 neurology clinic at Loyola Medicine in Maywood, Illinois. “So, it could be the lungs, it could be cardiovascular, it could be the nervous system, it could be mental health or behavioral problems.”

Estimates vary widely on how many people may be affected. Research suggests about 10% to 20% of people experience mid- or long-term issues from COVID-19, according to the World Health Organization.

That may sound small, but COVID has affected hundreds of millions of people, said Dr. Siddharth Singh, director of the post-COVID-19 cardiology clinic at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles. In the U.S. alone, about 80 million people have been infected with the coronavirus since the pandemic started in early 2020.

There are many more questions than answers, including about who is most at risk for post-COVID problems and how long the effects might last. But experts say people who have had COVID-19 should be aware of these potential risks:

Heart disease and stroke

A study published in Nature Medicine in February concluded the risk of heart problems one year after COVID-19 infection is “substantial.”

Those heart problems include irregular heartbeats, heart failure (the inability of the heart to pump properly), coronary disease (buildup in arteries that limits blood flow), heart attacks and more.

The study included 153,760 U.S. veterans, most of them white and male, who tested positive for COVID-19 between March 1, 2020, and Jan. 15, 2021, and survived at least 30 days. They were compared to a control group of more than 5.6 million veterans without COVID-19.

Researchers adjusted for pre-existing conditions and found that after one year, those who had COVID-19 were 63% more likely to have some kind of cardiovascular issue, resulting in about 45 additional cases per 1,000 people.

Risks were elevated even among people who did not have severe COVID-19. That matches what Singh has seen in his post-COVID clinic, which began treating patients in December 2020. “A lot of patients that we have seen with long-haul symptoms had minor illness and had been treated at home.”

Singh also treats many people with postural orthostatic tachycardia syndrome, or POTS, which can cause dizziness, fainting and heart palpitations. “These palpitations mostly tend to happen when people are standing or sitting upright,” he said.

In rare cases, “smoldering inflammation around the heart or in the heart” can occur, Singh said.

The Nature Medicine study also found a 52% increased risk of stroke at one year among COVID-19 survivors, or about four extra strokes per 1,000 people.

Brain problems

Among the 113 patients in Biller’s long COVID clinic, almost 3 in 4 reported so-called brain fog. “They are unable to multitask, and have difficulties in learning new skills,” said Biller, who also leads the department of neurology at the Loyola University Chicago Stritch School of Medicine.

A recent Nature study of 785 people ages 51 to 81 found those who had COVID-19 lost more grey matter and had more brain shrinkage than those who had not.

Mental health

A study published in February in BMJ used the same pool of U.S. veterans as the Nature Medicine study and found a 35% increased risk of anxiety disorders after COVID-19, or 11 additional cases per 1,000 people after one year compared to those without COVID-19. The risk for depression was slightly higher.

When researchers compared people who’d had COVID-19 versus the flu, the risk of mental health disorders was again significantly higher with COVID-19.

“Mental health is closely tied to cardiovascular health,” Singh said. If somebody is anxious or depressed, “they’re not going to exercise that much. They’re not going to watch their diet, take control of their hypertension and other risk factors, their sleep is affected which can impact cardiovascular health, and so on.”

He said many COVID-19 survivors also have unresolved pain, grief and post-traumatic stress disorder, which can contribute to a decline in mental health.

Fatigue

At Biller’s post-COVID clinic, patients often describe experiencing “crushing” fatigue. Fatigue was the most common post-COVID symptom reported in a review of several studies published in August in Scientific Reports.

What you can do

Even though the long-term risks from having COVID-19 may be real, Singh said, they should not cause most people to be terribly worried. Instead, he said, it’s a good time to be proactive:

  • Take care of yourself. “A lot of my family and friends have gotten COVID earlier this year and last year,” Singh said. “What I’m telling them is just to be a bit more vigilant when it comes to their cardiovascular health and making sure their cardiovascular risk factors are well-controlled. Obviously, if one is having chest pain, shortness of breath or palpitations, that should not be ignored.”
  • Symptoms lingering? See a doctor. “It can take anywhere from two to six weeks to completely bounce back from the infection,” Singh said. But if people have persistent physical and mental symptoms beyond four to six weeks, “it’s wise to get checked out.”
  • Pay attention to sleep. Sleep disorders – which are linked to heart problems – can develop after COVID-19, research shows. “The importance of good sleep cannot be overemphasized,” Singh said. If you’re having trouble, you might need to see a specialist.
  • Stay informed. As research continues to untangle the mysteries of COVID-19, people will need trustworthy information. The Centers for Disease Control and Prevention offers regular updates about the coronavirus, and the National Library of Medicine provides a tutorial for evaluating health information.
  • Get vaccinated. COVID-19 vaccines reduce the risk of infection and severe illness. And while it’s not yet clear whether vaccination influences long-term symptoms in people who get breakthrough infections, Biller said, “prevention is the key.”


Source: American Heart Association

Charts: Global Recorded Music Revenues Grew 18.5% in 2021


See large image . . . . . .

Source : IFPI

Eating an Avocado Once a Week May Lower Heart Disease Risk

Eating two or more servings of avocado weekly was associated with a lower risk of cardiovascular disease, and substituting avocado for certain fat-containing foods like butter, cheese or processed meats was associated with a lower risk of cardiovascular disease events, according to new research published in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

Avocados contain dietary fiber, unsaturated fats especially monounsaturated fat (healthy fats) and other favorable components that have been associated with good cardiovascular health. Clinical trials have previously found avocados have a positive impact on cardiovascular risk factors including high cholesterol.

Researchers believe this is the first, large, prospective study to support the positive association between higher avocado consumption and lower cardiovascular events, such as coronary heart disease and stroke.

“Our study provides further evidence that the intake of plant-sourced unsaturated fats can improve diet quality and is an important component in cardiovascular disease prevention,” said Lorena S. Pacheco, Ph.D., M.P.H., R.D.N., lead author of the study and a postdoctoral research fellow in the nutrition department at the Harvard T.H. Chan School of Public Health in Boston. “These are particularly notable findings since the consumption of avocados has risen steeply in the U.S. in the last 20 years, according to data from the U.S. Department of Agriculture.”

For 30 years, researchers followed more than 68,780 women (ages 30 to 55 years) from the Nurses’ Health Study and more than 41,700 men (ages 40 to 75 years) from the Health Professionals Follow-up Study. All study participants were free of cancer, coronary heart disease and stroke at the start of the study and living in the United States. Researchers documented 9,185 coronary heart disease events and 5,290 strokes during more than 30 years of follow-up. Researchers assessed participants’ diet using food frequency questionnaires given at the beginning of the study and then every four years. They calculated avocado intake from a questionnaire item that asked about the amount consumed and frequency. One serving equaled half of an avocado or a half cup of avocado.

The analysis found:

  • After considering a wide range of cardiovascular risk factors and overall diet, study participants who ate at least two servings of avocado each week had a 16% lower risk of cardiovascular disease and a 21% lower risk of coronary heart disease, compared to those who never or rarely ate avocados.
  • Based on statistical modeling, replacing half a serving daily of margarine, butter, egg, yogurt, cheese or processed meats such as bacon with the same amount of avocado was associated with a 16% to 22% lower risk of cardiovascular disease events.
  • Substituting half a serving a day of avocado for the equivalent amount of olive oil, nuts and other plant oils showed no additional benefit.
  • No significant associations were noted in relation to stroke risk and how much avocado was eaten.

The study’s results provide additional guidance for health care professionals to share. Offering the suggestion to “replace certain spreads and saturated fat-containing foods, such as cheese and processed meats, with avocado is something physicians and other health care practitioners such as registered dietitians can do when they meet with patients, especially since avocado is a well-accepted food,” Pacheco said.

The study aligns with the American Heart Association’s guidance to follow the Mediterranean diet – a dietary pattern focused on fruits, vegetables, grains, beans, fish and other healthy foods and plant-based fats such as olive, canola, sesame and other non-tropical oils.

“These findings are significant because a healthy dietary pattern is the cornerstone for cardiovascular health, however, it can be difficult for many Americans to achieve and adhere to healthy eating patterns,” said Cheryl Anderson, Ph.D., M.P.H., FAHA, chair of the American Heart Association’s Council on Epidemiology and Prevention.

“We desperately need strategies to improve intake of AHA-recommended healthy diets — such as the Mediterranean diet — that are rich in vegetables and fruits,” said Anderson, who is professor and dean of the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego. “Although no one food is the solution to routinely eating a healthy diet, this study is evidence that avocados have possible health benefits. This is promising because it is a food item that is popular, accessible, desirable and easy to include in meals eaten by many Americans at home and in restaurants.”

The study is observational, so a direct cause and effect cannot be proved. Two other limitations of the research involve data collection and the composition of the study population. The study analyses may be affected by measurement errors because dietary consumption was self-reported. Participants were mostly white nurses and health care professionals, so these results may not apply to other groups.


Source: American Heart Association