WHAT WE DO

If we are going to make America great again in health care, from birth to death, let’s start at birth, okay? If we can’t take care of our babies, how good, let alone great, can we be?

As the Centers for Disease Control and Prevention (CDC) notes, infant mortality “is often used as an indicator to measure the health and well-being of a nation, because factors affecting the health of entire populations can also impact the mortality rate of infants.”¹

Well sure, we’re better than the rest of the world when it comes to winning Olympic medals, but when it comes to infant mortality, our performance is not gold, silver, or bronze, not even copper, zinc, or tin.

The term “infant mortality” sounds so cold and technical. Let’s call it what it is—babies dying before they get to celebrate their first birthday. It’s hard to wrap your mind around the meaning of a rate expressed as 6 deaths per 1,000 live births. Better understood in the heart and soul when we say that 23,000 babies in the US die every year.¹

We have a higher baby death rate than at least 25 other industrialized countries.² Pull out a map of Europe, if you will, and imagine that you are working in an adult coloring book. Let’s give a color to every country that has a lower baby death rate than the US of A.

Begin in Scandinavia with Finland, Norway, Sweden, and Denmark. Loop around the North Sea and Atlantic Ocean to England and Ireland, buzz the coast of the Iberian Peninsula in Portugal and Spain, and cruise the sunny Mediterranean, where you can pick up Italy, Greece, and Israel for good measure.

Take river cruises in Belgium, the Netherlands, Poland, Austria, and Hungary (color the Danube blue while you’re at it). And don’t miss Switzerland (it’s small), as well as the Czech Republic and Slovakia. Strap yourself in for a flight to the other wide of the world in time to check off Japan, Korea, Australia, and New Zealand. Come back home in time to color in our congenial neighbor to the north, Canada, eh?

There, you’ve completed your tour of countries that do a better job than we do of protecting the health of newborns. America first? I think not.

What will it take to make us great again? Better prenatal and postnatal care for mom and baby. Better access to prenatal and postnatal care. It’s not quite that simple but it’s not all that complicated, either. You have to start somewhere.

The US Department of Health and Human Services initiated a campaign a few years ago called A Healthy Baby Starts With You.³ It identified 9 factors that contribute to infant mortality, arising from the mother’s health status and behavior during and after pregnancy:

• Late prenatal care
• Smoking
• Substance abuse
• Poor nutrition
• Obesity
• High stress
• Domestic violence
• Low maternal weight gain
• Preterm labor

The bad news is that infant mortality offers a striking example of disparities in health care: a black baby in the US is twice as likely as a white baby to die in the first year of life.¹

The good news is that so much of what ails us is preventable with timely and appropriate education and intervention—and once again, access to same. Open memo to the next Surgeon General, whoever you may be: Put “prevent infant deaths” at or near the top of your to-do list.

Of course, preventing infant deaths is a challenge not just for the Surgeon General but for all of us so-called stakeholders in the health system, from the top down and the bottom up—patients, families, health professionals, hospitals and health systems, the pharmaceutical industry, policy making and legislative bodies at all levels of government. Together, let’s own it.

We hear a lot about patient-centered outcomes these days. From a baby’s point of view, a chance at life is a good outcome. Let this be one of our moonshots.

Woof.

1. Centers for Disease Control and Prevention (CDC). Infant mortality. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm. Accessed January 24, 2017.
2. MacDorman MF, Mathews TJ, Mohangoo AD, Zeitlin J. International comparisons of infant mortality and related factors: United States and Europe, 2010. National Vital Statistics Reports. 2014;63(5):1-6.
3. US Department of Health and Human Services, Office of Minority Health. A Healthy Baby Begins With You. https://minorityhealth.hhs.gov/Assets/pdf/checked/brochure.pdf. Accessed January 24, 2017.

THE PATRIOTS WILL WIN THE SUPER BOWL—BUT IT HAS NOTHING TO DO WITH TOM BRADY

Patriots vs. Falcons. People vs. animals. The people win.

You can look it up, folks: Of the first 50 Super Bowls, 37 have been won by teams named for people (Steelers, Cowboys, Giants, 49ers, Packers, Patriots, etc) and only 12 have been won by teams named for animals (Broncos, Colts, Seahawks, Bears, Rams, Ravens, etc).

A single Super Bowl, as certain New York football fans know all too well, has been won by a team named for a form of transportation (Jets-Jets-Jets, ETA of next championship unknown).

Lest you think the dice are loaded, consider that of the 32 teams in the National Football League, 15 by my count are named for animals and 15 are named for people. One, as mentioned, is named for a form of transportation, and one is a computer accessory (San Diego Chargers).

We counted the Buffalo Bills as animals , considering them more Buffalo than Bill (check out the helmet). And we decided that the Cleveland Brown is a person, even though the team is best known for its raucous Dawg Pound section of fans in the end zone.

It’s not easy being a cat (Lions and Jaguars have never been to the big dance, oh my) and the Bengals and Panthers have been there but haven’t done it. Here’s the problem: No teams named for dogs in the NFL.

I sigh, rest my case, and curl up to take a well-deserved nap. As an animal, it pains me to see the handwriting on the wall. I will hope that the Falcons can fly high, taking heart from that old football fanatic Emily Dickinson (1830-1886), who said that “Hope is the thing with feathers.” And where was she from? New England!

At this time of year, and at any time of year, you can find PRI representatives at many of the major clinical meetings of doctors, nurses, pharmacists, researchers, and other healthcare professionals. Late in 2016, for example, we were out and about covering key presentations at the San Antonio Breast Cancer Symposium, the American College of Rheumatology in Washington, DC; the American College of Asthma, Allergy and Immunology in San Francisco, and the American Society of Health-System Pharmacists in Las Vegas, among other locations.

At each of these venues, we work closely with our clients and key opinion leaders on everything from the logistics of live meetings to the development of content for enduring materials emanating from these gatherings. We’re producing newsletters on breast cancer and rheumatoid arthritis based on the proceedings of symposia and Product Theaters, or arranging one-on-one interviews for clients with thought leaders to provide the scientific background on a new antibiotic.

Early in 2017, we’re packing our bags for the Florida Immunization Summit in St. Petersburg, where we’ll add to the growing national dialogue on vaccines, providing health professionals with helpful advice on how to respond to parents’ questions and concerns. We’ll make a similar stop in Denver with the National Association of Pediatrics Nurse Practitioners

In this space, look for regular, on-the-scene reports from our key people at key meetings. We’ll give you a sense of what’s hot and happening in health care today and provide an insider’s perspective on both science and strategy.

Food for thought (and action):

• Some 3.5 million Americans have chronic hepatitis C infection, but only half of them have been diagnosed.
• The 1.75 million people who are undiagnosed are at risk for life-threatening complications, including cirrhosis and liver cancer.
• Hepatitis C infection, in fact, is the leading cause of liver transplantation and liver cancer.
• 75% of persons who are infected with hepatitis C virus are Baby Boomers, many of whom are unaware that they have been harboring the infection for 20 years or more
• Health officials recommend 1-time screening of all Baby Boomers (born between 1946 and 1964) for hepatitis C. That would be your 53- to 71-year-old demographic, by the way.
• The good news is that HCV can be curable with timely and appropriate diagnosis and intervention.
• To learn more, check out the Hepatitis C Fact Pack, developed by PRI Healthcare Solutions. It includes information on diagnostic testing, coding for screening tests, and referral to specialists, and other practical aspects of care.

PRI Healthcare Solutions has trained and continues to develop final year PharmD candidates through our exceptional PharmD Student Rotations Program. PRI pharmacists, Dimpy Mehra, PharmD, Scientific Director, and Bethsy Jacob, PharmD, Associate Scientific Director, serve as preceptors and formally guide students who choose our unique rotation site. Pharmacy students come from throughout the New York-New Jersey-Pennsylvania area, from schools such as Philadelphia College of Pharmacy, St. John’s College of Pharmacy and Health Sciences.

In their rotation with PRI, pharmacy students have sharpened their medical writing and research skills as they learn to present pertinent clinical information in digital, print, and live platforms across multiple therapeutic areas. Our students have the unique opportunity to contribute and understand how educational programs are created. Through a hands-on approach, students learn how to meet regulatory standards in medical communication while achieving clinical relevance and accuracy.

The 4-5 weeks they spend at PRI conclude with a formal and engaging talk, often presented to members of the PRI Scientific Affairs team. Here, pharmacy students have the opportunity to showcase their presentation skills along with the knowledge gained in a specific topic of clinical and scientific interest.

“The students we precept are taught different skills that are important to their overall professional development,” notes Bethsy Jacob, Pharm D. “They learn how to prioritize projects, manage time, communicate effectively, and use their clinical skills to improve patient health on a larger scale. In the end, our students are exposed to another career option they may not have considered during pharmacy school, which is what makes the PRI rotation site distinct.”

Haymarket has participated as an elective site for students interested in medical communications since the 1990s, notes Dimpy Mehra, PharmD. “The program helps students gain experience in medical communications, practice their writing skills, and help shape their career aspirations.”