As we go through our busy lives we are usually consumed with our daily activities and rarely give pause to recognize bigger issues. For those that are interested in bigger issues, most get their information from the television, radio, and other standard news sources. Rarely do we go outside of these sanctioned outlets of information.
While there are many valuable pieces of information that we get from these standard sources, what we do get is filtered through a large number of biases. Biases based on corporate interests, politics, preconceptions, and other factors distort what we hear and what we hear about any particular topic.
While a new medication, vaccine, or surgical treatment will almost always get a large amount of generally favorable press, a study that shows leafy green vegetables greatly decreases the risk of skin cancer, meat and dairy greatly increase the risk of cancer, or coffee increases spontaneous abortion hardly gets any mention. The first group has a large financial and well established belief bias, whereas the later group has either no positive monetary component or worse yet may challenge an existing profitable industry and may require disruption to established beliefs or lifestyles. These truths are inconvenient.
However, despite the bias against the acknowledgement of certain issues some eventually come forward into the public consciousness. Former Vice President Al Gore has brought up such an issue in his new documentary “An Inconvenient Truth”. The documentary attempts to raise awareness of global warming and the possible dire consequences of public inaction.
But global warming is just one of many problems that face humanity. The vast majority of people are simply unaware of most if not all of these inconvenient issues and of those that are aware there are only a very few people that are addressing them in any meaningful way. By examining medical and scientific journals we can bypass the built in biases that currently exist to find some of the major issues that simply don’t make it into the public sphere.
“Water resources in many countries remain fragile, more due to poor demand-and-supply management than to actual water scarcity. Measures promoting sustainable use of water are far from satisfactory. About 1.2 billion people still have no access to safe drinking water, and 2.4 billion do not have adequate sanitation services. Some 2 million children die every year from water-related diseases. In the poorest countries, one in five children dies before the age of five mainly from water-related infectious diseases arising from insufficient water availability, in both quantity and quality.” (World Summit on Sustainable Development - Johannsesburg 2002 - United Nations, August 1, 2002)
“Each year, approximately 2 million patients in the United States acquire infections while hospitalized for other conditions. These infections account for 88,000 deaths and cost approximately $4.6 billion. Similar infections occur in nursing homes, outpatient clinics, dialysis centers, and other sites of healthcare delivery. ” (MMWR, February 25, 2000, Vol. 49, Num. 7, pp. 138)
“The direct medical costs associated with ADEs [Adverse Drug Events] have been estimated to be in the range of $US30 billion to $US130 billion annually in the US alone. These estimates are even more meaningful when compared with other high cost conditions or diseases, such as diabetes mellitus ($US45.2 billion), obesity ($US70 billion), and cardiovascular disease ($US199.5 billion). Drug-related mortality has been estimated to claim 218,000 lives annually.” (Drug Safety, September 1, 2004)
“Of the 304,702 deaths that occurred among patients who developed one or more patient safety incidents, 250,246 were potentially preventable. Medicare beneficiaries that developed one or more patient safety incidents had a one-in-four chance of dying during the hospitalization during 2002-2004.” (HealthGrades Third Annual Patient Safety in American Hospitals Study, April 2006)
“Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures of all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated.” (The American Journal of Medicine, July 27, 1998)
“The Nutrition Screening Initiative [NSI], a multidisciplinary coalition headed by the America Dietetic Association and the American Academy of Family Physicians, estimates that 40% to 60% of hospitalized older adults are malnourished or at risk of malnutrition; it also estimates that 40% to 85% of nursing home residents suffer from malnutrition and that 20% to 60% of home care patients are so afflicted.” (American Journal of Nursing, March 2005)
“More than 1 of every 4 (27.6%)” nursing home residents receiving Medicare receives antipsychotic medications. The study also found that “over half (58.2%)” of these residents received antipsychotic medications that exceeded the maximum recommended dose of the medication, received duplicate therapy, or had inappropriate indications for the medication in the first place according to guidelines. More than 200,000 nursing home residents received antipsychotic therapy but had, “no appropriate indications for use.” Most of the out of guideline prescriptions were for memory problems, restlessness, unsociability, uncooperativeness, indifference to their surroundings, or depression. Prescriptions for these conditions was strongly discouraged by a recently assembled expert panel on the appropriate use of antipsychotics in seniors. (Archives of Internal Medicine, June 13 2005)
“We observed a significant positive association between NSAID use, particularly the use of aspirin, and patient falls. NSAIDs may potentially increase the risk of falls because of the adverse CNS [Central Nervous System] effects, which include confusion, dizziness or light-headedness, drowsiness, and vision impairment in the elderly, and previous studies have found an increased risk of falls among users of NSAIDs. In hospitalized elderly patients, there was a significant association between NSAID use and falls, an effect largely accounted for by low-dose aspirin.” (American Journal of Health-System Pharmacy, December 2005)
“We found an elevated risk of fetal death according to coffee consumption in pregnancy, and the risk increased with increasing number of cups of coffee per day … In a case-control study of 1,835 stillbirths, Little and Weinberg found an elevated risk of stillbirth for women who consumed more than four cups of coffee per day. Wisborg et al. found that women who consumed eight cups of coffee per day had nearly double the risk of stillbirth as nonconsumers.” (American Journal of Epidemiology, November 2005)
“Organophosphate poisoning continues to be a relatively common occurrence, especially in rural areas of the United States. Insecticides fall into four classes: organophosphates, carbamates, organochlorines, and pyrethroids. All compounds can precipitate seizures except for carbamates, which have poor central nervous system (CNS) penetration.” (Pediatric Emergency Care, June 2003)
“A composite of red and processed meat servings in place of carbohydrate food servings was associated with a 44 percent increase risk of CHD [Coronary Heart Disease] mortality, and a similar increased risk was observed with dairy servings.” (American Journal of Epidemiology, February 2005)
“People who consume red meat and processed meat frequently have higher risk of rectal cancer than people who consume these products infrequently, and this raises the possibility that they could reduce their risk by substituting other types of meat such as chicken or fish.” (Cancer Epidemiology Biomarkers & Prevention, September 2004)
“In summary, our results provide evidence that high intake of refined carbohydrates may increase risk of hemorrhagic stroke in women and that the deleterious effect is stronger among those who are overweight or obese. In addition, our data support a benefit of cereal fiber in preventing hemorrhagic stroke. These findings suggest that replacing sugar and refined starches with whole-grain, high-fiber forms of carbohydrate may reduce hemorrhagic stroke, particularly among women who are overweight or obese.” (American Journal of Epidemiology, January 2005)
“OTC (Over-the-counter) cough and cold preparations are nearly ubiquitous, and are marketed for the relief of those most irritating symptoms of the common cold: rhinorrhea and cough. Although they may alleviate some symptoms in adolescents and adults, many studies have demonstrated that OTC cough and cold preparations do not achieve such claims in the younger pediatric population. In fact, studies in children of the immediate, short-term (within 48 hours), and long-term (after 72 hours) effects of cough and cold preparations showed no significant difference between OTC medications and placebo in the reduction of cough. In addition, OTC cough and cold medications are associated with potentially serious side effects.” (Pediatrics, September 1, 2001)
“All NSAIDs, both COX-2 selective and nonselective, provide only a modest symptomatic benefit over placebo, and this benefit has been proven only in short-term trials. With long-term therapy, it is not known whether the benefits of this class of drugs exceed the harms. In fact, there is evidence to suggest that the opposite is true. Meta-analysis of FDA data from the CLASS and VIGOR trials shows, first, that COX-2 selective NSAIDs do not necessarily reduce the incidence of complicated ulcers. Second, the meta-analysis demonstrates that, rather than proving safer, COX-2 selective NSAIDs cause more morbidity (total SAEs) than nonselective NSAIDs.” (CMAJ (Canadian Medical Association Journal), November 12, 2002)
"In the population studied in HERS [Heart and Estrogen/progestin Replacement Study], ie, postmenopausal women with established coronary disease and an average age of 66.7 years, daily use of conjugated equine estrogens and plus medroxyprogesterone acetate did not reduce the overall risk for MI [Myocardial Infarction] and CHD [Coronary Heart Disease] death or any other cardiovascular outcome during an average of 4.1 years of follow-up. This therapy did increase the risk of venous thromboembolic events and gallbladder disease." (JAMA, August 19, 1998)
“Approximately 90% of 21 billion marketing budget of the pharmaceutical industry continues to be directed at physicians, despite a dramatic increase in direct-to consumer advertising.” (JAMA, January 25, 2006)