World’s Population Living Longer, New Report Suggests

A sharp decline in deaths from malnutrition and diseases like measles and tuberculosis has caused a shift in global mortality patterns over the past 20 years, according to a new report, with far more of the world’s population now living into old age and dying from diseases more associated with rich countries, like cancer and heart disease.

The shift reflects improvements in sanitation, medical services and access to food throughout the developing world, as well as the success of broad public health efforts like vaccine programs. The results are dramatic: infant mortality has declined by more than half between 1990 and 2010, and malnutrition, the No. 1 risk factor for death and years of life lost in 1990, has fallen to No. 8.

At the same time, chronic diseases like cancer now account for about two out of every three deaths worldwide, up from just over half in 1990. Eight million people died of cancer in 2010, 38 percent more than in 1990. Diabetes claimed 1.3 million lives in 2010, double the number in 1990.

But while developing countries made big strides – the average age of death in Brazil and Paraguay, for example, jumped to 63 in 2010, up from 28 in 1970 – the United States stagnated. American women registered the smallest gains in life expectancy of all high-income countries between 1990 and 2010. The two years of life they gained was less than in Cyprus, where women gained 2.3 years of life, and Canada, where women gained 2.4 years. The slow increase caused American women to fall to 36th place in the report’s global ranking of life expectancy, down from 22nd in 1990.

“It’s alarming just how little progress there has been for women in the United States,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation, a health research organization financed by the Bill and Melinda Gates Foundation at the University of Washington that coordinated the report. Rising rates of obesity among American women and the legacy of smoking, a habit women in this country formed later than men, are among the factors contributing to the stagnation, he said.

The World Health Organization issued a statement Thursday saying that some of the estimates in the report differ substantially from those done by United Nations agencies, though others are similar. All comprehensive estimates of global mortality rely heavily on statistical modeling because only 34 countries – representing about 15 percent of the world’s population – produce quality cause-of-death data.

Health experts from more than 300 institutions contributed to the report, which measured disease and mortality for populations in more than 180 countries. It was published Thursday in the Lancet, a British health publication.

The one exception to the trend was sub-Saharan Africa, where infectious diseases, childhood illnesses and maternal causes of death still account for about 70 percent of all illness. In contrast, they account for just one-third in South Asia, and less than a fifth in all other regions. Sub-Saharan Africa also lagged in mortality gains, with the average age of death there rising by fewer than 10 years from 1970 to 2010, compared with a more than 25-year increase in Latin America, Asia and North Africa.

The change means that people are living longer, an outcome that public health experts praised. But it also raises troubling questions. Behavior affects people’s risks of developing noncommunicable diseases like cancer, heart disease and diabetes, and public health experts say it is far harder to get people to change their ways than to administer a vaccine that protects children from an infectious disease like measles.

“Adult mortality is a much harder task for the public health systems in the world,” said Colin Mathers, a senior scientist at the World Health Organization in Geneva. “It’s not something that medical services can address as easily.”

Read More..

European Leaders Hail Accord on Banking Supervision

BRUSSELS — European Union leaders gathering here Thursday for their year-end summit meeting hailed an agreement to place euro zone banks under a single supervisor, calling it a concrete measure to maintain the viability of the currency as well as a step in laying the groundwork for a broader economic union.

Pool photograph by Michael Euler

Angela Merkel, the German chancellor, and François Hollande, the French president, conferring on Thursday at a summit meeting of European leaders. "It's a good day for Europe," Mr. Hollande said.

The pact was hashed out in an all-night session of finance ministers that ended Thursday morning after France and Germany made significant compromises. Under the agreement, between 100 and 200 large banks in the euro zone will fall under the direct supervision of the European Central Bank.

A round of talks a week earlier broke up amid French-German discord over how many banks in the currency union should be covered by the new system.

In a concession to Germany, the finance ministers agreed that thousands of smaller banks would be primarily overseen by national regulators. But to satisfy the French, who wanted all euro zone banks to be held accountable, the E.C.B. would be able to take over supervision of any bank in the region at any time.

The agreement by the finance ministers, which still requires the approval of the European Parliament and some national parliaments including the German Bundestag, made it possible for E.U. leaders arriving here later Thursday to gather in a spirit unity.

“It’s a good day for Europe,” said François Hollande, the French president. “The crisis came from the banks, and mechanisms have been put in place that will mean nothing is as it was before.”

Angela Merkel, the German chancellor, said the agreement was “a big step toward more trust and confidence in the euro zone.” The summit meeting could now focus “on strengthening economic coordination” and “set out a road map for the coming months,” she added.

In another measure to shore up the euro, the finance ministers approved the release of nearly €50 billion, or $65 billion, in further aid to Greece, including long-delayed payments, support that is crucial for the government to avoid defaulting on its debts.

“Today is not only a new day for Greece, it is indeed a new day for Europe,” Antonis Samaras, the Greek prime minister, said ahead of the summit meeting.

But threatening to spoil the upbeat atmosphere were questions over the future leadership of Italy, where the economy is contracting, debt levels are rising, and Silvio Berlusconi, the former prime minister, has threatened to try to reclaim the office in an election next year.

It remained unclear Thursday whether Mr. Berlusconi would run and, if that were to happen, whether he would campaign on promises to reverse reforms put in place by Mario Monti, the current prime minister. Even so, the re-emergence of Mr. Berlusconi — who attended a summit meeting of center-right parties in Brussels on Thursday — could destabilize markets and even rekindle the financial crisis.

The bank supervision plan was first discussed in June and wrapped up in a matter of months — record time by the glacial standards of E.U. rulemaking. The agreement should serve as a springboard for leaders to weigh further steps toward economic integration during their meeting.

Such measures could include a unified system, and perhaps shared euro area resources, to ensure failing banks are closed in an orderly fashion. This could be followed, in time, by measures intended to reinforce economic and monetary union, including, possibly, the creation of a shared fund that could be used to shore up the economies of vulnerable members of the euro zone.

Mario Draghi, the president of the European Central Bank, said the agreement on banking supervision “marks an important step towards a stable economic and monetary union, and toward further European integration.” But he noted that governments and the European Commission still had to work on the details of the supervision mechanism.

The new system should be fully operational by March 2014, but ministers left the door open for the E.C.B. to push that date back if the central bank would “not be ready for exercising in full its tasks.”

A series of compromises were needed for finance ministers to reach agreement on banking supervision.

Read More..

IHT Rendezvous: In China, Fears Ours Would Be a 'One-Week Puppy'

BEIJING — China has many genuine pet lovers who care well for their dogs, but also many owners who don’t. The dog trade is virtually unsupervised and selling sick animals to unsuspecting customers is common. Animal shelters are full. The pet scene is tough. Buying a dog, which I write about in my latest Letter from China, can be a risky business.

“Some breeders just want to make money. Some are real animal lovers,” said Xing Xiaosi, an editor and marketer at goumin.com, a Web site for dog lovers in China that offers an interactive education and information platform.

“But in general, the situation isn’t that positive or optimistic,” she said.

A week after we bought our boxer puppy, Xiao Tongzhi, or Little Comrade, he fell ill.

Knowing the horror stories, I took him to the vet, feeling queasy.

Here’s how Ms. Xing described an all-too common scenario: “Many dogs are not well treated in kennels and if the owners feel the dog looks sick, they may give it an injection to stimulate it, and make it more active. It usually lasts for about a week. They hope to sell the dog within a week to make their money, but the dog may die very soon after the week. If the buyer takes it to an animal hospital for treatment it may live. But if he doesn’t want to spend the money, it won’t.”

The serious — possibly deadly — illnesses include puppy distemper, canine parvovirus and canine coronavirus, usually contracted in dirty and crowded conditions at kennels.

Was Little Comrade a “one-week puppy,” as they are called?

Thankfully, the vet said he had only caught a cold. He tested negative for parvovirus and distemper, though he had been exposed to coronavirus, she said. Beijing’s cold had turned even harsher the weekend we bought him in early December, with temperatures dropping below freezing.

Still, the vet didn’t take any chances, administering anti-distemper serum and large amounts of antibiotics. The bottom line was — all puppies are vulnerable to serious disease because of the conditions they are often kept in before sale.

Overall, animal rights awareness here is low, said Ms. Xing.

“Many people are not responsible towards their pets,” she said. “They buy them as if they were toys. Then, once they have them back home, they feel they are difficult to care for because they urinate and defecate and they feel that’s dirty.”

“Some people throw their pets away when the family gets a baby,” she added. “When they’re abandoned some people do try to look for a new home. But many just throw them into the streets.”

As a result, animal shelters in Beijing and other cities are full.

“People’s consciousness about keeping pets needs to be raised,” Ms. Xing said. “They need to feel responsible for their lives.”

Read More..

App Smart: Apps Help Extend the Battery Life of Devices

As you jet off on a winter vacation or a holiday season trip to see family, chances are you’ll face a 21st-century problem: mobile device battery angst. It’s a never-ending itch at the back of your thoughts. Though we all love to use our smartphones to stave off boredom, or to navigate a new city, every moment of use eats precious battery time. And, particularly during a journey, you never know when you will find power next.

Thanks to my job, I experience more battery angst than most people, so I have tried some battery life apps. You may too. But unlike other types of apps, you need to be wary with these.

Apple’s tight control of iOS means battery apps on the App Store, even popular ones like Battery Life Pro All-in-One (free on iTunes), cannot automatically control an iPhone or iPad’s real-time battery consumption. This is because of Apple’s own systems for protecting battery life and app security. That said, there are some supposed best practices you can follow to keep your iDevice’s battery healthy. And there are ways you can manually adjust your phone.

Battery Doctor Pro is one of the best-designed battery advice apps ($1 on iTunes). Its main page has a graph showing current battery charge and a grid of icons that activate submenus. The “status” submenu lists estimates of how much talk time your battery offers at that moment, how much video playback and so on. The “inspection” submenu offers a list of actions to help extend battery life — like disabling Wi-Fi. Some of these actions are accompanied with tips on how to carry them out. These are the really useful parts of the app, which teach you about your phone.

Another useful feature is the “maintain” submenu, which guides you through a process said to increase the performance of lithium batteries. This involves letting the battery run down to less than 20 percent charge, then charging it to 100 percent and letting it remain on charge for a while.

Battery Doctor Pro has a long list of other options, like a selection of themes — monitoring the device, keeping track of charges — but really these are just useless frills. For example, it may be interesting to use the “monitor” to see what code your phone is running, but it will not be of immediate use in extending battery life.

Battery Boost Magic (free on iTunes) is a very similar app, with a slightly flashier interface, and its battery life tips section may be more easily accessible for iDevice beginners. Essentially, however, this app works in the same way as Battery Doctor Pro. If you are really into these apps, Battery Life Pro All-in-One has a very flashy interface, although it too works the same way.

Android device owners face a different situation. Android apps can get access directly to some settings in the device to help preserve battery life without the user’s having to dive into them manually. But the more open design of Android itself presents a problem, because some apps can run in ways that really do eat up battery life.

The 2X Battery — Battery Saver app (free) is perhaps one of the more straightforward battery life apps for Android. It indicates how long a battery has left until it runs out and also offers alerts about whether power-hungry systems like GPS are turned on. Tapping these alerts takes you directly to Android’s settings so you can turn off services to save battery life. The app also has different modes, so it can automatically control a device’s behavior — turning Wi-Fi off for long intervals at night, for example, on the premise that you are not using the device while asleep.

Easy Battery Saver (free) is another good battery app. Its best feature is its main dashboard, which reports on current battery status and allows one-tap access to turn off or adjust Wi-Fi, Bluetooth, GPS, mobile data and screen brightness. Like 2X Battery, this app has different power-saving modes that try to minimize power-gulping activities like getting access to wireless networks. The app also shows graphically which apps seem to be using the most power. This data may prompt you to turn off an especially power-hungry app you may have forgotten is running, like a live wallpaper app.

The problem with these apps is that the next time you pick up your Android device, you might find you have turned off the very function you need. For example, you may have selected low screen brightness to save battery life, but suddenly find you need to read the screen in a brightly lighted room. Thus you may have to jump in and out of your battery saver apps to adjust their settings.

My advice would be to concentrate on free versions of these different apps on iOS or Android. Try them for a while to see if they help, or at least teach you good habits. But do not panic about battery apps; you bought your phone to use it, after all.

Quick Calls

YouSendIt, the popular cloud file-sharing service, has introduced an exclusive Windows Phone 8 app on the Nokia Lumia 920 and 820. The app has all the usual YouSendIt tricks about syncing and sharing files, and users can share files directly between phones using NFC. ... Etsy, the online store for handmade crafts, has finally released a dedicated Android app (free on Google Play) to help you shop among its wares.

Read More..

Health Centers Find Opportunity in Brownfields

PHILADELPHIA — The community health center rising on a derelict corner here in West Philadelphia never would have broken ground if not for the asbestos inside the building that was demolished to make way for it. Because of the contamination, Spectrum Health Services received a $2 million federal cleanup grant, the first piece of a $14 million construction financing puzzle.

When complete, the 36,000-square-foot building will provide a new home for a health center that has been squeezed into a deteriorating strip mall nearby for decades. It will also be the latest in a nationwide trend to replace contaminated tracts in distressed neighborhoods with health centers, in essence taking a potential source of health problems for a community and turning it into a place for health care. In recent years, health care facilities have been built on cleaned-up sites in Florida, Colorado, New Hampshire, Minnesota, Oregon and California.

“These health care providers are getting good at it,” said Elizabeth Schilling, policy manager for Smart Growth America, an advocacy group. “They have internalized the idea that this is an opportunity for them.”

Because these sites are contaminated, many qualify for government tax credits and grants, providing health centers with vital seed money to build. Community health centers, by design, exist to serve populations in poor neighborhoods, where there also tend to be available but contaminated properties like old gas stations, repair shops and industrial sites.

In fact, many of the country’s 450,000 contaminated sites, known as brownfields, are in poor neighborhoods, according to the Environmental Protection Agency. These tracts are disproportionately concentrated in poor communities because contaminated sites are more difficult to redevelop if property values are depressed. Banks are often reluctant to finance construction on a property that might require a costly cleanup.

“In communities where the real estate market isn’t working that well, you end up with a brownfield,” said Jody Kass, executive director of New Partners for Community Revitalization, a brownfield advocacy group.

“It’s a Catch-22,” said Phyllis B. Cater, chief executive of Spectrum Health Services. “The environmental issues are significant and yet there are scarce resources for communities to do the cleanup and remediation that’s required.”

But if the state or federal government provides the first piece of financing, other funders are more likely to fall into step.

Community health centers, in particular, are under pressure to grow. By 2015, the number of Americans who rely on community health centers for care is expected to double to 40 million from the 20 million who relied on the centers in 2010, according to the National Association of Community Health Centers. The Affordable Care Act allocated $11 billion to expand these centers. Of that, $1.5 billion was allotted to construction.

But finding a viable site is not always easy. It took Spectrum 15 years to find its new home on Haverford Avenue. The original building, an aging medical office, went up for auction in 2007 after the owner was arrested on a tax evasion charge. Spectrum bought the property for $650,000. Ms. Cater speculated that if Spectrum hadn’t bought the site, it most likely would have fallen into disrepair like the decaying row houses and the dilapidated bodega across the street that Spectrum hopes to redevelop eventually.

Spectrum currently occupies 10,000 square feet in a rundown strip mall four blocks away. The center is divided among three crowded spaces, so employees must walk outside to get from the medical offices to the billing department. The treatment rooms are dreary and cramped, with holes in the drywall and collapsing ceiling panels.

“I’ve seen better centers in rural Mississippi. This is not how you support a community,” Ms. Cater said.

When it opens next summer, the new, three-story center will have 34 exam rooms, eight dental rooms, a spacious community center and a full-service laboratory. It will also employ twice as many people as the current facility, adding 66 jobs to Spectrum’s payroll.

The 50-year-old building was in poor shape, but it was the presence of asbestos that allowed Spectrum to qualify for the critical first piece of financing: a $2 million brownfield redevelopment grant from the federal Department of Housing and Urban Development. The organization also received an additional $2 million H.U.D. loan that was tied to the brownfield grant, a $1.7 million redevelopment grant from Pennsylvania and $3.45 million in other loans.

Read More..

Mandela Is Suffering From Lung Infection

Alexander Joe/Agence France-Presse — Getty Images

In Soweto, an area of Johannesburg, a resident walked past images of Nelson Mandela, the 94-year-old former president of South Africa and hero of the antiapartheid movement, who remained hospitalized on Tuesday.

JOHANNESBURG — Former President Nelson Mandela, who has been hospitalized since Saturday, is suffering from a recurrence of a lung infection and is responding to treatment, the office of South Africa’s current president, Jacob Zuma, announced on Tuesday.

It was the first indication of Mr. Mandela’s medical condition since he was flown to Pretoria and taken to a hospital for unspecified tests over the weekend. It was his second hospitalization this year; in February he s checked into a hospital for tests to address a chronic stomach complaint, the government said at the time. He was released after minor diagnostic surgery, officials said.

Mr. Mandela, who is 94 and increasingly frail, was said by Mr. Zuma’s office to be “receiving appropriate treatment and he is responding to the treatment.”

The current stay in the hospital is the longest in recent memory, raising fears that Mr. Mandela’s condition is grave. Government officials have been upbeat about his prognosis while offering few details about his condition. Given his age, any infection is by its nature serious, medical experts say.

“I’m not sure we should press the panic button every single time a man of his age has the sniffles,” Mark Sonderup, vice chairman at the South African Medical Association, told The Mail and Guardian, a weekly newspaper, this week. “But unfortunately, we have to accept that simple health matters for a person of that age can turn very serious, very quickly.”

Mr. Mandela, South Africa’s first black president, has suffered from respiratory ailments for years, in part owing to the 27 years he spent in prison, most of it on Robben Island, working in a bleak quarry. He was diagnosed with tuberculosis in 1988 and had fluid drained from his lungs.

Mr. Mandela retired from public life some years ago, and was last seen publicly at the celebrations for the World Cup soccer tournament, which South Africa hosted in 2010, although he receives frequent visits from old friends and visiting dignitaries.

In January 2011, he was hospitalized for an acute respiratory infection, and the news of that illness set off a panic about his health.

When Secretary of State Hillary Rodham Clinton visited South Africa in August, she stopped by his home in the rural village of Qunu to see him. In a photograph of the two of them, Mr. Mandela beamed his trademark grin, but looked frail seated in an armchair and dressed in a gray cardigan.

Mr. Mandela led the African National Congress to a resounding victory in the first fully democratic elections in South Africa’s history in 1994, after successfully negotiating a peaceful transition from white rule. Despite harsh treatments at the hands of the apartheid government, Mr. Mandela advocated forgiveness and reconciliation, making him an icon of peacemaking the world over. After a single term as president, Mr. Mandela retired from politics in 1999.

Read More..

DealBook: Wallflowers of Silicon Valley Get Asked to Dance

SAN FRANCISCO — After years of being wallflowers at Silicon Valley’s hottest tech conferences and Sean Parker’s after-parties, enterprise technology firms are now part of the “in” crowd.

The flameouts of social media stocks over the last year have left venture capital firms searching for a more measured approach to investing.

“Watching capital markets do what they just did — to Facebook, to Groupon, to Zynga — not a lot of people want to get over their skis,” said Hans Swildens, the managing director of Industry Ventures, who said he had not invested in consumer tech since 2010. “They want a nice ride down the hill.”

That means technology sectors — including mobile security, data analytics and storage companies and mobile payment systems — which previously elicited a shrug or a snooze, are suddenly finding millions of dollars of investments coming at them. Here’s a look at some of the more promising sectors.

SEALING THE LEAKS Increasingly, employees are taking sensitive corporate data home with them, frustrated with the limits of corporate technology and using their personal phones and tablets to work. That has created huge security and compliance headaches for chief information officers struggling to regain control over corporate data.

Enter the mobile security industry. Venture firms like Sequoia Capital, Greylock Partners, Andreessen Horowitz and Accel Partners are backing companies that wrap extra security around employees’ personal iPhones and Android devices.

Lookout, a start-up, has already been valued at $1 billion. Its software offers spyware and malware protection, helps locate lost or stolen phones and alerts users when their phones have connected to unencrypted Wi-Fi networks.

Okta, a start-up that helps employees at companies like LinkedIn and Pandora securely connect to their work applications from their personal devices, recently raised $25 million in fresh financing from Sequoia Capital.

The mobile security sector is also attracting merger deals. ZenPrise, a mobile security start-up, was acquired last week by Citrix, a maker of virtualization software. Investors expect similar acquisitions to follow.

STORING THE BYTES New storage methods will be critical to harnessing the gigabytes of data now pouring in from those mobile devices, as well as the Web, social networks and video. To accommodate the fire hose of information, companies have started revamping their data centers. Increasingly, they are moving away from expensive disk drives and slow backup solutions to the cheaper, high-speed flash memory used in iPhones and digital cameras.

“For 30 years, companies stored everything on spinning disks. Now they’re moving to a flash memory-based model,” said Joseph Ansanelli, a partner at Greylock Partners.

Investors are taking note. Fusion-io, a high-capacity flash memory company, had a successful public offering last year, then increased revenue by 82 percent, to $359 million, in its latest fiscal year. Its technology packs in storage capacity and speeds up database performance — a compelling proposition for Facebook, its largest customer, which now stores 2.7 billion “Likes” and 300 million photos a day, or roughly 105 terabytes of data each half-hour.

Flash storage sites like Pure Storage and Nimble Storage are now attracting millions in venture backing. Pure Storage emerged from stealth mode only a year ago and now serves a wide range of businesses, including Sierra Nevada Brewing and the city of Davenport, Iowa. In August, it raised $40 million, bringing its total funding to $95 million. A month later, Nimble Storage doubled its funding with $40 million in new capital from Sequoia, Accel and others.

CRUNCHING MOUNTAINS OF DATA Some of the hottest innovations are in large-scale data mining. With the right analytical tools, big data can be used to solve complex problems quickly.

“Companies now need to be able to do large-scale data mining and analysis in real time, as opposed to one guy in the I.T. department running a pricing analysis over the weekend,” said Rich Wong, a partner at Accel Partners.

Corporate demand for such high-powered analysis helped make Splunk, a data analytics company, one of 2012’s top-performing I.P.O.’s.

Investors searching for the next Splunk are now watching several start-ups. One front-runner is Cloudera, founded by alumni of Yahoo, Google, Oracle and Facebook. The firm incorporates Hadoop, an open-source software, to make complex data queries that help drug firms predict adverse drug side effects, or media companies target readers with relevant content.

DIGITAL WALLET It may not be the end of paper money just yet, but more and more commercial products are making mobile payments a huge business. In hindsight, eBay’s $1.5 billion acquisition 10 years ago of PayPal, the mobile payments company, was a bargain; PayPal is expected to generate $10 billion in payment volume this year. Square, the four-year-old mobile payments start-up run by a Twitter co-founder, Jack Dorsey, has caught up. In November, it said that it, too, was now processing $10 billion in payments a year.

Both are also vying for attention with Google and Intuit, which offer mobile payment services, and, more recently, with big retail chains like Best Buy and Walmart, which said in August that it were working on ways for customers to pay with smartphones.

Even with brutal competition, venture capitalists are still eagerly throwing money at a new crop of start-ups like Braintree, which helps e-commerce sites process credit card payments, and Stripe, which offers a similar service for software developers.

In the last two years, Braintree has raised nearly $70 million. And, this year, Stripe raised $40 million from venture firms and angels, including some of the PayPal founders, Peter Thiel, Elon Musk and Max Levchin.

Smaller start-ups may have a harder time taking on PayPal and Square as those services become more ubiquitous. They will also have to compete on the security front, where even one hacker breach can lead to a lack of confidence among customers.

MOBILE CONCIERGE Apps, with the proverbial “touch of a button,” have converted phones into urban remote controls, allowing customers to order meals, errands, car rides, concert tickets and even cocktails.

The darling of the space is Uber, an app that lets users order a car service with the touch of a screen. The three-year-old start-up has already raised $50 million from the likes of Goldman Sachs and Jeff Bezos, Amazon’s chief.

Though Uber has run into battles with municipal transportation authorities, other firms, including Cabulous, Taxi Magic and Hailo, are jumping into the space.

Similarly, GrubHub’s app offers mobile convenience for food delivery. Hotel Tonight’s app does the same for same-day hotel bookings. Every day at noon, spontaneous or stranded travelers can find heavily discounted rates for hotel rooms that night. The two-year-old mobile app has already raised more than $35 million in financing.

A younger start-up, WillCall, lets users buy concert and theater tickets. And Coaster even lets users order, pay and tip for cocktails at bars with their smartphones. Those two apps are only in San Francisco, but venture capitalists are optimistic that on-demand mobile services are no fad.

“Soon there will be a remote control for your life,” said Peter Fenton, a venture partner at Benchmark Capital. “The future has arrived.”

Read More..

Rate of Childhood Obesity Falls in Several Cities

Jessica Kourkounis for The New York Times

At William H. Ziegler Elementary in Northeast Philadelphia, students are getting acquainted with vegetables and healthy snacks.

PHILADELPHIA — After decades of rising childhood obesity rates, several American cities are reporting their first declines.

The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.

“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.

The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation’s most intractable health problems, may actually be reversing course.

The first dips — noted in a September report by the Robert Wood Johnson Foundation — were so surprising that some researchers did not believe them.

Deanna M. Hoelscher, a researcher at the University of Texas, who in 2010 recorded one of the earliest declines — among mostly poor Hispanic fourth graders in the El Paso area — did a double-take. “We reran the numbers a couple of times,” she said. “I kept saying, ‘Will you please check that again for me?’ ”

Researchers say they are not sure what is behind the declines. They may be an early sign of a national shift that is visible only in cities that routinely measure the height and weight of schoolchildren. The decline in Los Angeles, for instance, was for fifth, seventh and ninth graders — the grades that are measured each year — between 2005 and 2010. Nor is it clear whether the drops have more to do with fewer obese children entering school or currently enrolled children losing weight. But researchers note that declines occurred in cities that have had obesity reduction policies in place for a number of years.

Though obesity is now part of the national conversation, with aggressive advertising campaigns in major cities and a push by Michelle Obama, many scientists doubt that anti-obesity programs actually work. Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.

Philadelphia has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.

Change has been slow. Schools made money on sugary drinks, and some set up rogue drink machines that had to be hunted down. Deep fat fryers, favored by school administrators who did not want to lose popular items like French fries, were unplugged only after Wayne T. Grasela, the head of food services for the school district, stopped buying oil to fill them.

But the message seems to be getting through, even if acting on it is daunting. Josh Monserrat, an eighth grader at John Welsh Elementary, uses words like “carbs,” and “portion size.” He is part of a student group that promotes healthy eating. He has even dressed as an orange to try to get other children to eat better. Still, he struggles with his own weight. He is 5-foot-3 but weighed nearly 200 pounds at his last doctor’s visit.

“I was thinking, ‘Wow, I’m obese for my age,’ ” said Josh, who is 13. “I set a goal for myself to lose 50 pounds.”

Nationally, about 17 percent of children under 20 are obese, or about 12.5 million people, according to the Centers for Disease Control and Prevention, which defines childhood obesity as a body mass index at or above the 95th percentile for children of the same age and sex. That rate, which has tripled since 1980, has leveled off in recent years but has remained at historical highs, and public health experts warn that it could bring long-term health risks.

Obese children are more likely to be obese as adults, creating a higher risk of heart disease and stroke. The American Cancer Society says that being overweight or obese is the culprit in one of seven cancer deaths. Diabetes in children is up by a fifth since 2000, according to federal data.

“I’m deeply worried about it,” said Francis S. Collins, the director of the National Institutes of Health, who added that obesity is “almost certain to result in a serious downturn in longevity based on the risks people are taking on.”

Read More..

Rate of Childhood Obesity Falls in Several Cities

Jessica Kourkounis for The New York Times

At William H. Ziegler Elementary in Northeast Philadelphia, students are getting acquainted with vegetables and healthy snacks.

PHILADELPHIA — After decades of rising childhood obesity rates, several American cities are reporting their first declines.

The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.

“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.

The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation’s most intractable health problems, may actually be reversing course.

The first dips — noted in a September report by the Robert Wood Johnson Foundation — were so surprising that some researchers did not believe them.

Deanna M. Hoelscher, a researcher at the University of Texas, who in 2010 recorded one of the earliest declines — among mostly poor Hispanic fourth graders in the El Paso area — did a double-take. “We reran the numbers a couple of times,” she said. “I kept saying, ‘Will you please check that again for me?’ ”

Researchers say they are not sure what is behind the declines. They may be an early sign of a national shift that is visible only in cities that routinely measure the height and weight of schoolchildren. The decline in Los Angeles, for instance, was for fifth, seventh and ninth graders — the grades that are measured each year — between 2005 and 2010. Nor is it clear whether the drops have more to do with fewer obese children entering school or currently enrolled children losing weight. But researchers note that declines occurred in cities that have had obesity reduction policies in place for a number of years.

Though obesity is now part of the national conversation, with aggressive advertising campaigns in major cities and a push by Michelle Obama, many scientists doubt that anti-obesity programs actually work. Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.

Philadelphia has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.

Change has been slow. Schools made money on sugary drinks, and some set up rogue drink machines that had to be hunted down. Deep fat fryers, favored by school administrators who did not want to lose popular items like French fries, were unplugged only after Wayne T. Grasela, the head of food services for the school district, stopped buying oil to fill them.

But the message seems to be getting through, even if acting on it is daunting. Josh Monserrat, an eighth grader at John Welsh Elementary, uses words like “carbs,” and “portion size.” He is part of a student group that promotes healthy eating. He has even dressed as an orange to try to get other children to eat better. Still, he struggles with his own weight. He is 5-foot-3 but weighed nearly 200 pounds at his last doctor’s visit.

“I was thinking, ‘Wow, I’m obese for my age,’ ” said Josh, who is 13. “I set a goal for myself to lose 50 pounds.”

Nationally, about 17 percent of children under 20 are obese, or about 12.5 million people, according to the Centers for Disease Control and Prevention, which defines childhood obesity as a body mass index at or above the 95th percentile for children of the same age and sex. That rate, which has tripled since 1980, has leveled off in recent years but has remained at historical highs, and public health experts warn that it could bring long-term health risks.

Obese children are more likely to be obese as adults, creating a higher risk of heart disease and stroke. The American Cancer Society says that being overweight or obese is the culprit in one of seven cancer deaths. Diabetes in children is up by a fifth since 2000, according to federal data.

“I’m deeply worried about it,” said Francis S. Collins, the director of the National Institutes of Health, who added that obesity is “almost certain to result in a serious downturn in longevity based on the risks people are taking on.”

Read More..

Health Centers Find Opportunity in Brownfields

PHILADELPHIA — The community health center rising on a derelict corner here in West Philadelphia never would have broken ground if not for the asbestos inside the building that was demolished to make way for it. Because of the contamination, Spectrum Health Services received a $2 million federal cleanup grant, the first piece of a $14 million construction financing puzzle.

When complete, the 36,000-square-foot building will provide a new home for a health center that has been squeezed into a deteriorating strip mall nearby for decades. It will also be the latest in a nationwide trend to replace contaminated tracts in distressed neighborhoods with health centers, in essence taking a potential source of health problems for a community and turning it into a place for health care. In recent years, health care facilities have been built on cleaned-up sites in Florida, Colorado, New Hampshire, Minnesota, Oregon and California.

“These health care providers are getting good at it,” said Elizabeth Schilling, policy manager for Smart Growth America, an advocacy group. “They have internalized the idea that this is an opportunity for them.”

Because these sites are contaminated, many qualify for government tax credits and grants, providing health centers with vital seed money to build. Community health centers, by design, exist to serve populations in poor neighborhoods, where there also tend to be available but contaminated properties like old gas stations, repair shops and industrial sites.

In fact, many of the country’s 450,000 contaminated sites, known as brownfields, are in poor neighborhoods, according to the Environmental Protection Agency. These tracts are disproportionately concentrated in poor communities because contaminated sites are more difficult to redevelop if property values are depressed. Banks are often reluctant to finance construction on a property that might require a costly cleanup.

“In communities where the real estate market isn’t working that well, you end up with a brownfield,” said Jody Kass, executive director of New Partners for Community Revitalization, a brownfield advocacy group.

“It’s a Catch-22,” said Phyllis B. Cater, chief executive of Spectrum Health Services. “The environmental issues are significant and yet there are scarce resources for communities to do the cleanup and remediation that’s required.”

But if the state or federal government provides the first piece of financing, other funders are more likely to fall into step.

Community health centers, in particular, are under pressure to grow. By 2015, the number of Americans who rely on community health centers for care is expected to double to 40 million from the 20 million who relied on the centers in 2010, according to the National Association of Community Health Centers. The Affordable Care Act allocated $11 billion to expand these centers. Of that, $1.5 billion was allotted to construction.

But finding a viable site is not always easy. It took Spectrum 15 years to find its new home on Haverford Avenue. The original building, an aging medical office, went up for auction in 2007 after the owner was arrested on a tax evasion charge. Spectrum bought the property for $650,000. Ms. Cater speculated that if Spectrum hadn’t bought the site, it most likely would have fallen into disrepair like the decaying row houses and the dilapidated bodega across the street that Spectrum hopes to redevelop eventually.

Spectrum currently occupies 10,000 square feet in a rundown strip mall four blocks away. The center is divided among three crowded spaces, so employees must walk outside to get from the medical offices to the billing department. The treatment rooms are dreary and cramped, with holes in the drywall and collapsing ceiling panels.

“I’ve seen better centers in rural Mississippi. This is not how you support a community,” Ms. Cater said.

When it opens next summer, the new, three-story center will have 34 exam rooms, eight dental rooms, a spacious community center and a full-service laboratory. It will also employ twice as many people as the current facility, adding 66 jobs to Spectrum’s payroll.

The 50-year-old building was in poor shape, but it was the presence of asbestos that allowed Spectrum to qualify for the critical first piece of financing: a $2 million brownfield redevelopment grant from the federal Department of Housing and Urban Development. The organization also received an additional $2 million H.U.D. loan that was tied to the brownfield grant, a $1.7 million redevelopment grant from Pennsylvania and $3.45 million in other loans.

Read More..