What You Should Know About the Flu — A Chat with the CDC’s Angela Campbell, MD

Flu season is here. And to help us prepare for what the season may bring, we were lucky enough to get a few minutes with Dr. Angela Campbell, a medical officer in the Center for Disease Control and Prevention’s Influenza Division.

To welcome Dr. Campbell to the blog, we started out with one of our favorite questions.

Angela Campbell, MD

Angela Campbell, MD

Q: In a few words, what does Total Health mean to you?

A: Total health means caring for myself physically, intellectually, and spiritually, and working to sustain and improve the health of others.

Q: How does influenza vaccination factor into that view?

A: To me, influenza vaccination is an important component of caring for my own physical health – it is something I choose for myself every year. I am also passionate about encouraging flu vaccination for those whom I love, for my patients, and for the U.S. public at large. Flu is a serious disease that can lead to hospitalization and sometimes death. Even healthy people can get very sick from the flu. Because every flu season is different, it’s important to do what you can every year to protect yourself and those around you – and the first and most important line of defense against the flu is getting a yearly flu vaccination. Flu vaccination can keep you from getting sick from flu and, by protecting yourself from flu by getting vaccinated; you’re also protecting the people around you who may be more vulnerable to complications from flu illness.

Q: What is NIVW?

A: NIVW stands for National Influenza Vaccination Week, which was December 7-13 this year. CDC established NIVW in 2005 to highlight the importance of continuing flu vaccination throughout the holiday season and beyond. Flu vaccination coverage estimates from past seasons have shown that flu vaccination typically drops near the end of November, so this is a time to stress the important reminder that as long as flu viruses are circulating, it’s not too late to get your flu vaccine.

Q: Really? Is it worth getting your flu vaccine in December or even after the New Year?

A: Yes! Flu activity most commonly peaks between December and February, but can continue as late as May, so it’s not too late to protect yourself as long as flu activity is ongoing. In fact, even unvaccinated people who have already gotten sick with flu this season can still benefit from getting vaccinated since the flu vaccine protects against three or four different flu viruses (depending on which flu vaccine you receive) that are expected to circulate each season.

 Q: Can flu be more serious for some people than others?

A: Yes. CDC recommends a yearly flu vaccine for everyone 6 months and older; however, vaccination is especially important for protecting those at high risk for serious flu complications, including young children, pregnant women, people with certain chronic health conditions like asthma, diabetes, or heart and lung disease, and people age 65 years and older. Pneumonia and bronchitis are examples of flu-related complications that can result in a hospital stay or sometimes even death. The flu can also make chronic health problems worse for those who have them. And since babies younger than 6 months are too young to get their own flu vaccine, parents, caregivers and others in the household should be vaccinated to help protect them. By getting vaccinated, you will be less likely to get the flu and, therefore, less likely to spread the flu to others in these vulnerable groups.

Q: Should children receive one or two doses of the flu vaccine? We’ve heard different things.

A: Children 6 months through 8 years of age who are getting vaccinated for the first time, as well as some who have been vaccinated previously, will need two doses. Your child’s doctor, nurse, or other health care professional can tell you if two doses are recommended for your child. If your child has not already received their first dose of vaccine, get your child vaccinated now. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine. If two doses are needed, begin the process as early as possible. The doses should be given at least 28 days apart and it usually takes about 2 weeks after the second dose is given for protection to begin.

Q: If you don’t have time to get to the doctor, will insurance work at other vaccination locations?

A: Since September 2010, new health insurance plans are required to cover recommended vaccines without co-pays or deductibles when provided by an in-network health care provider. For more information on the Health Insurance Marketplace, visit https://www.healthcare.gov/. Many private health insurance plans also cover the cost of vaccines, but you should check with your insurance provider before going to the doctor. Flu vaccines are offered in many locations, including doctor’s offices, clinics, health departments, pharmacies and college health centers. They also are offered by many employers, and are even available in some schools. Another useful tool is the HealthMap Vaccine Finder to find the nearest location where you can get vaccinated.

How to Be a Present Parent

Last week, we reminded folks about the ways mindfulness can help us manage stress during the holidays.  Today, we share another Total Health Radio episode that focuses on managing stress — specifically the kind parents deal with on a daily basis. 

Each of us wants to be more present for our kids — and during this time of year, that can feel nearly impossible.  But as this show reveals, there are things you can do — steps and simple techniques — that may help.  It’s definitely worth a listen.

Total Health Questionnaire: Elisa Mendel

Elisa_Mendel editedElisa Mendel is Kaiser Permanente’s vice president of Healthworks & Product Innovation.

Q: In a few words, what does Total Health mean to you?
A: Mind, body, spirit.

Q: What’s your first health-related memory?
A: My dad is a radiologist. The smell of the x-ray department is an early familiar positive memory.

Q: What is your favorite food?
A: Peanut butter.

Q: If you could change one thing in health care, what would it be?
A: More value and emphasis on emotional health.

Q: In your opinion, what is the most underrated way to improve health for individuals?
A: Daily movement and laughter.

Q: Where do/would you most like to travel?
A: Anywhere I’ve never been.

Q: If you could have dinner with any three people, living or dead, who would you pick?
A: My mom (she died when I was young), Gandhi, and Jimmy Stewart.

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How Practicing Mindfulness Can Help You Through the Holiday Season Stress

With all the joy the holiday season brings, most of us know that this time of year carries it with it something else, as well:  Stress.

A little bit of stress can be fine.  A lot of stress — including the challenges of shopping for gifts, baking, party-planning, family tensions and unrealistic expectations — is bad all around.  Bad for the mind and the spirit, certainly, but mental stress can lead to physical health problems, too.  So learning to manage the hectic nature of our lives over the coming weeks is important.

To that end, we’re sharing this episode of Total Health Radio, which is all about Mindfulness.  If you can pay attention — without judgment (that’s key!) — to how you are feeling, it’s the first step to regulating your emotional reactions to the stressors in your life.  Check it out.


For exclusive bonus content — including interview excerpts on overcoming barriers to mindfulness as well as the top three things you can do to introduce mindfulness into your life, visit the episode’s official page at totalhealthradio.org.

Supporting Communities to End an Epidemic

In 2013, Kaiser Permanente announced an initiative to provide support to community organizations whose work it is to improve the health of individuals newly diagnosed with HIV in minority communities disproportionately affected by the HIV epidemic.

Seven organizations currently funded by Kaiser Permanente through this initiative are developing innovative approaches to prevent new HIV infections; identifying HIV positive patients sooner, getting them into high quality HIV care sooner and remain in such care.

In light of World AIDS Day, Kyra Nead, senior communications consultant at Kaiser Permanente, sits down with a few representatives of these organizations about the work they are involved in and speaks with Alexandra Caraballo, Manager of Charitable Contributions at Kaiser Permanente about why Kaiser Permanente was interested in creating this initiative.

Check it out below.  The transcript for this recording is available after the jump.

 

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Leadership Perspective: Prediabetes Tsunami — We Can’t Just Wait For It to Hit

Editor’s Note: This post is part of the “Leadership Perspectives” series on the Center for Total Health blog —  a collection of guest blog posts from Kaiser Permanente leaders all about why we need to take a Total Health approach.

Today’s guest author is Trina Histon, PhD, senior principal consultant with the Kaiser Permanente Care Management Institute, who shares her thoughts on prediabetes.


 

Few would deny the burden diabetes places on those who suffer from it and their loved ones who support them as they manage this disease. Estimates suggest that Americans with diabetes spend about $6,000 out of pocket per year managing their disease, monies that could be put to other use if we had more comprehensive ways implemented nationwide to prevent diabetes.

Trina Histon, PhD

Trina Histon, PhD

Many liken the next wave of diabetes as a tsunami that will hit the United States and its citizens, so let’s play that analogy through. Recent weather patterns have shown how devastating tsunamis are in the world, so much so, that efforts have been put in place to create sophisticated warning systems. So should another tsunami strike, countries will have advance warning so they are able to evacuate low-lying coastal areas and get people to safety.

In the U.S., the screening equivalent of that warning system for diabetes is an a1C test and the ADA has established a range of 5.7-6.4 as placing the individual in the “prediabetes” range. There are other tests, such as fasting blood sugar, but more and more health care is moving away from fasting blood work as it’s hard for people to fast for long periods of time. So this a1C range is our early warning system, and like most systems, it’s not perfect. In the literature this year, a few articles that discuss diabetes care and BMI have called into question the value of addressing prediabetes. These critiques are valid and perform an important function in both advancing the science and dialogue of where we want to spend our precious health care dollars.

Preparing for a Disaster We Know is on the Horizon

Kaiser Permanente today has 600,000 members with diabetes. We have also developed a cohort of just under one million members with lab values in the prediabetes range. Rather than wait for perfect science on exactly who needs an intervention, we feel ethically that if someone has a risk we should inform them and partner with them to address that risk, should they choose. One of the complexities of determining prediabetes risk is the prediabetes range has varying origins. For example, an a1C of 5.8 does not necessarily mean you will convert to diabetes, but you are at higher risk, and clearly are showing early signs of beta cell damage. What we do see is those with an a1C of 6.0 and higher and with BMIs in the obese range are most likely to convert. We are looking at our own data to see how we can further subtype the prediabetes risk spectrum and then subtype the interventions.

The Powerful Effect of Lifestyle Changes

The good news is lifestyle is the first line of treatment. The original diabetes prevention program (DPP) and subsequent translation trials show that those who lost 5 to 7 percent of their weight and increased their activity to 150 minutes/week prevented or delayed diabetes in 58 percent of participants over a three-year period – and 52 percent over 10 years. For most people, that translates to a 12- to 15-pound reduction, more attainable than the 30-40 percent of weight people might like to lose as reported on consumer surveys.
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Total Health Questionnaire: Faye Sahai

Faye Sahai is vice president of innovation & advanced technology for Kaiser Permanante Digital Faye SahaiTechnologies & Operations. 

Q: In a few words, what does total health mean to you?
A:  Wellbeing of mind, body, and spirit.

Q: What’s your first health-related memory?
A: When i was six, going to see the doctor who said I needed more iron – and I thought he meant metal plates like a robot would have.

Q: Which person, living or dead, is your health hero or role model?
A: My mother is my health hero as a pediatrician and sole practitioner and business owner. She is very knowledgable, intuitive and caring.

Q: What do you value most in your work? What inspires you to continue?
A: Working with great people to make a positive difference.

Q: If you could change one thing about health care, what would it be?
A: Affordable for all.

Q: Where would you most like to live?
A: Where I am today – in the Bay Area.

Q: What do you consider your greatest achievement so far?
A: Working with children from war-torn countries to discuss a new vision of a peaceful future and presenting to the UN with request and result of more countries signing the International Children’s Rights Agreement.

How much do you know about diabetes?

In observance of Diabetes Awareness Month, we’re sharing the Total Health Radio episode, “Diabetes 101.”

Diabetes affects 25.8 million people in the United States. But numbers can sometimes distance us from the day-to-day realities of a serious health condition. Exactly how does diabetes affect the body? This show explores the the basics about the disease: Its short-and long-term effects on the body’s systems, and what each of us can do to reduce our risk of developing Type 2 diabetes – and live more healthfully if diagnosed.

Reducing Health Disparities in Hypertension Care for African Americans

3KeystoCombatingHealthDisparitiesMichelle, 55, an African American Kaiser Permanente member in Southern California, was disheartened when she learned that she had high blood pressure. But her outlook changed with the encouragement of her doctor who worked with her to develop a diet and exercise regimen.

Michelle was grateful for the support.

“Even in my visits when I started the weight loss, she was very encouraging,” she said. “That makes you want to lose a little more and do the best you can. I think that I started doing some of these things so by the time I came back she would notice a difference.”

Michelle has successfully reduced her blood pressure, lost over 20 pounds, and built a sustainable, healthy lifestyle.

More than 40 percent of African Americans have high blood pressure, a rate that is one of the highest in the world.

More than 40 percent of African Americans have high blood pressure, a rate that is one of the highest in the world.

African Americans consistently have lower rates of hypertension control than whites, a higher prevalence of high blood pressure, and are more likely to develop hypertension at a younger age. In addition to genetic, environmental, social, and lifestyle factors, researchers believe that disparities in health care quality are driving these differences.

A new Kaiser Permanente Policy Story from the Institute for Health Policy highlights recent measures implemented in Kaiser Permanente facilities to treat African American patients with hypertension. It discusses how these efforts have led to improved care through increased access, better patient/provider communication, support in lifestyle changes, practice of evidence-based medicine, and use of health information technology (HIT).

Another effort is a $2.55 million grant to the American Heart Association Initiative to address high blood pressure among African Americans in two U.S. cities (Atlanta and San Diego) over three years. The program will depend upon community-based efforts to track blood pressure readings between community clinic workers, volunteer health mentors, doctors, and patients to create a model that can be replicated in communities across the country.

Another Kaiser Permanente initiative known as “ALL/PHASE” – that includes the use of three low-cost medications to reduce heart attacks and strokes – is aimed at reducing disparities in cardiovascular disease among low-income diabetics over the age of 50.

“It takes awareness and community engagement, gaining buy-in from leaders, integrating disparities work into quality improvement projects, and spreading best practices,” said Murray Ross, PhD, vice president with Kaiser Permanente and director of the Institute for Health Policy. “An increased focus on health disparities will help to reduce the occurrences of health inequities and inequalities, ensuring that all patients receive high quality health care.”

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