PUBLIC HEALTH

Helping You Lead a Healthier Life

The Medical Society of the State of New York is part of the leading force in public health. MSSNY has and continues to remain committed to the health and fullfillment of a healthy life for all of New York.

According to the American Lung Association, more than 17 million Americans suffer from asthma, which is the seventh ranking chronic health condition in America. The Medical Society of the State of New York recognizes that asthma can be a life-threatening disease if not treated properly. This webpage provides links to information pertaining to the causes of and treatments for asthma, including in-depth reports and clinical updates, medications available, pollen counts and various other asthma triggers, advice to prevent attacks, and links to additional sites and community resources.

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Breast cancer has reached epidemic proportions. The Medical Society of the State of New York advocates early detection efforts and proper medical treatment in the interest of saving lives. The following information is provided to assist physicians & patients in this fight, including technologies available for detection and diagnosis, potential strategies for preventing the development of the disease, new research treatments, breast cancer centers and additional community resources.

  • Breast cancer is the most common cancer among women, excluding skin cancer.
  • Breast cancer is the leading cause of cancer death in women between the ages of 40 and 55.
  • About 77% of women with a new diagnosis of breast cancer are over the age of 50.
  • Approximately 180,000 new cases of breast cancer occur each year in the United States.
  • One out of every 8 women in the United States is at risk of developing breast cancer, and 1 out of every 28 women are at risk of dying from breast cancer.
  • In North America and Western Europe the incidence of breast cancer is 6 to 10 times higher than in Japan and most parts of Asia and Africa.
  • In women of all age groups, white women are more likely to develop breast cancer than African-American women. However, of all women younger than 45, African-American women are more likely to develop breast cancer than White women.
  • Low-income, African-American women are three times more likely to be diagnosed with advanced disease than high-income women.
  • Increased use of mammography has resulted in breast cancers being found earlier in their development when they are smaller and at less advanced stages.
  • In the 1940s, only 72% of women diagnosed with breast cancer
  • survived for 5 years. Today, the 5-year survival rate from localized breast cancer has increased to 97%.

The Breast Cancer site sponsors at least one free mammogram a day to an underprivileged woman, based on “hits” on their website. It takes less than a minute to go to their site and click on “donating a mammogram” for free (pink window in the middle).

Susan G. Komen Breast Cancer Foundation

For more than 20 years, the Susan G. Komen Breast Cancer Foundation has been a global leader in the fight against breast cancer by funding research grants and supporting education, screening and treatment projects in communities around the world.

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Diabetes is a life-threatening condition.

  • Worldwide, 3.2 million deaths are attributable to diabetes every year.
  • One in 20 deaths is attributable to diabetes; 8,700 deaths every day; six deaths every minute.
  • At least one in ten deaths among adults between 35 and 64 years old is attributable to diabetes.
  • Three-quarters of the deaths among people with diabetes aged under 35 years are due to their condition.

Diabetes is a common condition and its frequency is dramatically rising all over the world.

  • At least 171 million people worldwide have diabetes. This figure is likely to more than double by 2030.
  • In developing countries the number of people with diabetes will increase by 150% in the next 25 years.
  • The global increase in diabetes will occur because of population ageing and growth, and because of increasing trends towards obesity, unhealthy diets and sedentary lifestyles.
  • In developed countries most people with diabetes are above the age of retirement, whereas in developing countries those most frequently affected are aged between 35 and 64.

A full and healthy life is possible with Diabetes.

  • Studies have shown that, with good management, many of the complications of diabetes can be prevented or delayed.
  • Effective management includes lifestyle measures such as a healthy diet, physical activity, maintaining appropriate weight and not smoking.
  • Medication often has an important role to play, particularly for the control of blood glucose, blood pressure and blood lipids.
  • Through the provision of optimal health care the risk of developing diabetic complications can be reduced substantially.
  • Helping people with diabetes to acquire the knowledge and skills to manage their own condition is central to their leading a full and healthy life.

In many cases, Diabetes can be prevented.

  • The prevention of type 1 diabetes is not yet possible and remains an objective for the future. The prevention of type 2 diabetes has been shown to be possible and requires action now.
  • Trials have shown that sustained lifestyle changes in diet and physical activity can reduce the risk of developing type 2 diabetes. For example, the Finnish Diabetes Prevention Study showed that a better diet, increased physical activity and modest weight loss could substantially reduce the development of type 2 diabetes in middle-aged adults at high risk.
  • In all the studies conducted so far in people at high risk, lifestyle changes have been substantially more effective than the use of drugs.
  • The scale of the problem requires population-wide measures to reduce levels of overweight and obesity, and physical inactivity.
  • Informed policy decisions on transport, urban design, and on food pricing and advertising can play an important part in reducing the population-wide risks of developing type 2 diabetes.

The Diabetes Program of the Noncommunicable Diseases and Mental Health cluster provides advice on appropriate policies and strategies for monitoring, prevention and control of diabetes. At least 171 million people worldwide suffer from diabetes; this figure is likely to more than double, to reach 366 million, by 2030. Most of this increase will occur as a result of a 150% rise in developing countries.

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Hepatitis C virus (HCV) causes liver disease and it is found in the blood of persons who are infected. HCV is spread by contact with the blood of an infected person.

Hepatitis C infects about 25,000 people each year with most developing chronic infection. However, many of those with chronic hepatitis C do not even know they are infected. Those individuals with chronic infection are at risk for developing chronic liver diseases such as cirrhosis and cancer of the liver. Individuals who injected drugs are at highest risk for infection even if they injected only once many years ago.

Unlike hepatitis A and hepatitis B there is not a vaccine to prevent hepatitis C. Over the years, the treatments for hepatitis C have become more effective. However, treatment is not for everyone and a specialist should be consulted when determining if someone should get treated.

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The preferred method of transportation for Americans continues to be the private automobile. In many instances, public transit and private transportation services are either unavailable, unaffordable, or unacceptable for reasons of convenience, accessibility, or perceived lack of security. More than 70 percent of persons age 75+, the fastest growing segment of our population, live in suburbs and small towns that have been designed to accommodate automobile use. Housing areas are typically not close to shops and services, so walking is not often possible.

As we grow older, we each are at increasingly greater risk of experiencing impairment in the various functional capabilities needed to drive safely, whether because of medication, disease, or ultimately, the normal aging process. These include the visual abilities needed to detect hazards, while effectively directing attention to critical driving tasks in the face of mounting distractions.

Also essential are the perceptual skills needed to accurately judge gaps in traffic, and the cognitive functions necessary to make rapid and appropriate maneuver decisions. Also important are physical abilities, including head and neck flexibility to scan for safety threats before turning, backing up, changing lanes, or merging, as well as arm and leg strength and stamina needed to effectively control the vehicle under normal and emergency response situations. To safely operate a motor vehicle demands a higher level of functional ability and functional integration than any other activity of daily living. (7)

Whether an impairment results from normal aging, or from diabetes, dementia, vision loss, hearing loss, medication, or any of a number of diseases that become more prevalent as we grow older, there is reason for serious concern that the result will lead to increased crash risk.

Department of Motor Vehicle studies have found that unrestricted drivers with certain medical conditions have significantly higher crash and conviction rates than control groups without impairments. Given current practices and demographic trends, analysts project a sharp increase in both the number and proportion of traffic fatalities related to the frailties of aging over the first quarter of the 21 st century – even to an extent that exceeds alcohol-related fatalities. Therefore, as background for this paper, it may be asserted that driving while impaired due to functional loss deserves the same recognition as a public health concern as other types of impaired driving.

A number of medical conditions may have an impact upon the ability of an individual to drive.

In some instances age is used as a determinant to trigger medical examinations and re-examinations in the licensing process. There are a number of reasons for singling out older drivers as high risk groups. First, in normal aging, there is frequently some psycho motor slowing that may affect driving ability. Second, age-related decreases in reaction time, divided attention (performing two or more simultaneous tasks), and selective attention (filtering out irrelevant information) have been documented. Third, older adults may be at increased risk for medical conditions that may compromise their ability to drive safely. Even though there is some deterioration of mental, motor, and sensory functions with increasing age, it is not known to what.extent this affects driving performance, and elderly persons usually drive safely. Reviews of the research, in fact, show that little data support the assumption that older drivers are, per se, unsafe drivers. According to current statistical trends, the crash rate per miles driven among older adults is not as high as it is among drivers less than 25 years of age. Furthermore, there is some limited research to suggest that healthy older drivers pose less of a threat to others and commit fewer errors on standardized road tests compared to younger drivers. Many older drivers also avoid serious driving problems because they recognize their limitations and adjust their driving by avoiding driving at night, in heavy traffic, and in bad weather. On the other hand, even if self-regulation is a common practice among older drivers, it is not a foolproof method of protecting public safety, especially if one considers that aging drivers with disorders affecting mental functioning (e.g. dementia), for example, may lack insight into their driving difficulties.

Another factor to consider is that older drivers show the greatest variability of any age group, with some older drivers possessing adequate driving skills until a very late age, and others singled out relatively early as being high-risk drivers. Performance is impaired only after a significant loss of function, perhaps because of the onset of a significant medical condition combined with age-associated inefficiencies that interact to significantly impair driving performance. The legal requirements for driver licenses may need updating to ensure that only those adults, of any age, who are at high risk for unsafe driving are required to undergo re-evaluation.

High risk factors might include the presence of vision, psychological, physical or other medical problems. While specific conditions might affect driving skills regardless of age, many are more common and prevalent with increasing age.

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Influenza viruses are spread from person to person primarily through the coughing and sneezing of infected persons. The typical incubation period for influenza is 1–4 days, with an average of 2 days. Adults can be infectious from the day before symptoms begin through approximately 5 days after illness onset. Children can be infectious for > 10 days, and young children can shed virus for several days before their illness onset. Severely immunocompromised persons can shed virus for weeks or months.

Uncomplicated influenza illness is characterized by the abrupt onset of constitutional and respiratory signs and symptoms (e.g., fever, myalgia, headache, malaise, nonproductive cough, sore throat, and rhinitis). Among children, otitis media, nausea, and vomiting are also commonly reported with influenza illness. Respiratory illness caused by influenza is difficult to distinguish from illness caused by other respiratory pathogens on the basis of symptoms alone (see Role of Laboratory Diagnosis).

Reported sensitivities and specificities of clinical definitions for influenza-like illness (ILI) in studies primarily among adults that include fever and cough have ranged from 63% to 78% and 55% to 71%, respectively, compared with viral culture. Sensitivity and predictive value of clinical definitions can vary, depending on the degree of co-circulation of other respiratory pathogens and the level of influenza activity. A study among older nonhospitalized patients determined that symptoms of fever, cough, and acute onset had a positive predictive value of 30% for influenza, whereas a study of hospitalized older patients with chronic cardiopulmonary disease determined that a combination of fever, cough, and illness of <7 days was 78% sensitive and 73% specific for influenza). However, a study among vaccinated older persons with chronic lung disease reported that cough was not predictive of influenza infection, although having a fever or feverishness was 68% sensitive and 54% specific for influenza infection. Influenza illness typically resolves after 3–7 days for the majority of persons, although cough and malaise can persist for >2 weeks. Among certain persons, influenza can exacerbate underlying medical conditions (e.g., pulmonary or cardiac disease), lead to secondary bacterial pneumonia or primary influenza viral pneumonia, or occur as part of a coinfection with other viral or bacterial pathogens. Young children with influenza infection can have initial symptoms mimicking bacterial sepsis with high fevers, and < 20% of children hospitalized with influenza can have febrile seizures. Influenza infection has also been associated with encephalopathy, transverse myelitis, Reye syndrome, myositis, myocarditis, and pericarditis.

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In New York State, approximately 8,000 people are waiting for livers, hearts, kidneys, lungs and various combinations of two or more organs to become available for transplant. Increasing awareness of the need for organ donors is a high priority issue of the Medical Society of the State of New York. The following is designed to provide physicians and patients with information about organ donation, how to approach families and alleviate misconceptions that prevent individuals from making informed decisions about donation, and resources available to assist in this effort.

Helpful Links

Organ Procurement Organizations
ALBANY
Center for Donation and Transplant
218 Great Oaks Boulevard
Albany, NY 12203
(518) 262-5606
800-256-7811
E-mail: bdavis@cdtny.org
website: www.cdtny.org/
NEW YORK CITY/METRO NY
New York Organ Donor Network
475 Riverside Drive, Suite 1244
New York, NY 10115
(212) 870-2240
800-443-8469
BUFFALO
Upstate NY Transplant Services
110 Broadway Avenue
Buffalo, NY 14203
(716) 853-6667
800-227-4771
E-mail: info@unyts.org
website: www.unyts.org
ROCHESTER/SYRACUSE
Finger Lakes Donor
Recovery Network
30 Corporate Woods, Suite 220
Rochester, NY 14623
(716) 272-4930
800-810-5494
Tissue Banks
NEW YORK CITY/METRO NY
New York Organ Donor Network
475 Riverside Drive, Suite 1244
New York, NY 10115
(212) 870-2240
800-443-8469
ROCHESTER
Rochester Eye and Human Parts Bank
524 White Spruce Boulevard
Rochester, NY 14623
(716) 272-7890
800-568-4321
NEW YORK TISSUE SERVICES
1 Edgewater Plaza, Suite 704
Staten Island, NY 10305
(718) 273-5913
888-Tissue5
E-mail: JENYTS@mindspring.com
SYRACUSE
American Red Cross Tissue Services
Greater Northeast Area
636 South Warren Street
Syracuse, NY 13202
(315) 425-1666
800-836-6677
NY FIREFIGHTERS SKIN BANK
New York Hospital Burn Center
525 East 68th Street
New York, NY 10021
(212) 746-7546
Eye Banks
ALBANY
Lions Eye Bank at Albany
Lions Eye Institute
35 Hackett Boulevard
Albany, NY 12208
(518) 262-2500
888-Lions Eye
E-mail: mas@global2000.net
BUFFALO
Upstate New York Transplant Services
165 Genesee Street, Suite 102
Buffalo, NY 14203
(716) 853-6667
800-227-4771
E-mail: info@unyts.org
Website: www.unyts.org
NEW YORK CITY/METRO NY
Eye Bank for Sight Restoration
120 Wall Street, 3rd Floor
New York, NY 10005
212-742-9000
E-mail: info@ebsr.org
Website: www.eyedonation.org
ROCHESTER
Rochester Eye and Human Parts Bank,
524 White Spruce Boulevard
Rochester, NY 14623
(716) 272-7890
800-568-4321
E-mail: info@rehpb.org
Website: www.rehpb.org
Lions Eye Bank for Long Island
300 Community Drive
Manhasset, NY 11030
(516) 465-8430New York Organ Donor Network
475 Riverside Dr. Suite 1244
New York, NY 10115 -1244
SYRACUSE
Central New York Eye Bank and Research Corp.
475 Irving Avenue, Suite 100
Syracuse, NY 13210
(315) 476-0199
800-393-7487
E-mail: ebmike@dreamscape.com
Website: www.cnyeyebank.com
CENTER FOR DONATION AND TRANSPLANT
218 Great Oaks Blvd.
Albany, NY 12203
UNIVERSITY OF ROCHESTER OPO
Corporate Woods of Brighton
Bldg.120, Suite 180
Rochester, NY  14623

Tobacco use continues to be the leading preventable cause of morbidity and mortality, accounting for more than 450,000 deaths each year. In New York State, 25,000 deaths are caused by smoking and there are 570,000 New Yorkers living with tobacco-caused illness. Smoking is a known cause of multiple cancers, heart disease, stroke, chronic obstructive pulmonary disease (COPD), and many other diseases. Smoking during and after pregnancy adversely affects fetal development and the health of infants. In addition, a recent U.S. Surgeon General’s report concluded that there is no risk-free level of exposure to secondhand smoke. Overall, the impact of smoking and secondhand smoke on our society is enormous costing billions of dollars in healthcare expenditures, lost productivity and most importantly, personal lives.

A recent article in the July 2010 issue of the New England Journal of Medicine, Don’t Forget Tobacco, reminds readers that cigarette smoking is still the most common cause of preventable death and disability in the U.S. Although significant strides have been made in tobacco control, especially in New York State with the passage of the Clean Indoor Air Act in 2003 and higher taxes on tobacco products, there is still much work to be done in order to prevent premature death and disease related to smoking. Physicians play a critical role in helping patients quit smoking and cite a physician’s advice to quit as an important motivator. Physicians are encouraged to take MSSNY’s CME courses on Effective Tobacco Dependence: Pharmacotherapy and Counseling and Tobacco Use in Adolescents and Women by visiting http://cme.mssny.org. Additional resources are listed below which provide valuable information on services available in New York State as well as reputable websites on tobacco dependence

The New York State Smokers Quitsite
The New York State Smokers Quitline offers free coaching; FREE starter kit of Nicotine Patches, Gum or Lozenges for eligible NYS smokers; tips and information and a new Online Smokefree Community where you can get a personalized quit plan. Healthcare providers can use the Fax-to-Quit program to refer their tobacco–using patients and can obtain posters and literature on tobacco use for their offices. The toll-free Quitline number is 1-866-NY-QUITS (1-866-697-8487) and the Quitline Website is www.nysmokefree.com.

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The Medical Society of the State of New York (MSSNY) has been deeply concerned about the threat that increasing obesity and overweight rates will have on overall health and well being of the citizens of New York State. Significant studies have shown that obesity and overweight leads to other diseases – diseases that cost the United States and New York State billions of dollars to treat.

Obesity, overweight and other weight management issues occur in all ethnic populations and occur within all urban, suburban and rural areas of New York State.

At its 2002 House of Delegates, the Medical Society of the State of New York specifically targeted obesity, as one of today’s most prominent health issues, urgently focusing our full attention on the diagnosis and aggressive management of this condition. This paper articulates the growing problem concerning overweight, obesity and other conditions related to weight management such as bulimia and anorexia nervosa.

The Medical Society believes firmly that physicians and other health care providers, the educational institutions, the food industry, businesses, employers, the community, parents and other caregivers, must work together to resolve the rising levels of obesity in New York State’s young residents and adults. At the same time, the Medical Society also believes attention must be given to those individuals who suffer a distorted body image – leading to a vast array of medical conditions and death.

This paper is intended to help generate discussion within New York State in order to best meet the challenges before us. To that end, the Medical Society will begin to focus on key areas such as physician education, patient and community education, and changes within public policy that would allow individuals to seek the medical interventions addressing weight management. The Medical Society will depend strongly on the enthusiastic partnership of legislative leaders to help us educate, motivate and promote physical education programs for all New Yorkers. We will also need their committed support in effecting these changes in public policies related to weight management and healthy lifestyles.

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Humanity faces an unprecedented existential threat from climate instability and global temperature rise caused by human activities, most notably the emission of greenhouse gases from the combustion of fossil fuels. The threat to human health from climate instability has been called the greatest of the 21st century. New York State does not escape this threat. The Medical Society of the State of New York acknowledges that immediate action is needed to prevent catastrophic health effects related to climate instability. Physicians must warn society and advocate for protecting the health of our patients and communities.

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