Stories about: population health

Scientists find link between increases in local temperature and antibiotic resistance

Image representing the rise of antibiotic resistance
Illustration by Fawn Gracey

Over-prescribing has long been thought to increase antibiotic resistance in bacteria. But could much bigger environmental pressures be at play?

While studying the role of climate on the distribution of antibiotic resistance across the geography of the U.S., a multidisciplinary team of epidemiologists from Boston Children’s Hospital found that higher local temperatures and population densities correlate with higher antibiotic resistance in common bacterial strains. Their findings were published today in Nature Climate Change.

“The effects of climate are increasingly being recognized in a variety of infectious diseases, but so far as we know this is the first time it has been implicated in the distribution of antibiotic resistance over geographies,” says the study’s lead author, Derek MacFadden, MD, an infectious disease specialist and research fellow at Boston Children’s Hospital. “We also found a signal that the associations between antibiotic resistance and temperature could be increasing over time.”

During their study, the team assembled a large database of U.S. antibiotic resistance in E. coli, K. pneumoniae and S. aureus, pulling from hospital, laboratory and disease surveillance data documented between 2013 and 2015. Altogether, their database comprised more than 1.6 million bacterial specimens from 602 unique records across 223 facilities and 41 states.

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Population health: Bringing together medical, public health and payer communities

The people who deliver care are starting to think in terms of population health.
The people who deliver care are starting to think in terms of population health.
A growing number of health care professionals are looking at their patients not just as individuals with unique concerns but also as members of larger groups with common problems and needs. This broader, population-based framework could lead to better health outcomes for more people, according to Jonathan Finkelstein, MD, MPH of Boston Children’s Hospital.

“The health care system is changing from one that’s more reactive to illness—you come see the doctor when you’re not well—to one that’s more responsible for the promotion of health for defined groups of people,” he explains. While individual patients will always be treated as, well, individuals, the concept of population health can help providers “figure out the most appropriate services within a set of limited resources for specific groups.”

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Yes, PCPs can help youth with smoking, but can we get incentives to align?

Teen girl smoking cropped-shutterstock_108536432Claire McCarthy, MD, has been a primary care pediatrician and writer for more than 20 years. She blogs for the Huffington Post, Boston.com and the Children’s pediatric health blog, Thriving. She practices at the Children’s Hospital Primary Care Center. Follow her on Twitter @drClaire.

When I read about the report from the U.S. Preventive Services Task Force saying that pediatricians can “move the needle” when it comes to youth smoking, I had a few different reactions.

My first reaction was:  Cool! I don’t want youth to smoke. We all know the health problems it causes. It’s good to know that we can make a difference.

My second reaction, as I thought about it more, was:  Duh. Of course we can make a difference. We primary care pediatricians are perfectly positioned to influence the health behaviors of youth. We have relationships with them and their parents. We see them regularly, we have the opportunity to build trust and to get to know and understand them. We talk to them about all aspects of their health and well-being. While they don’t always listen to us, there’s always the chance they will.

And then, as I thought about it even more, my reaction was:  Is anyone going to help us do it?

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