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Scholarship & Creative Work
News in red and blue: Messages about social factors and health can backfire

Here's a health idea that Democrats and Republicans agree on: when given information on the genetic factors that cause diabetes, both parties equally supported public health policies to prevent the disease.

But a study designed by U-M showed Republicans were less supportive of such policies after reading news reports that people with diabetes got their illness because of social or economic factors in which they live, such as lack of neighborhood grocery stores or safe places to exercise.

The social factors increased Democrats' support.

The study that examines the media trend of focusing on social factors and health will appear in the December issue of the American Journal of Public Health but is online now.

"Policymakers and journalists should be aware that social values influence people's opinions about health policy, and certain messages in the media might trigger these values," says Sarah Gollust, a Robert Wood Johnson Foundation Health and Society Scholar at the University of Pennsylvania, who worked on the study during doctoral work at the School of Public Health.

Increasing public awareness of social factors that impact health may not uniformly increase public support for action because some groups simply do not believe they are credible, the authors write.

The findings contribute to evidence that Americans' opinions about health policy are polarized by political party lines, the study states.

Gollust designed the study with Paula Lantz, social epidemiologist and chair of the Department of Health Management and Policy at SPH, and Dr. Peter Ubel, professor of internal medicine and director of the Center for Behavioral and Decision Sciences in Medicine.

Study shows aging skin improved by aggressive microdermabrasion

Aggressive microdermabrasion appears to improve the appearance of aged human skin, according to a report in the October issue of Archives of Dermatology, one of the JAMA/Archives journals.

"The significance of this study lies in the fact that this procedure is minimally wounding," says Dr. Darius Karimipour, who conducted the research while a clinical assistant professor in U-M Health System department of Dermatology. He now has a private practice.

"Healing occurs in the course of a day instead of weeks to months as is seen with other procedures that improve sun-damaged skin," he adds.

Aggressive microdermabrasion involves either sand-blasting the skin with aluminum oxide crystals or buffing the skin using a hand piece studded with minute diamond crystals. In order to objectively change the appearance of wrinkled skin, this procedure would have to induce the production of collagen, the major structural protein in the skin.

Previous studies have shown that microdermabrasion using aluminum oxide may not always stimulate collagen production. However, the authors of this study wondered if increasing the aggressiveness with which microdermabrasion was performed would stimulate production.

"Our study shows that microdermabrasion, if performed aggressively, can stimulate a wound healing response that may correct adverse changes in sun damaged or wrinkled skin," says Karimipour, the study's lead author.

Other authors include Laure Rittie, Craig Hammerberg, Victoria Min, Dr. John Voorhees, Dr. Jeffrey Orringer, Dr. Dana Sachs, Ted Hamilton, and Gary Fisher.

Pregnant women risk early delivery from psychiatric medication use

The odds triple for early child delivery among pregnant women with a history of depression who used psychiatric medication, a new study shows.

Researchers at U-M, Michigan State University and University of Washington found that a combination of medication use and depression — either before or during pregnancy — strongly was linked to delivery before 35 weeks' gestation.

"Medication use may be an indicator of depressive symptom severity, which is a direct or indirect contributing factor to pre-term delivery," says Kristine Siefert, the study's co-author and professor of social work.

Most physicians initiated pre-term deliveries after the women suffered complications, such as preeclampsia, poor fetal growth or acute hemorrhage.

Researchers analyzed responses of nearly 3,020 women who participated in the Michigan-based Pregnancy Outcomes and Community Health study, which asked about depressive symptoms that occurred within the week of taking the questionnaire. The study also asked about the women's history of depression that required medication, such as tranquilizers or sleeping pills.

Overall, 335 women (11 percent) delivered pre-term. Among the women who reported having depression during pregnancy, 75 percent had a history of depression and 62 percent used medication in the first half of pregnancy.

Another finding showed that without medication use, elevated levels of depressive symptoms at mid-pregnancy and history of depression did not pose an increased risk of pre-term delivery.

The findings appear in the September/October issue of Women's Health Issues.

Extra care for outwardly healthy workers costs companies millions annually

Someone healthy enough to work still could cost an employer more than $4,000 annually in unnecessary health care costs.

A new U-M study shows workers with metabolic syndrome (MetS) and associated chronic disease can cost employers up to $5,867 annually in health care, pharmacy and short-term disability — compared to $1,600 for a healthy worker. But the good news: Companies can stop those chronic health problems before they start.

MetS is a collection of health risks that includes body mass index, cholesterol, glucose, blood pressure and triglycerides. The study, conducted by researchers at the Health Management Research Center in the School of Kinesiology, was designed to determine the relationship between MetS and disease among employed adults.

People in the general population with MetS are known to be more likely to develop health problems such as heart disease and diabetes without health intervention, says research associate and study author Alyssa Schultz, but this is the first time the link has been studied and shown in working populations.

Employees with MetS were significantly more likely to report arthritis, chronic pain, diabetes, heartburn and heart disease, Schultz says.

The first step for employers says Schultz, is a health risk appraisal to determine the health of employees. When at-risk employees are identified, a prevention and intervention programs can cost as little as $150 a year per employee, according to a source in the paper.

Dee Edington, professor of movement science and director of the Health Management Research Center, is the co-author on the study, which will appear this month in the journal Value in Health.

Higher risk of pancreatic cancer in Lynch syndrome families

A new study has documented a nine-fold higher risk of pancreatic cancer in individuals with Lynch syndrome, a rare genetic cancer predisposition syndrome, report scientists from the Dana-Farber Cancer Institute and the U-M Comprehensive Cancer Center.

The study, published in the Journal of the American Medical Association, is the first using rigorous statistical methods to confirm the elevated risk, the authors say. Previous studies yielded conflicting results.

Carriers of the Lynch syndrome gene mutations have an 80 percent risk of colorectal cancer beginning at a young age, as well as an array of other cancers of the digestive system, brain and skin, and endometrium and ovaries in women.

Dr. Sapna Syngal, Dana-Farber and Brigham and Women's Hospital is the report's senior author along with Dr. Stephen Gruber, associate director for cancer prevention and control at the U-M Comprehensive Cancer Center.

"In light of these findings, we believe that if you have Lynch syndrome and there is pancreatic cancer in your family, you should be aggressively screened," says Syngal.

Dr. Fay Kastrinos, first author of the publication, noted, "Patients with Lynch syndrome are living longer because we're doing a great job with screening and genetic testing as a strategy for preventing colon cancer."

Pancreatic cancer is the fourth leading cause of cancer deaths in the United States.

"Because pancreatic cancer is a relatively rare cancer, pooling together the databases at the University of Michigan and Dana-Farber was critical to this analysis," says Bhramar Mukherjee, a biostatistician at the School of Public Health.

Other authors: Nabihah Tayob, Victoria M. Raymond, and Fei Wang, SPH; Dr. Jennifer Sparr, Dr. Prathap Bandipalliam, Dr. Elena Stoffel and Dana-Farber.

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