I find this to be a very peculiar turn of events. But that may be because I’m terrified of ambulances. Living in NYC, I see people getting carted away in them daily and it looks very unpleasant.

 

And yet, ambulance dispatches for minor injuries like abrasions, burns and muscle sprains rose by 37% in New York City after ACA provided health insurance to previously uninsured people.

Just because you can get an ambulance for $3 under your Medicaid plan doesn’t mean you should call one for all your minor ailments. People are so weird!

It’s gotten to be so commonplace, there’s even an acronym for it – PNR (see above).

 

Per Medical Xpress:

When ambulances (at $3) are cheaper than an Uber, researchers found a massive spike in ambulance calls for minor ailments.

The exact opposite of previous research which found that when Uber shows up in a city, the usage of ambulance services dropped off.

Medicaid patients, in particular, have incredibly low out-of-pocket responsibility for ambulances. The most an ambulance ride covered under Medicaid costs the patient is three dollars. If there’s a low-cost alternative to Uber to get the hospital, you’re going to take it.

However, dispatches for more severe injuries (such as chest pain, compound fractures, and unconsciousness) remained unchanged.

In response to these unnecessary calls for ambulances, a handful of major U.S. cities are implementing 911 nurse triage call centers to address non-emergency calls and redirect those patients away from ambulances.

NYC—and most U.S. cities—don’t do that yet, but as dispatches for scrapes and sprains tie up emergency responders, that may soon change.

 

Bottom Line.

I find this all so so incomprehensible. I would be so embarrassed (mortified really) to call an ambulance for anything less than imminent demise. Where do you all stand on this?

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I turned into a conscientious gym-goer 20 years ago (for health reasons) and can’t imagine life without this daily routine.

 

My experience with arthritis and weight loss has made fitness even more integral to my lifestyle. The last three years, in particular, have been game-changers in terms of how I work out including getting a trainer and my approach to eating and drinking.

I’m writing about it today (again) for two reasons:  1. I believe if I had started this way of life earlier, e.g., in my early thirties vs. late forties, I might have avoided this arthritis situation altogether and 2. I’ve seen so many of my friends (mostly younger) struggle to get motivated with fitness.

I used to be gym-averse also. I can’t count the number of times I joined a gym only never to go. It took being diagnosed with high blood pressure and high cholesterol to get me motivated. Now, going to the gym is as ingrained a habit for me, as taking a shower or brushing my teeth.

Today’s post features the Top 5 Fitness Trends just released by Sara Kooperman, CEO of SCW (which I believe stands for Sara’s City Workout). I wanted to share this because every word of what Sara writes mirrors my fitness journey. One sentence, in particular, got my attention:

• Exercise is medicine, and fitness and health professionals are emphasizing prehab rather than rehab.

This is so relevant to my situation. Twenty years ago, my doctor gave me the choice of taking medicines to treat my high blood pressure and high cholesterol OR going to the gym. For whatever reason, I was adamant NOT to become a pill popper to stay healthy. And fortunately, I saw results quickly which turned my then new gym-routine, into an unbreakable habit.

 

Sara’s top five fitness trends are based on surveys conducted among fitness instructors, personal trainers, owners and managers at independent health clubs, recreation centers, YMCAs and boutique studios.

The top five most sought-after areas of fitness/wellness across the nation are:

1. Functional Training
2. Active Aging
3. Nutrition
4. Strength Training
5. Personal Training

 

Read on below for a recap of the top trends, but if fitness is a topic of particular concern or something you’re struggling with, please read this in its entirety.

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First of all, do you know where the 10,000 step a day regimen came from? No? Read on below; it’s pretty funny.

 

My goal recently has been to get in 12,000 steps daily, which I read is ideal for good health. But I am not reaching that number. I am lucky to rack up 10,000 steps a few times a week.

For 2019, my daily average has only been 6061 steps versus 7834 per day in 2018. This is a result of spending an additional day a week sitting at my desk writing. Fortunately, I do get to the gym every day for a one-hour workout.

Now, however, a new 4-year study of 17,000 women (ages 62-101!) from Brigham and Women’s Hospital, found that the sweet spot for optimal health is between 4,400 and 7,500 steps daily. The danger zone is anything below 2,700 steps. Drop below that number and your risk of early death increases by 40 percent.

They don’t give you any indication of how the findings vary for a younger age group, e.g., women in their 40’s or for men.

But one thing is certain according to the press release, hitting 10,000 daily steps isn’t all it’s cracked up to be.

And here’s a fun fact: The 10,000-steps phenomenon became popular as a result of a marketing campaign for a Japanese pedometer that was invented in 1965, called Manpo-kei (which translates to 10,000-step meter).

 

Bottom Line.

Despite “10,000 steps” being more of a marketing ploy than science, I am still a believer.

P.S. Happy to report that yesterday (Friday) I got in 11,849 steps!

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Two-thirds of the entire reported global measles caseload is attributable to just two countries: Ukraine and Madagascar.

 

Check out this must-read article from reliefweb. If you can’t get to it right now, here are the must-knows:

• Measles cases globally rose 300% in the first quarter of 2019 according to surveillance data covering 190 countries released last week from the World Health Organization.
• 112,000 cases were reported at the start of this year, as opposed to 28,000 at the beginning of 2018.

The spread of misinformation about childhood vaccination is leading to a wave of what the World Health Organization calls “vaccine hesitancy.” They call it one of the world’s “top ten” threats to global health.

However, the enormous jump in measles cases over the last year is attributable to just two countries: Ukraine and Madagascar.  They’re the “canary in the coalmine” for the underlying weaknesses of public health systems.

Why the Ukraine?

The answer is conflict. Prior to 2014, Ukraine maintained a measles vaccination rate of 95%, considered the gold standard.

• Then, conflict broke out between Ukraine and Russia. As a result, budgets were frozen and measles vaccination procurement ceased and the vaccination rate plunged to 41%, one of the lowest rates on the planet.
• In subsequent years, the vaccination rate crept back up close to its pre-conflict levels, with 91% coverage in 2018.
• But the damage had been done. Measles took root again quickly and began to spread through international travel especially to New York and Israel.

What about Madagascar?

Madagascar is one of the least developed countries, with a Human Development Index (HDI) that ranks 161st out of 189 measured countries.

• The measles vaccination rate in Madagascar has fallen to one of the world’s lowest at 58%.
• Additionally, children in Madagascar suffer from poor nutrition which leads to weakened immune systems.

Measles is highly infectious.

• A single measles infection commonly produces at least 18 new infections in the absence of counter-measures.
• Additionally, measles is infectious for 7 days prior to the individual becoming symptomatic.

In America, 695 cases have been reported. It’s the highest annual number since the disease was declared eliminated in this country in 2000. Most cases are linked to two groups: Orthodox Jewish communities in NYC and a group of anti-vaxxers in Washington State. However, cases have now been reported in 22 states.

Bottom Line.

Disruptions to health systems in one country spread quickly throughout the world because we are so mobile these days. Nothing can be isolated to one country or area of the world anymore because everyone is on planes going here, there and everywhere.

This is no time to be an anti-vaxxer or even “vaccine-hesitant.”

And, remember, measles might just be the tip of the iceberg.

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