The Official Modest Needs Blog

Low Income Americans at 50% Greater Risk for Heart Disease

There is some very disconcerting, but certainly interesting, medical news that relates directly to the working poor in the United States:

People with lower socioeconomic status are much more likely to develop heart disease than those who are wealthier or better educated, according to a recent UC Davis study. Published online in BMC Cardiovascular Disorders, the outcomes also show that this risk persists even with long-term progress in addressing traditional risk factors such as smoking, high blood pressure and elevated cholesterol.

"Being poor or having less than a high school education can be regarded as an extra risk when assessing a patient's chances of developing cardiovascular disease," said Peter Franks, a UC Davis professor of family and community medicine and lead author of the study. "People with low socioeconomic status need to have their heart-disease indicators managed more aggressively."

Using data from the Atherosclerosis Risk in Communities Study, authors of the current study included information on more than 12,000 people aged 45 to 64 years living in North Carolina, Mississippi, Minnesota and Maryland. Participants reported their education and income levels in 1987, and then over the course of 10 years were periodically evaluated for heart-disease diagnoses and changes in their risk factors, including cholesterol, blood pressure and smoking.

The results indicated that people with lower socioeconomic status had a 50 percent greater risk of developing heart disease than other study participants.

According to Franks, although it is known that people with low socioeconomic status have a greater risk for developing heart disease and other health problems, the reason is often attributed to reduced health-care access or poor adherence to treatments such as smoking cessation or medication. This study showed for the first time that the increased risk endured despite long-term improvements in other risk factors, indicating that access and adherence could not account for the differences.

"Low socioeconomic status is a heart-disease risk factor on its own and needs to be regarded as such by the medical community," Franks said.

50%?! That is outrageous. And what is interesting is the idea that socioeconomic status should be considered right off the bat when assessing potential heart disease. They may even give higher doses of cholesterol-lowering medicine to those with lower incomes.

This could, potentially, become a sticky issue. Treating people differently based on class has long been considered unfair, but in this instance it is in efforts to keep the poor healthy and safe.

What do you think about this study? We'd love to hear from you below.

[Photo by Tiffany]

Great News! A Cause of ALS (Lou Gehrig's Disease) Found

The Modest Needs Independent Living Grant is designed specifically to help individuals and families who live with a disability. Often these folks are uninsured. Sometimes they are insured, but the insurance company doesn't cover the cose of accessibility equipment. Severe disabilities--diseases like dementia and ALS (Lou Gherig's disease), for example--can require full time caretakers which causes the bank account to take a severe hit, whether you hire someone or leave your job to take care of a loved one.

Even more frustrating is that for the longest time, ALS was a disease without a cause. Happily, that is no longer the case:

A new University study published in Nature identifying evidence of a common cause in all forms of amyotrophic lateral sclerosis (ALS, better known as Lou Gehrig's disease), a neurodegenerative disease causing fatal paralysis, opens a door to a cure for a disease that has long stumped scientists.

The study from the Northwestern University Feinberg School of Medicine found that irregular protein degradation of ubiquilin2 is common in all forms of ALS. When the disease is present, the damaged proteins are not recycled and taken away, instead they accumulate in neurons in the brain and spinal cord. This accumulations causes the nervous system to lose its ability to relay messages to the body's muscular system, gradually depriving those with the disease of their ability to move and breathe. This discovery could have a broader impact on treatment of other neurodegenerative diseases also characterized by the irregular accumulation of proteins, like Parkinson's, Alzheimer's disease and other dementias. Neuroscientist and senior author of the study, Dr. Teepu Siddique has been studying ALS for a quarter century. He said, "It was one of the most difficult problems in neurology and the most devastating, a disease without any treatment or known cause."

Terrific news! Dementia, Alzheimer's, Parkinson's and ALS affect such a wide swath of Americans that this discovery must stoke the hopes of families in the thousands and thousands. Yay, science!

[Image via Fotis Bobolas]

Good News for Those Crippled by the Cost of Health Care

With health care being prohibitively expensive for this country's working poor, it's no surprise that a large number of Modest Needs applicants are in dire straits because of costly co-pays, medical exams and prescription drugs. But just because it is not shocking, doesn't mean it isn't disheartening all the same. In fact, the number of requests made that describe being forced to choose between food and medicine is absolutely heartbreaking.

However, there is some good news on the horizon for those who are crippled by the cost of health care:

In the next 14 months, seven of the world's 20 best-selling drugs are scheduled to go "off patent." As they do, the brand-name drugs will lose out to generic versions, cutting costs for patients and companies that provide health benefits.

Generic versions of big-selling drugs for high cholesterol, high blood pressure, asthma, diabetes, depression, high triglycerides, HIV/AIDS, and bipolar disorder also are on the way.

Generic medicines - chemically equivalent to the original brand-name drugs - typically cost 20 percent to 80 percent less than the brand names.

The flood of generics will continue for the next decade or so, as about 120 brand-name prescription drugs lose market exclusivity, according to prescription benefit manager Medco Health Solutions Inc.

"My estimation is at least 15 percent of the population is currently using one of the drugs whose patents will expire in 2011 or 2012," says Joel Owerbach, chief pharmacy officer for Excellus Blue Cross Blue Shield, which serves upstate New York.

The new generics will slice copayments of those with insurance. For the uninsured, who have been paying full price, the savings will be much bigger.

These changes to these common drugs won't wipe out the poverty problem in the United States, but let's hope it is at least a slight relief for a good portion of people who find themselves choosing between rent and medicine.

[Photo by Charles Williams]

Giving is Good for You: Get a "Helper's High"

You know why giving is good: seeing others happy, warm fuzzies, a sense of belonging to something bigger than yourself. But, check it out--giving is also great for your health. So, go ahead and have those fries*!

New research suggests there may be a biochemical explanation for the positive emotions associated with doing good. In a recent study published in the Proceedings of the National Academy of Science, participants’ brains were monitored by MRI scans while they made decisions about donating part of their research payment to charitable organizations. When participants chose to donate money, the brain’s mesolimbic system was activated, the same part of the brain that’s activated in response to monetary rewards, sex, and other positive stimuli. Choosing to donate also activated the brain’s subgenual area, the part of the brain that produces feel-good chemicals, like oxytocin, that promote social bonding.

[...]

“When you’re experiencing compassion, benevolence, and kindness, they push aside the negative emotions,” says Post. “One of the best ways to overcome stress is to do something to help someone else.”

Even better, feeling good and doing good can combine to create a positive feedback loop, where doing good helps us to feel good and feeling good also makes us more likely to do good.

“Numerous studies have found that happy people are more helpful," says Dr. David Myers, a social psychologist at Hope College and author of The Pursuit of Happiness. “Those who've just found money in a phone booth are more likely to help a passerby with dropped papers. Those who feel successful are more likely to volunteer as a tutor."

How wonderful to know that something as simple as helping someone else will allow you to let go of negative thoughts and emotions. How great to see that actions that benefit many are beneficial to all involved. It's a great way to go into a weekend--two days to reach out and show your generosity. Saturday night "helper's high"? Don't mind if we do!

*Okay, maybe just a few fries.

[Photo by Tanel Teemusk]

Why Do You Give?

Why do you give? How do you choose whom to give to?

That is a question being asked in this informative article in The Nonprofit Quarterly about "What Donors Want."

It is a look at calls for more objective data about charity and nonprofit operations and the effect that data has on giving habits. The article makes no definitive conclusion about whether knowing more statistics about how nonprofits operate changes the way people donate, but it does suggest, at least in part, that more stats and numbers about charities is not necessarily going to impact how or why or how much someone gives.

Why? Because studies show that people often give for reasons related to emotion. Here's an excerpt from the piece:

The Center on Philanthropy study, which was sponsored by Bank of America’s Philanthropic Management practice, found that the most important motivationsvii for charitable giving by high-net-worth households were “meeting critical needs, giving back to society, and social reciprocity,” while “charity as making good business sense” was ranked lower on the list.iii A Center for High-Impact Philanthropy study comprised a sample of only 33 individuals—too few to carry any statistical significance.iv Meanwhile, a 2004 attempt by Harvard Business School students to determine what constitutes “rigorous performance metrics”viiiended up being scrapped because the investigators found little evidence to support their initial hypothesis that donors want this sort of information.

A forthcoming book by Princeton University’s Daniel Oppenheimervi summarizes the research of several prominent social scientists on the determinants of giving behavior generally and finds that “no matter what objective information is available, the large majority of donors will give as a result of emotional or relational factors.” A recent article in The Economist cites a study that found that donors “do good because it makes them look good to those whose opinions they care about”—what researchers call the “image motivation.” And a recent study of 4,000 donors conducted by Hope Consulting found that few investigate nonprofits’ performances, with only one-quarter of them saying they would consider switching their support to different charities if those groups improved in areas donors care about. Only one-third said they’d be interested in giving more if the nonprofits they supported improved their performance.

Nonprofit leaders tend to agree. According to interviews with a diverse group of high-performing nonprofits conducted by one of the authors of this article, nonprofit leaders said that “while it’s nice to have data,” most of their donors continue to give “because of the relationships we cultivate with them.” In fact, almost all said while high-performance data helped enhance their credibility in the business community, it wasn’t instrumental in attracting donors, especially new individual donors. They also said that they continued to believe that ultimately, their financial support was going to come from relationships and “emotional connections,” rather than from data about performance and impact.

Organizations like the Better Business Bureau and Charity Navigator rank and rate charities and nonprofits using statistical data to give potential donors objective information about where their dollars will go. And many donors choose charities based on how much overhead the charity may have, how much they spend on fund raising or how often they are "in the red." But one should not underestimate the draw of sheer emotional impact--a big reason why many reach into their wallets to give.

So, let's hear from you: Why did you, if you are a Modest Needs donor, choose to give to our organization? And if you donate to other charities, what compelled you to choose those particular nonprofits?

Tell us in the comments.

[Photo by rabbitmatch.org]