U.S. states with the highest levels of adult death rates have become increasingly concentrated in the South, while the most improvement has been witnessed in Northeast, Upper Midwest, and Pacific Coast states, reports the Population Reference Bureau . A blog post by the National Institute on Aging's (NIA) John Haaga elaborates on these regional patterns and encourages researchers to explore the underlying causes. "States in the Southern, Appalachian, and Old Midwest regions have been doing poorly," Haaga writes. "This problem predates the opioid epidemic, having persisted for decades, through multiple presidential administrations, health policy changes, and changes of power in Congress and in state legislatures. Older people in West Virginia, Mississippi, Kentucky, Oklahoma, and Alabama had relatively poor health in 1980 and have seen almost no improvement since then for women and very little for men." This project was underwritten by the NIA Division of Behavioral and Social Research, via a grant from the University of Michigan Center on the Demography of Aging. The center coordinates dissemination of findings from the NIA demography centers located in academic institutions throughout the U.S.

A new guidance statement from the American College of Occupational and Environmental Medicine (ACOEM) published in the Journal of Occupational and Environmental Medicine says wellness programs and insurance coverage that includes bariatric surgery can help manage employee obesity and mitigate its economic costs to employers, reports Safety + Health . The statement is from a multidisciplinary panel assembled by ACOEM that reviewed 275 articles on interventions dealing with obesity in the workplace. One study found absenteeism, one factor related to employee obesity, costs employers $8.65 billion a year. Other implications for employers include higher risk of injury to employees, more healthcare costs, and lower productivity. Modern workplace factors that can boost or hinder management of obesity include job and social stress, fatigue from overwork or shift work, fewer manual labor jobs, and more desk-related jobs. "Whereas the impact of obesity on life expectancy, diabetes, sleep apnea, and healthcare costs are frequently discussed, the hidden damage and consequences of obesity on the American workforce are less-known and incredibly detrimental," says Dr. Mitchell Roslin at Lenox Hill Hospital in New York City. "Obesity is a key determinant of health, yet increasing at alarming rates. The importance of adding greater awareness and better programs to combat obesity to the workplace cannot be overstated." A recent survey gauging participants' perceptions of medical services provided by their health insurance indicated that respondents reported low prevalence of coverage for obesity treatment. The ACOEM panel recommends employers use workplace wellness programs and behavioral counseling to help employees adopt healthy lifestyles, in addition to insurance coverage and access to bariatric surgery.

Some hospitals are working to improve seniors' physical condition in preparing them for surgery by prescribing exercise, healthy eating, and minimization of anxiety and stress, reports Kaiser Health News . In 2018, the American College of Surgeons (ACS) plans to roll out a national effort to improve surgical care for seniors, after defining standards that hospitals should meet. The goal is to promote and recognize "centers of excellence in geriatric surgery" across the U.S., according to ACS's Dr. Ronnie Rosenthal. New evidence from Duke University Medical Center's Perioperative Optimization of Senior Health (POSH) program illustrates the value of readying at-risk seniors for surgery. Seniors referred to the program by surgeons attend sessions at Duke's Geriatric Evaluation and Treatment Clinic, where they receive a geriatric assessment focused on their functioning, mobility, cognition, medications, nutrition, existing medical conditions, and support at home from family or other caregivers. A study published in JAMA Surgery found older adults who followed the POSH program before major abdominal operations spent less time hospitalized, were less likely to return to the hospital in the next 30 days, were more likely to return home without requiring home healthcare, and have fewer complications. POSH participant Dr. Shelley McDonald recommends seniors walk 20 minutes a day, five days a week, and perform core-strengthening exercises three times a week, practice deep breathing three to four times daily, refrain from drugs that can interact poorly with anesthesia, consume 30 grams of protein three times a day, drink plenty of fluids starting three days before surgery, and make sure someone can sit with them in the hospital and be with them when they come home.

A study published in the New England Journal of Medicine found solanezumab, a monoclonal antibody-based treatment for Alzheimer's disease developed by Eli Lilly that targets amyloid plaques, failed to significantly retard cognitive decline, reports ScienceDaily . A total of 2,129 individuals with mild dementia from Alzheimer's disease participated in the trial. Solanezumab was designed to reduce the level of soluble amyloid molecules before they build up. Although the treatment did have some positive effects, in the main measure of outcome, measured via the Alzheimer's Disease Assessment Scale-cognitive subscale test, did not show any statistically significant benefit in comparison with placebo. "Although we are disappointed that this particular drug did not prove successful, the field is benefiting from each study," says lead study author and Columbia University Irving Medical Center Professor Lawrence Honig. "There is hope that one of the newer ongoing studies may result in an effective treatment for slowing the course of Alzheimer's disease."

The Administration for Community Living (ACL) will host a webinar on Feb. 7 that invites Adult Protective Services (APS) agencies and community-based organizations in the aging and disability networks to learn about tools and strategies to address senior financial exploitation. The event will detail how federal agencies are partnering to help law enforcement agencies and financial institutions more effectively respond to this exploitation and how APS and community-based organizations can help. The webinar also will cover how APS can collaborate with law enforcement, financial institutions, and community-based organizations to improve a coordinated community response to financial exploitation so that services to victims and prosecutions of perpetrators are effectively delivered. The event will explain the Memorandum on Financial Institution and Law Enforcement Efforts to Combat Elder Financial Exploitation, issued by the Consumer Financial Protection Bureau, the Treasury Department, and the Financial Crimes Enforcement Network on Aug. 30, 2017. The memo urges coordination among law enforcement agencies, financial institutions, and APS agencies and specifies how Suspicious Activity Reports can aid law enforcement probing cases of senior financial exploitation. Participants can register here .

The Senate has advanced the nomination of Alex Azar to be Health and Human Services (HHS) Secretary by a vote of 54 to 43, reports The Hill . Most Democrats opposed his advancement, but seven Democrats joined Republicans to move his nomination forward. Azar will replace Tom Price, who resigned in September following a scandal surrounding his travel on private planes. Azar was deputy HHS Secretary under President George W. Bush before his tenure at Eli Lilly. He says combating high drug prices will be a priority. Azar also espouses GOP-supported moves such as increasing competition in the marketplace, instead of Democratic-leaning options such as allowing Medicare to negotiate drug prices. Former HHS Secretaries Tommy Thompson and Mike Leavitt have endorsed Azar, claiming he has "the track record from his previous time at HHS to be a successful manager." Certain Democrats are less confident about Azar, with Sen. Patty Murray (D-Wash.) saying, "He failed to persuade me that he can effectively lead any effort to lower drug prices given his tenure at Eli Lilly, where he worked to raise drug prices." She also cites Azar's indications "that he would continue the administration's harmful plan to create Trumpcare by sabotage."

A study published in the American Journal of Preventive Medicine found 25 percent of the public health workforce could either retire or lose their jobs on account of attrition, reports Fierce Healthcare . "Because of the Great Recession beginning in 2008 and other economic considerations, staff are delaying retirement in unprecedented numbers," says study co-author Jonathon Leider at the Johns Hopkins Bloomberg School of Public Health. "However, this can't last forever, and agencies will see the 'silver tsunami' show up, if they haven't already. Our research helps quantify this challenge." About 197,000 people are currently employed at state and local public health agencies, and at least 65,000 are due to retire by 2020. The study estimates that 100,000 staffers could leave the workforce by 2020. Universities issue about 25,000 public health degrees annually, so theoretically there would be enough graduates to meet demand. However, private entities, which can offer better pay and benefits, have an advantage on recruiting graduates. Elizabeth Harper with the Association of State and Territorial Health Officials says public health agencies must be able to adapt to draw and retain qualified hires. "Workforce shortages are more than a mere numbers game, since the potential supply of workers far exceeds potential demand," she notes. Meanwhile, the healthcare sector also is facing a national physician shortage, although many baby boomer physicians are reluctant to retire. Nevertheless, estimates peg the shortage of physicians at 100,000 by 2030.

Staples' Annual Workplace Survey of 1,004 full-time U.S. and Canadian employees, 12 percent of whom work in healthcare, found healthcare employees assigned their workplace a "B" grade, reports Becker's Hospital Review . In comparison, employees in other industries gave their workplace a"B-." In addition, the poll found healthcare employees are more likely than other employees to include "a private place to rest" and "breakroom" on their workplace wishlist. Twenty-six percent desired private places to rest, versus 21 percent of employees in other industries. Nineteen percent of healthcare employees also wanted more breakrooms compared to 12 percent of employees in other industries. Staples also found 49 percent of healthcare employees have taken a mental health day.

The U.S. Occupational Safety and Health Administration (OSHA) has informed employers who must keep and maintain an OSHA 300 injury and illness log that they must publicly post their 300A summary sheet from Feb. 1 to April 30, reports Safety+Health . Form 300A summarizes work-related injuries and illnesses posted last year. OSHA says the summary must be posted in work areas where employee notices are usually placed. OSHA states employers with 10 or fewer workers or who work in certain low-hazard industries do not have to post the summary.

A study published in Diabetes, Obesity & Metabolism found 38.8 percent of older adults in primary care with type 2 diabetes and a target stringent glycated hemoglobin (HbA1c) of greater than 7 percent were "overtreated," comprising nearly 20 percent of all older persons, reports MedPage Today . Those with a target HbA1c of greater than 7 percent had a significantly higher rate of complications. "The beneficial effects of stringent glycated hemoglobin (HbA1c) goals in older adults with long-existing type 2 diabetes and vascular complications are not proven," the authors note. They also report "the risk of harm associated with an HbA1c target lower than the conventional 7 percent (53 mmol/mol) seems to outweigh the possible benefits for adults aged 70 years or older." The older adults considered overtreated were more frequently prescribed metformin and sulfonylureas. About 17 percent of this cohort noted a hypoglycemic event during the observation period, which led to four falls and one emergency department visit. "Care professionals should abandon the 'one size fits all' approach and realize the possible benefits of de-intensifying blood glucose-lowering treatment," the researchers recommend. "To prevent overtreatment, a lower HbA1c limit in the guidelines might be helpful. Diabetes quality indicators should not be based on population-based mean values, because means will overlook under- and overtreatment completely."