Listen to the radio reports:

New Jersey National Guard Chaplain Joanne Martindale is just returning from a national conference for military chaplains – and says she and her colleagues are concerned about anxiety levels among military families following the shootings:

Martindale: They are wondering well, will Ft. Dix be the next base, or what will the next base be where somebody will do a copy cat shooting. So I think families are anxious.

Martindale plans to reach out to families, especially to children already in support groups, and encourage them to talk about their worries.

Michelle Sherman is a psychologist who works with military families. Sherman has written several books, among them "My Story, Four Blogs by Military Teens". She says in families that have a loved one in the service, parents should discuss the issues with their children, but they should limit exposure to media coverage of the shootings.

The shooting in Fort Hood has focused the attention of the nation on the state of mind of a single soldier. But mental health providers in the service say the shootings don't reflect on the military's increasingly pro-active approach to soldiers' mental health.

West Point psychologist Dr. Michael Matthews says the military has started to focus on resilience with its comprehensive soldier fitness program. Developed in collaboration with the Center for Positive Psychology at the University of Pennsylvania, it screens soldiers for potential mental health problems – and provides tools for improvement:

Matthews: If they come out a little low on any of the domains, there will be a series of recommended actions that they can get and resources they can tap into on their own to get better.

Matthews says focusing on what keeps soldiers mentally healthy reduces the stigma of seeking help for a mental health issue.

In terms of preventing future shootings – experts say there are often warning signs such as changes in behavior, or mood – but Temple University psychiatrist William Dubin says they easily go undetected because they tend to be isolated and random.

Listen:

The blueprint always includes goals for preventing infant deaths, cancer and helping Americans lose weight, but this time the plan also tackles the societal determinants of health. Rear Admiral Penelope Slade-Sawyer explains.

Slade-Sawyer: In a nutshell health is too important to be left to the health sector alone. It means that there are many other areas of our lives that effect our health. Where you live and what school you go to, what's the quality of the air you breathe. What about the water you drink?

Slade-Sawyer directs the federal Office of Disease Prevention and Health Promotion. She says other new topics include genomics and the drug-resistant infections the get passed from patient to patient in the hospital.

David Nash is dean of The Jefferson School of Population Health.

Nash: The dissemination of the report helps employers and others who pay for health care. It gives them ammunition to sponsor more effective prevention and wellness programs. This is especially critical given the recession.

Nash says poor health is jeopardizing America's competitiveness because chronic disease and preventable illness cost the national millions of dollars.

Slade-Sawyer says the new national agenda tackles health equity.

Slade-Sawyer: In other words someone in a small rural community should have access to the same services as someone in a major metropolitan area might have. We understand that they might have to drive to get there, but never the less, we want these people to access services no matter where they are.

Slade-Sawyer says the 2010 plan wasn't able to prevent increasing rates of overweight and obesity. She says the nation has continued to pack on pounds in recent years.

Officials are unveiling the 2020 plan as hundreds of researchers and scientists descend on Philadelphia. The annual meeting of the American Public Health Association begins Saturday.

Jefferson School of Population Health
Connelly Auditorium

1001 Locust Street

Philadelphia, PA
www.healthypeople.gov
www.jefferson.edu/population_health/

Listen:

Now that Pfizer and Wyeth have merged, and so have Merck and Schering Plough, tens of thousands of employees face layoffs.

On top of that, add the 8000 job cuts that Johnson and Johnson announced last week, and another 7000 cuts from Astra Zeneca. All told…

Staton: You're looking at a blood bath in pharma.

Tracy Staton is the editor of Fierce Pharma. She calculates that drug companies have trimmed more than 100,000 positions in the last eighteen months.

Many of these firms have facilities in this region, but the job loss is spread globally. Staton says many of the positions have been in sales.

Staton: A lot of the companies are going to more high tech methods of sales, where they do drug promotion over the Internet. So you're going to see the kinds of technology-replacing-people things that you've seen in other industries.

Most recently, companies are eying research and drug development jobs for elimination — looking instead to outsource that kind of work. Colleen Hamilton's group, the Life Sciences Career Alliance, is working to find those laid off workers new positions in the Delaware Valley.

Hamilton: I think it's probably the most difficult task for the research and development life science professionals to look to see what their future may be, because typically they would like to try to stay in the same type of company doing the same job.

Bill Ashton is the dean of the Mayes College of Healthcare Business and Policy at the University of the Sciences. He says salespeople, researchers, and even executives are getting the axe.

Ashton: I've got these people, to be frank with you, calling me looking for teaching jobs because there's just nothing out there and typically they want to stay in the area. So this is draconian from what I've seen before.

Job cuts and mergers among pharmaceutical companies have been propelled by the anticipation of top-selling, brand-name drugs like Lipitor losing their patent protection. The upside to this trend is that generic manufacturers, like Pennsylvania's Teva, are considered to be thriving.

So our news staff, which is full of people who bike to work, has stepped up to help. From WHYY's Susan Phillips, Peter Crimmins, Kerry Grens, Shai Ben-Yaacov and Elizabeth Fiedler, here are five helpful tips on how to bike to work safely.

Listen to the audio only below or click on the link to the right to view the audio slideshow:

Just some of the many bikes that popped up around the city this week.

Listen:

Delaware's Division of Public Health reports that at the Brennen School in Newark, only 10 out of 320 students got the vaccine. This is a tough issue for parents of children with autism, says Theda Ellis, who directs Autism Delaware, a non-profit advocacy organization. She says worries about a connection between autism and vaccines still prevail:

Ellis: Many parents give anecdotal information that their children developed symptoms of autism following a vaccination so particularly for those parents, it's a big issue.

She says some parents think a preservative used in vaccines is related to autism. In addition, Ellis says there are other worries:

Ellis: For some people it's the impact on the auto-immune system, and so little being known about it, and then the third concern about the swine flu vaccine is that there's a sense that it hasn't really been adequately researched yet.

Dr. David Mandell of the Children's Hospital of Philadelphia says no research has shown a connection between autism and vaccines. He says parents should consider the health benefits of getting the vaccine when making their decision.

Mandell: Vaccines are extraordinarily safe, that is the risk from having any kind of problem associated with the vaccine is much lower than the risk of getting what could be a very serious infection.

School vaccines are also under way in Pennsylvania and New Jersey, but student participation rates are not available.

AARP represents people over age 50. Stella Hyde is on the executive council for the Pennsylvania branch of AARP. She says one of the appealing provisions in the House bill is a limit on how much more insurance companies are permitted to charge people because of their age.

Hyde: That would have a direct impact on people in this state, absolutely. Especially that 50-64 age group that are not covered by Medicare that have difficulty getting coverage and of finding it affordable.

Hyde says Pennsylvania does not impose limits on so-called "age rating." Under the House plan, insurers could charge older people no more than twice what it charges younger people.

The House may vote on the bill this week.

Listen:

Bill Cruice leads the nurses union. He says the hospital's last contract offer included a gag clause that subjects workers to discipline if they speak out.

Cruice: If you're a nurse and you see something that is wrong in your hospital and you want to criticize your employer either privately or even in the public square, you have the right to do that.

The hospital's interim CEO Sandy Gomberg says the proposal was a signal to the union, not hospital workers. She says there's no gag order on employees.

Gomberg: The union has confused our position about their defamatory activity with the rights and responsibilities of individuals or employees in the organization.

Gomberg says the hospital wants workers to speak up and take action when they perceive that patient care or hospital operations need improvement.

Cruice leads the Pennsylvania Association of Staff Nurses and Allied Professionals. He says the proposal would have a chilling effect on nurses trying to advocate for their patients.

Cruice: Subjecting nurses and other professionals to discipline if they criticize publicly Temple's policies or any actions that may have happened in the hospital. We think that this would be very bad for patients, very bad for nurses and the other professionals who work there.

Gomberg says Temple will not tolerate defamatory or derogatory statements from union officials. She says there is no move to stifle the free-speech rights of workers.

Gomberg: It is not a gag order on our employees in any way, shape or form. It is our position that any of our employees should have the freedom to speak on any topic they like, in whatever forum they like to whomever they like.

Listen:

Carolyn Cannuscio (Photo: Caleb Rader)

"There is solid evidence that being exposed to violence or other forms of trauma during childhood has enduring health effects." – Urban health researcher – Carolyn Cannuscio

Urban health researchers at Penn equipped residents with disposable cameras and asked them to document where they live, work and play. It's an attempt to understand how health conditions vary across three neighborhoods with starkly different income levels.

Carolyn Cannuscio led the project.

Cannuscio: I think what pictures can do is they can first, help really tune into the details of how people are living. We can really observe the hard evidence in photographs of the nature of people's living environments.

'Park Grocery' (Photo: Elias Friedman for the Health of Philadelphia Photo-documentation Project)

City resident: When you go inside, it's a protective glass, it's like going into a prison or something. You shove your money in there, and then they shove your food out too you.

She says the corner store near her work supports an unhealthy, underground economy.

'Chinese Takeout' (Photo: Aaron Walker for the Health of Philadelphia Photo-documentation Project)

The exhibit is called Trauma, Trash, and Triumph. Researcher Carolyn Cannuscio says there is solid evidence that violence in childhood has enduring effects — both on well being and physical health. She says many participants reported that they feel boxed in by the violence in their neighborhood.

Cannuscio: That is crazy, that we can't secure a zone of safety for our children so that they can walk to the rec center three blocks away and play or exercise there.

'Stop and Go Ridge Ave.' (Photo: Hannah Johnston for the Health of Philadelphia Photo-documentation Project)

Cannuscio: So you'll see the poetry in the words of ordinary Philadelphians. You'll see that really living in a city makes you an expert on the health of the city.

What: Trauma, Trash, and Triumph: Images from the Health of Philadelphia Photo-documentation Project
When: Nov 5 – 20
Where: Fox Art Gallery
Cohen Hall at the University of Pennsylvania
Web site: http://www.visualepi.com/index.html

THIS WEEK'S TOPIC: Free or cheap health care

Growing numbers of people are finding themselves without health insurance — but that doesn't mean they are out of options.

Discounted insurance, free medicine, and sliding-scale pricetags: they're out there, and our next guests on Digest This can help you find them.

Discover what drug companies, state and federal governments, hospitals, doctors, and other organizations offer to help people get health care. Ask for advice or share what you've learned.

When: 12:00 noon Tues, November 10th.

Where: Right here. Click the button in the right sidebar at noon Tuesday to join the chat.

Moderator: Kerry Grens

Our guests are:
Before cofounding Health Advocate, Marty Rosen served as Head of Communications for Aetna U.S. Healthcare where he was responsible for directing all communications and overseeing the company’s brand. He was previously a marketing executive at NYLCare Health Plans and Sanus Corporation Health Systems.

Abbie Leibowitz, MD is a co-founder, chief medical officer and EVP of Health Advocate, Inc. Previously, Dr. Leibowitz served as chief medical officer and other senior positions for Aetna U.S. Healthcare. He also spent 12 years in private pediatric practice.

Katy Weeks, Health Care Navigator at the Philadelphia Unemployment Project. Ms. Weeks assists families and individuals in accessing affordable health care.

 

More info:
See Kerry Grens' story on free or cheap medical care for resources to help you find free or low-cost care.

Most of the home health aides at In Home Program rely on Septa to get to their patients. Christina Visco, the director of In Home Program, says some patients will not get a visit today.

Visco: We're trying to rent a van or one of the people who work there if they have a van that we can have someone pick them up and take them to their patients because the patients depend on our aides and they're not getting the care they need because, this strike, no one heard about it until they woke up this morning.

Visco says her aides bathe and feed their patients, and perform household chores. She says by tomorrow transportation will be arranged so that no one will miss a home health visit.