Consulo Indicium - 6/2/25
Information for your Consideration…
The Pathetic!! – Our newly minted DHHS Secretary – Robert F. Kennedy, Jr. – made a unilateral decision this past week to disallow COVID vaccinations for women who are pregnant and children. Not only was the US Centers for Disease Control not in the loop, but the combination of the Secretary plus the head of the Food and Drug Administration (FDA) simply reversed all of the recommendations on the topic unilaterally!! This is the implementation of the “de-sciencing of health care” by an unqualified leader who is simply exerting power without any rational data and/or process in place. Now – for my detractors who think I’m a shill for the Democrats, consider the following. This is not about being a “Republican” or anything similar. This is about the critical importance of science in making decisions related to public health and health care. I have supported prior Republican DHHS Secretaries, notably President Ronald Reagan’s first, Richard Schweiker (R), who, by the way, was a co-sponsor of Senator Ted Kennedy's (D-MA) Health Security Act, a bill proposing universal health coverage in America through a government-run program.[1]. The irony made the current direction of health care oversight seem even more “pathetic,” a word I seldom use.
Wait A Minute – About 10 minutes after I sent off my final FickFiles for the first of June, I decided to turn on the news, which I have ignored for the last 3 weeks. The lead discussion that was announced shortly after I turned it on was that the CDC staff had posted a notice that immunizations for pregnant women and children was encouraged!! Was this a revolt among the scientists? And, will there be other revolts in the coming weeks and months? You be the judge as this story will no doubt change even further before you received the files.
The Case of Water Fluoridation – The vast majority of USA dentists and pediatricians believe that fluoride provided in small doses, akin to what you would find in the water of USA cities' water supply, has contributed to the marked decline since 1945. It was at that point that many cities made the decision to introduce fluoridation into the nation’s water supply. You can also check out the one study that compared over 70+ studies on the topic which showed equivocal results on IQ variation. In addition, the comprehensive study of fluoride addition to the water supply included 74 studies that were compared, of which 52 were set aside due to internal study biases. Of the remaining 22 rated with low bias, the differential impact (my assessment) was marginal. Finally, none of the studies were derived from the USA. Rather they were all conducted in a wide range of countries with variable infrastructure, including: “Canada (n = 3), Denmark (n = 1), India (n = 12), Iran (n = 4), Mexico (n = 4), New Zealand (n = 1), Pakistan (n = 2), Spain (n = 1), and Taiwan (n = 1)”. Furthermore, if we remove the fluoride from the water, we will face another national problem as parents – in an effort to prevent cavities – will potentially “over medicate” children, creating a societal problem. In addition, if the cavity rate increases to the pre-1945 levels, we will also face a major shortage of dentists in the nation.
Some GOOD News: Overdose Deaths Decline – In a recent data release by the US Centers for Disease Control (CDC), there were “30,000 fewer U.S. drug overdose deaths in 2024,” or a marked reduction of 27% from 2023 when the nation experienced 110,000 deaths.” This represents the largest year-on-year decline since data was gathered. The only states that did not see a decline were South Dakota and Nevada, versus the experience of states like West Virginia and Ohio, which experienced the largest declines. Experts cited the availability of naloxone, the availability of addiction treatment programs, and the availability of “opioid lawsuit settlement money” in the billions of dollars level. Such outcomes are the result of focused public health policies emanating from the states over the last decade. Unfortunately, these programs are now at risk as reductions in funding appear to be moving forward from Congress by pushing the responsibility solely to the states rather than a combined initiative. The health care community needs to aggressively monitor the results over the next couple of years…
Gut Health and Longevity – I recently read an article by Heather Hurlock on the dietary contributions to our health. It’s a topic that I’ve taken greater interest in as a personal approach toward creating a more sustainable lifestyle. Or, as my wife chastises me on a regular basis: “Kevin, you need to eat six cups of fruits and vegetables every day.” What that means is putting aside the fast foods, fried foods and such. At the end of the day, our dietary intake impacts our “gut microbiota.” There is a framework that’s been developed by dietetics experts referred to as the Dietary Index for Gut Microbiota (DIGM). Items that many of us eat on a regular basis, which contribute to a reduction in gut health, include the following:
- Refined Grains – such as white bread and plain white rice.
- Processed Meats – sausage, bacon (Oy Vey!!!), deli meats, and any other meats that have high levels of nitrates.
- Red Meat – primarily from the high-fat red meats or highly processed meats due to the microbial shifts that are created in our intestinal systems.
- High-Fat Diets – where the percent of caloric intake exceeds 40% derived from fat.
So, why do these foods create such a negative impact? It relates to several factors that create ongoing, chronic damage to the intestinal barrier, resulting in systemic inflammation. The intestinal inflammation occurs because the intake of the above dietary items starves the bacteria, resulting in dietary wall inflammation. So, long story short, to reduce your DIGM score and increase your health, stay away from the above-noted processed foods and, in addition, reduce your risk of diabetes and other chronic diseases. Good luck. [NOTE: It’s hard for me to put aside “Carl’s Spicy Bacon”, a specialty available in Kittery, Maine. Perhaps I can reduce my intake to once per week 😊].
The Devastating Impact Of Staff Reductions At DHHS – While I truly believe that any large organization – such as DHHS, a multi-hospital system over multiple states, a large producer of technology services – can be improved through a thorough analysis of ongoing work and outcomes – the approach of “DOGE” will be catastrophic at best. DHHS staff have been reduced from a level of about 82,000 (which has not increased very much since the George W. Bush Administration) to about 62,000, or by about one-fourth of the existing staffing level. The final Musk Plan essentially consolidated the number of divisions and program areas from 28 to 15. For a comprehensive review and analysis, read about the staffing reductions published recently in Health Affairs. Simply “breaking” programs and initiatives through arbitrary staffing and program reductions is a massive national and global mistake. As the (previously premier) nation in the world, we hold an obligation (from my perspective) to help others develop their capabilities, services, infrastructure, and economies. Without healthy people, it is nearly impossible for nations to lift themselves out of poverty and economic distress. We can point to the destruction (I used that word intentionally) of the USAID program as an example of massive short-term thinking with long-range complications for the USA as an international leader. The health care community needs to take up this banner and push over the time in which this Administration exists to restore funding for international health programs!! It is our obligation to “make health care better” – not just for us in the USA but for the world as well!
Enhancing Medical Practice Through AI Integration – A recent study from the UK discovered that just over a quarter of physicians in the UK and Portugal used AI systems, with ChatGPT being the most popular of the available systems. In fact, in Portugal, it was reported that 87.1% of physicians report using AI systems on a daily basis for support of clinical decision-making. The concern is whether or not there is an evolving “over-reliance” upon AI systems to support care delivery, especially among the less experienced clinicians. Also, systems like ChatGPT cull information from a wide variety of available resources, some of which may not be fully vetted in a formal way – like the medical literature. In the present environment, AI systems provide variable analysis of information and inconsistent output that can confuse care delivery without adequate knowledge on the issues at hand. This becomes an important issue as some nations begin to use AI systems to support less trained clinicians (e.g., many countries in Africa) for delivering care services. While I am an “over-the-top” supporter of the evolving AI/ML systems and their potential contribution to care delivery – I also believe we need to be very prudent in how, where, and with whom these capabilities are delivered. All thoughts appreciated… For an overview of the topic, consider a review of a longer overview article in Medscape that provides a good analysis of the use and evolution of AI/ML in health care. In addition, there is an important report on the impact of AI integration in hospital operations through a survey of the nation’s hospitals. Check it out!!
Dementia and Hearing Loss – As an individual who is reaching the “elder” stage of life, I’ve become much more cognizant of not only dietary intake (SEE above note on gut microbiota 😊), I have also become aware of the literature on “hearing loss” and its association with dementia. In a recent study reported in MedPage Today a reported dementia may be accelerated with hearing lost playing “a bigger role in dementia than previously thought.” A sampling of about 3,000 elder adults revealed that upwards of 32% of incident dementia over a period of 8 years could be attributed to audiometric hearing loss. And, it relates to the severity of hearing loss. For example, those elders with mild hearing loss, the association was 16.2%. For moderate or greater hearing loss, 16.6%.” But, the associated incident was for “people ages 75 and older (30.5%), women (30.8%). For a review of the study, check out the publication in JAMA Otolaryngology-Heat & Neck Surgery.
