National health expenditures are expected to hit $3.35 trillion this year, most of it spent on care for one person at a time: doctors’ visits, hospital stays, prescription drugs. But to really improve the health of Americans, two new studies suggest, we also need to aim for a culture of health in communities as a whole.

In one of two studies out last week in the journal Health Affairs, researchers found that deaths from preventable diseases, such as cardiovascular disease and diabetes, declined significantly over time in communities with tight-knit health networks, such as hospitals and community centers working together to promote exercise or track a flu outbreak. In the second, a team found that cohesive neighborhoods foster good mental health during adolescence, with life-long benefits for children who grow up there.

“Building a culture of health is about how we can get our communities to place greater value on health and well-being,” says Glen Mays at the University of Kentucky, author of the first paper on preventable deaths. “Communities and members of the public absolutely have a clear role in shaping the environment for health.”Read the entire article on The Boston Globe

What Should You Choose: Time or Money?

Given the choice between more time or more money, which would you pick? For a beach vacation, you might pay more for a direct flight to gain a couple of extra hours getting sand between your toes. On the other hand, you might take a better-paying job that requires late nights at the office.

One of us, Professor Hershfield, recently faced such a choice. He was invited to teach a weekend seminar out of state. But he had a baby girl at home, born 12 weeks earlier. The pay would offset the costs of child care, but the job would require two days of not oohing, aahing and bonding with the baby.

The value of the money was easy to quantify. But it was harder to put a value on the amount of time that would be lost with the family. He determined that there were only 222 weekends left before the baby would start kindergarten, when quality family hours would give way to car pools to friends’ houses.Read the entire article on The New York Times

Men make more money just six years after enrolling in college than women do 10 years after entering school, a wage gap that persists across public and private four-year universities, according to a study released Tuesday by the Center for American Progress, a left-leaning think tank.

The study used data from the College Scorecard, a government database that includes earnings for students who received financial aid, to gauge how quickly the gender wage gap sets in after college. The analysis focuses on students who entered school in 2001 or 2002, the most recent cohort that includes six-year and 10-year data, and found men at the six-year mark pulling in roughly $4,000 a year more than women at 10 years.

‘‘We know there’s a gender wage gap, but this visualizes what that looks like at every college,’’ said Antoinette Flores, author of the study and a policy analyst at the center. Flores created an interactive database that lets people look up the average earnings by gender at every public and nonprofit private four-year school.Read the entire article on The Boston Globe

A matter of judgment

A THOROUGH psychiatric exam assesses for mood and psychosis. It also assesses for thinking. The screening tests can feel a little fly-by, like hovering over a very large piece of territory before deciding where to land. There is the spelling of WORLD forwards and backwards to gauge attention; three words recalled at five minutes to test memory; drawing an imaginary clock and setting its hands to precisely 10:10, to rule out early dementia.

For many years, there was also a ridiculous yet comforting question about judgment: If you saw a sealed, stamped envelope lying on the street, would you mail it?

In those days, we knew the answer with certainty. You stooped down, picked up the envelope, popped it into the nearest mailbox, and got on with the day. In some imaginary place, some imaginary reader was waiting, and this was the right thing to do. What other choice could a decent person make?Read the entire article on The Boston Globe

When you wake up this Sunday, it will probably be a bit brighter than usual, and the day will plunge into darkness much earlier in the afternoon — at 4:31 pm. Welcome to the return of standard time.

The extra hour of sleep gained during the switch from daylight saving time to standard time feels great. But the time change overall may negatively affect the mental health of some people, according to a new study in the journal Epidemiology. Researchers in Denmark have documented an 8 percent increase in the number of people diagnosed with depression in the month following the time change.

“Depression is a fairly prevalent disorder, so 8 percent actually corresponds to quite a number of cases,” says senior author Soren D. Ostergaard of Aarhus University Hospital. To combat the effect, he recommends that individuals try to get out into the sunlight as much as possible during the day, for example by exercising outdoors in the morning or taking a walk at lunch.Read the entire article on The Boston Globe

Recently, when I picked up my 4-year-old daughter from preschool she announced that she wanted to get a new toy. I cringed, preparing for a battle.

Later, my son, a first-grader, whipped out my iPhone and pulled up the $50 pair of sneakers he’s obsessed with. “I need these,” he said.

The other night, they actually cried when my husband and I told them we were taking them out to dinner. They didn’t like the restaurant we chose: They wanted pizza.Read the entire article on The Boston Globe

Children know lying is wrong from a young age, but that doesn’t stop them from doing it. Most parents (myself included) wonder how to encourage kids to tell the truth, whether it be about a broken lamp or a missed homework assignment.

A new study suggests that parental behavior can help steer children to tell the truth. In work published online this month in the Journal of Experimental Child Psychology, researchers found that children who anticipate a positive reaction from their parents after a confession are more likely to come forward, even if they might be punished.

“A parent who stays calm in the moment — listening to their kid and expressing pleasure their child has been honest — is more likely to have that happen again,” says study author Craig Smith of the University of Michigan Center for Human Growth and Development. The findings support past research that has shown celebrating honesty as a virtue encourages kids to be more truthful.Read the entire article on The Boston Globe

“You look tired,” my mother recently said to me as my 4-year-old daughter and I were ending a Facetime call with her. “Make sure you carve out some time for yourself to recharge.”

Free time felt like a novel concept to me. Between juggling my work schedule with my daughter’s preschool day, my first grader’s after-school activities, weekend birthday parties and play dates, and maintaining our household I was flat out. Exercise seemed impossible to fit in, and I was always tired. I was snappy with my husband too frequently and my patience with the kids was often short.Read the entire article on The Boston Globe

IMAGINE THAT you are a medical doctor. You need to tell one of your patients that he has advanced-stage pancreatic cancer, an almost incurable condition. You learn that your patient’s only daughter is getting married five months from now. Without treatment, your patient has about a year left to live. Chemotherapy would increase his chances of being alive in five years by about 20 percent but would also double his chances of dying before his daughter’s wedding. What do you tell him? Of course, the choice is by no means easy or clear-cut.

Doctors are scientists who operate in a world of statistics, odds, and probability. Yet they’ve long been taught that when dealing with patients they should convey a reassuring level of confidence and certainty. As a result, patients expect their doctors to give them a clear diagnosis and a straightforward course of treatment.

But now that information about every medical condition imaginable is just a few clicks away, experts are asking whether doctors’ apparent certainty when communicating with their patients actually does more harm than good. With the information overload brought by the progress of medicine and technology, answers are rarely black or white. Medical schools are only just starting to teach doctors how to deal with this, and patients’ expectations haven’t adjusted, either.Read the entire article on The Boston Globe

You May Want to Marry My Husband

I have been trying to write this for a while, but the morphine and lack of juicy cheeseburgers (what has it been now, five weeks without real food?) have drained my energy and interfered with whatever prose prowess remains. Additionally, the intermittent micronaps that keep whisking me away midsentence are clearly not propelling my work forward as quickly as I would like. But they are, admittedly, a bit of trippy fun.Read the entire article on The New York Times

Last year, my mother, a few weeks before a milestone birthday, learned she needed major surgery. The circumstances were not life-threatening. She would not be in the hospital long. But the recovery would still be protracted and restrict her ability to care for my father, who has Parkinson’s.Read the entire article on The New York Times

About one in six American adults reported taking at least one psychiatric drug, usually an antidepressant or an anti-anxiety medication, and most had been doing so for a year or more, according to a new analysis. The report is based on 2013 government survey data on some 37,421 adults and provides the finest-grained snapshot of prescription drug use for psychological and sleep problems to date.Read the entire article on The New York Times

All in a day’s (and night’s) work

As soon as he awakes, Brian Porrell checks his e-mail, sometimes firing off a message before he gets out of bed. He makes calls during his commute to the Waltham staffing firm WinterWyman, spends 10 to 12 hours at the office and out visiting clients, and keeps his phone by his side at night, checking work e-mails while he watches sports on TV.

Like many workers today, Porrell, 30, is on the job wherever he is — and he doesn’t count out-of-office exchanges in his 50-plus hour week.

The millennial generation, the first to grow up with smartphones in their hands, is often stereotyped as lazy and entitled. But workplace experts say workaholics are common among 19-to-35-year-olds, perhaps more so than among older members of Generation X and baby boomers.Read the entire article on The Boston Globe

The End of Identity Liberalism

It is a truism that America has become a more diverse country. It is also a beautiful thing to watch. Visitors from other countries, particularly those having trouble incorporating different ethnic groups and faiths, are amazed that we manage to pull it off. Not perfectly, of course, but certainly better than any European or Asian nation today. It’s an extraordinary success story.Read the entire article on The Boston Globe

WASHINGTON — It used to be that, along with certain tax benefits, one advantage to being married was having more sex than singletons.

That benefit is steadily diminishing, according to a study released Tuesday. Overall, American adults are having less sex than they did a quarter-century ago, with married people showing the most dramatic decline of all.

The paper, published in the journal Archives of Sexual Behavior, showed a drop across gender, race, region, education level, and work status.Read the entire article on The Boston Globe

NEW YORK — Feel down about getting older? Wish your life was better? Worried about all the problems that come with age?

A new survey suggests you need only wait: Many pessimistic feelings held by people earlier in life take an optimistic turn as they move toward old age. Even hallmark concerns of old age — about declining health, lack of independence, and memory loss — lessen as Americans age.

‘‘The younger generation is less optimistic,’’ said Dr. Zia Agha, chief medical officer at West Health, a nonprofit focused on aging issues whose related research institute released the poll Wednesday with the research organization NORC at the University of Chicago. ‘‘Perhaps as they age they will build resilience and they build the capacity that will help them cope better.’’Read the entire article on The Boston Globe

Kay Abramowitz has been working, with a few breaks, since she was 14. Now 76, she is a partner in a law firm in Portland, Ore. — with no intention of stopping anytime soon. “Retirement or death is always on the horizon, but I have no plans,” she said. “I’m actually having way too much fun.”

The arc of women’s working lives is changing — reaching higher levels when they’re younger and stretching out much longer — according to two new analyses of census, earnings, and retirement data that provide the most comprehensive look yet at women’s career paths.

Overall, the paths look much more like men’s careers than they used to. Women are more likely than in previous generations to work at almost every point in their lives, including in their 20s and 30s when they often used to be home with children. Now, if mothers take breaks at all, it’s often not until their late 30s or early 40s — and those who leave are likely to return to the labor force.Read the entire article on The Boston Globe

CHICAGO — Gorging on bacon, skimping on nuts? These are among food habits that new research links with deaths from heart disease, strokes, and diabetes.

Overeating or not eating enough of healthful foods and nutrients contributes to about 45 percent of US deaths from these causes, the study suggests.

‘‘Good’’ foods that were under-eaten include: nuts and seeds, seafood rich in omega-3 fats including salmon and sardines; fruits and vegetables; and whole grains.Read the entire article on The Boston Globe

Working parents often feel guilty for not spending more time with our children. But it turns out we’re doing well compared to parents 50 years ago, according to a new study of parental involvement since the 1960s.

Between 1965 and 2012, parents in 10 of 11 Western nations all showed a dramatic increase in the amount of time spent with their kids. That’s a very good thing: When a parent spends more time with a child, it has been shown to improve his or her language skills, brain development, social behavior, and more.

“Not just moms but also dads are getting into the act spending more time with their children,” says Judith Treas, a sociologist at the University of California, Irvine, and co-author of the paper, published recently in the Journal of Marriage and Family.Read the entire article on The Boston Globe

AMERICA’S HEALTH CRISIS is really three crises rolled into one. The first is public health: America’s life expectancy is now several years below that of many other countries, and, for some parts of the population, life expectancy is falling. The second is health inequality: The gaps in public health according to race and class are shockingly large. The third is health care cost: America’s health care is by far the costliest in the world.

Obamacare certainly did not solve these crises. Its main positive contribution has been to expand health coverage. Americans without health insurance fell from around 15.5 percent of the population in 2010 to around 9.1 percent today, a significant decline. Yet health care premiums are once again soaring, and the deeper causes of poor health are not being properly addressed. Obamacare amounted to a limited patch on a flawed system.

The numbers tell the story of the three crises. First, US health outcomes are actually below the averages of other high-income countries in the Organization for Economic Co-operation and Development, or OECD. US life expectancy at birth in 2013 stood at 78.8 years, almost two years below the OECD average of 80.5 years. The United States also had higher-than-average infant mortality, a greater incidence of low-birth-weight babies, and a higher incidence of both breast cancer and prostate cancer.Read the entire article on The Boston Globe

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