Home > Weekly Newsletters > General

MONDAY, Sept. 8 (HealthDay News) -- You spend less when paying with cash, and more when using credit cards, gift cards or gift certificates, according to a new study.

The findings, published in the September issue of the Journal of Experimental Psychology: Applied, also show that people spend less when they have to estimate expenses in detail.

"The more transparent the payment outflow, the greater the aversion to spending, or higher the 'pain of paying,' " researchers Priya Raghubir, of the Stern School of Business at New York University, and Joydeep Srivastava, of the Robert H. Smith School of Business at the University of Maryland, College Park, wrote.

The researchers asked participants to answer questions about how much they would spend using cash versus various cash equivalents in various buying scenarios. The scenarios included paying for a vividly described restaurant meal or estimating the expense to pay for a Thanksgiving dinner item by item rather than as a whole.

The researchers attributed the difference in spending behavior to the way cash can reinforce the pain of paying.

In another study, participants received either $1 in cash or a $1 "gift certificate" to buy candy. At first, they were more willing to spend the gift certificate than the cash. But after having the gift certificate for an hour, thus treating it like cash, the participants became less likely to spend it -- a sign that they had assimilated its value.

"The studies suggest that less transparent payment forms tend to be treated like [play] money and are hence more easily spent (or parted with)," the authors wrote. "Treating nonlegal tender as play money leads to overspending that authorities can warn consumers about."

More information

The American Psychological Association has more about how finances can affect your mental well-being  .

THURSDAY, Sept. 4 (HealthDay News) -- Cocaine and methamphetamine use among young adults in the United States fell significantly in 2007, while abuse of prescription drugs increased fairly dramatically, according to a new U.S. survey.

The 2007 National Survey on Drug Use and Health, which included about 67,500 Americans, was released Thursday by the Substance Abuse and Mental Health Services Administration (SAMHSA).

From 2006 to 2007, cocaine use among adults ages 18-25 decreased 23 percent to 1.7 percent, the annual report found, and methamphetamine use fell by a third to 0.4 percent.

However, the abuse of prescription pain relievers by young adults rose 12 percent to 4.6 percent, according to the survey.

The poll also found a significant decline in overall past-month illicit drug use among youth ages 12-17 -- dropping from 11.6 percent in 2002 to 9.5 percent in 2007. There were reductions in the use of almost every type of illicit drug, including marijuana, cocaine, hallucinogens, LSD, Ecstasy and methamphetamine, and in the abuse of such prescription drugs as pain relievers.

Alcohol use in this age group decreased from 17.6 percent in 2002 to 15.9 percent in 2007 and cigarette use declined from 13.0 percent in 2002 to 9.8 percent in 2007, according to the report, released at the start of the 19th annual National Alcohol and Drug Addiction Recovery Month.

The reductions in cocaine and methamphetamine use among adults ages 18-25 coincide with reductions in their use among American workers.

Since 2005, there has been a 50 percent reduction in the level of workplace positive drug tests for methamphetamine. Pricing and quality for "meth" also underwent changes: according to the report, in 2007 there was an 84 percent increase in average price per pure gram and a 26 percent decrease in methamphetamine purity.

In 2007, the number of workplace positive drug tests for cocaine decreased 19 percent to the lowest levels in the history of the workplace testing system. Also in 2007, there was a 10 percent decrease in cocaine purity and a 21 percent increase in the average price per gram of the drug, the survey found.

The report did find that illicit drug use among older adults -- those aged 55 to 59 -- more than doubled, to 4.1 percent, in 2007. The finding seems to confirm that baby boomers have continued their higher levels of substance abuse as they age.

"Our efforts against methamphetamine, cocaine, and other illegal drugs are working," John Walters, director of National Drug Control Policy, said in a SAMHSA news release. "The markets for these poisons are shrinking, and the deadly grip they hold on the lives of individuals, families, and communities is being countered."

But, he added, "when it comes to prescription drugs, we cannot afford to re-live the painful experiences we've had with illegal drugs. We must act quickly to increase awareness of the dangers of prescription drug abuse, decrease the illegal diversion of these products, and shore up safer practices for their prescription and distribution."

The survey also examined mental health issues and found that 24.3 million Americans aged 18 or older experienced serious psychological distress and 16.5 million Americans suffered at least one episode of major depression in 2007.

There's a strong association between substance abuse and mental health, the report noted. For example, adults 18 and older who had a major bout of depression in 2007 were more than twice as likely as other adults to have used illicit drugs -- 27.4 percent vs. 12.8 percent.

More information

The U.S. National Institute on Drug Abuse has more about drug abuse.

WEDNESDAY, Sept. 3 (HealthDay News) -- Physicians could dramatically reduce the number of suicides by restricting at-risk patients' access to guns and other highly lethal ways of killing themselves, say Harvard School of Public Health researchers.

"The temporary nature and fleeting sway of many suicidal crises is evident by the fact that more than 90 percent of people who survive a suicide attempt do not go on to die by suicide. A suicide attempt with a firearm rarely affords a second chance," the researchers said in an article in the Sept. 4 issue of the New England Journal of Medicine.

Among Americans, guns are used in more than half of all completed suicides. Studies estimate that one-third to four-fifths of all suicide attempts are impulsive, with 24 percent of victims taking less than five minutes between the decision to kill themselves and the actual attempt, while 70 percent take less than one hour.

Suicide attempts that involve drugs or cutting account for more than 90 percent of all suicidal acts but are fatal far less often than attempts involving guns.

A Harvard Injury Control Research Center Web site provides guidance for physicians on how to assess and restrict an at-risk patient's access to lethal means, including advice on how to approach family members about the possible presence of a gun in the home and how to suggest to family members that guns be moved out of the house temporarily, or locked and stored more securely.

The Harvard team noted that suicidal crises are often caused by an immediate stressor, such as the loss of a job, the breakup of a romantic relationship, or a run-in with police. By intervening to get guns out of patients' reach during these critical times, physicians can help prevent many suicides.

"The suicide prevention field is where the motor vehicle safety movement was 50 years ago and the patient safety movement 20 years ago: The focus of prevention is almost exclusively on the individual," said study author Matthew Miller, associate director of the Harvard Injury Control Research Center. "Psychiatrists, psychologists and other medical professionals tend naturally to focus on the mental health of the individual patient, one patient at a time."

"We are proposing a population-based approach to reducing suicide. This approach recognizes that the physical environment [e.g., the availability of household guns in the U.S., the toxicity of pesticides in Sri Lanka, a frequent method of suicide there] can have a profound effect on the likelihood of completed suicide -- and that the physical environment can be modified to save lives. This approach is based on understanding that the number of Americans who die each year can be reduced not only by reducing the rate at which Americans attempt suicide [the traditional target of screening and treatment prevention efforts] but also, and perhaps most dramatically, by making it less likely that suicide attempts prove fatal. One of the best ways to reduce the probability that an impulsive suicidal act proves fatal is to remove firearms from the home."

Miller and study co-author David Hemenway noted that a number of U.S. studies have concluded that a gun in the home is associated with a two-to-10-times increased risk of suicide compared to homes without guns. Research has also found that the higher risk of completed suicide in homes with firearms applies not only to the gun owner but also to the gun owner's spouse and children.

"Too many clinicians seem to believe that anyone who uses a gun to attempt suicide must be serious enough that if a gun were not available, they would find an equally lethal way to kill themselves," said Hemenway, director of the Harvard Injury Control Research Center. "This belief is invalid. Physicians need to embrace all effective measures that can prevent completed suicide, including means restriction."

More information

Mental Health America has more about suicide  .

THURSDAY, Aug. 7 (HealthDay News) -- The vast majority of Americans are dissatisfied with the U.S. health care system, and 82 percent think it needs to be overhauled, a new survey found.

"There is a broad view by the public that our health care system needs a full overhaul, either to be totally rebuilt or reformed," said Cathy Schoen, senior vice president for research and evaluation at The Commonwealth Fund, which commissioned the survey.

The survey, titled Public Views on U.S. Health Care System Organization: A Call for New Directions, questioned 1,004 adults on their views of the U.S. health care system.

The frustration with the current system stems from a shared experience of inefficient and time-consuming care, Schoen said. "Often paperwork doesn't arrive, or your records aren't available when you show up. There are also concerns about getting timely access to care," she said.

Schoen thinks the survey clearly indicates that Americans want better organized care. "Also, having a regular doctor who is available to see you, getting timely referrals, and having more affordable care are important to people," she said.

Nine out of 10 people surveyed said the presidential candidates should propose reforms that would improve the quality of health care, ensure that all Americans have affordable care, and reduce the number of uninsured.

Eight in 10 people said they supported efforts to improve health care performance, access, quality and cost. For example, one in three said their doctors ordered tests that had already been done or recommended unnecessary treatment.

Most of the people surveyed expressed frustration with the way their health care was managed. For instance, 47 percent said their health care was poorly coordinated; this lack of coordination included not being informed about test results and having to make several calls to get the results.

In addition, survey respondents felt that important medical information wasn't shared between doctors and nurses or communicated between their doctor and specialists.

Nine of 10 people said it was important that they have one place or one doctor responsible for their primary care and coordination of all their care. And, nine of 10 wanted easier access to their medical records.

Seventy-three percent said they had difficulty getting a doctor appointment, phone advice, or after-hours care without going to the emergency department. Among insured patients, 26 percent said it was hard to get same- or next-day appointments when they were sick, and 39 percent said it was difficult to reach their doctors by phone when they needed them.

Dr. Steffie Woolhandler, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program, thinks Americans are being ill served, given the amount of money spent on health care in the United States.

"We now spend twice per capita what other developed nations spend on care, yet we die younger, have worse access to care, and are even behind on medical computerization," Woolhandler said. "These survey results are a clarion call for the health financing mechanism used elsewhere -- nonprofit national health insurance."

Kathleen D. Stoll, director of Health Policy at Families USA, thinks the survey reinforces what is already known about Americans' frustration with the current health care system.

"We have seen the number of uninsured rise. We have seen people facing higher out-of-pocket costs. We see layers of complications in terms of billing problems," she said. "All that adds up to an American public that is quite ready for health care reform."

In a separate report titled Organizing the U.S. Health Care System for High Performance, The Commonwealth Fund outlined its strategies for improving the health care system.

Among the recommendations was moving away from fee-for-service payments and paying doctors and hospitals based on the quality of care. In addition, the report recommends patient incentives that reward them for choosing doctors and hospitals that provide the most efficient, highest quality care.

To achieve these goals, the report recommends removing barriers that prevent doctors from sharing essential information; accrediting doctors and hospitals based on quality measures; making patient information more available to doctors at the point of care; and enforcing clear accountability for patient care.

Moreover, doctors and other health care professionals should be trained to work as teams. And, switching to electronic health records should be mandated and supported by the federal government, according to the report.

More information

For more on health care reform, visit The Commonwealth Fund  .