Archive for the ‘Health’ Category
Ariana Eunjung Cha has an interesting albeit infuriating article in the Washington Post:
Cancer patients taking high doses of opioid painkillers are often afflicted by a new discomfort: constipation. Researcher Jonathan Moss thought he could help, but no drug company was interested in his ideas for relieving suffering among the dying.
So Moss and his colleagues pieced together small grants and, in 1997, received permission to test their treatment. But not on cancer patients. Federal regulators urged them to use a less frail — and by then, rapidly expanding — group: addicts caught in the throes of a nationwide opioid epidemic.
Suddenly, Moss said, investors were knocking at his door.
“As clinicians, we wanted to help palliative patients,” said Moss, a professor and physician at University of Chicago Medicine. “The company that bought our work saw a broader market.”
Today, Moss’s side project is hailed as the next billion-dollar drug. And the once-disinterested pharmaceutical industry is bombarding doctors and the public with information about a serious, if previously unrecognized, condition common among the millions of Americans who take prescription painkillers. They call it “opioid-induced constipation,” or “OIC.”
The story of OIC illuminates the opportunism of pharmaceutical innovators and the consequences of a heavily drug-dependent society. Six in 10 American adults take prescription drugs, creating a vast market for new meds to treat the side effects of the old ones.
Opioid prescriptions alone have skyrocketed from 112 million in 1992 to nearly 249 million in 2015, the latest year for which numbers are available, and America’s dependence on the drugs has reached crisis levels. Millions are addicted to or abusing prescription painkillers such as OxyContin, Vicodin and Percocet. Statistics from the Centers for Disease Control and Prevention show that, from 1999 to 2014, more than 165,000 people died in the United States from prescription-opioid overdoses, which have contributed to a startling increase in early mortality among whites, particularly women — a devastating toll that has hit hardest insmall towns and rural areas.
The pharmaceutical industry’s response has been more drugs. The opioid market — now worth nearly $10 billion a year in sales in the United States — has expanded to include a growing universe of medications aimed at treating secondary effects rather than controlling pain.
There’s Suboxone, financed and promoted by the U.S. government as a safer alternative to methadone for those trying to break their dependence on opioids. There’s naloxone, the emergency injection and nasal spray carried by first responders to treat overdoses. And now there’s Relistor, the drug based on Moss’s work, and a competitor, Movantik, for constipation.
In colorful charts designed to entice investors, numerous pharmaceutical makers tout the “expansion opportunity” that exists in the “opioid use disorders population.”
Indivior, a specialty pharmaceutical company listed on the London Stock Exchange, sees “around 2.5m potential patients, the majority of whom are addicted to prescription painkillers,” as opposed to illicit drugs such as heroin. Another company, New Jersey-based Braeburn Pharmaceuticals,highlights “growth drivers” for the market, noting that millions of additional Americans not yet identified are also likely to be dependent on opioid painkillers.
Analysts estimate that each of these submarkets — addiction, overdose and side effects — is worth at least $1 billion a year in sales. These economics, experts say, work against efforts to end the epidemic.
If opioid addiction disappeared tomorrow, it would wipe billions of dollars from the drug companies’ bottom lines.A potent product
From a profit-making standpoint, opioids are a potent product. Chronic use can cause myriad side effects that usually are mild enough to keep people taking painkillers but sufficiently uncomfortable to send them back to the doctor.
Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, said this domino effect can turn a patient worth a few hundred dollars a month into one worth several thousand dollars a month.
“Many patients wind up very sedated from opioids, and it’s not uncommon to give them amphetamines to make them more alert. But now they can’t sleep, so they get Ambien or Lunesta. The amphetamines also make them anxious, paranoid and sweaty, and that means even more drugs,” said Kolodny, who also serves as chief medical officer to Phoenix House, a nonprofit organization that offers drug and alcohol treatment in 10 states and the District.
Women, in particular, are ideal customers [probably should say “victims” – LG] . . .
The system, which is supposed to protect the public, is breaking down left and right. Here’s the latest example, reported by Melody Petersen in the LA Times:
Many thousands of Californians are dying every year from infections they caught while in hospitals. But you’d never know that from their death certificates.
Sharley McMullen of Manhattan Beach came down with a fever just hours after being wheeled out of a Torrance Memorial Medical Center operating room on May 4, 2014. A missionary’s daughter who worked as a secretary at Cape Canaveral, Fla., at the height of the space race, McMullen, 72, was there for treatment of a bleeding stomach ulcer. Soon, though, she was fighting for her life.
On her medical chart, a doctor scribbled “CRKP,” an ominous abbreviation for one of the world’s most lethal superbugs, underlining it three times.
Doctors tried antibiotic after antibiotic. But after five weeks in the hospital, mostly in intensive care and on morphine because of the pain, McMullen died.
Her death certificate does not mention the hospital-acquired infection or CRKP, however. Instead, her doctor wrote that McMullen had died from respiratory failure and septic shock caused by her ulcer.
The doctor’s conclusion outraged Shawn Chen, McMullen’s daughter.
“It should say she died of an infection she got in the hospital,” said Chen. “She was so hardy. She would have made it through if it wasn’t for this infection.”
Dr. Yasmeen Shaw, who treated McMullen in the ICU and filled out the death certificate, said she was following directions from health officials by recording the underlying cause of death, which in her opinion was the perforated ulcer.
“Everything that happened to her health is a consequence of the initial condition she came in with,” Shaw said. “Had the patient not have had a perforated ulcer they wouldn’t have been in the hospital in the first place.”
An epidemic of hospital-acquired infections is going unreported, scientists have found.
University of Michigan researchers reported in a 2014 study that infections – both those acquired inside and outside hospitals – would replace heart disease and cancer as the leading causes of death in hospitals if the count was performed by looking at patients’ medical billing records, which show what they were being treated for, rather than death certificates.
“Even if one person dies from a hospital-acquired infection, it’s one too many,” said Dr. Chesley Richards, who oversees the Centers for Disease Control and Prevention’s Center for Health Statistics and who met recently with a group of families to discuss the misleading death certificates.
California does not track deaths from hospital-acquired infections. And unlike two dozen other states, California does not . . .
Shelly Fan has a post at Scientific American that will be of interest to those who follow a low-carb, high-fat diet:
Disclaimer: First things first. Please note that I am in no way endorsing nutritional ketosis as a supplement to, or a replacement for medication. As you’ll see below, data exploring the potential neuroprotective effects of ketosis are still scarce, and we don’t yet know the side effects of a long-term ketogenic diet. This post talks about the SCIENCE behind ketosis, and is not meant in any way as medical advice.
The ketogenic diet is a nutritionist’s nightmare. High in saturated fat and VERY low in carbohydrates, “keto” is adopted by a growing population to paradoxically promote weight loss and mental well-being. Drinking coffee with butter? Eating a block of cream cheese? Little to no fruit? To the uninitiated, keto defies all common sense, inviting skeptics to wave it off as an unnatural “bacon-and-steak” fad diet.
Yet versions of the ketogenic diet have been used to successfully treat drug-resistant epilepsy in children since the 1920s – potentially even back in the biblical ages. Emerging evidence from animal models and clinical trials suggest keto may be therapeutically used in many other neurological disorders, including head ache, neurodegenerative diseases, sleep disorders, bipolar disorder, autism and brain cancer. With no apparent side effects.
Sound too good to be true? I feel ya! Where are these neuroprotective effects coming from? What’s going on in the brain on a ketogenic diet?
Ketosis in a nutshell
In essence, a ketogenic diet mimics starvation, allowing the body to go into a metabolic state called ketosis (key-tow-sis). Normally, human bodies are sugar-driven machines: ingested carbohydrates are broken down into glucose, which is mainly transported and used as energy or stored as glycogen in liver and muscle tissue. When deprived of dietary carbohydrates (usually below 50g/day), the liver becomes the sole provider of glucose to feed your hungry organs – especially the brain, a particularly greedy entity accounting for ~20% of total energy expenditure. The brain cannot DIRECTLY use fat for energy. Once liver glycogen is depleted, without a backup energy source, humanity would’ve long disappeared in the eons of evolution.
The backup is ketone bodies that the liver derives primarily from fatty acids in your diet or body fat. These ketones – ?-hydroxybutyrate (BHB), acetoacetate and acetone – are released into the bloodstream, taken up by the brain and other organs, shuttled into the “energy factory” mitochondria and used up as fuel. Excess BHB and acetoacetate are excreted from urine, while acetone, due to its volatile nature, is breathed out (hence the characteristically sweet “keto breath”). Meanwhile, blood glucose remains physiologically normal due to glucose derived from certain amino acids and the breakdown of fatty acids – voila, low blood sugar avoided!
Brain on ketones: Energetics, Oxidation and Inflammation
So the brain is happily deriving energy from ketones – sure, but why would this be protective against such a variety of brain diseases?
One answer may be energy. Despite their superficial differences, many neurological diseases share one major problem – deficient energy production. During metabolic stress, ketones serve as an alternative energy source to maintain normal brain cell metabolism. In fact, BHB (a major ketone) may be an even more efficient fuel than glucose, providing more energy per unit oxygen used. A ketogenic diet also increases the number of mitochondria, so called “energy factories” in brain cells. A recent study found enhanced expression of genes encoding for mitochondrial enzymes and energy metabolism in the hippocampus, a part of the brain important for learning and memory. Hippocampal cells often degenerate in age-related brain diseases, leading to cognitive dysfunction and memory loss. With increased energy reserve, neurons may be able to ward off disease stressors that would usually exhaust and kill the cell.
A ketogenic diet may also DIRECTLY inhibit a major source of neuronal stress, by -well- acting like a blueberry. Reactive oxygen species are unfortunate byproducts of cellular metabolism. Unlike the gas Oxygen, these “oxidants” have a single electron that makes them highly reactive, bombarding into proteins and membranes and wrecking their structure. Increased oxidants are a hallmark of aging, stroke and neurodegeneration.
Ketones directly inhibit the production of these violent molecules, and enhance their breakdown through increasing the activity of glutathione peroxidase, a part of our innate anti-oxidant system. The low intake of carbohydrates also directly reduces glucose oxidation (something called “glycolysis”). Using a glucose-like non-metabolized analogue, one studyfound that neurons activate stress proteins to lower oxidant levels and stabilize mitochondria.
Due to its high fat nature, keto increases poly-unsaturated fatty acids (PUFAs, such as DHA and EPA, both sold over-the-counter as “brain healthy” supplements), which in turn reduces oxidant production and inflammation. Inflammatory stress is another “root of all evil”, which PUFAs target by inhibiting the expression of genes encoding for pro-inflammatory factors.
Neurons on Ketones: Dampen that enthusiasm!
Excited neurons transmit signals, process information and form the basis of a functioning brain. OVER-excited neurons tend to die.
The brain teeters on a balance between excitation and inhibition through two main neurotransmitters, the excitatory glutamate and the inhibitory GABA. Tilt the scale towards glutamate, which occurs in stroke, seizures and neurodegeneration, and you get excitotoxicity. In other words, hyper-activity is toxic.
Back in the 1930s, researchers found that direct injection of various ketone bodies into rabbits prevented chemically-induced seizures through inhibiting glutamate release, but the precise mechanism was unclear. A recent study in hippocampal neurons showed that ketones directly inhibited the neuron’s ability to “load up” on glutamate – that is, the transmitter can’t be packaged into vesicles and released – and thus decreased excitatory transmission. In a model of epilepsy that used a chemical similar to glutamate to induce damage, the diet protected mice against cell death in the hippocampus by inhibiting pro-death signaling molecules. On the other end of the excitation-inhibition balance, ketones increase GABA in the synapses (where neurotransmitters are released) of rats and in the brains of some (but not all) epileptic humans subjects. This increase in inhibition may confer both anti-seizure effects and neuroprotection, though data is still scant.
Then there are some fringe hypotheses. . .
I think the DEA is suffering from severe anxiety because of the changing attitudes toward the War on Drugs, which has turned out to be enormously expensive, extremely destructive of civil and human rights (not to mention the governments of Mexico, Colombia, and other countries), totally ineffective, and seems to do much more harm than would be done if drugs were legalized and addiction treated medically instead of criminally. (BTW, a very interesting drug-war movie showing some outcomes of the War on Drugs is available now on Amazon Prime: Sicario, with Emily Blunt, Benicio Del Toro, and Josh Brolin: very well done.) The DEA’s anxiety is played out in its absolute refusal to face facts (e.g., saying that marijuana has no medical use, when in fact it does and has helped in pain management and PTSD without the drawbacks of severe opioid addiction that results from opioid painkillers).
Philip Smith reports in the Drug War Chronicles:
In a last ditch bid to stop the DEA from criminalizing an herb widely hailed for its ability to treat pain, depression, and anxiety, and help people wean themselves from more dangerous opioid pain relievers, a bipartisan group of lawmakers sent a letter to the agency Monday asking it to reconsider its decision to place kratom on Schedule I of the Controlled Substances Act.
Kratom is a southeast Asian herb made from the leaves of Mitragyna speciose, a tree related to the coffee plant. In small doses, it has a mild stimulant effect, but in larger doses, it acts like a mild opioid. To be precise, the DEA has moved to criminalize not the herb itself, but two alkaloids, mitragynine and 7-hydroxmitragynine, which activate opioid receptors in the brain.
Last month, the DEA exercised its emergency scheduling powersin announcing that it was moving kratom to Schedule I, effective at the end of this week. The drug agency said kratom poses “an imminent hazard to public safety,” citing only press reports of some 15 deaths linked to kratom use. But in at least 14 of those cases, the victims were also using other drugs or had pre-existing life-threatening conditions. (Meanwhile, some 25,000 people died of prescription drug overdoses last year.)
Kratom users, who could number in the millions, immediately raised the alarm, organizing campaigns to undo the decision and lobbying Congress for help. That’s what sparked Monday’s letter from 51 lawmakers, including 22 Republicans.
“This significant regulatory action was done without any opportunity for public comment from researchers, consumers, and other stakeholders,” reads the letter, drafted by Reps. Mark Pocan (D-WI) and Matt Salmon (R-AZ). “This hasty decision could have serious effects on consumer access and choice of an internationally recognized herbal supplement.”
Given the ongoing high level of heroin and prescription opioid use and the associated overdose deaths, he DEA was hypocritical in mounting a campaign against kratom, the lawmakers said.
“The DEA’s decision to place kratom as a Schedule I substance will put a halt on federally funded research and innovation surrounding the treatment of individuals suffering from opioid and other addictions — a significant public health threat,” they wrote.
The lawmakers called on DEA Administrator Chuck Rosenberg to delay the emergency scheduling and instead “engage consumers, researchers, and other stakeholders, in keeping with well-established protocol for such matters.”
Since first emerging in the US a few years ago, kratom has been unregulated at the federal level, although the Food & Drug Administration began seizing shipments of it in 2014. At the state level, a half dozen states have entertained moves to ban it, but such efforts failed in all except Alabama. In other states, kratom advocates have managed to turn bans into regulation, with age restrictions and similar limits.
A ban on kratom would be disastrous, said Susan Ash, founder of the American Kratom Association. Ash said she had been diagnosed with fibromyalgia in 2006 and ended up essentially disabled under the weight of 13 different prescriptions, including opioids, benzodiazepines, and amphetamines (to counter the opioids and the benzos). She became addicted to the opioids and finally tried kratom as a last resort.
“I didn’t really want to have anything to do with a plant, but I decided to try it, and it worked day and night,” she said Tuesday. “Within two weeks, I went from home bound to starting this organization.”
With the kratom ban looming, her members are facing “our darkest hour,” Ash said. “Our average member is a middle-aged woman, about 40% of whom have experienced addition, and tens of thousands of them are using it as an alternative to pharmaceutical medications because they believe it is safer and more natural. Now, people are saying they are going to lose their quality of life, that they will be re-disabled. People are terrified. What we need is regulation, not prohibition.”
“Despite the moral, political, and scientific consensus that drug use and addiction are best treated as public health issues, the DEA wants to subject people with kratom to prison sentences,” said Jag Davies, director of communications strategy for the Drug Policy Alliance (DPA), which is also fighting the ban. “The DEA’s move would also effectively halt promising scientific investigations into the plant’s uses and medicinal benefits, including helping many people struggling with opioid addiction.”
The scientific studies are promising indeed. Researchers at Columbia University just published a study on kratom alkaloids and found that they activate opioid receptors in a way that doesn’t trigger respiratory depression, the lethal side effect of most opioids. Such research could lead to the “holy grail” of narcotic analgesics, a painkiller that doesn’t kill users and doesn’t get them addicted. . .
The DEA has never shown the slightest interest in scientific findings. They operate purely from a power-based outlook: if they have the power to do something, they feel that justifies doing it.
From the article:
. . . CRISPR/Cas9 has been taking the world by storm since it was first developed in 2013by researchers at the Broad Institute. The gene-editing technology works by taking advantage of a property of DNA called clustered regularly interspaced short palindromic repeats, or small repetitions of DNA base sequences. These sequences produce an enzyme called Cas9, which essentially functions as a pair of genetic scissors which can cut the DNA sequences at certain points to add or remove small DNA segments.
Yet the ease with which researchers and companies like Monsanto could use gene-editing technology to irreversibly fuck with living things like people and plants has also raised concern that the technology might become widely deployed without understanding the consequences. This is why the “responsible use” of CRISPR/Cas9 cited by Rozen is a key stipulation in Monsanto’s latest move to corner the GMO industry (as the most recent acquisition of the chemical company Bayer, Monsanto and its affiliates now control a full 25 percent of the world’s seeds and pesticides).
Monsanto has never been a company that has been particularly lauded for doingresponsible things, and its forays into genetically modified plants have had a number of unintended consequences, such as encouraging pesticide resistant “super bugs” and weeds. In order to ensure more responsible use of this powerful gene-editing tool, the agreement prohibits Monsanto from using CRISPR/Cas9 to promote gene drives (where a genetically modified trait, such as pesticide resistance, is intentionally spread through an entire plant population), the production of sterile “terminator” seeds, or the production of tobacco to be used for smoking.
Gene drives were recently cited as a concern in a National Academy of Sciences reporton the topic since genetically modified plant traits could ravage ecosystems in ways that aren’t yet fully understood. . .
This will not end well.
Very interesting article by Jordan Kisner in the Guardian:
First, the myths. There are no “super rats”. Apart from a specific subtropical breed, they do not get much bigger than 20 inches long, including the tail. They are not blind, nor are they afraid of cats. They do not carry rabies. They do not, as was reported in 1969 regarding an island in Indonesia, fall from the sky. Their communities are not led by elusive, giant “king rats”. Rat skeletons cannot liquefy and reconstitute at will. (For some otherwise rational people, this is a genuine concern.) They are not indestructible, and there are not as many of them as we think. The one-rat-per-human in New York City estimate is pure fiction. Consider this the good news.
In most other respects, “the rat problem”, as it has come to be known, is a perfect nightmare. Wherever humans go, rats follow, forming shadow cities under our metropolises and hollows beneath our farmlands. They thrive in our squalor, making homes of our sewers, abandoned alleys, and neglected parks. They poison food, bite babies, undermine buildings, spread disease, decimate crop yields, andvery occasionally eat people alive. A male and female left to their own devices for one year – the average lifespan of a city rat – can beget 15,000 descendants.
There may be no “king rat”, but there are “rat kings”, groups of up to 30 rats whose tails have knotted together to form one giant, swirling mass. Rats may be unable to liquefy their bones to slide under doors, but they don’t need to: their skeletons are so flexible that they can squeeze their way through any hole or crack wider than half an inch. They are cannibals, and they sometimes laugh (sort of) – especially when tickled. They can appear en masse, as if from nowhere, moving as fast as seven feet per second. They do not carry rabies, but a 2014 study from Columbia University found that the average New York City subway rat carried 18 viruses previously unknown to science, along with dozens of familiar, dangerous pathogens, such as C difficile and hepatitis C. As recently as 1994 there was a major recurrence of bubonic plague in India, an unpleasant flashback to the 14th century, when that rat-borne illness killed 25 million people in five years. Collectively, rats are responsible for more human death than any other mammal on earth.
Humans have a peculiar talent for exterminating other species. In the case of rats, we have been pursuing their total demise for centuries. We have invented elaborate, gruesome traps. We have trained dogs, ferrets, and cats to kill them. We have invented ultrasonic machines to drive them away with high-pitched noise. (Those machines, still popular, do not work.) We have poisoned them in their millions. In 1930, faced with a rat infestation on Rikers Island, New York City officials flushed the area with mustard gas. In the late 1940s, scientists developed anticoagulants to treat thrombosis in humans, and some years later supertoxic versions of the drugs were developed in order to kill rats by making them bleed to death from the inside after a single dose. Cityscapes and farmlands were drenched with thousands of tons of these chemicals. During the 1970s, we used DDT. These days, rat poison is not just sown in the earth by the truckload, it is rained from helicopters that track the rats with radar – in 2011 80 metric tonnes of poison-laced bait were dumped on to Henderson Island, home to one of the last untouched coral reefs in the South Pacific. In 2010, Chicago officials went “natural”: figuring a natural predator might track and kill rats, they released 60 coyotes wearing radio collars on to the city streets.
Still, here they are. According to Bobby Corrigan, the world’s leading expert on rodent control, many of the world’s great cities remain totally overcome. “In New York – we’re losing that war in a big way,” he told me. Combat metaphors have become a central feature of rat conversation among pest control professionals. In Robert Sullivan’s 2014 book Rats, he described humanity’s relationship with the species as an “unending and brutish war”, a battle we seem always, always to lose.
Why? How is it that we can send robots to Mars, build the internet, keep alive infants born so early that their skin isn’t even fully made – and yet remain unable to keep rats from threatening our food supplies, biting our babies, and appearing in our toilet bowls?
rankly, rodents are the most successful species,” Loretta Mayer told me recently. “After the next holocaust, rats and Twinkies will be the only things left.” Mayer is a biologist, and she contends that the rat problem is actually a human problem, a result of our foolish choices and failures of imagination. In 2007, she co-founded SenesTech, a biotech startup that offers the promise of an armistice in a conflict that has lasted thousands of years. The concept is simple: rat birth control
The rat’s primary survival skill, as a species, is its unnerving rate of reproduction. Female rats ovulate every four days, copulate dozens of times a day and remain fertile until they die. (Like humans, they have sex for pleasure as well as for procreation.) This is how you go from two to 15,000 in a single year. When poison or traps thin out a population, they mate faster until their numbers regenerate. Conversely, if you can keep them from mating, colonies collapse in weeks and do not rebound.
Solving the rat problem by putting them on the pill sounds ridiculous. Until recently no pharmaceutical product existed that could make rats infertile, and even if it had, there was still the question of how it could be administered. But if such a thing were to work, the impact could be historic. Rats would die off without the need for poison, radar or coyotes.
SenesTech, which is based in Flagstaff, Arizona, claims to have created a liquid that will do exactly that. In tests conducted in Indonesian rice fields, South Carolina pig farms, the suburbs of Boston and the New York City subway, the product, called ContraPest, caused a drop in rat populations of roughly 40% in 12 weeks. This autumn, for the first time, the company is making ContraPest available to commercial markets in the US and Europe. The team at SenesTech believes it could be the first meaningful advance in the fight against rats in a hundred years, and the first viable alternative to poison. Mayer was blunt about the implications: “This will change the world.”
Mayer is a tall, vigorous woman in her mid-60s with bright eyes, spiky grey hair and a toothy grin. Her ideologies of choice are Buddhism and the Girl Scouts. “It’s kind of my core,” she said of the latter, “to do for others.” In conversation, her manner is so upbeat that she seems to be holding forth radiantly before an audience or on the verge of bursting into song. When asked how she is doing, she frequently responds in a near-rapture: “If I was any better, I’d be a twin!” – she also appears to enjoy watching people wonder whether this is an expression they should know.
When I took a seat in her office earlier this year, she clapped her hands triumphantly and said “Ooh! You’re sitting in history and strength!” There was a pause. “I had a feng shui person come and do my office,” she explained. . .
There’s a lot more, and it’s interesting, informative, and intertaining (the three I’s). Later in the article:
It sounds crazy: a band of animal lovers and firemen in the mountains of Arizona, led by a Buddhist girl scout, making a pink milkshake for rats that may eventually improve the lives of millions of people. They are unruffled by scepticism: In the middle of one interview, Mayer forgot a detail and yelled towards the door, “Cheryl, who said to you, ‘That’s just not how we do it?’” Dyer hollered back from the other room. “Which time?” In response, they point to hard science, solicitations from governments and companies around the world, and an endorsement from Stephen Hawking, who featured them on his documentary mini-series Brave New World.
A very interesting article by Todd Oppenheimer in Craftsmanship magazine:
Several years ago, Janice O’Donnell, the director of the Providence Children’s Museum, conducted a survey of public school superintendents in her community to see how much recess time was available to students. Virtually everyone who responded said they considered recess important, but only a tiny percentage of the schools actually offered it anymore. When O’Donnell started looking into why this was happening, not only in Rhode Island but elsewhere in the country, she was stunned by what she learned.
Over the last 10 to 15 years, many teachers felt their students no longer had time for recess. With the increased emphasis put on standardized testing, their primary job now was to make sure students got high scores. Playtime could be handled after school. At other schools, especially those in crowded inner city neighborhoods, there was no longer any space for playgrounds, or even a basketball hoop. Among those who could and did offer recess, many teachers used it for leverage with difficult students. If they misbehaved, or didn’t finish their work, they had to stay in class during recess. And the pattern in poor urban communities was the worst.
In many inner city neighborhoods, after-school playtime has become a fiction. “Half these kids end up in after-school programs for homework help,” O’Donnell told me. The supervisors assigned to these programs, she added, are typically unskilled; students therefore tend to make little progress, which means they continually get assigned to more of it. Those who aren’t in after-school study often go to schools with few other after-school programs, such as organized sports. In the most troubled communities, once these youngsters get home, the options are even bleeker. The adults in the family are either working, or absent entirely. “They can’t roam their neighborhoods,” O’Donnell says, “so they’re on their screens.”
In the meantime, other opportunities for growth in school were shrinking as well. To allow more time for serious study, subjects such as music and art were being dropped. In some cases, even science classes were getting cut, because the new federal education law only monitored math and reading.
Schools with formal Physical Education programs don’t necessarily fill these gaps, either. In 2007, in a survey of 1,005 schools, the Robert Wood Johnson Foundation found that physical activity during PE isn’t a robust as we think. When opportunities for activity were compared between PE, recess, and after-school programs, recess won. It commanded 42 percent of a youngster’s chances to be active, as compared with PE, which came in at 32 percent. (After-school activities were lower still, at 26 percent.)
As time went on, O’Donnell noticed the growing mound of literature supporting the importance of recess, along with other opportunities for free play. The studies showed that active, open-ended play not only makes for happier, calmer kids, it also is critical to our full development—intellectually, physically, and emotionally.
The irony in that finding was certainly not lost on O’Donnell, or on the large number of experts in child development who study American education. Here we have a system intent on improving student’s abilities in subjects like math and reading by spending more time on those subjects in younger years; in the process, we sideline the very exercises that might build up our capacities to use math and reading in the richest way.
Adding to that irony is yet another one: . . .