Contraceptive pill gives
women choiceThe issue: State lawmakers are considering
a bill for the "morning after" pill to
be sold without prescriptions.A bill that would make emergency contraceptive pills more easily available provides women with another way to avoid unintended pregnancies. Because the measure also could reduce the rate of abortions -- a contentious method of birth control -- it warrants approval by state lawmakers.
The legislation would permit pharmacists to dispense without a doctor's prescription the so-called "morning after" pill. The pill -- consisting of a higher dose of birth control drugs that have been used safely for more than 30 years -- works by preventing or delaying ovulation or implantation of the egg. It does not interrupt or harm an established pregnancy or cause abortions; it should not be confused with RU-486, a drug that ends pregnancy several weeks after it has begun.
The American College of Obstetricians and Gynecologists and the Food and Drug Administration have declared the morning-after pill a safe method of emergency contraception. It is effective 75 percent of the time and can reduce the number of abortions by half. Side effects are minimal, limited to nausea, dizziness or cramps. The American Medical Association several years ago proposed that the contraceptive be available over the counter.
To be effective, however, the pill must be taken within 72 hours after sexual intercourse and the sooner the better. The intent of the bill is get the contraceptive to women without them having to wait to see a doctor, which may be a problem on weekends, or when a woman lives in a rural area or does not have health insurance.
Minors would still require prescriptions. Some of the bill's supporters say minors may have the most need because they often do not use contraceptives correctly. However, family involvement and a doctor's care would be prudent for teenagers who also may need guidance and counseling about sexual activity.
Pharmacists object to the measure because of concerns about dispensing drugs in the absence of a doctor. The bill would require that pharmacists receive training before they are allowed to give out the pills, so if a pharmacist objects to the plan, he or she can simply opt out of training. The bill's opponents contend that some women may abuse the pill, using it instead of a regular regime of oral contraceptives. However, the cost and lessened efficacy likely will deter such abuse.
No form of contraception is totally effective; abstinence is an ideal. The morning-after pill furnishes women with a choice certainly less onerous than abortion and should be obtainable without unnecessary barriers.
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Weight problems are
becoming more costlyThe issue: Obesity eclipses smoking and
alcohol in costs for health care and medication.BECAUSE obesity triggers health problems, a new report concludes unsurprisingly that the condition translates into increased costs for health care and medication. Startling is that these costs surpass spending for health problems linked to smoking and alcohol abuse.
That the price of obesity also stretches beyond monetary aspects to a diminished quality of life should trigger a heightened awareness of the problem and related chronic illnesses, such as diabetes and heart disease. With weight reduction difficult in adults, the key may be to focus on helping children, more of whom have become increasingly overweight in the past two decades.
A Rand Corp. study showed that being obese raises health care costs 36 percent and medication costs 77 percent, while smoking increases those costs 21 percent and 30 percent, respectively. Obesity contributed to a decline in quality of life at almost four times the rate of smoking or alcohol abuse.
By quality of life, experts point to physical as well as mental challenges. For example, patients of Type 2 diabetes, which is caused in part by obesity, spend a lifetime having to monitor blood sugar levels and food intake daily and taking medication not only to manage insulin but cholesterol. The condition may lead to blindness and amputations when blood circulation is reduced. Infections become more frequent, healing of small cuts and bruises slow. Overweight people also have difficulty with common movements, such as walking or climbing stairs, and with those emerge psychological problems, such as depression.
Losing weight becomes harder with age and children who are obese will more likely carry their pounds through adulthood. Parents can do their part by restricting fatty foods and engaging their children in exercise. Hawaii's public schools should also help by increasing physical education programs. At present, children in kindergarten through grade 3 are required to perform only 22 minutes a day of physical exercise. From grades 4 through 6, that number drops to 18 minutes daily, while middle and high school students take only a year of physical education.
High fat and cholesterol diets also may affect mental capacity, according to a San Francisco veteran's hospital study. The study found that high cholesterol levels appear to harm the brain and lead to the kind of mental decline seen in Alzheimer's disease.
In the past, obesity has been more often assessed as matter of appearance. However, medical research on the consequences has appropriately shifted weight problems to the health arena.
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Published by Oahu Publications Inc., a subsidiary of Black Press.Don Kendall, Publisher
Frank Bridgewater, managing editor 529-4791; fbridgewater@starbulletin.com
Michael Rovner, assistant managing editor 529-4768; mrovner@starbulletin.com
Lucy Young-Oda, assistant managing editor 529-4762; lyoungoda@starbulletin.comJohn Flanagan, contributing editor 294-3533; jflanagan@starbulletin.com
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