6 ms·

Why a Health Program That Works in America Failed in Britain

33 points by nols 11y ago

pjc50 11y ago
Lede is buried in the middle: One reason the U.K. results were so lackluster might be that the Lancet study compared home-visiting to “usual care,” or the health care new moms would receive anyway. But since the U.K. has universal health care and the U.S. does not, it could be that there was less of a difference between the two British groups than the two American ones.
- sago 11y ago
  Also most of the American studies on NFP were conducted by the program’s own developer
  - mike_hearn 11y ago
    Scientifically, it’s not ideal to have the same person who came up with a program trying to determine whether the program is any good. Not ideal? This is a great example of the use of understatement if there ever was one. I'd say such a conflict of interest would put the credibility of the entire study at risk.
- mrweasel 11y ago
  Also important >The study also focused on young moms, using their youth as a proxy for low income, so its subjects might have been less disadvantaged than their American counterparts to begin with. The article does mention that similar programs did show good results in the Netherlands and Germany (if at a smaller scale than in the US). I don't think the article really answer the question it raises. It seems odd that you would keep smoking or drink just because you have universal healthcare. It that was the case it would indicate that we care more about our finances that our health (which might be true).
JamesMcMinn 11y ago
Fail -> Isn't Needed.
- DanBC 11y ago
  No, it is needed. There's a bunch of public health stuff where England needs to do better. (Mothers smoking through pregnancy, mothers drinking too much through pregnancy, mother taking drugs through pregnancy, mothers eating too much through pregnancy, children not breast fed, children weaned too soon, children weaned with wrong food, children given added-sugar drinks, children and mothers at risk of violence, children and mothers at risk of accidental harm, etc etc. (It's a long list! And there's plenty more) This are partially helped by the universal access new mothers have to health visitors, and access to things like Sure Start Centres (I'm not sure if those centres are still available though), but there's still a lot to be done.
  - robk 11y ago
    Drinking during pregnancy seems pretty usual across Europe. I don't think I ever saw a pregnant woman drinking even once in the USA.
    - hacker_9 11y ago
      It's known and accepted in the UK you can't drink/smoke when pregnant. It's social taboo. I've never seen it in the UK.
      - DanBC 11y ago
        "never seen it" is not the same as "it doesn't happen". Smoking during pregnancy has been on the decline for years, and 2014 was the lowest it's been. http://www.hscic.gov.uk/article/4788/Prevalence-of-mothers-smoking-whilst-pregnant-is-lowest-on-record http://www.hscic.gov.uk/article/4788/Prevalence-of-mothers-s... > Today's report shows the prevalence of women who classed themselves as smokers whilst pregnant fell to 12.0 per cent (75,910 out of 632,960 maternities)3 from 12.7 per cent (83,490 out of 658,110 maternities) in the previous year4, and this continues the steady decline from 2006-07 when this was 15.1 per cent.5 Lowest on record, but still 12% is pretty high. I suspect the reason, as you say, is the taboo. A pregnant woman who smokes faces a lot of judgement, so she's probably going to smoke at home.
javert 11y ago
99% of science today involves people self-reporting results, with tenure, grant money, etc. dependent on those results. So are you saying that the credibility of 99% of science is at risk? Note that peer review doesn't get out of this because it really is "peer" review, i.e., an old boys' network.
- TeMPOraL 11y ago
  Depending on the branch, it's sometimes not just at risk, it's dead and buried. That upwards of 90% of soft sciences is bullshit is pretty obvious, but last few years also revealed that ~90% of results of recent medical studies are crap too. It's pretty scary, if you think of it.
- 0x49 11y ago
  This should make anyone think twice when they see that next study on climate change.
  - PhasmaFelis 11y ago
    Why do climate change deniers always assume that anything that even vaguely implies a problem with even one climate-change study is a complete refutation of the entire field of climate science?
    - 0x49 11y ago
      Because its not 1 study. Its 99% of all studies..and if the system is this way, how can you possibly trust any studies?? The system needs to be scrapped and started over. If you cant see this or dont want this, you are part of the problem. Hackernews is supposed to be about free thought and open source and in reality, anyone with an opinion against the narrative is silenced. Im not even close to a troll and i have had many of my comments silenced over the past week. True science is striving for the truth, even if it makes that same person wrong. without truth, we will have no progress. I suppose this means that myself and hackernews just dont have a good 'culture fit'. Im more about getting to the truth, expressing free thought, and having intelligent discussions. Not having to walk on egg-shells and fear the down vote and account ban for saying something that goes against the personal beliefs of the mods. the community rules are also heavily skewed toward one group, because like many other inclusive groups, its an attempt to socially engineer the thoughts and beliefs of the community. Dictatorships and evil people have been using these techniques for centuries. If i wanted this, i would work for a big corporation again. Im done. Its only been a week, but im not coming back.
javert 11y ago
What you are describing is "stupid." Why even bother to try to fix stupid? Stupid people do stupid things and the more you try to support them, the more they do it. People need to learn discipline.
- DanBC 11y ago
  What a nasty, judgemental, comment. You support people to stop smoking / drinking because being a judgemental cunt and yelling "JUST STOP SMOKING" at them doesn't work, and we know it doesn't work. Your approach literally kills babies.
  - javert 11y ago
    All right, but the smoking point is not really relevant and the rest of your comment is just emotionalism and insults. If you can't make an actual argument, and all you can do is whine, you are just showing that you don't have a rational argument.
    - rodgerd 11y ago
      > the rest of your comment is just emotionalism and insults. > Stupid people do stupid things and the more you try to support them, the more they do it. You're a hypocrite.
      - javert 11y ago
        No, I'm not. I put forward arguments and observations. "Stupid" is an observation, a correct observation, and it is not targeted at a HN user, and it is not supposed to motivate an argument by itself. In contrast, the comment that insults me does not put forth correct observations; rather, it puts forth an "argument" that is motivated by being insulting (i.e., is not even a valid argument). Please double check before you call someone on HN a hypocrite. Unfortunately it's a very serious allegation and it's not OK to make that allegation casually and be wrong about it. Technically, you owe me an apology, though I'm not holding my breath.
      - 11y ago
deleted 11y ago
[deleted]
im3w1l 11y ago
>Just as many moms who were visited by nurses had a second pregnancy within two years. It is just hinted at in The Atlantic's article, but the original Lancet article confirms that they wanted to reduce second pregnancies. Why was that?
ommunist 11y ago
It should read otherwise. Why America never attempted to copy successful British model of healthcare. Paracetamol is the key!

33 points by nols 11y ago

pjc50 11y ago

Lede is buried in the middle: One reason the U.K. results were so lackluster might be that the Lancet study compared home-visiting to “usual care,” or the health care new moms would receive anyway. But since the U.K. has universal health care and the U.S. does not, it could be that there was less of a difference between the two British groups than the two American ones.

sago 11y ago
Also most of the American studies on NFP were conducted by the program’s own developer
- mike_hearn 11y ago
  Scientifically, it’s not ideal to have the same person who came up with a program trying to determine whether the program is any good. Not ideal? This is a great example of the use of understatement if there ever was one. I'd say such a conflict of interest would put the credibility of the entire study at risk.
mrweasel 11y ago
Also important >The study also focused on young moms, using their youth as a proxy for low income, so its subjects might have been less disadvantaged than their American counterparts to begin with. The article does mention that similar programs did show good results in the Netherlands and Germany (if at a smaller scale than in the US). I don't think the article really answer the question it raises. It seems odd that you would keep smoking or drink just because you have universal healthcare. It that was the case it would indicate that we care more about our finances that our health (which might be true).

JamesMcMinn 11y ago

Fail -> Isn't Needed.

DanBC 11y ago
No, it is needed. There's a bunch of public health stuff where England needs to do better. (Mothers smoking through pregnancy, mothers drinking too much through pregnancy, mother taking drugs through pregnancy, mothers eating too much through pregnancy, children not breast fed, children weaned too soon, children weaned with wrong food, children given added-sugar drinks, children and mothers at risk of violence, children and mothers at risk of accidental harm, etc etc. (It's a long list! And there's plenty more) This are partially helped by the universal access new mothers have to health visitors, and access to things like Sure Start Centres (I'm not sure if those centres are still available though), but there's still a lot to be done.
- robk 11y ago
  Drinking during pregnancy seems pretty usual across Europe. I don't think I ever saw a pregnant woman drinking even once in the USA.
  - hacker_9 11y ago
    It's known and accepted in the UK you can't drink/smoke when pregnant. It's social taboo. I've never seen it in the UK.
    - DanBC 11y ago
      "never seen it" is not the same as "it doesn't happen". Smoking during pregnancy has been on the decline for years, and 2014 was the lowest it's been. http://www.hscic.gov.uk/article/4788/Prevalence-of-mothers-smoking-whilst-pregnant-is-lowest-on-record http://www.hscic.gov.uk/article/4788/Prevalence-of-mothers-s... > Today's report shows the prevalence of women who classed themselves as smokers whilst pregnant fell to 12.0 per cent (75,910 out of 632,960 maternities)3 from 12.7 per cent (83,490 out of 658,110 maternities) in the previous year4, and this continues the steady decline from 2006-07 when this was 15.1 per cent.5 Lowest on record, but still 12% is pretty high. I suspect the reason, as you say, is the taboo. A pregnant woman who smokes faces a lot of judgement, so she's probably going to smoke at home.

javert 11y ago

99% of science today involves people self-reporting results, with tenure, grant money, etc. dependent on those results. So are you saying that the credibility of 99% of science is at risk? Note that peer review doesn't get out of this because it really is "peer" review, i.e., an old boys' network.

TeMPOraL 11y ago
Depending on the branch, it's sometimes not just at risk, it's dead and buried. That upwards of 90% of soft sciences is bullshit is pretty obvious, but last few years also revealed that ~90% of results of recent medical studies are crap too. It's pretty scary, if you think of it.
0x49 11y ago
This should make anyone think twice when they see that next study on climate change.
- PhasmaFelis 11y ago
  Why do climate change deniers always assume that anything that even vaguely implies a problem with even one climate-change study is a complete refutation of the entire field of climate science?
  - 0x49 11y ago
    Because its not 1 study. Its 99% of all studies..and if the system is this way, how can you possibly trust any studies?? The system needs to be scrapped and started over. If you cant see this or dont want this, you are part of the problem. Hackernews is supposed to be about free thought and open source and in reality, anyone with an opinion against the narrative is silenced. Im not even close to a troll and i have had many of my comments silenced over the past week. True science is striving for the truth, even if it makes that same person wrong. without truth, we will have no progress. I suppose this means that myself and hackernews just dont have a good 'culture fit'. Im more about getting to the truth, expressing free thought, and having intelligent discussions. Not having to walk on egg-shells and fear the down vote and account ban for saying something that goes against the personal beliefs of the mods. the community rules are also heavily skewed toward one group, because like many other inclusive groups, its an attempt to socially engineer the thoughts and beliefs of the community. Dictatorships and evil people have been using these techniques for centuries. If i wanted this, i would work for a big corporation again. Im done. Its only been a week, but im not coming back.

javert 11y ago

What you are describing is "stupid." Why even bother to try to fix stupid? Stupid people do stupid things and the more you try to support them, the more they do it. People need to learn discipline.

DanBC 11y ago
What a nasty, judgemental, comment. You support people to stop smoking / drinking because being a judgemental cunt and yelling "JUST STOP SMOKING" at them doesn't work, and we know it doesn't work. Your approach literally kills babies.
- javert 11y ago
  All right, but the smoking point is not really relevant and the rest of your comment is just emotionalism and insults. If you can't make an actual argument, and all you can do is whine, you are just showing that you don't have a rational argument.
  - rodgerd 11y ago
    > the rest of your comment is just emotionalism and insults. > Stupid people do stupid things and the more you try to support them, the more they do it. You're a hypocrite.
    - javert 11y ago
      No, I'm not. I put forward arguments and observations. "Stupid" is an observation, a correct observation, and it is not targeted at a HN user, and it is not supposed to motivate an argument by itself. In contrast, the comment that insults me does not put forth correct observations; rather, it puts forth an "argument" that is motivated by being insulting (i.e., is not even a valid argument). Please double check before you call someone on HN a hypocrite. Unfortunately it's a very serious allegation and it's not OK to make that allegation casually and be wrong about it. Technically, you owe me an apology, though I'm not holding my breath.
    - 11y ago

deleted 11y ago

[deleted]

im3w1l 11y ago

>Just as many moms who were visited by nurses had a second pregnancy within two years. It is just hinted at in The Atlantic's article, but the original Lancet article confirms that they wanted to reduce second pregnancies. Why was that?

ommunist 11y ago

It should read otherwise. Why America never attempted to copy successful British model of healthcare. Paracetamol is the key!