Employee Health Systems - May 2005 Newsletter

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EAP Newsletter - February 2006

In This Issue:

Your to-do list for a more prosperous year

Serious depression raises risk of heart ailments

Dark chocolate: a fix for smoker's plumbing?

Men with dysfunction should ask about heart

Finding information online from peers and professionals

Taking stress seriously

Your to-do list for a more prosperous year

New Year's resolutions are made to be broken. By hour 14 of 2006, you have already abandoned those vows to establish financial goals, to spend as wisely as Benjamin Franklin, and to channel money into investments as efficiently as Wal-Mart distributes Cheetos.

So forget about those impossibly grand ideas. Instead, here are 10 easy ways to ensure a more secure future.

1. Boost your savings. The savings rate of Americans is currently a disastrous - 1.5 percent. If you have a 401(k) or other retirement plan at work, go to your benefits department and raise your contribution by at least 1 percent; you'll never miss it. If you receive a raise, promise to have half the total automatically deducted from your paycheck and placed in your retirement plan.

2. Put some money in the bank. Annual rates on one-year CDs are hovering above 4 percent. Anytime you receive a bonus or some other windfall, plunk it in one. You can find top rates at two Internet banks; ING (APY 4.4 percent, no minimum) and Nexity Bank (APY 4.75 percent, $1,000 minimum).

3. Review your homeowners insurance. Rita, Wilma, and Katrina have brought home the message that your insurance policy should reflect the current value of your house. Making sure that you have the right value is more important than ever because some insurers set caps on the total they'll pay at 120 to 125 percent, at most, of the home's insured value. You're on the hook for anything more. Homeowners policies do not cover floods, however. To learn whether your house is in a flood-prone area, go to www.floodsmart.gov. You can buy insurance from the Federal Emergency Management Agency's National Flood Insurance Program through private insurers. The NFIP policy will pay up to $250,000 for your house (and $100,000 for the contents), but if it's worth more, you can buy excess flood coverage from, among others, Chubb and Fireman's Fund.

4. Get out of credit-card hell (fast). First the don'ts: Don't transfer your balances to another card that promises a 0 percent annual rate. You may pay a fee equal to 3 percent of the amount transferred, which lands you more deeply in hock. And refinancing your house to pay off cards will cost you 30 years of interest on the pizzas and sneakers of yesteryear. Instead, list all your debts. Pay those with low balances immediately. Then focus on the cards with the highest rates. Pay at least double the minimum on all of them. If you can't make minimum payments, call the credit card company immediately and try to work out a plan that stretches out payments.

5. Move to a fixed-rate loan. Rates on adjustable-rate mortgages and home-equity lines of credit have risen about 1.5 percentage points in the last year, and if analysts are correct, they'll rise some more. If you are financing your home with one of those puppies, it's time to convert to a loan with a plain-vanilla fixed rate. Look for one with no points and no closing costs. To compare loans, go to www.hsh.com or www.bankrate.com.

6. Use the new energy tax credits. Credits are much better than other tax breaks because they are subtracted directly from your tax bill. Starting in January, a batch are available to homeowners who, among other things, install solar energy for water heating or electricity (30 percent of the cost up to $2,000). Other credits; insulation (10 percent of cost) and electric or geothermal heat pumps (up to $300). The total cap on the last two improvements is $500. You can also get a tax credit on a new hybrid car (a maximum of $3,400 for an 8,500-pound car). You may have to buy early in the year because the credit is limited to 60,000 vehicles per manufacturer.

7. Give yourself a budget cut. Trick yourself into spending less by having a set amount, say, $50 a week, deducted from your paycheck and deposited in a bank or credit-union savings account. (Or have a mutual-fund company extract money from your checking account.) If an emergency pops up-say, an unexpected car or dental bill - you can draw on your trove instead of using a credit card. If the balance piles up to more than three to six months' worth of income, deposit the excess in a stock index fund that tracks a broad market index, such as the Standard & Poor's 500. The Vanguard 500 Index Fund and the T. Rowe Price Equity Index 500 are among those with no sales commissions and low annual expenses.

8. Automate bill-paying. By setting up an online bank account with automatic payment for regular bills, you can avoid late fees forever. At most banks, you simply enter the date you want the mortgage or the car payment made each month and the amount. You can even set a regular low payment for your credit cards, enough to avoid getting whacked with a late fee.

9. Audit casual spending. Use your debit card to see where your money goes. Once you spot the budget leaks - bookstore binges, gourmet-tea purchases, lotto tickets - you should be able to plug them.

10. Unload bad investments. If you would not buy the stock or fund today, and it's no longer performing on a par with similar investments, sell. For a stock, look at its Income Statement (available at finance.yahoo.com), find "operating income," and divide by total revenue. Then do the same for its closest rival. If it's lagging, say adios. for mutual finds, go to www.morningstar.com, click on Funds, and then on Category Returns. It provides the average returns for periods from 3 months to 5 years. If your fund is above the middle, hang on.

Consumer Reports, February 2006

A large Swedish study published recently reports that men and women hospitalized for depression are about one and a half times as likely as others to develop coronary heart disease. The risk is even greater for people hospitalized before age 50.

The researchers identified 44,826 men and women hospitalized for depression from 1987 to 2001 in Sweden, and then traced their history of heart disease using the Swedish national discharge registry. The study appears in the December issue of The American Journal of Preventive Medicine.
As patients get older, the risk declines, and people ages 70 to 79 at the onset of depression have no increased risk for cardiac illness compared with people in control groups. But those hospitalized for depression from age 25 to 49 were almost three times as likely to suffer heart attacks as those not hospitalized.
The association between severe depression and heart disease held even after accounting for socioeconomic status and geography.

According to Dr. Kristina Sundquist, the senior author and an associate professor of medicine at the Karolinska Institute in Stockholm, this strong association between severe depression and heart disease suggests that treating depression could be a preventive.

"However," she said, "in order to find evidence that successfully treated depression would make the risk for heart disease decrease, other types of studies are needed, such as randomized controlled studies."

Dr. Sundquist said she doubted that such a study could be ethically undertaken because it would require a control group of untreated patients.

Dark chocolate, but not white chocolate, may improve the ability of smokers' blood vessels to expand and contract in response to the body's needs, Swiss researchers have found.

The scientists divided 25 smokers into two groups. One group ate about two ounces of dark chocolate containing 74 percent cocoa, and the other consumed two ounces of white chocolate, which contains no cocoa.

The investigators calculated platelet activity and the flexibility of the blood vessels, two measures of healthy function, in an artery in the upper arm of each subject. In those who ate dark chocolate, both measures were considerably improved, and the effect lasted about eight hours.

White chocolate had no effect on the blood vessels. Total antioxidant status also significantly increased two hours after eating dark chocolate, but not after eating white chocolate. The report appears in the Dec. 19 issue of Heart.

The scientists believe the effect is caused by a large class of substances in chocolate called polyphenols, a group that includes flavonols, which are potent antioxidants. Dark chocolate, the authors write, has a higher polyphenol concentration than other antioxidant-rich foods like wine, tea or berries.

Dr. Roberto Corti, a cardiologist at University Hospital in Zurich and the lead author of the study, stressed that eating chocolate will not counter the ill effects of smoking. "We 'used' smokers as a model for decreased vascular function," he wrote in an e-mail message." We believe that the beneficial effect can probably be seen in all patients who have a high oxidative stress. This highlights the potential of substances such as flavonols in cardiovascular health."

Erectile dysfunction is almost as strong a predictor of heart disease as smoking or family history, according to a report published recently in The Journal of the American Medical Association.

Researchers studied 3,816 men with erectile dysfunction and 4,247 men with no dysfunction, and they tracked the incidence of angina, heart attack, arrhythmias, stroke and other heart problems over seven years. Men who reported erectile dysfunction before or during the study had a 45 percent increased risk of a cardiovascular event compared with men who never reported the problem.

"Erectile dysfunction is treatable," said Dr. Ian M. Thompson, the lead author of the report and chairman of urology at the University of Texas Health Science Center at San Antonio. "It may be the event that gets a man in to see a doctor. That patient should ask his physician: 'I used to smoke. My dad died of a heart attack. Now I have E.D., do I need further evaluation?" Then the doctor has additional responsibilities to think about cardiac illness as well."

The link between erectile dysfunction and cardiovascular disease, the authors write, has previously been established, but the magnitude of the effect has not been known until now.

The authors acknowledge that the results depend on patient reports of erectile dysfunction that may be difficult to assess and that they did not collect data on blood pressure medications or medications for erectile dysfunction, which may have altered the results.

Still, the association held even after controlling for smoking, cholesterol level, family history and other factors.

Web sites and mental health support groups, many doctors agree, can provide patients with valuable information about treatments for depression, anxiety, attention deficit disorder and other problems. And learning about psychiatric medications from peers, they say, can destigmatize mental illness in a way that no medical authority ever could.

But they caution that such unmediated modes of communication can also be dangerously misleading. People who frequent Internet discussion forums on mental health, psychiatrists and forum participants say, tend to have more intractable conditions and be more daring about managing their own medications.

"There's so much out there and such a mixture of information and misinformation," said Dr. Ivan K. Goldberg, a psychiatrist in New York. "People are not always the best judges about what's going on with themselves."

Information about medications and forums on mental health, moderated by doctors, can be found at www.webmd.com. The site's parent company recently bought www.rxlist.com, an unmoderated site whose popular discussion groups are organized by the names of prescription drugs.

For those who want to learn more about dosage guidelines or the side effects of a particular drug, the Food and Drug Administration recently introduced a Web site called Daily Med System. The site publishes the information contained in the package inserts of prescription drugs. Drug makers are now required to submit label changes electronically, so the site can be updated immediately.

At the Mood Disorders Support Group of New York City, the moderators do not have medical degrees, but they are trained to intervene with basic information about medication when participants appear to be leading one another astray. The group's Web site, with links to other groups around the country, is www.mdsg.org.

Dr. Goldberg, the group's medical adviser, maintains a Web site called Depression Central with links to information he has vetted about treatments for a range of mood disorders.

As a place to share experiences online, he suggests www.wingofmadness.com, a Web site with discussion forums, and the Pendulum e-mail list. Dr. Goldberg recommends viewing the information in any anonymous forum with a healthy skepticism.

Dr. Goldberg and other doctors said they have had patients leave their offices on several occasions when they refused to give the patients the medications they wanted based on advice found on the Internet. On the other hand, Dr. Goldberg said, "Every once in a while I say, 'Wow, that's 100 percent right on.'"

By Amy Harmon

It is almost un-American to take stress seriously. While we have accepted the importance of controlling blood pressure, cholesterol, weight, diet, smoking and activity level, we are slower to admit that stress could really be a problem.

But stress can be a problem, especially when it settles into our daily lives as chronic, uncontrollable, over-whelming overload. Feelings of anger and depression can be especially damaging. The problems created by too much stress are not "all in your mind." The physical changes that occur in your body when stress becomes chronic are just as real as the changes caused by smoking or a high-fat diet.

How much stress is "too much" depends upon your point of view. As Hans Selye, one of the early stress scientists, observed, "We all boil at different degrees." Too much stress for your friend might be an interesting and stimulating life for you, or vice versa.

Stress is not only about what is happening in your life, although that is certainly very important. The impact that stress has on your health is also a function of your perception - what's happening in your mind. For example, you may get anxious or angry about something that may never have happened, but the stress of that anger is very real. So are the muscle tension, digestive problems and chest pain that the anger produces. Or you may perceive a problem in ways that make you more stressed than necessary.

We really can't say how much stress is too much for any given individual. We do know that feelings of anger, hostility and despair can be harmful, so the less of these in your life, the better. Replacing them with humor, optimism and a spiritual outlook will improve your quality of life, and probably your long-term health as well.

Some individuals may not feel much anger or depression, but they can still be overloaded and often feel over-whelmed, which can cause tightness while breathing. This sense of tension is bad for your health too.

Chronic stress means your body is in a constant state of arousal from the fight-or-flight response that gears you up to respond to an emergency. This fight-or-flight response is very useful when you need to rescue a child in danger, run to catch a bus or deliver a brilliant presentation. Our problem now is that nature never intended this adaptive response to stay turned on for more than short periods. Once the emergency is over, we need to gradually unwind and recover to an unstressed state.

What's the best way to get yourself to relax? Balance is the issue. Stress does not appear to be harmful to your health as long as your body has some time each day to recover. Learning to provide a balance will greatly reduce the toll it takes on your health.

The first step in reducing stress is to figure out what is causing stress in your life and do whatever you can to address those issues. A stress-management workshop or seminar might help you learn how to change the way you respond to stress.

Lifestyle is equally important. Get enough sleep, eat well, and eliminate or reduce stress-provoking chemicals such as caffeine, nicotine and alcohol.

Make time for healthy pleasures, such as a hobby, a hot bath or a good movie. Spend time with your friends and write about your stress in a diary.

Daily exercise is the best stress antidote available. Exercise reduces feelings of stress, helps you to relax and counteracts many of the negative health effects of stress. Exercise improves mood and self-confidence, and helps turn those stress mountains back into mole hills.

Your Health & Fitness
By Barbara A. Brehm, Ed. D.