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Cats do not harm children’s mental health, study finds

New research brings some good news for cat lovers. Contrary to previous claims, researchers have found no link between cat ownership in childhood and increased risk of mental illness.

Researchers say there is no link between cat ownership in childhood and later risk of mental health problems.

Lead study author Dr. Francesca Solmi, of the Division of Psychiatry at University College London (UCL) in the United Kingdom, and colleagues recently reported their findings in the journal Psychological Medicine.

Cats are among the most popular pets in the United States, with more than 30 percent of households owning at least one feline friend.

As well as being beloved companions, studies have shown that cats and other pets can benefit mental health, helping to reduce anxiety and stress and improve overall psychological well-being.

Some research, however, has suggested the opposite. One study reported by Medical News Today in 2015, for example, associated cat ownership in childhood with increased risk of schizophrenia, bipolar disorder, and other mental health conditions in later life.

But according to Dr. Solmi and colleagues, there is insufficient evidence to suggest this is the case.

Toxoplasma gondii and mental illness

The previously reported link between childhood cat ownership and mental health disorders has been attributed to Toxoplasma gondii, a parasite that cats shed in their feces. Coming into contact with cat feces contaminated with this parasite – through cleaning a litter tray, for example – may lead to T. gondii infection, known as toxoplasmosis.

While more than 60 million people in the U.S. are believed to be infected with T. gondii, the immune system is normally able to stave it off, meaning very few people have symptoms.

Pregnant women, however, are more susceptible to T. gondii infection, which may have serious implications for their offspring, such as birth defects. Studies have also suggested that T. gondii infection in early life may raise the risk of mental health disorders later on.

The new study, however, finds that simply growing up with a cat is unlikely to raise the risk of mental illness.

Dr. Solmi and colleagues came to their findings by analyzing data from the Avon Longitudinal Study of Parents and Children (ALSPAC), identifying 4,676 children who were born between 1991 and 1992.

Cat ownership during their mother’s pregnancy and between the ages of 4-10 years was assessed, and each child underwent assessment for psychotic symptoms at the ages of 13 and 18.

‘No evidence that cats pose a risk to children’s mental health’

Initially, the researchers found a small link between cat ownership in childhood and psychotic symptoms at the age of 13. However, this association disappeared when the team accounted for other factors.

“Once we controlled for factors such as household overcrowding and socioeconomic status, the data showed that cats were not to blame,” explains Dr. Solmi. “Previous studies reporting links between cat ownership and psychosis simply failed to adequately control for other possible explanations.”

Additionally, the team says previous studies were relatively small, had missing data, and did not follow families for long periods. This new study addressed these shortfalls.

“The message for cat owners is clear: there is no evidence that cats pose a risk to children’s mental health.”

Dr. Francesca Solmi

While the researchers were unable to assess the children’s direct exposure to T. gondii, they say their findings suggest that cat ownership in pregnancy or childhood is not a risk factor for mental illness.

“However, there is good evidence that T. gondii exposure during pregnancy can lead to serious birth defects and other health problems in children,” warns senior author Dr. James Kirkbride, also of the Division of Psychiatry at UCL.

“As such, we recommend that pregnant women should continue to follow advice not to handle soiled cat litter in case it contains T. gondii,” he adds.

Read about how people with “rage” disorder are at greater risk of toxoplasmosis.

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Republicans Want You in a Health Savings Account. So Now What?

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Key Republican in Health Law’s Fate Hails From a State That Embraced It

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New report identifies neighborhoods in need of behavioral health services

At first glance, the Philadelphia neighborhoods in zip codes 19148 and 19120 might seem to have little in common.

The 19120 zip code is on the northern edge of the city, bordering Cheltenham Township and including parts of the Olney, East Oak Lane, and Lawncrest neighborhoods.

The 19148 zip code is along the Delaware River in Southeast Philadelphia, just below the Pennsport neighborhood and bisected by Interstate 76 before the highway links to the Walt Whitman Bridge.

But these two areas both have a shortage of behavioral health services, according to a new study comparing the availability of such services to the need for them.

The study, called “Place Matters,” uses sophisticated mapping techniques to identify neighborhoods that are likely to be underserved by mental health providers, particularly those serving young children.

“Traditional services aren’t always located where the kids need them to be,” said Joe Pyle,  president of the Thomas Scattergood Behavioral Health Foundation, one of the sponsoring agencies of the study.

The others are the Drexel University Dornsife School of Public Health and the city’s Department of Behavioral Health and Intellectual Disability Services (DBHIDS).

“Increasingly, we are recognizing that where people live makes a real difference in their health status,” said Arthur Evans, outgoing commissioner of the city department.

“Zip code is a better predictor of health status than the genetic code.”

The study was designed to identify the areas of greatest need for children’s services “based on indicators of poverty, low education, unemployment, exposure to crime and adverse childhood experiences.”

Evans said he hoped that in future years, using more sophisticated population health data would lead the city to make smarter decisions on where to locate behavioral health facilities, school-based mental health programs, and other community assets such as libraries, playgrounds, recreation centers, and physical health providers.

The study’s lead researcher, former Drexel graduate student Quan Truong, combined existing data in several areas.

“We took a lot of available data and tried to make sense of it all,” said Truong, who is now with the Palo Alto Medical Foundation Research Institute.

This data included:

  • Crime, poverty and unemployment figures.

  • Medicaid claim data from DBHIDS.

  • Education levels.

  • The landmark Adverse Childhood Experiences (ACE) study, expanded for Philadelphia in 2013, with a follow-up survey of 1,784 residents by the Public Health Management Corp.

The follow-up survey explored traumatic childhood experiences, including witnessing violence, feeling discrimination, experiencing bullying, and feeling unsafe in the neighborhood.

In the report, Truong quoted national estimates that half of all lifetime cases of mental illness begin by age 14 and research that links low socioeconomic status with poor mental health in children.

And she cited research indicating that the farther a child is located from a medical facility, the less chance he or she will receive needed preventive care.

The study created a risk factor analysis combining poverty, unemployment, lack of education, exposure to violence, and other traumatic experiences and correlating these with a person’s mental health status.

It also factored in two components of resiliency: perceived community support and access to clinical care.

In addition to discrepancies among zip codes, the survey indicated considerable unmet need citywide for mental health services.

“Of Philadelphia’s 46 zip codes, 39 fall below the national average for need,” the report stated.

With about 272,000 children in Philadelphia under age 17 who are Medicaid-eligible, the report estimated, there are more than 54,000 children “who may be in need of mental and behavioral health treatment within the Community Behavioral Health network. The current network served approximately 33,700 children in 2015.”

In the 19148 and 19120 zip codes alone, the report stated, “There may be roughly 2,971 children … who may be in need of services and are currently not getting services.”

Both Evans and Pyle said that the report was only the first step in helping the city take a population-health approach to mental health needs.

Both the foundation and DBHIDS say they are committed to moving from a zip code approach to a more detailed census-tract approach.

Researchers will also look at factors such as stigma, cultural competence, quality of care, and their influence on care utilization.

Evans also stressed the importance of keeping the database current, because gentrification and other changes can quickly alter an area’s level of need.

The report expressed the hope that in the future, “decisions driven by evidence and data, rather than instinct, would ensure a thoughtful approach to meeting the city’s needs.”

This story is part of a continuing series by the Notebook on student behavioral health, with support from the van Ameringen Foundation. Contact reporter Paul Jablow  @Paulj1940 with your ideas and feedback. He would like to hear about your experiences with the system: where it has succeeded, where it needs improvement, and what you would like to read more about on this topic.



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How Demi Lovato Is Using Her Voice To Elevate Mental Health

The film is a project of Be Vocal: Speak Up For Mental Health, a campaign Lovato’s been involved with since it was started in 2015 by the National Alliance for Mental Illness, the Jed Foundation, Mental Health America, the Depression and Bipolar Support Alliance and the National Council for Behavioral Health. Through Be Vocal, which focuses on starting conversations about mental health, Lovato shared about her treatment for bipolar disorder and even went to Capitol Hill to campaign for better mental health reform in America.

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People with mental health disorders at risk of stroke, study finds

Stroke is a leading cause of disability in the United States, and mental illness affects tens of millions of Americans each year. New research finds a link between the two, as psychiatric illness is found to raise the risk of stroke.

A new study suggests those who have mental health problems may also be at an increased risk of stroke.

The American Heart Association (AHA) estimate that almost 800,000 Americans have a stroke each year, and almost 130,000 people die from it.

Stroke is the leading preventable cause of death in the U.S.

Mental disorders also affect a large number of the U.S. population. According to the latest statistics from the National Institute of Mental Health (NIMH), over 43 million American adults aged 18 and above have had a form of mental illness in the past year. This represents nearly 18 percent of all American adults.

New research connects mental illness with stroke, as those with anxiety, depression, post-traumatic stress disorder (PTSD), and other mental disorders seem to have an increased risk of stroke.

The study was led by Jonah P. Zuflacht, a fourth-year medical student at Columbia University’s College of Physicians and Surgeons in New York, and the findings were presented at the American Stroke Association’s International Stroke Conference 2017.

The study’s lead author explains the motivation behind the research.

“Based on my clinical experience in the hospital, I have noticed that many patients believe that stress for whatever reason – work, family, work-life balance – contributed to their stroke,” Zuflacht says. “But the data to support a connection between stress and stroke is limited and often relies on a patient’s subjective recall of distress, which can bias results.”

Stroke almost 3.5 times more likely in people with psychiatric disorders

The researchers examined data from the Healthcare Cost and Utilization Project (HCUP) database for California. The HCUP is the most comprehensive hospital care database in the U.S., and it includes information on hospital visits, in-patient stays, as well as ambulatory services.

Zuflacht and colleagues found a total of 52,068 individuals who received hospital care for stroke between 2007 and 2009. Of these, 3,337 people also received care for depression, anxiety, PTSD, or other mental health issues.

The team applied a case-crossover analysis to examine if psychiatric disorders led to an increase in the risk of stroke within several time periods.

They found that people who had visited the hospital for a mental health concern were 3.48 times more likely to have a stroke within 15 days of their visit, and 3.11 times more likely within 30 days.

The odds of a stroke decreased as the time period increased, although they remained significantly high for psychiatric patients for up to a year. The risk was 2.41 times higher within 90 days of the hospital visit, 2.23 times higher within 180 days, and 2.61 times higher within 360 days of their psychiatry-related hospital visit.

Although this is an observational study and the authors did not set out to establish causality, lead author Zuflacht speculates on possible explanations for the results. Psychologic distress, he explains, may cause the brain to react with a “fight-or-flight” response – the body’s natural reaction to a state of danger. This, in turn, triggers high blood pressure, which is the leading risk factor for stroke.

Psychiatric disorders may also lead to changes within the cell, causing inflammation and oxidative stress, which are also believed to contribute to the risk of stroke, Zuflacht explains.

The study’s lead author also comments on the significance of the study.

“Healthcare professionals should listen to their patients for symptoms of psychiatric illness, especially in those who may be at increased risk of stroke. A patient with high blood pressure, high cholesterol, and 6 months of depressive symptoms should raise concerns regarding possible stroke risk.”

Dr. Jonah P. Zuflacht

Some of the limitations of the study include the missing information on what specific psychiatric condition each individual had. Such detailed information might have shed some light on which mental illnesses correlated more strongly with stroke. Additionally, the team did not include any information on outpatients with psychiatric conditions.

Learn how alcohol affects stroke risk.

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Quorum Health probing disclosures ahead of 2016 spin-off: sources

NEW YORK Hospital operator Quorum Health Corp (QHC.N) is investigating whether it provided adequate disclosure to investors prior to its spin-off last year, according to a letter seen by Reuters and a person familiar with the matter.

Quorum has retained attorney Robert Varian from Orrick Herrington Sutcliffe LLP as independent counsel to be part of its board’s probe into how its separation from Community Health Systems Inc (CYH.N) was handled in April 2016, according to the letter and the person familiar with the matter.

The letter was sent to Quorum’s board by one of its investors earlier this month. It included a reference to earlier correspondence in which Quorum indicated to the investor that it was starting an internal probe and requested more information.

The investigation comes after the investor, Texas-based hedge fund Q Investments LP, wrote to Quorum’s board last October, alleging that debt-laden Community Health Systems duped Quorum investors.

Quorum’s stock fell as much as 80 percent in the months after the spin-off, and have since bounced back slightly, giving it a market value of $240 million. The company also had total debt of $1.24 billion as of the end of September.

“We believe Community Health was desperate to raise cash, and they saw an easy path to do so by stuffing new investors in Quorum with inflated guidance and concealing costs within what they knew was a disintegrating business,” according to the letter from last October, which was also seen by Reuters.

Q Investments called on the company to launch an investigation in the October letter.

Brentwood, Tennessee-based Quorum owns or leases 36 hospitals. The company’s Chief Financial Officer Michael Culotta did not return calls on Thursday seeking comment.

Community Health Systems spokeswoman Tomi Galin said: “We categorically reject the allegations by Q Investments that Community Health Systems committed fraud or any other wrongdoing in connection with the Quorum spin-off. Community Health Systems conducted itself appropriately and made all necessary disclosures throughout the process.”

The spin-off allowed Community Health to focus on its largest markets. As part of the separation, Quorum borrowed $1.2 billion to pay a dividend to its former parent. 

Four months later, Quorum cut its earnings guidance, citing high costs and weak sales, sending its stock into free-fall.

Q Investments, which was a top 10 Quorum shareholder at the time of the spin-off and has since reduced its position, has said that Community Health likely knew about the costs and failed to properly disclose them. The hedge fund is also a Quorum bond holder.

Community Health has been looking to turn its business around by selling some of its assets in the past few months to ease its debt load of more than $15 billion.

(Editing by Greg Roumeliotis and Bill Rigby)

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Cancer patients, survivors fear GOP efforts to dismantle the Affordable Care Act

Ashley Walton was 25 when a mole on her back turned out to be melanoma. She had it removed, but three years later she discovered a lump in her abdomen. She was then unemployed and uninsured, and so she put off going to a doctor. She tried to buy health insurance. Every company rejected her.

By the time Walton finally sought medical help, the melanoma had spread to her brain, lungs and elsewhere. And she eventually became eligible for California’s Medicaid program, which had been expanded under the Affordable Care Act. Two major surgeries, radiation and immunotherapy did not cure the cancer — but did beat it back.

The 32-year-old Oakland resident credits her survival to the ACA. Without it, “I would likely be dead, and my family would likely be bankrupt from trying to save me,” she said. Her greatest concern is that Republican assaults on the law will imperil that coverage.

“For cancer survivors, we literally live and die by insurance,” Walton said.

As the battle over the law escalates, cancer patients and survivors are among the most vocal of groups raising alarms about the GOP’s repeal effort. They are calling congressional offices and showing up at their representatives’ town hall meetings with angst-filled stories about a pre-ACA world in which they couldn’t get individual health plans because of their medical histories.

Lawmakers seem to be hearing the message, especially on the issue of preexisting conditions, and they are reiterating promises to protect people with health problems in any replacement legislation. So far, though, Republicans have yet to identify a plan that would do that and still sustain insurers’ economic viability.

The fate of patient protections in the fight over the health-care law looms especially large for the cancer community because of the disease’s prevalence and the enormous cost of treatment. More than 15 million people in the United States are patients or survivors, with millions more affected as family members. And although new therapies offer much promise, the disease remains the second-leading cause of death in this country.

When The Washington Post recently asked readers how they may be affected by changes in health-care policy, a striking number said they or family members were fighting cancer and outlined an array of concerns.

“People are scared out of their minds,” said 34-year-old Erin Price Schabert, who seven years ago was treated for breast cancer. She frets whether that history would make her “uninsurable” in the individual market if she were to leave her job.

Indeed, many people described a kind of existential dread that matches their fear of cancer. Some worry that the law’s likely dismantling may put the latest oncology treatments, which can run $10,000 a month, out of reach. Others point to research showing that insurance status affects cancer patients’ survival. Still others are apprehensive about a possible end to the Medicaid expansion, which has covered millions of lower-income Americans in 31 states.

Even amid complaints about plans’ high premiums and deductibles, most people said they would rather see the imperfect law fixed than torn apart.

Erin Price Schabert, a cancer survivor who works at Smith Center for Healing and the Arts in Washington, says many survivors are “scared out of their minds” over the likely dismantling of the Affordable Care Act. (Bonnie Jo Mount/Washington Post)

The issue affects Schabert professionally as well as personally. She works in Washington with young adults at a local cancer support organization, Smith Center for Healing and the Arts. Most are too old to stay on their parents’ insurance, and many are independent contractors and so aren’t covered by employer-based insurance.

“The ACA has been their lifeline,” she said.

The 2010 law included several protections for people with preexisting conditions such as cancer, asthma or diabetes. It required insurers to accept all applicants and prohibited them from setting premiums based on health status. It also barred them from setting limits on annual and lifetime benefits — a critical provision for cancer patients.

None of that was the case before the ACA, when insurers in the individual market routinely rejected sicker, more-expensive patients or charged them much more. “Many cancer patients were unable to get coverage . . . or could only get inadequate coverage,” J. Leonard Lichtenfeld, deputy chief medical officer of the American Cancer Society, told lawmakers at a recent House committee hearing. “Cancer patients need to know that they have insurance.”

This month, House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) introduced legislation that would continue several patient protections included in the ACA. His bill would require health plans to accept all applicants and prohibit them from excluding benefits for preexisting conditions. It would also ban insurers from setting premiums based on people’s health status.

“The push to rebuild our health care system is all about patients, which is why we are making this commitment to protect patients living with preexisting conditions — it’s only fair,” Walden said in a statement.

Kirsten Sloan, senior director for policy analysis at the American Cancer Society Cancer Action Network, said it would be “a plus” if protections for people with preexisting conditions were maintained. But looking at the whole picture is crucial, she added.

“What we don’t know is what happens to the [premium] subsidies, to Medicaid, to all the other components,” she said.

House Republicans last week released a policy statement designed to show where they are headed on health care. It called for major changes in those federal subsidies, which have helped the vast majority of people with ACA policies afford their plans. The statement also talked up a drastic Medicaid overhaul and touted a “next generation” of state high-risk health insurance pools for people with big medical bills.

The latter idea sets Herbert Malamut of Southampton, N.J., on edge. He remembers the old insurance pools, which dozens of states used before the ACA as a fallback for people who couldn’t get coverage.

“Those pools were poorly funded and had high premiums and skimpy benefits,” said Malamut, 61, who was diagnosed with non-Hodgkin’s lymphoma in 2012. “I don’t know why we would go back to them.”

The GOP intends to eliminate the law’s mandate that most Americans be insured, but leaders have not detailed how they plan to motivate healthy people to sign up. Without a balance of healthy and sick enrollees, premiums can skyrocket and insurers opt out, putting the individual market at risk of collapse.

One potential approach would require individuals to maintain health insurance or face some kind of financial penalty when they next seek coverage, ­although insurers still could be blocked from charging higher premiums based on health status. Some experts note the negatives of a continuous coverage requirement for people dealing with a disease such as cancer. Individuals may have gaps in coverage because they are too sick to work or have unexpected expenses, or lose insurance because of a divorce or spouse’s death.

“Some people will fall through the cracks,” said Larry Levitt, senior vice president at the ­Kaiser Family Foundation.

The swirl of Republican ideas is only stoking the cancer community’s anxiety.

Elizabeth Alcorn, 56, and her husband have a small-group policy through her dental practice in Charlottesville. Because she has severe arthritis, she wants to retire early but is worried about coverage in a post-ACA world. “How are we going to manage this?” she said. “We are too young for Medicare.”

Her husband, who is 60, shares her concerns. He’s dealing with prostate cancer that just recurred after several years. “I have had good security with [the ACA],” Gerry Corridon said, “and now we don’t know how this is going to end up.”

In Thousand Oaks, Calif., the law’s bleak future is weighing heavily on 61-year-old Maryann Hammers, too. Diagnosed with ovarian cancer three years ago, the freelance writer underwent surgery and chemotherapy and often couldn’t work. The disease recurred seven months later, and now blood tests suggest that it’s back yet again.

“I know what’s coming next,” she said. “And it’s a friggin’ nightmare.”

There’s one thing she hasn’t had to worry about: paying for her treatment. Since January 2014, Hammers has been covered by an ACA health plan. She’s “completely panicked” about the Republicans’ plan to repeal the law and what that could do to her coverage next year.

“Without coverage, I don’t get care, and without care, I die,” she said. “So, to me, the people trying do away with the ACA are the ultimate death panel.”

Read more:

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Polarizing HHS secretary sworn in

Insurers warn of wider defections from ACA marketplaces in 2018

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Ryan Tannehill reportedly at full health for Dolphins

Ryan Tannehill will be available for the entirety of the Miami Dolphins’ offseason program after missing the last three regular-season games and the postseason with a severe knee sprain.

NFL Network Insider Ian Rapoport reported late last month that Tannehill’s partially torn ACL is no longer an issue and full reconstructive surgery will not be necessary.

Tannehill weeks ago passed a battery of tests on his ACL and Grade 2 MCL sprain, The Miami Herald’s Armando Salguero reported Thursday. He is not only fully healthy, per Salguero, but also no more susceptible to a future ACL tear in his left knee than if he’d undergone surgery.

How did Tannehill recover in such timely fashion? His treatment and rigorous rehab involved adult stem cell treatment, Salguero added. Rapoport reported last month that Tannehill was considering possibly undergoing Regenokine, a form of platelet-rich plasma therapy made famous by Lakers star Kobe Bryant. Essentially, it takes a patient’s blood, spins it to separate the platelets, then is re-injected into the knee.

The successfully recovery means Tannehill will participate in the team’s April conditioning program and organized team activities in May. The quarterback is expected to sport a knee brace throughout the 2017 season, though, and coach Adam Gase might opt to scale back his reps in offseason practices.

Barring an unexpected setback, Tannehill should be ready for his full workload by the start of training camp in late July.

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Dr. Oz: EEG Brain Scans Reveal Fake News Threatens Your Health

Sony Pictures TelevisionSony Pictures Television

Dr. Oz discusses the QEEG test, scanning brains on fake news, with Dr. Daniel Amen. Dr. Oz / Sony Pictures Television

Tomorrow, our show will spotlight a first-of-its-kind social experiment to identify the dangerous and disruptive effect of fake news on our brains. We had high profile fake news creator Jestin Coler craft two fictional stories: one designed to prey on liberals and another on conservatives. Women read the articles, not knowing they were fake, as neuropsychiatrist Dr. Daniel Amen gathered quantitative EEG assessments. The findings supported results of a functional MRI study recently published in Nature Scientific Reports, which showed how challenging a person’s political beliefs could activate the parts of the brain associated with emotion and self-identity.

A self-described liberal woman in our social experiment reported feeling sad after reading a fictional article on illegal immigrants, but revealed stronger irritation and anger when processing a fake story about a jailed climate change researcher. Simultaneous changes in her brain activity were also much greater when processing the climate change story and correlated with a strong emotional response of angst and fear. A conservative woman demonstrated opposite reactions. For her, the article on illegal immigration elicited changes in brain activity changes that you would see during a physical threat.

The women were not told that the articles were fake until they were seated on stage. What happened next was startling. First, the women understandably, but awkwardly, tried to defend why they believed the false stories, rather than expressing frustration that they had been duped. This natural human tendency was highlighted by one woman’s comment that while the news was fake, it reinforced a truth she felt about our country—so the piece was tolerable. Restated, our preexisting beliefs can reinforce and validate fake news, thus making it seem more truthful.

Coler understood that he was able to basically hack our brains to mimic the panic of physical attack, and justified his self-described “fictional” news business, because humans will believe whatever validates their world view anyway—so why not make some money with click bait in the meantime?

Why should you care?

This brings us to the real epiphany. Fake news is about money—not political or philosophical differences. It is not a noble effort to win elections or hearts, but rather crass, commercial and immoral efforts to make money.

Dr. Oz / Sony Pictures TelevisionDr. Oz / Sony Pictures Television

An audience member’s brain is scanned as she reads fake news. Dr. Oz / Sony Pictures Television

Coler is a democrat who voted for Hillary Clinton, yet wrote devastating pieces about her catering to the alt-right because it was more profitable. Apparently social conservatives, especially older ones, buy into conspiracy theories more readily.

Fake news affects and harms us all, though. Pope Francis recently proclaimed that “Disinformation is probably the greatest damage that the media can do.” In the current era, damage can be done rapidly.  That’s because we tend to be more likely to believe something when it comes from a trusted source like a friend on social media, and since it’s so easy to share these stories, they can quickly spread.

Eventually repetition leads us to forget the source, but we don’t forget the content. Stopping the misinformation after its publication and social sharing is tough. As Winston Churchill quipped, “A lie gets halfway around the world before the truth has a chance to get its pants on.”

Fake news can be written by just about anyone with very little downside risk: Democrats like Coler trying to make money; unemployed waiters; bored Republican students like Cameron Harris from Maryland, who pulled six million people into his bogus story about the discovery of fraudulent ballots for Hillary Clinton; poverty-stricken Macedonians; and illegal Russian syndicates. Their only goal is to get pennies by creating clickbait just for you, based on your biases.

So fake news is all about the money, and it’s not chump change either. Fake news publishers can rake in six-figure salaries—more than many real journalists. But where the money comes from is even more shocking!

Some of the most respected companies in America look the other way while deception takes place in their own backyards. These companies both serve up and place advertisements on websites often without regard for the quality of the content. The more eyeballs on the ads, the more money the fake news publishers—and eventually the advertisers—make.

Randall Rothenberg, leader of the Interactive Advertising Bureau, joined the show with an urgent plea to major companies. His organization represents the 650 biggest online publishers—including Google, Facebook and Spotify. Rothenberg likens today’s situation to the growth of sweatshops. In that case, major companies did not check their supply chains, and by looking the other way, large conglomerates encouraged the growth of exploitive practices. When consumers started shaming companies for these practices, corporate America shut them down. On the Internet, the supply chain is even more porous, but we have the technology and obligation to audit it and clean it up. Companies that don’t invest in this effort should be called out by consumers and other more honorable companies. If a respected auto company put inferior tires from a disreputable supplier on your brand new car, we wouldn’t stand for it. The same should apply to reputable companies who make money off of fake news.

Fake news is designed to rip you off.

You may not have thought about it, but fake news extends beyond the domain of politics—to sell cheap products with greatly inflated prices. The margins can be quite large. In fact, we have found companies offering an 80 percent commission on the purchase price for converting an ad to a sale of their goods online.

With math like this, it’s no wonder publishers will do anything, including create deceptive ads that look just like news to generate a sale. Fake news can contain all manners of claims, celebrity endorsements, and before and after pictures—all designed to steal your money and, in some cases, your health.

How the business works.

Follow the incentives to understand the actions. Online retailers offer commissions on sales to ad publishers with no idea where the leads are coming from or what the ads look like. This is not an accident and allows seemingly respectable companies to lump their ads with unscrupulous vendors to compete with the same eyeballs and subsidize the same clickbait trolling techniques offered by fake news. Producers of scam products can offer especially high commissions, since they spend a trivial amount to create their junk products.

American ad aggregator companies customize delivery of all the offered ads (reputable or not) to you based on insights they have gained by studying your habits. They are like trigger and bullet manufacturers who can avoid being blamed for the creation of guns and so they duck the ethical challenges to their business model.

The biggest companies in America purposely look the other way while crimes are committed on their sites or in their names. Legally, social media sites have been treated like billboards, where owners take no responsibility for what gets posted. But these sites are now where a large portion of the population gets their news. This essentially morphs them into news agencies, which now must be held to the same standards. This new role creates what is akin to an existential crisis for these companies. Leaders on the inside appear divided on their ethical obligation to clean up the cesspool in which they do business. Competitors with cleaner ecosystems (like gated communities) will ultimately threaten their business model, but what do consumers do in the meantime? The hypocrisy of these large companies who promise to do no evil is matched only by the impotence of U.S. regulators and lethargy of the legal system in creating rules that encourage ethical behavior and protect Americans.

So what should we do to beat fake news?

First: avoid the embarrassingly reflexive sharing of fake news. Remember that your brain is being hacked on purpose—so take control back from your amygdala. Our new mantra should be BE AWARE BEFORE YOUR SHARE.

  • Double check that the website urls match the article and are real. One great example from just this week is that US Weekly is not plural—so it is not the same as, which we found selling supplements with outlandish promises.
  • Type over-the-top news into your favorite search engine to see if any known hard news agency is reporting the same findings.
  • Be especially careful if the title of the article employs all CAPITALS. This is atypical for reputable journalists.
  • Use a fact checking website like Snopes, PolitiFact, or

Let’s push lawmakers and state attorney generals to file complaints against ad aggregators for serial offenses, while legal scholars ponder new laws that no longer protect web scammers from laws that govern print media.

Finally, let me speak to corporate America. I support Randall Rothenberg’s plea for companies to clean up their supply chains. Those mired in unethical environments should create a self-policing body and invest in technologies that cleanse the system, like they have for more traditional illegal activities like prostitution and child pornography. The spread of fake news is not good for society or our businesses. As legal and ethics expert Dov Seidman pointed out, solutions are not easy but we have the most innovative companies on the planet and should be on a journey to clean up the web—which has become especially pernicious when it comes to health.

Dr. Mehmet Oz is the director of the Integrative Medicine Center at Columbia University’s College of Physicians and Surgeons, and host of The Dr. Oz Show.

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