A Solution to Admin Baiting

One issue that would sometimes arise in our old public discussion forums could be described as admin baiting.

This is when some members assert the right to ask an administrative question, challenge a community rule or its application, or challenge an admin decision – by posting a message in the forum community for all to see.

From the perspective of an individual member, this makes some degree of sense. That person is a member of the community and asserts the right to pose such questions or challenges, expecting a staff member to answer them. From their perspective it may seem similar to sending an email or private message to a staff member. They could also justify posting the message publicly by considering that maybe other members would like to chime in as well, or perhaps others might be interested in the answers. So yeah, on that level I agree that it may seem like a reasonable thing to do.

This practice gets very problematic when you consider the admin perspective though. From the admin’s viewpoint, it’s much easier to see why this sort of behavior could be seen as an unreasonable form of entitlement.

Interestingly, I virtually never see this kind of behavior in certain groups that I’ve participated in, including groups consisting of entrepreneurs, coaches, or website owners. When I think about the culture of those groups, I’d say that most members would likely consider it rude or obnoxious to do this. Those community cultures wouldn’t reward this kind of behavior and would frown on it if a member did this, especially if it happened semi-regularly. They’d expect admin-related matters to be handled privately. When admin matters are handled within the public space of the group, there can be a real risk of stirring up drama and distraction for the community.

In other communities, this type of behavior can be very common, including in communities I’ve managed. A lot of communities have it; it’s usually just a question of how much. If you’ve ever managed your own community, how often have you seen members practice admin baiting? Did you feel obligated to answer publicly?

In our public forums, I didn’t see this as too big of a deal. We had a dozen volunteer moderators, so the load was spread around. My ex-wife Erin and I were also active in the forums, so we could field these types of questions or concerns when they came up. We didn’t necessarily see it as a problem, just a routine part of managing an online community.

The reason I use the admin baiting label is that from an admin perspective, there’s a sense of obligation to personally reply. You want to be helpful to community members, including answering questions and addressing concerns. But those good intentions can really trap you sometimes, even when you can see the nature of the trap well in advance.

For many instances of admin baiting, a quick reply or two is all it takes to handle the request – no big deal. But what if the matter is contentious? What if other members have different opinions about the initial post? What if you can predict that it would lead to a complex discussion, and you’d rather not take the time to engage in that? That’s where it begins to feel like you’ve been baited into a potential time and energy sink. Have you ever taken the bait and felt icky about it afterwards?

What if you simply ignore such requests? Community members may not like that. You may not like it either. Some may start trying to answer on your behalf, with posts that start with, “Maybe they …” or “Maybe it’s because …” Some members may post false or misleading answers – it happens. Members could even start debating with each other about it, right in front of you. If you wait too long, members may start posting conspiracy theories to explain your silence.

If you give a quick, short reply, some members may be unsatisfied with it, concluding that you’re being illusive. They may ask more follow-up questions, which only draws more attention to the discussion, inviting even more replies from other members. And if you reply to those, you may invite even more.

On the other hand, if you provide a long answer, trying to dispatch with the issue in a single reply, you actually give people more hooks to latch onto for asking more follow-up questions and/or debating with you.

How this plays out will differ greatly from group to group, but it’s easy for it to appear that you have no good options. As soon as a member posts the initial admin baiting message, you may feel that you have little choice but to take the bait, even if you can predict that there will be negative effects without much upside, like stirring up a lot of drama.

I’ve experienced this dynamic in Conscious Growth Club as well, ever since we started in 2017. In the beginning, having open discussions about the administrative aspects of the group made sense to me. It was a co-creative effort, I maintained a progress log within the group, and these open discussions seemed like a good way to be transparent with members and keep them in the loop. It felt sort of like maintaining a friendly open door policy.

Sometimes it was a bit draining though. I didn’t always want to share information on decisions if I thought people might want to debate it a lot, especially if I was busy with other projects. Sometimes I also felt that people over-stepped in their demands for info, as if they were entitled to interview me about the details whenever a member quit the group or was ejected. More than one I would see an admin baiting post and say to myself, “Oh great… this is going to lead to some drama for a few days.”

I adapted as best I could. I learned to detach emotionally, answer honestly, and let such discussions run their course. I got used to dealing with all sorts of member dynamics. I’ve a lot of practice since I’ve been involved in online communities since 1994, including founding a few of them. I’ve spent well over 10 years of my life as the head admin of one community or another. For some reason though, it took me a really long time to feel like I really understood admin baiting and why it can be so problematic. Basically I dealt with so much of it that I developed strong coping skills over a period of years without stopping to question the framing behind the issue.

Recently there was another round of this in CGC, which led to days of discussion and many dozens of posts, and some members still consider it unresolved to their satisfaction. Along the way I kept feeling that there was something entirely wrong with this approach.

I’m not entirely sure if this is related, but I’m also doing a 31-day dietary experiment this month – no grains, no legumes/beans, and no sugar for the month of August. I often experience improvements in mental and emotional clarity when I experiment with more restrictive diets. So it’s possible that this was a contributing factor to seeing the problem from a different perspective.

Eventually this question popped into my mind, and it was a game-changer for me:

Is it reasonable for members to assume the right to engage in admin baiting by posting a question, challenge, or demand related to community policies or admin decisions within the community forums, and thereby to obligate me (or any staff member) to answer them?

What do you think? Do you think that’s a reasonable privilege that a community member should have? Think about it. What’s your honest opinion on this?

Even though this privilege isn’t explicitly granted or promised, I think a lot of community members assume that it’s reasonable. They may even feel it’s unreasonable to be told otherwise. And so they may engage in the practice without even giving it much thought. It’s not unlike sending an email, right?

But if I were to ask other community managers or entrepreneurs this particular question, I think more of them would shake their heads and recognize just how unreasonable it is. It’s a disempowering obligation.

That’s when I finally realized – this assumption isn’t reasonable at all. It’s actually a ridiculously unreasonable expectation that anyone in the community should be able to assert the right to bind me to a potentially time-consuming group discussion – any time they want, as often as they want.

Note that this is entirely different from one-on-one communication, like sending someone an email. Expecting decent customer service does seem reasonable – privately.

This problem can easily creep up on admins in a slippery slope manner. Many admin-related questions are no problem to answer publicly in a forum setting. Some are just a little more complex but still easily dispatched. But every now and then, usually at random intervals, a more complex or contentious case of admin baiting can occur, and now you’re looking at many hours of work – and potentially some community drama – if you accept that invite.

Do you, as a community admin, have the freedom to say no to such invitations? Can’t you just decline, especially when you can clearly see the downsides of getting involved?

Well, how would you do that, assuming you care about maintaining a quality community with a positive and mutually supportive culture?

Will it work if you ignore it? No, we covered that already. In many cases that will make it worse.

Will it work if you reply, “No comment” or equivalent? Probably not since some members may interpret that as meaning that you have something to hide.

The problem is actually upstream. Once someone has engaged in admin baiting, your good options are limited, and they all require some time investment – time that could be better spent elsewhere.

Admin baiting is like going to a party at someone’s house, and sometime during the party, you click your glass to get everyone’s attention, and then you ask the host a question, or you challenge the host to explain something, or you demand that the host change or fix something at the party. You’ve effectively baited the host into having to respond, not just to you but now to everyone in the room. And no matter what kind of reply the host gives, anyone else in the room may assert the right to continue discussing, debating with, or interviewing the host. This could last for a minute… or 10 minutes… or the rest of the evening. The host never really had a good option after being put on the spot, and their ability to engage with the party the way they’d have preferred was derailed to some extent.

For in-person settings like a party or live event, this kind of behavior is typically considered a bit obnoxious except in certain limited settings. But people tend to think differently about online communities. They don’t see all the other people while looking at a forum window, so the social cues aren’t the same.

Within the past several days, I pondered how to solve this problem. I still want to serve community members. I still like being able to provide some transparency. Is there a win-win solution that would serve the same purpose without the practice of admin baiting?

If we take admin baiting off the table, what could we do instead? I think the basic solution looks like this (and “thank you” to the friend who suggested this phrasing):

Take it outside.

In other words, handle administrative issues privately, via one-on-one communication such as email or private messages. Don’t handle them within the community space in front of all of the other members.

Such interactions are likely to be faster and shorter, and they don’t clutter the community with admin-related discussions (especially lengthy ones).

Admin baiting often turns into member baiting as well. Generally speaking members usually prefer to engage with a community on the basis of the community’s core focus and purpose. But if an admin-related discussion arises, especially a complex or contentious one, it can easily draw other members into the discussion, even though they’d probably be better served by focusing on other discussions instead.

An issue that a few members care enough about to engage in a private exchange with an admin could blow up to rope in 3x, 5x, or 10x as many members if discussed openly in the community space. That potentially creates a lot more burden for both the admins and the members.

Now if an admin sees that multiple members are having the same sort of requests through private interactions, the admin can disseminate relevant information more widely, such as by adding an item to a FAQ or by sending out a group email. But in that case it’s a choice – an option – not an immediate obligation.

I saw many other potential benefits to the removal of admin baiting, including better focus for the community, fewer distractions, better community morale, and more value for the members. Consequently, I’ve opted to test this approach in CGC. Yesterday I updated our member rules and guidelines to prohibit admin baiting in the community, steering members to handle admin-related items through private communication, including admin-related questions, sharing feedback on decisions, and more.

It’s barely been 24 hours, and I’m already seeing benefits from this approach. For starters, it’s predictable that this will save a lot of time, energy, and angst down the road. My wife Rachelle is our Community Manager, and she’s also pleased with this change since it makes her job much easier too.

Secondly, the initial feedback and questions that are coming through privately have been thoughtful, useful, and actionable. I like that communicating with a member one-on-one feels more intimate than doing it in the public space of the community forums. I can focus more intently on one person’s questions, comments, or concerns instead of seeing a long page of mixed messaging to decipher.

I can understand that some members may see this as a move away from transparency because we won’t be having open discussions about admin policies and decisions in the forums. I thought about that in advance, and my thinking was that this is probably a neutral type of change transparency-wise. It doesn’t limit my ability to share information with the members. It just gives me more options for doing so.

If I really want to do so, I can still invite an open discussion regarding a policy or decision if I think it would be useful and reasonable. So I always have that option; it just isn’t obligatory. I can see some situations where that might be useful and productive.

Also, there’s still the open door for members to share the same types of issues. We’re just handling this communication outside of the community space.

I like quality feedback, especially when it’s actionable. I’m okay with some debating now and then. I like helping customers and CGC members. And gradually I’ve been learning that some communication is much better suited to a private, one-on-one format.

Even when you consider the transparency aspects, it’s easier to be transparent in one-on-one communication, especially when the relationship is high-trust, and you can customize the communication for each person.

In some ways this is similar to the decision I made not to have public comments on my blog. I actually started with having comments when I began blogging in 2004, but I removed that option in 2005 after it reached about 100 comments per day. What happened afterwards was that I received private feedback via email that was much lower in volume and much higher in quality. I found that to be a very positive change, which is why I’ve kept it this way for 15 years now. I have no regrets about that; it still seems like it was a wise change.

Interestingly, people are more likely to add posts to a community discussion than to send a private message about it. A blog post that might have garnered 100 public comments may generate only a few private emails, sometimes none at all. A forum post on an issue that could have generated dozens of replies may generate just a handful of private messages.

You might think there would be a lot of redundancy from having to field the same types of questions and comments privately, but it’s actually the opposite. There’s way more redundancy when discussions are public. When people send private messages, they tend to be more unique and varied. I’m still pondering why that is. Maybe it’s because people are strongly influenced by what they read in a discussion, and it narrows their focus.

I genuinely feel this type of change is better for our members too, although I can understand why it may be harder to see that when the change is still fresh. I imagine that it will take some members a bit of time to get used to it, but I think they’ll grow to like it when they see how much simpler and smoother it is for all involved.

I think it has a lot of promise, but it is reversible, so if for some reason it doesn’t work out, we can always revert back to the old ways if necessary. I’d be reticent to return to the old reality though, and I’m hopeful that this change will prove itself to be an intelligent, win-win solution. It’s also pretty flexible, so if problems arise there are still plenty of ways to tweak it. In fact, if you know of a better approach than what I’ve outlined here, please do let me know about it. I’m still on the lookout for intelligent communication practices for online communities.

Lastly, I want to make it clear that I harbor no resentment towards anyone who has engaged in this practice in any community I’ve managed. It’s the behavioral pattern and its consequences that I’m addressing here. I surely must admit that in some communities, I occasionally engaged in admin baiting too, not seeing it from the admin perspective at the time. Going forward I want to watch out for this pattern within myself and do my best to “take it outside” for matters that would be more gracefully handled in private.

It’s interesting what solutions can emerge when we look at a problem or challenge from multiple angles.

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Mount Everest summit success rates double, death rate stays the same over last 30 years

As the world’s tallest peak, Mount Everest draws more than 500 climbers each spring to attempt the summit during a small window of favorable conditions on the rugged Himalayan mountain that tops out at just over 29,000 feet.

A new study led by researchers at the University of Washington and the University of California, Davis, finds that the success rate of summiting Mount Everest has doubled in the last three decades, even though the number of climbers has greatly increased, crowding the narrow route through the dangerous “death zone” near the summit. However, the death rate for climbers has hovered unchanged at around 1% since 1990.

The findings were published Aug. 26 in the open-access journal PLOS ONE. They represent the most comprehensive look at success and death rates in the published literature on Everest. The paper also identifies patterns in the characteristics of mountaineers — such as age, sex and prior experience — that might influence their likelihood of summiting or dying during the spring climbing season.

“Mount Everest is still a very dangerous mountain, and climbing it will never become a walk in the park, because it’s way above the limits of what most people can do,” said lead author Raymond Huey, a UW professor emeritus of biology. “Unfortunately, reported statistics of risk on Everest are often inaccurate. By analyzing climbing data, we provide accurate information on the chances of success and on the chances of dying, thereby helping climbers make an informed decision about whether to attempt this great peak.”

These patterns also can help Nepal and China in deciding whether to institute restrictions on climbers such as maximum age or experience level, Huey added.

Huey and colleagues analyzed the success and death rates for all first-time climbers who had a permit to summit Everest during the period of 2006 to 2019. Previously, they applied the same statistical methods to climbers during the period of 1990 to 2005 and, as a result, they were able to compare success and death rates between the two periods.

During 1990 to 2005, more than 2,200 first-time climbers attempted to summit Everest. During 2006 to 2019, that number increased to more than 3,600 climbers. Importantly, the researchers focused on climbers with paid permits, excluding climbers with additional tasks — such as high-altitude porters, photographers and support staff — along with climbers who attempted to summit in other seasons, or who were attempting the summit for the second time or more.

They also excluded a handful of years from the analyses when extreme events such as ice fall avalanches or earthquakes led to cancellations of the climbing season.

Comparisons between the two periods show that:

  • Summit success rates from the first period to the second period have essentially doubled; two-thirds of climbers now reach the summit, verses one-third previously
  • The overall death rate of around 1% hasn’t changed
  • A contemporary 60-year-old climber has the same success rate (about 40%) as a 40-year-old climber in the prior period — i.e., 60 is the new 40
  • A contemporary 60-year-old climber has the about the same death rate (about 2%) as a 48.5-year-old in the earlier period
  • More women are attempting the climb in recent years (14.6%) verses the previous period (9.1%)
  • Women and men had very similar odds of success or death in both periods

The researchers say the doubling of the summit success rate is likely due to a number of factors. Weather forecasting has dramatically improved since the “Into Thin Air” storm of 1996, Huey said, giving climbers more information on the best window to push for the summit. Some climbers are using elevated flow rates of supplemental oxygen — and doing so lower on the mountain. The most popular routes have fixed lines, meaning climbers can clip into ropes tethered to the mountain for their ascent and descent, making it safer if they fall.

Increased experience of expedition leaders and high-altitude porters may also have helped boost success rates. Interestingly, while more climbers are making it to the top in recent years, today’s climbers are actually less experienced in climbing tall peaks in Nepal than climbers who attempted Everest in the 1990s and early 2000s.

Finally, the researchers looked at the effects of crowding near the summit for the past two climbing seasons (permits were not issued in spring of 2020 because of COVID-19). Detecting possible effects of crowding is difficult with available information, they said, but their analysis didn’t show any impacts of crowding on success or death rates. However, crowding must slow climbers, increasing their exposure in the death zone, they added.

The data for these analyses came from The Himalayan Database, a comprehensive website based on archival interview records of Elizabeth Hawley. Hawley, a news correspondent for Reuters based in Kathmandu, and originally from Chicago, maintained the official record of all climbers and summit successes for Everest and hundreds of other Nepalese peaks until she died several years ago. The project continues under new leadership.

“It’s a remarkable data source,” Huey said. “She was legendary — climbers used to say you have not climbed Mount Everest until Ms. Hawley says you’ve climbed Mount Everest.”

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How cold was the ice age? Researchers now know

A University of Arizona-led team has nailed down the temperature of the last ice age — the Last Glacial Maximum of 20,000 years ago — to about 46 degrees Fahrenheit.

Their findings allow climate scientists to better understand the relationship between today’s rising levels of atmospheric carbon dioxide — a major greenhouse gas — and average global temperature.

The Last Glacial Maximum, or LGM, was a frigid period when huge glaciers covered about half of North America, Europe and South America and many parts of Asia, while flora and fauna that were adapted to the cold thrived.

“We have a lot of data about this time period because it has been studied for so long,” said Jessica Tierney, associate professor in the UArizona Department of Geosciences. “But one question science has long wanted answers to is simple: How cold was the ice age?”

Tracking Temperature

Tierney is lead author of a paper published today in Nature that found that the average global temperature of the ice age was 6 degrees Celsius (11 F) cooler than today. For context, the average global temperature of the 20th century was 14 C (57 F).

“In your own personal experience that might not sound like a big difference, but, in fact, it’s a huge change,” Tierney said.

She and her team also created maps to illustrate how temperature differences varied in specific regions across the globe.

“In North America and Europe, the most northern parts were covered in ice and were extremely cold. Even here in Arizona, there was big cooling,” Tierney said. “But the biggest cooling was in high latitudes, such as the Arctic, where it was about 14 C (25 F) colder than today.”

Their findings fit with scientific understanding of how Earth’s poles react to temperature changes.

“Climate models predict that the high latitudes will get warmer faster than low latitudes,” Tierney said. “When you look at future projections, it gets really warm over the Arctic. That’s referred to as polar amplification. Similarly, during the LGM, we find the reverse pattern. Higher latitudes are just more sensitive to climate change and will remain so going forward.”

Counting Carbon

Knowing the temperature of the ice age matters because it is used to calculate climate sensitivity, meaning how much the global temperature shifts in response to atmospheric carbon.

Tierney and her team determined that for every doubling of atmospheric carbon, global temperature should increase by 3.4 C (6.1 F), which is in the middle of the range predicted by the latest generation of climate models (1.8 to 5.6 C).

Atmospheric carbon dioxide levels during the ice age were about 180 parts per million, which is very low. Before the Industrial Revolution, levels rose to about 280 parts per million, and today they’ve reached 415 parts per million.

“The Paris Agreement wanted to keep global warming to no larger than 2.7 F (1.5 C) over pre-industrial levels, but with carbon dioxide levels increasing the way they are, it would be extremely difficult to avoid more than 3.6 F (2 C) of warming,” Tierney said. “We already have about 2 F (1.1 C) under our belt, but the less warm we get the better, because the Earth system really does respond to changes in carbon dioxide.”

Making a Model

Since there were no thermometers in the ice age, Tierney and her team developed models to translate data collected from ocean plankton fossils into sea-surface temperatures. They then combined the fossil data with climate model simulations of the LGM using a technique called data assimilation, which is used in weather forecasting.

“What happens in a weather office is they measure the temperature, pressure, humidity and use these measurements to update a forecasting model and predict the weather,” Tierney said. “Here, we use the Boulder, Colorado-based National Center for Atmospheric Research climate model to produce a hindcast of the LGM, and then we update this hindcast with the actual data to predict what the climate was like.”

In the future, Tierney and her team plan to use the same technique to recreate warm periods in Earth’s past.

“If we can reconstruct past warm climates,” she said, “then we can start to answer important questions about how the Earth reacts to really high carbon dioxide levels, and improve our understanding of what future climate change might hold.”

The research was supported by the Heisings-Simons Foundation and the National Science Foundation.

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Antarctic ice shelves vulnerable to sudden meltwater-driven fracturing, says study

A new study says that many of the ice shelves ringing Antarctica could be vulnerable to quick destruction if rising temperatures drive melt water into the numerous fractures that currently penetrate their surfaces. The shelves help slow interior glaciers’ slide toward the ocean, so if they were to fail, sea levels around the world could surge rapidly as a result. The study appears this week in the leading journal Nature.

Ice shelves are giant tongues of ice floating on the ocean around the edges of the continent. The vast land-bound glaciers behind them are constantly pushing seaward. But because many shelves are largely confined within expansive bays and gulfs, they are compressed from the sides and slow the glaciers’ march — somewhat like a person in a narrow hallway bracing their arms against the walls to slow someone trying to push past them. But ice shelves experience a competing stress: they stretch out as they approach the ocean. Satellite observations show that, as a result, they rip apart; most are raked with numerous long fractures perpendicular to the direction of stretching. Fractures that form at the surface can be tens of meters deep; others, forming from the bottom, can penetrate the ice hundreds of meters upward. Some fractures are hundreds of meters wide.

Currently, most of the shelves are frozen year round, and stable. But scientists project that widespread warming could occur later in the century. And, existing research has shown that even subtle temperature swings can spur widespread melting. This could send melt water surging into the surface fractures. Such surges would potentially cause hydrofracturing-a process in which liquid water, heavier than ice, would violently force the fractures to zip open, and cause the shelf to rapidly disintegrate The new study estimates that 50 to 70 percent of the areas of the ice shelves buttressing the glaciers are vulnerable to such processes.

“It’s not just about melting, but where it’s melting,” said lead author Ching-Yao Lai, a postdoctoral researcher at Columbia University’s Lamont-Doherty Earth Observatory.

“The ice shelves-that’s the weak spot, where the atmosphere, the ice and ocean interact,” said study coauthor Jonathan Kingslake, a glaciologist at Lamont-Doherty. “If they fill up with melt water, things can happen very quickly after that, and there could be major consequences for sea levels.”

Hydrofracturing has already occurred in a few places. Parts of the Larsen Ice Shelf, which had been stable for at least 10,000 years, disintegrated within just days in 1995 and 2002. This was followed by the partial breakup of the Wilkins Ice Shelf in 2008 and 2009. The main agreed-upon causes: hydrofracturing. The Larsen and Wilkins comprise some of the northernmost ice on the continent, and so have been the first to suffer under rising temperatures and seasonal melting.

The new study follows a 2017 paper led by Kingslake showing that seasonal ponds and streams on the ice surface are far more common across Antarctica than previously believed; some reach within 375 miles of the South Pole. But most cataloged features are in places not subject to hydrofracturing. The new study shows that, so far, only about 0.6 percent of East Antarctic ice shelves that provide buttressing experience melt-water ponding, making them vulnerable. A much larger percentage would potentially be endangered, if warming takes hold.

In collaboration with Cameron Chen, a researcher from Google, Lai trained a machine-learning model to identify ice-shelf fracture locations across Antarctica, to produce the first continent-wide map of such features. Although most fractures now contain no liquid water, the scientists considered future cases in which melt water might fully fill the surface fractures. This allowed them to predict which parts of the shelves would be vulnerable to hydrofracturing, when factoring in the competing forces of compression from the sides, and stretching of the ice from back to front.

They calculated that inflow of liquid into the existing fractures could potentially exert enough force to cause widespread hydrofracturing across 50 to 70 percent of the ice-shelf areas that provide buttressing. The main exceptions were smaller, solider areas of ice closest to land, which experience less stress from stretching. The end portions of the shelves, mostly surrounded by open ocean, are also vulnerable, but floating freely as they do, those do not help hold back the glaciers.

While the study flashes a warning, the researchers say they cannot predict the ice shelves’ behavior with any exactitude. “How fast melt water would form and fill in those cracks is the first question,” said Kingslake. He said the worst-case scenario would be that “lots of places will be covered by lots and lots of water by the end of the century.” But projections vary widely, depending on which models scientists use, and how vigorously humanity cuts greenhouse gases, or not. The second question is whether particular locations will undergo hydrofracturing, he said. The third question: whether the process would run away, causing the shelf to undergo explosive Larsen-type disintegration.

Theodore Scambos, a leading Antarctic glaciologist and the National Snow and Ice Data Center, said the paper “does a great job of pointing to areas where one can say, ‘If it floods with melt here, it’s likely to break up the shelf.” He added that it “has huge implications for sea level” if summer temperatures along the coasts rise.

“Eventually, all the ice shelves could be covered by melt water,” said Lai. “But we don’t have a time frame, and there are a lot of big questions left.”

The study was also coauthored by Martin Wearing of the University of Edinburgh; Pierre Gentine, Harold Li and Julian Spergel of Columbia; and J. Melchior van Wessem of Utrecht University.

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Health24.com | More money, better heart health? Not always

Young people who pull themselves out of poverty may be no better off when it comes to their heart health, a new study suggests.

Researchers found that “upwardly mobile” US adults tended to be less stressed and depressed than peers who spent their whole lives below the poverty line. Unfortunately, it did not make a difference in their cardiovascular health.

They were just as likely to have conditions like obesity and elevated blood pressure, blood sugar and cholesterol, the study found.

The results might sound surprising, said Dr Nieca Goldberg, a cardiologist and volunteer expert with the American Heart Association. After all, both higher income and better mental health have been consistently linked with better physical health.

Better mental shape

“But I can think of a few reasons for the findings,” said Goldberg, who was not involved in the study.

“When you consider it, these are people who work very hard,” she said. “They may be really focused on their jobs, at the expense of other things. They may have no time for exercise, or end up eating a lot of grab-and-go foods.”

Compared with people whose income stays low, Goldberg said, they may be less worried about money and security – and, therefore, in better mental shape. But that doesn’t necessarily mean their lifestyles are healthy.

Lead researcher Gregory Miller agreed that lack of time for exercise or “restorative activities” like vacations could be a factor. But he also pointed to the “direct physical toll” of constant striving for the proverbial American dream.

Upwardly mobile Americans did show less psychological distress. But measures used in the study might not have picked up subtler issues, according to Miller, a faculty fellow at Northwestern University’s Institute for Policy Research in Evanston, Illinois.

“When you talk to people,” he said, “you hear things like, ‘I got to where I am due to great determination.’ And the attitude can be, ‘I don’t have time to be depressed, I don’t have time to be stressed. I have to keep going.'”

Signs of faster ageing

It can all start early, when a kid from a poor family “beats the odds” and gets into college, according to Miller. If earlier schooling left them less prepared, they may need to hit the books twice as hard as more-advantaged classmates.

The mindset of “I need to work twice as hard” can persist, especially for minorities facing racial discrimination, Miller said.

Other research has linked that type of striving to higher levels of stress hormones and signs of faster “ageing” in blood cells, according to Miller’s team.

The current findings are based on data from two US health studies begun in the 1990s. One involved a nationally representative sample of teens who were followed until their early 30s; the other included adults of all ages.

Participants were considered upwardly mobile if they grew up in families living below the poverty line or receiving welfare but their own incomes were higher.

Compared with their peers who remained in poverty, that group did report less “perceived stress” and depression symptoms, Miller’s team found. But they were just as likely to have metabolic syndrome – a collection of risk factors for heart disease that includes abdominal obesity, and elevated blood pressure, blood sugar and cholesterol.

‘Money can’t buy you health’

Overall, 29% of upwardly mobile Americans had metabolic syndrome by age 29, and 44% had developed it by middle-age. That compared with 24% and 33%, respectively, among people who were more advantaged throughout life.

The findings were published online in April in the Journal of the American Heart Association.

According to Goldberg, higher earnings may protect upwardly mobile people from some major stressors their parents faced – like worrying about paying the rent or affording groceries. “But money can’t buy you health,” she said.

Goldberg encouraged hard-working people to remember to care for themselves, too. That, she said, can be as simple as taking walks with your family.

Beyond that, Miller pointed to the need for broader efforts.

At colleges, for example, students from disadvantaged backgrounds can often get academic help if they need it; but, Miller said, “We don’t do much to help them feel more included.”

It can be isolating, he noted, “when you don’t have enough money for the football game, let alone the weekend ski trip.”

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Health24.com | Could a hormone help spur high blood pressure?

Many people with high blood pressure may have an unrecognised hormonal condition driving their numbers up, a new study suggests.

The condition, called primary aldosteronism, arises when the adrenal glands overproduce the hormone aldosterone. That causes the body to retain sodium and lose potassium, spurring a spike in blood pressure.

Doctors have long considered the condition an uncommon cause of high blood pressure. But that, researchers say, is because they are simply not testing for it.

In the new study, about 22% of patients with more severe high blood pressure had primary aldosteronism. The same was true of almost 16% of patients with milder, stage 1 high blood pressure, according to findings published online in May in the Annals of Internal Medicine.

Common cause of hypertension

It all suggests doctors need to “redefine” the traditional view of primary aldosteronism, said researcher Dr Anand Vaidya, of Brigham and Women’s Hospital, in Boston.

Far from being rare, he said, it appears to be a common cause of high blood pressure.

The study is a “game-changer”, according to Dr John Funder, a distinguished scientist with the Hudson Institute of Medical Research, in Melbourne, Australia.

Funder said it shows that the way doctors have been screening for primary aldosteronism – for decades – does not provide the true story.

Funder, who wrote an editorial published with the findings, said the standard screening method is “fatally flawed”.

It is done via a single blood draw, taken in the morning. But aldosterone levels, like those of other hormones, fluctuate over the course of a day. So that single blood measurement, Funder explained, does not capture a person’s daily aldosterone secretion.

On top of the “misleading” test, he said, few people are screened at all.

Primary aldosteronism can be treated

Current guidelines suggest screening only in certain cases. That includes people who have “resistant” hypertension (the medical term for high blood pressure), which means blood pressure that remains high despite a three-medication regimen; and people with hypertension plus low potassium.

Yet even among those patients, only between 2% and 3% are ever screened, said Dr William F. Young Jr, chair of endocrinology at the Mayo Clinic in Rochester, Minnesota.

“Primary care providers don’t think about primary aldosteronism [PA] and do not test for it,” he said.

As an endocrinologist, Young generally sees patients only after their primary doctor refers them for specialist care.

“For more than three decades,” he said, “it has been frustrating to me to see patients who were not tested for PA when they were first diagnosed with hypertension, but rather only after they have developed irreversible, stage four to five chronic kidney disease.”

Varying degrees of hypertension

The good news is, primary aldosteronism can be treated. Most often, that means healthy lifestyle changes and taking aldosterone-blocking medications called mineralocorticoid receptor antagonists – which include spironolactone and eplerenone.

The new findings are based on 1 015 patients at four US hospitals. Some had normal blood pressure; the rest had varying degrees of hypertension. To screen for primary aldosterone, Vaidya’s team used a rigorous method: After some days on a high-sodium diet or sodium pills, patients collected their urine samples over 24 hours.

The researchers found that even among people with normal blood pressure, 11% had primary aldosteronism. That rate was 22% among people with resistant hypertension and those with stage 2 hypertension (blood pressure of at least 140/90 mm Hg).

But if someone with primary aldosteronism is already on blood pressure medication, isn’t that enough? No, Funder said.

He pointed to one 2018 study. It found that when patients with primary aldosteronism did not have the condition sufficiently controlled with medication, their risk of heart complications and death were three times higher, versus people with hypertension only.

Screening method ‘laborious’

Whether screening guidelines change remains to be seen. For now, Vaidya said that people with resistant hypertension should be screened (as already recommended), and that doctors “might consider it” for patients with more moderate hypertension.

An issue, though, is that the screening method used in this study is “laborious”, Vaidya noted. He said another option is to prescribe spironolactone for a period, to see if that lowers a patient’s blood pressure further. The drug has been around for years, and is available as a generic.

Funder was even more supportive of that tactic. “A three-month trial of spironolactone for patients with established hypertension is the way to go,” he said.

The study was funded by the US National Institutes of Health.

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Health24.com | Flu shots for kids protect everybody, a US study shows

  •  In the USA, there is an issue of vaccine hesitance when it comes to children
  • When kids get the flu shot, there is, however, a general reduction in flu hospitalisations
  • An expert described children as ‘magnifying influenza’

When elementary school students get their annual flu shot, everyone benefits, a new study shows.

An increased vaccination rate among grade-schoolers in California was associated with a decrease in flu hospitalisations for people in every other age bracket, researchers report.

The results come as no surprise to public health experts, given children’s well-earned reputation as a major vector for the spread of viral diseases.

“It basically correlates with everything we know about public health, about vaccination, and about children and children’s impact on spreading viral illness throughout a community,” said Dr Eric Cioe-Pena, director of global health for Northwell Health in New Hyde Park, New York.

Vaccine hesitance

However, the study does highlight the continuing need to convince reluctant parents of the importance of getting their kids an annual flu shot, Cioe-Pena added.

“We have an issue of vaccine hesitance in [the United States] when it comes to children,” said Cioe-Pena. “To me, if you don’t get to the root cause of the hesitance, it probably won’t have much of an impact.”

For this study, researchers led by Jade Benjamin-Chung, from the University of California, Berkeley, tracked a city-wide school flu vaccine program in Oakland, California, and compared its success to rates of flu-associated hospitalisations.

After four years, the programme had improved vaccination coverage by 11% among children attending more than 95 preschools and elementary schools in Oakland, the researchers reported.

The increased vaccination rate was associated with 37 fewer flu-related hospitalisations per 100 000 people among all other people in the community – children aged four and younger as well as people aged 13 and older.

Fewer school absences

There were also 160 fewer influenza hospitalisations per 100 000 among people aged 65 and older, the results showed.

The elementary school children also benefited; researchers observed a decrease in illness-related school absences during the flu season.

The findings were published online on 18 August in the journal PLOS Medicine.

“We know that children magnify influenza,” said Dr Amesh Adalja, a senior scholar with the Johns Hopkins Center for Health Security in Baltimore. “Trying to increase children’s vaccination rates can be expected to have a cascading impact on the flu season. Making it easy for children to get vaccinated is one way to improve our ability to deal with influenza.”

Children tend to benefit more from the flu vaccine, because their immune systems are fresher and more responsive, Adalja added.

Congregational settings

“In younger people, the vaccine induces more antibodies than in individuals 70 years or older,” Adalja explained. “Older people’s immune systems do not respond to the vaccine as well as a younger individual does. That’s why we use high-dose vaccines with the elderly population.”

Given these results, it might make sense to promote flu shots for children as much as they are promoted for the elderly and health care workers, said Dr Waleed Javaid, director of infection prevention and control at Mount Sinai Downtown in New York City.

“When we can enhance our protection of any aspect of society where we have congregational settings and people are going to mingle with each other – like [the] military or hospitals or schools – that protects society in general,” Javaid said.

Adalja agreed.

“Our goal in the United States is to vaccinate everybody above the age of six months with influenza vaccine. That should still be the goal,” Adalja said. “If you’re trying to prioritise within that group, then children should be a major priority group to be vaccinated because they do drive it, but I do think you also have to vaccinate the vulnerable – the elderly and people with other medical conditions. They have to be a priority group as well.”

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