WASHINGTON — Some good health news: Americans’ cholesterol levels are dropping, and more people at especially high risk are getting treatment.
Researchers say Monday’s report suggests a controversial change in recommendations for cholesterol treatment may be starting to pay off.
“It is very heartening,” said Dr. Pankaj Arora of the University of Alabama at Birmingham, who led the study. “But there is more to do.”
Heart disease is the world’s leading killer and high cholesterol is a key risk factor — but not the only one. Doctors long treated patients based mostly on their level of so-called “bad” cholesterol, whether they had other risks or not. In 2013, national guidelines urged them instead to focus more on people’s overall heart risk, by taking into account age, blood pressure, diabetes and other factors. Those at highest risk would get the most benefit from cholesterol-lowering statin drugs.
The Alabama team examined records from the Centers for Disease Control and Prevention that tracked cholesterol information from more than 32,000 adults between 2005 and 2016.
Among people taking cholesterol medication, the average level of that “bad” cholesterol — what’s known as LDL cholesterol — dropped 21 points over the study period, the researchers reported in the Journal of the American College of Cardiology. It was declining even before the 2013 guidelines but continued to inch down afterward.
Total cholesterol levels and another fat known as triglycerides likewise decreased.
“These are surprisingly impressive results” that together predict a 15% to 20% reduction in risk of heart attacks and strokes, said Dr. Michael Miller, preventive cardiology chief at the University of Maryland Medical Center, who wasn’t involved with the study.
Moreover, there was an uptick in statin use by people with diabetes over the study period, from less than half to over 60% getting one. Diabetics are particularly vulnerable to heart attacks and tend to have poorer outcomes.
“It’s very important for those with a diagnosis of diabetes to not get that first heart attack,” said Dr. Neil J. Stone, a cardiologist at Northwestern University. He led development of the 2013 guidelines from the American College of Cardiology and American Heart Association, and he co-authored an update last year.
Arora cautioned that other high-risk groups haven’t seen an increase in treatment — and that still too many Americans don’t know if they have a cholesterol problem.
The advice for consumers? If you haven’t had a cholesterol check recently, get one, Miller said.
Testing is easier than ever, as fasting no longer is required. Especially if you have additional risk factors, high cholesterol should spark a frank conversation about diet, exercise and the pros and cons of statins.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
Yakima School District leaders intend to request a more extensive independent survey of employee culture and civility.
The decision comes after the May release of a report conducted by the state Labor Department, which found reports of autocratic leadership and threats to employment through in-depth interviews with 23 district employees.
The intent is to get a better understanding of how widespread the issue is in the roughly 2,000-employee district and to work to eradicate it, said Superintendent Trevor Greene.
“It’s about doing the best that we can together, and only together can we really improve outcomes for our students,” he said. This collaboration isn’t possible “if people are feeling disenfranchised, not valued.”
In May, a study conducted by the state Labor Department’s Safety and Health Assessment and Research for Prevention program revealed employee reports of a top-down environment of disrespect and unprofessional behavior in the district.
The study was requested by district counselor Michael Rhine, a Yakima Education Association executive board member.
It was based on detailed interviews with 23 district employees during the 2018-19 school year and was published shortly before former superintendent Jack Irion retired at the end of June.
The anonymized results detailed school administrators yelling, threatening people’s jobs and using staff relocation as a retaliatory measure.
Reports by those interviewed included anecdotes of principals micromanaging staff, ignoring staff concerns, pounding their fists during meetings and yelling, as well as allowing parents to yell at or put down teachers in front of students.
Study participants also reported school and district leaders targeting and intimidating “individuals in protected categories,” putting the district at risk of Equal Employment Opportunity Commission-related lawsuits, the study said.
Those interviewed said the behavior disrupted classrooms and interfered with learning. It also led some staff to think about leaving education, and others to consider self-harm.
The study was paid for by the Safety and Health Assessment and Research for Prevention program, which examines how work environments influence occupational safety, retention and turnover, as well as worker health and well-being.
This was the first time SHARP conducted a civility report in a school district in Washington. The organization previously studied civility among state librarians.
Rhine, of the YEA executive board, said he had seen an “immediate improvement across the district” in work culture in the wake of the survey.
For one thing, school board President Raymond Navarro put out a call to current and former employees to share further concerns related to the study, he said.
“That was an immediately positive impact that that report had,” Rhine said.
Greene said he collaborated with the board to address concerns raised by each respondent to Navarro’s call.
Rhine also noted that Greene highlighted civility work in the district as one of his top three priorities when he joined the district in July.
“I’ve seen the immediate positive steps in acknowledgment, so this isn’t just something that’s going away,” he said.
Rhine said the report had created a “rippling effect,” with lawmakers and other school districts striking up conversations about work culture in schools statewide.
Moving forward, Rhine said he hoped to see the Yakima School District undergo a more expansive survey, as well as receive staff training around civility, self-care, communication styles and conflict management.
Greene said last week that he planned to request a more widespread survey of district staff from the state Labor Department. He hoped the follow-up would reveal how widespread the issue is and serve as a baseline for improvement.
The request would likely be made in January, Greene said, around his six-month mark in the position. This was intended to allow more time for him to build trust and relationship with school and district staff, Greene said.
YEA President Steve McKenna said the union had already reached out to Nanette Yragui, the occupational health research psychologist from SHARP who led the initial survey. She is putting together a proposal for a survey “much wider in scope,” McKenna said. He added that this survey would again be conducted independently and anonymized to allow candid responses by district staff.
Yragui could not be reached for comment.
Separately, Greene said he hoped to collaborate with YEA to conduct a joint school climate survey — something suggested in the original report. Ideally, he said, this would take place in April if YEA agreed on the survey and timing.
McKenna said more trust needs to be built before employees would feel safe responding honestly to an administration-led survey.
“We want to make sure that people’s identities are protected so that supervisors aren’t going to go after them, which has happened multiple times in multiple buildings in the past,” said McKenna. “So I think we need to establish more trust before we get to that point.
“The fact that we’re able to discuss these things directly and recognize that there’s a problem is a huge step forward, and so I think that we believe we’re moving in the right direction,” he said.
Greene echoed McKenna’s belief that things are improving. A significant step, he noted, was new or revived lines of communication between administrators and employees.
“I think that has shown in some of the comments regarding some uncivil behavior,” he said. “There were things that could have been addressed better that I know we’re being much more intentional about in these past few months and that will continue to happen.”
Before bringing on new assistant superintendent of human resources Anthony Murrietta this school year, the role had been unfilled. Murrietta has started meeting regularly with representatives of each of the district’s 13 bargaining units to address concerns more proactively, Greene said.
Greene has been participating in the monthly meetings with YEA, the district’s largest bargaining unit.
“We want to make sure that we’re addressing the issues that they saw” that provoked the survey request initially, he said.
Parents, community members and business leaders in Yakima have also been brought into conversation in English and Spanish about the district’s direction as a new five- to seven-year strategic plan is being developed, Greene said.
“I feel that there’s been a culture shift, and that (information) is coming in through more quality conversations and feedback,” he said. “It does take time to turn that ship around, and I do think we’re making that turn.”
After seven years of planning, more than a dozen months of construction and many days of fine-tuning, the $22 million YMCA and Yakima Rotary Aquatic Center will open this week.
For some, it’s already open. YMCA Legacy and Charter members could check out the 72,000-square-foot facility at 3800 River Road from 7 a.m. to 7 p.m. Monday and Tuesday, even as subcontractors and construction workers are finishing jobs throughout the building.
“The idea for (Monday and Tuesday) is to get our members in to get familiar with the equipment; give them an opportunity to come in and get to know the facility a little bit,” said Bob Romero, executive director of Yakima Family YMCA, on Monday.
“We’ve had a pretty steady flow of people throughout the day,” he said.
On Wednesday, Romero will help lead a ribbon-cutting ceremony inside the aquatic center at 10 a.m. It’s invitation only because of space limitations, but the YMCA will have a public open house for tours from noon to 8 p.m. Those interested in joining may sign up then as well, or at the existing YMCA at 5 N. Naches Ave. in downtown Yakima, which is staying open.
The new facility will open for regular operations at 5 a.m. Thursday, with the pool opening at 5:30 a.m. Regular hours will be 5 a.m. to 10 p.m. Monday through Friday, 7 a.m. to 8 p.m. Saturday and noon to 6 p.m. Sunday.
Construction began in July 2018 after seven years of planning. More than 400 individual donors have contributed to the facility, in addition to support from the city, Rotary and government programs and tax credits.
Developed in partnership with the city, the aquatic center is available for use by all community members.
“We have an eight-lane pool, and the vast majority of the time we’ll maintain lap swimming,” Romero said, with the rare exception of events and swim meets. Even if a class is underway, lap swimming can continue in other lanes, he said.
Along with the 25-yard, eight-lane pool; there’s a warm-water therapy pool; an on-deck hot tub and a coed steam room. The warm-water lazy river is part of a family water playground with three slides and two large water slides (blue and green) extending in and out the side of the building.
Caden Rowe and Ellie Dolsen helped christen the two large water slides already. Caden’s group visited on Nov. 3 and Ellie had a party on Friday. The chances to be the first to head down those slides were auctioned off during the YMCA’s fundraising dinner in May, Romero said.
The facility hosted eight pool and birthday parties over the weekend, he noted. Those reservations were made when YMCA officials were planning to open a week earlier, “(and we) honored those commitments,” Romero added. The facility also hosted a special event for project contractors and subcontractors and their families on Nov. 2.
The pools are one wing of the larger facility. YMCA members also will have access to the gyms.
A gym on the main floor has a full-size basketball court that can also be used as two smaller courts. A track overlooks the gym and bends around an upstairs cardio area, with roughly 12 laps making up a mile-long run or walk.
Beyond the cardio gym, a large open area is designated for free weights, and behind a set of doors is an expansive exercise studio that can be divided in two by a sliding wall, enabling two classes at once.
While the cost to build the aquatic center is just under $22 million, Romero said a little more than $1 million is still to be raised to cover furnishings, equipment and other costs.
“That’s a pretty amazing achievement,” he said, considering how much has been raised in Yakima and the fact that some Y facilities carry much higher debt ranging from $5 million to $8 million. “We feel very fortunate.”
Along with fundraising, the fine-tuning continues. As a worker carved out holes for the posts of bike racks going up near the main doors, Romero mentioned tending to details such as toilet seat covers, locks and soap dispensers.
“There will be a lot of long days this week, but it’s a good thing, for good reasons,” he said.
Romero has been executive director for 13½ years. He is pleased to be on the verge of opening a facility designed to serve the community, offer healthy options, outreach for youth and more.
“It’s pretty exciting to be to this point, especially when you know how much work a lot of people have done to get to this stage,” he said.