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Residents of poor neighborhoods may die sooner than residents of wealthier neighborhoods - regardless of what they eat, how active they are, or other individual risk factors, new research suggests.

This finding - that where you live might affect how long you live - comes from a study of more than 565,000 middle aged and older Americans enrolled in the NIH-AARP Diet and Health Study, which collected detailed data on diet, lifestyle, and medical history. Neighborhood characteristics were drawn from U.S. Census data for the year 2000.

“There was an increased risk of death from any cause or cancer in socioeconomically deprived neighborhoods,” Dr. Chyke Doubeni told Reuters Health. What’s noteworthy, he said, is that this difference “remained even after taking into account differences in dietary patterns and other person-level health risks.”

Doubeni, assistant professor of family medicine and community health and assistant vice provost for diversity at the University of Massachusetts Medical School in Worcester, presented his team’s findings today at the American Association for Cancer Research (AACR) Conference on Frontiers in Cancer Prevention Research underway in Houston.

“We were expecting that once we controlled for these lifestyle and medical risk factors, the differences would go away,” Doubeni noted in a conference statement. “We were surprised that the differences persisted after controlling for lifestyle factors such as smoking, diet, exercise and medical risks.”

Among the study participants, a higher percentage of adults from the most deprived neighborhoods reported poorer overall health and diet and higher average body weight. Even when these and other risk factors were taken into account, the chances of dying still rose as the level of deprivation in the place of residence increased, Doubeni and colleagues found.

Compared to people living in the least deprived neighborhoods, those living in the most deprived neighborhoods had roughly a 22 percent higher risk of dying over the 10-year study period, regardless of diet and lifestyle.

“This is a public health issue; we need to pay more attention to people who live in poor neighborhoods,” Doubeni told Reuters Health.

“We need to target public health interventions to these neighborhoods that are deprived by improving health resources and the physical environments in those areas,” Doubeni concludes.

Injections of oxytocin into the umbilical vein don’t decrease the need for manual removal in women with a retained placenta after giving birth, according to a new study.

Retained placenta occurs in 0.1 to 2 percent of deliveries, with higher rates in wealthier nations. Without prompt treatment, women with a retained placenta are at high risk of hemorrhage. Currently, treatment involves manual removal of the placenta, which requires an operating room, a surgeon and an anesthetist. But a lack of these resources means that the death rate for retained placenta is nearly 10 percent in rural communities, according to background information in the study.

An effective, cheap and simple treatment is needed. Some had thought that injecting the hormone oxytocin into the umbilical vein could fill this need, the study authors said.

This study included 577 women in Pakistan, Uganda and the United Kingdom who received 30 milliliters of saline containing either water (the placebo group) or 50 international units of oxytocin. The solution was injected into the placenta through an umbilical vein catheter.

The need for manual removal of the placenta was virtually the same for both groups: 61.3 percent for the oxytocin group and 62.1 percent for the placebo group. The researchers also found that the need for manual removal was higher in the United Kingdom (69 percent) than in Pakistan (62 percent) or Uganda (47 percent).

“These findings accord with a review in which rates of retained placenta in the U.K. are seen to be rising with time and seem to be greater in high-resource settings than in low-resource settings,” wrote Dr. Andrew D. Weeks, of the University of Liverpool and Liverpool Women’s Hospital, and colleagues.

“The reasons for this result are not clear, but it could represent the amount of exertion that is put into removal of the placenta by the attendants,” they added. “In settings in which there are long waits for [operating rooms] and in which women are tolerant of pain, there can be many attempts at placental delivery with prolonged cord traction, grasping of vaginal portions of the placenta and uterine massage. In the U.K., by contrast, operating [rooms] with regional anesthesia are easily accessible and so the woman does not need to undergo the discomfort of repeated attempts at placental delivery.”

The study authors concluded that their findings “have shown that umbilical vein oxytocin had no significant effect on the need for manual removal of the placenta or any other clinical outcome.”

Lead exposure well within levels generally considered safe may harm mental health, new research suggests.

Men and women in their 20s and 30s with the highest levels of lead in their blood were more than twice as likely to suffer from major depression as their peers with the lowest blood lead levels, while their risk of panic disorder was nearly five times greater, researchers found.

“This is true for the average American. We are not talking about excessively high exposures, it’s just average exposures,” Dr. Maryse Bouchard of University of Montreal in Canada and the Harvard School of Public Health in Boston told Reuters Health.

Lead is known to be toxic to the nervous system, Bouchard and her colleagues point out in the Archives of General Psychiatry. But most research on its effects has been done in children and in adults exposed to high levels of the toxic metal on the job.

To investigate whether lead exposure might affect the general population, Bouchard and her team looked at data from the National Health and Nutrition Examination Survey for 1999-2004 on 1,987 men and women 20 to 39 years old. About 7 percent met diagnostic criteria for major depression, while around 2 percent had panic disorder and another 2 percent had generalized anxiety disorder.

Study participants’ average blood lead level was 1.61 micrograms per deciliter of blood, and ranged from 0.3 to 37.3 micrograms per deciliter. The higher an individual’s blood lead, the greater their risk of depression or panic disorder, but lead levels had no influence on the likelihood of anxiety disorder.

Because smoking cigarettes can increase blood lead levels, Bouchard and her team did a separate analysis of non-smokers, and found similar results.

The Centers for Disease Control and Prevention has stated that blood lead levels of 10 micrograms per deciliter in children “should prompt public health actions,” but it has also stated that there is no “safe” blood level in children.

“In the general population, very little research has been done on lead and its potential adverse effects on adults,” Bouchard noted.

High levels of lead are known to interfere with the function of neurotransmitters in the brain like serotonin and dopamine, Bouchard added, and this could be the mechanism through which lead exposure might contribute to depression and panic disorder.

One drawback of the study, the researchers note in their report, is that blood lead levels are good for measuring short-term lead exposure, but less accurate for gauging long-term exposure — for this purpose, bone lead tests are more precise.

Nevertheless, they add, blood lead levels do reflect lead from past exposures being released from bone. Another limitation, they add, is the fact that depression or panic disorder might have made people engage in behaviors that would increase their blood levels of lead.

The current findings, the researchers say, suggest that efforts must be made to reduce people’s exposure to lead in the environment, for example from tap water contaminated by corroding pipes.

“The solutions are collective,” Bouchard said. “We need to enforce banning lead from all the applications that could involve potential exposure for the population.”

Diabetics who keep their blood sugar tightly controlled run the risk of having traffic accidents due to low blood sugar, Canadian researchers report.

Controlling blood sugar is the cornerstone of managing diabetes. By keeping blood sugar under control, diabetics can ward off many of the complications associated with the condition, including heart and kidney disease. However, blood sugar that is too low — known as hypoglycemia — can cause dizziness and loss of consciousness, the researchers say.

“Diabetes is a common disease that may impair an adult’s ability to drive,” said lead researcher Dr. Donald A. Redelmeier, a professor of medicine at the University of Toronto.

Worldwide, Redelmeier said, diabetics are required to produce proof of good blood-sugar control to keep their driver’s license. The United States, United Kingdom, Canada, Germany, Holland, Australia and other countries all have such laws, but they’re “based on theory rather than science,” he said.

And contrary to the prevailing theory, people with good blood-sugar control were found to have a higher risk for crashing, Redelmeier said of his study’s results. The risk was substantial, accounting for almost 50 percent of the accidents, he said.

The accidents were mostly related to severe hypoglycemia in association with strict blood sugar control, he noted. The findings were published online Dec. 8 in PLoS Medicine.

For the study, Redelmeier’s team collected data on 795 diabetic drivers. They found that one in 14 of the drivers had been involved in car accidents. Those with low blood sugar were more likely to have had an accident than were diabetics whose blood sugar was not as well controlled.

Moreover, the risk for having a car accident increased fourfold if the person had a history of hypoglycemia, the researchers found.

“This finding calls into question laws that restrict driver’s licenses on the basis of this measure of diabetes control,” Redelmeier said.

The study could be the first step in getting driving laws changed, he added. His research group, Redelmeier said, was the first to identify driving and talking on cell phones as a hazard, which led to laws restricting the use of cell phones while driving.

Dr. Luigi F. Meneghini, an associate professor of clinical medicine and director of clinical operations for the division of endocrinology, diabetes and metabolism at the University of Miami Miller School of Medicine, agreed that the study “brings up the risk of driving while you have diabetes.”

People taking medication to lower their blood sugar need to be aware of any symptoms of an oncoming hypoglycemic episode, Meneghini said. And older people, who he said often aren’t aware that a hypoglycemic episode is starting, should check their blood sugar more often.

“They should certainly check their blood sugar before they get into a car,” he said. “If they have low blood sugar, treat the low blood sugar and wait until their blood sugar is in a safe range before getting behind the wheel.”

Redelmeier said he advises diabetics not to drive if they feel dizzy or have other symptoms of hypoglycemia. In addition, he urges people to always have food available to boost the blood sugar should a hypoglycemic episode start.