Would You Rather Walk 5,000 Steps a Day or Pay More for Insurance?

That may sound like a hypothetical question, but one health insurer put this question to the test -- and a new study finds that the controversial question -- and resulting action taken -- actually worked to keep costs down and customers healthier.

It all started when the Michigan-based Blue Care Network began requiring obese patients on certain insurance plans to enroll in physical fitness programs in order or have to pay higher rates. One option was a pedometer-based program, which required participants to walk 450,000 steps every three months (an average of 5,000 steps, or 2.5 miles, a day) and to upload their activity to a tracking website. Those who didn't meet the quarterly goals would be 20 percent more for their insurance. 

University of Michigan and Stanford University researchers tracked the more than 6,000 people who chose the pedometer option, about a third of whom strongly disagreed with the "coercive" nature of the program and were extremely reluctant to participate. The researchers' findings, however, published today in the journal Translational Behavioral Medicine, tell a different story: After one year, 97 percent of participants had met their daily activity goals! 

However, there is still not nearly enough research to determine whether participation in these programs translates to meaningful changes in health and costs of health care.

What do you think about cash incentives for staying active? Smart or sleazy? Tweet us at @amandaemac and @SELFmagazine.

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Image Credit: Plamen Petkov

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Matchless strategy for tick removal; 6 steps to avoid tick bites

Posted June 07, 2013, 9:51 am

My first tick sighting was a mixture of horror and fascination. It happened during my one and only experience with summer camp, on the shores of Alma Lake in north-central Wisconsin. One of my cabin mates discovered a big, fat tick burrowed into the skin of his belly. “Gross!” we chorused, unable to stop looking. Ideas for how to remove the tick swirled fast and furious. The leading contender was to light a match, blow it out, and touch the hot tip to the back end of the tick. As we scurried around looking for matches, cooler heads prevailed and the kid went off to the nurse for a more effective form of tick removal.

Knowing how to remove a tick is a useful skill for anyone who spends time outdoors, or who cares for someone who does. The sooner a tick is removed—correctly—the less likely the critter can deliver microbes that cause Lyme disease or other tick-borne diseases.

There are several folk remedies for removing a tick. Touching it with a hot match is a common one. Others include covering it with petroleum jelly or nail polish (in theory to suffocate it), or freezing it off. These are all supposed to make the tick “back out” of the skin on its own. But they often have the opposite effect, forcing the tick to hold tight, burrow deeper, and possibly deposit more of its disease-carrying secretions into the wound, which increases the risk of infection.

The best way to remove a tick? Here’s what the Centers for Disease Control and Prevention recommend: Use a pair of fine-tipped tweezers to grasp the tick as close to the skin as possible. Then pull it out with a steady motion. Once the tick has been removed, clean the skin with soap and water. Dispose of the tick, which is probably still alive, by placing it in alcohol or flushing it down the toilet.

A tick feeds by way of a two-pronged mouthpart (hypostome) held in place with salivary cement and secured with tiny backward-pointing barbs. To remove the tick, use narrow-tipped tweezers and grasp it as close to the skin as possible; then pull upward slowly and steadily. If the mouthpart remains in the skin, try to remove it. If you can’t, check with your clinician. Wash your skin and hands with soap and warm water. Try not to crush or squeeze an attached tick.

For most people who are bitten by a tick, removal ends the saga. For others, though, it is just beginning.

In the United States, the most common tick-borne disease is Lyme disease. It is caused by Borrelia burgdorferi, a bacterium carried to humans by infected blacklegged ticks, also known as deer ticks. Most cases of Lyme disease follow the bite of an immature deer tick, which is about the size of a poppy seed. Adult deer ticks can also transmit Borrelia burgdorferi, but they are larger and more likely to be seen and removed before they’ve had time to infect a person.

Lyme disease continues to spread across the Northeast and upper Midwest, and is now found in most states. The CDC has an interactive map that shows its spread from 2001 to 2011.

Infection with Borrelia burgdorferi often—but not always—causes a rash that looks something like a red bull’s eye soon after the tick bite. Treatment with antibiotics can usually prevent any short- or long-term repercussions. If the infection isn’t treated, problems can develop in other parts of the body, including the joints, heart, and nerves. It can also cause arthritis that persists months or years after the tick bite.

Some people with Lyme disease and some community doctors have argued that Borrelia burgdorferi can somehow evade courses of antibiotics and become a chronic infection that needs long-term antibiotic treatment—even though conventional antibody tests are negative. Chronic Lyme disease has been blamed for causing pain, fatigue, muscle aches, loss of memory and thinking skills, and a host of other problems.

Most Lyme disease experts don’t believe active infection persists after antibiotic treatment and once blood tests are negative for antibodies. They’ve been critical of what they see as unreliable tests for infection and unwarranted, possibly harmful, long-term antibiotic therapy.

A recent front-page article in the Boston Globe highlighted the controversy around Lyme disease and its treatment.

Other tick-borne diseases include:

babesiosisehrlichiosisRocky Mountain spotted fevertularemiatickborne relapsing fever

The only foolproof method for staying tick free is avoiding areas where they lurk. That means staying out of brush and high grass in and around wooded areas.

If you like to be outdoors and find yourself frequenting those environments, the Connecticut Agricultural Experiment Station has published an excellent comprehensive handbook about tick management. If you don’t have the time to read all 80 pages, here are six tips for protecting yourself from ticks, culled mainly from that handbook.

1. Wear light-colored clothing. Light colors make ticks easier to spot, especially tiny deer tick nymphs.

2. Tuck your pants inside your socks. It may not be a flattering look, but it creates a physical barrier against ticks.

3. Use insect repellent. Most of the chemicals that repel mosquitoes are somewhat effective against ticks, although it may take a heavier concentration of DEET — between 30% and 40% — to really keep them away. Permethrin is a stronger chemical that kills ticks as well as repels them. Products containing permethrin should be sprayed on clothes, not on the skin. Picaridin repels mosquitoes and other insects but not ticks.

4. Stay in the middle of the path (or fairway). Ticks can’t fly or jump, so they can only get on you if you come into contact with the kind of environment they live in: moist, often shady, wooded areas, with leaves, low-lying plants, and shrubs.

5. Think sunny. Ticks don’t do well in dry, open areas. Lawn furniture and playground equipment should be set back from the edge of wooded, shady areas. If you’re picnicking, pick a patch of well-tended lawn or some open ground.

6. Inspect yourself and your children (and your pets), especially the legs and groin. Ticks usually get picked up on the lower legs and then climb upward in search of a meal. The odds of contracting Lyme or other tick-borne disease are minimized if a tick is removed soon after it’s attached, and there’s no risk if it’s still crawling around. The shower is a good place to conduct a tick check. Feel for any new bumps on soaped-up skin.

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Safe Steps: A Guide to Running in the Dark

We're pumped to present our favorite story of the week from our pals at POPSUGAR Fitness!

Even with the best intentions, it is sometimes impossible to avoid running well after sunset. If running at night is unavoidable, protect yourself in the dark by following these tips.

Run in familiar, well-lit areas: To ensure a clear running path, find an area that's lit by streetlamps, or hit up an outdoor track. If you want to experiment with a new trail, do it during daylight hours; sticking to your usual route will help avoid unseen bumps or potholes.Make sure others can see you: It's important to be visible to drivers, cyclists, pedestrians, and other runners on the road. Wear bright colors and reflective gear, and for extra caution, wear a headlamp or attach a blinking bike light to your clothing. Get started with our picks for reflective running gear.Be aware (and ditch the playlist): Because running at night cuts down on your line of sight, make sure you can hear and see clearly. Go running without an iPod or MP3 player, and make eye contact to alert others of your presence. This is especially important to do with drivers when you're crossing the street. Carry safety essentials: Keep a cell phone with you in the event of an emergency, and always carry identification and an insurance card in case you sustain an injury.Run with a buddy: There's safety in numbers, so try to run with a friend. You'll both be more visible and can rely on one another if something goes wrong. If you do run alone, make sure to tell someone the route you're running and around what time you'll be back. Run against traffic: It may seem counterintuitive, but you have a better chance of seeing cars and drivers have a better chance of seeing you. Ideally, try to run on a designated trail to avoid mixing with traffic. Change up your routine: Run a few different routes and at different times through the week. Potential attackers pick up on consistency. For extra protection, consider keeping pepper spray on you.More from POPSUGAR Fitness:

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Miley Cyrus steps out without engagement ring

Miley Cyrus has been pictured without her engagement ring, sparking rumours that all is not well between her and fiancé Liam Hemsworth.

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6 Simple Steps to Keep Your Heart Healthy

A healthy heart -- and a healthier you -- starts today with these quick tips from the experts.

Keeping your heart healthy is so simple it can be put into catchy, two-word phrases: Eat right. Get exercise. Don’t smoke.

Putting those heart-healthy catch phrases into action, of course, isn’t so simple.  Which matter most? How can you put them into daily practice?

Here are practical heart health hints you can use every day.

Adults need at least 30 minutes of exercise five or more days a week for heart health. But improving cardiovascular and overall health isn’t only about sweating on a treadmill or climbing stairs, say the pros. Getting out to play is exercise too, and improving heart health is just as easily about kickball with your kids, walking the dog, or shooting hoops with colleagues during your lunch break.

Get a total of at least 30 minutes of exercise daily -- and you don’t have to do it all at once. Aim for a 10-minute morning walk perhaps, a short workout with hand weights at lunch, and some digging in the garden before dinner, and you’ve met your goals.

To get the full benefits of aerobic exercise "folks should get their heart rate up so they’re somewhat breathless, but can still carry on a conversation," says Susan Moores, RD, MS, a registered dietitian and American Dietetic Association spokeswoman. She adds that all kinds of exercises are important, from strength training and aerobics, to flexibility and stretching exercises.

"Nobody’s going to keep an eye on your medical health other than you," says Elaine Magee, MPH, RD, author of Food Synergy, and WebMD’s "Recipe Doctor." "You are in charge."

That’s an easy thing to forget, especially when talking about the ho-hum pragmatism of routine health exams. Yet getting regular blood pressure, blood sugar, and cholesterol checks, as well as physical exams are important steps in maintaining heart health.

"Anything you can find out about what’s going on inside your body the better," says Magee. Especially true when you consider that heart-threatening conditions like high blood pressure and high cholesterol are "silent" -- meaning there’s almost no way to know you have them unless you get tested.

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