Richard Knox

Since he joined NPR in 2000, Knox has covered a broad range of issues and events in public health, medicine, and science. His reports can be heard on NPR's Morning Edition, All Things Considered, Weekend Edition, Talk of the Nation, and newscasts.

Among other things, Knox's NPR reports have examined the impact of HIV/AIDS in Africa, North America, and the Caribbean; anthrax terrorism; smallpox and other bioterrorism preparedness issues; the rising cost of medical care; early detection of lung cancer; community caregiving; music and the brain; and the SARS epidemic.

Before joining NPR, Knox covered medicine and health for The Boston Globe. His award-winning 1995 articles on medical errors are considered landmarks in the national movement to prevent medical mistakes. Knox is a graduate of the University of Illinois and Columbia University. He has held yearlong fellowships at Stanford and Harvard Universities, and is the author of a 1993 book on Germany's health care system.

He and his wife Jean, an editor, live in Boston. They have two daughters.

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3:15am

Thu April 12, 2012
Shots - Health Blog

Water In The Time Of Cholera: Haiti's Most Urgent Health Problem

Originally published on Mon April 16, 2012 12:40 pm

Marlene Lucien controls the hose that fills people's plastic buckets on one busy street corner in Port-au-Prince, Haiti.
John Poole NPR

In the teeming city of Port-au-Prince, Haiti, millions of people have no reliable water supply.

Many of the underground pipes that did exist were ruptured by the 2010 earthquake. Many public water kiosks are dry.

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10:22am

Tue April 10, 2012
Shots - Health Blog

Analysis Finds Lung Cancer Screening Worthwhile For Longtime Smokers

Dr. Steven Birnbaum positions a patient inside a CT scanner at Southern New Hampshire Medical Center in Nashua, N.H., in June 2010.
Jim Cole AP

Now there's fresh evidence that CT scans to detect early lung cancer belong on the short list of effective cancer screening technologies — at least for people at high risk.

Researchers conclude that spiral CT, which makes 3-D pictures of lungs, could reduce lung cancer deaths by 35 percent at a cost of $19,000 to $26,000 per year of life saved.

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6:10pm

Thu April 5, 2012
Shots - Health Blog

New Type Of Resistant Malaria Appears On Thai-Burmese Border

A micrograph shows red blood cells infected by the malaria parasite Plasmodium falciparum.
John C. Tan AP

Malaria experts have been holding their breath and hoping it wouldn't happen. But it has.

Malaria parasites resistant to the last, best drug treatment, called artemisinin combination therapy, or ACT, are infecting people along the border of Thailand and Myanmar.

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8:45am

Wed April 4, 2012
Shots - Health Blog

Doctors Urge Their Colleagues To Quit Doing Worthless Tests

Doctors, don't order that CT scan when a less-expensive ultrasound would work just as well, the Choosing Wisely campaign advises.
Catherine Yeulet iStockphoto.com

Nine national medical groups are launching a campaign called Choosing Wisely to get U.S. doctors to back off on 45 diagnostic tests, procedures and treatments that often may do patients no good.

Many involve imaging tests such as CT scans, MRIs and X-rays. Stop doing them, the groups say, for most cases of back pain, or on patients who come into the emergency room with a headache or after a fainting spell, or just because somebody's about to undergo surgery.

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12:48pm

Tue April 3, 2012
Shots - Health Blog

Mammograms May Lead To Breast Cancer 'Over-Diagnosis,' Study Finds

The problem of breast cancer overdiagnosis with mammograms is similar to the dilemma faced by men diagnosed with prostate cancer because of a PSA test.
Damian Dovarganes AP

Norwegian scientists say as many as 1 in every 4 cases of breast cancer doesn't need to be found because it would never have caused the woman any problem.

It's a startling idea for laypeople (and many doctors) thoroughly indoctrinated with the notion that any breast cancer is medically urgent — and should be found at the earliest possible moment.

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6:50pm

Sat March 31, 2012
Shots - Health Blog

Babies Take Longer To Come Out Than They Did In Grandma's Day

Originally published on Sat March 31, 2012 6:51 pm

Fifty years ago, the typical first-time mother in the U.S. took about four hours to give birth. These days, women labor about 6 1/2 hours.
Carsten/Three Lions Getty Images

The typical first-time mother takes 6 1/2 hours to give birth these days. Her counterpart 50 years ago labored for barely four hours.

That's the striking conclusion of a new federal study that compared nearly 140,000 births from two time periods.

One big implication: Today's obstetricians may be rushing to do cesarean sections too soon because they're using an out-of-date yardstick for how long a "normal" labor should take.

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10:41am

Tue March 27, 2012
Shots - Health Blog

Bypass Surgery Edges Stents For Heart Treatment

Originally published on Tue March 27, 2012 11:09 am

iStockphoto.com

The debate over coronary bypass surgery versus stenting goes back decades.

Studies have been inconclusive, but doctors and patients have voted with their feet in favor of the less-invasive procedure — clearing clogged arteries and propping them open with tiny scaffolds called stents.

U.S. doctors do at least two stenting procedures these days for every coronary bypass operation.

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12:01am

Tue March 27, 2012
Shots - Health Blog

In Haiti, Bureaucratic Delays Stall Mass Cholera Vaccinations

Originally published on Wed May 23, 2012 10:56 am

Joseph Francis, 54, says he came to this cholera clinic in Haiti's capital, Port-au-Prince,after becoming so dehydrated he could barely walk. Cholera has killed more than 7,000 Haitians since the first outbreak of the disease in October 2010. At the start of the rainy season, cases are once again beginning to climb.
John W. Poole NPR

A hundred thousand people in Haiti are ready and waiting to get vaccinated against cholera.

The vaccine is sitting in coolers. Vaccination teams are all trained. Willing recipients are registered and entered into databases.

The impending mass vaccination project aims to show that vaccinating against cholera is feasible in Haiti. It has never been done in the midst of an ongoing cholera epidemic. So far, more than 530,000 Haitians have fallen ill with cholera, and more than 7,000 have died.

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11:15am

Mon March 26, 2012
Shots - Health Blog

Study Finds Female Condoms Are Cost-Effective For HIV Prevention

A bus in Washington, D.C., displays an advertisement for a female condom in July 2010. To encourage their use, community groups distributed more than 500,000 of the female condoms, flexible pouches that are wider than a male condom but similar in length, during instruction sessions at beauty salons, barber shops, churches and restaurants.
Drew Angerer AP

Condoms aren't just for men.

A second generation of female condoms, which was approved in 2009, is cheaper than the first version. Still, the condoms for women are a lot more expensive than those for males. And female condoms remain pretty unfamiliar to most people.

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4:14am

Mon March 19, 2012
Shots - Health Blog

Prone To Failure, Some All-Metal Hip Implants Need To Be Removed Early

Originally published on Wed March 21, 2012 5:01 pm

Young-min Kwon of Massachusetts General Hospital holds the metal-alloy ball of Susy Mansfield's faulty artificial hip joint. The yellowish tissue on top is dead muscle caused by a reaction to the metal debris produced by the defective hip implant.
Richard Knox NPR

When Susy Mansfield needed a hip replacement in 2009, her orthopedic surgeon chose a relatively new and untested kind of artificial hip made entirely of metal.

"He said, 'You're young. Metal is good for younger people. It's going to last a lot longer,' " says Mansfield, who was 57 at the time.

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12:01am

Tue March 13, 2012
Shots - Health Blog

As Cholera Season Bears Down On Haiti, Vaccination Program Stalls

Originally published on Wed March 14, 2012 2:07 pm

Thousands of doses of cholera vaccine sit in a refrigerated trailer in a United Nations compound in Saint-Marc, Haiti. Vaccination was supposed to begin last week, but bureaucratic problems have delayed the start. April is the beginning of Haiti's rainy season, which will likely intensify Haiti's cholera outbreak.
John Poole NPR

The vaccine — $417,000 worth of it — is stacked high in refrigerated containers to protect it from the Haitian heat.

Hundreds of health workers are trained and ready to give the vaccine. They're armed with programmed smartphones and tablet computers to keep track of who has been vaccinated and who needs a second dose.

And 100,000 eager Haitians, from the teeming slums of Port-au-Prince to tiny hamlets in Haiti's rice bowl, have signed up to get the vaccine.

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11:10am

Tue February 21, 2012
The Salt

How Using Antibiotics In Animal Feed Creates Superbugs

Originally published on Tue February 21, 2012 5:19 pm

Many livestock groups say there's no evidence that antibiotics in livestock feed have caused a human health problem, but researchers beg to differ.
Scott Olson/Getty Images

Researchers have nailed down something scientists, government officials and agribusiness proponents have argued about for years: whether antibiotics in livestock feed give rise to antibiotic-resistant germs that can threaten humans.

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12:01am

Thu February 16, 2012
Shots - Health Blog

Latest Drug Shortage Threatens Children With Leukemia

Originally published on Tue February 21, 2012 5:55 pm

Many hospitals are perilously close to running out of a form of methotrexate that's necessary to inject in high doses to treat certain forms of cancer.
iStockphoto.com

It's a new kind of brinksmanship for U.S. doctors: caring for patients with life-threatening diseases when the supply of critical drugs threatens to disappear.

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2:40pm

Wed February 15, 2012
Shots - Health Blog

FDA Warns About Fake Avastin In US

Packaging for fake Avastin that was just flagged by the Food and Drug Administration.
Genentech

The Food and Drug Administration says counterfeit Avastin, a costly drug cancer drug, has made its way to doctors in the United States.

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12:01am

Mon February 13, 2012
Shots - Health Blog

Health Care In Massachusetts: 'Abject Failure' Or Work In Progress?

Originally published on Tue February 14, 2012 8:28 am

Voters are hearing a lot about health care this year. Republicans want to make the 2012 elections a referendum on the health care law that President Obama signed two years ago.

That law was largely based on one that then-Gov. Mitt Romney signed into law nearly six years ago in Massachusetts.

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12:43pm

Mon January 30, 2012
Shots - Health Blog

A Bid To Replace Neglect For Tropical Diseases With Attention

Originally published on Mon January 30, 2012 2:31 pm

An artist on Rio de Janeiro's Copacabana beach puts the final touches on a sand sculpture of the assassin bug, which spreads Chagas disease. The sculpture was part of an event in 2009 commemorating the 100th anniversary of the discovery of the disease.
Vanderlei Almeida AFP/Getty Images

Tropical diseases that have long been overlooked are getting their due.

An ambitious new push to eradicate, eliminate or control 17 scourges over the next eight years was just unveiled in London. The initiative brings together some of the world's largest drugmakers, health-oriented foundations and nongovernmental organizations. Governments from the developed world and the countries most affected by the diseases are also on board.

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6:30pm

Wed January 18, 2012
Shots - Health Blog

Many Older Women May Not Need Frequent Bone Scans

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NPR journalist Gisele Grayson got her hip bone scanned a couple of years ago and discovered she has osteopenia.
NPR

The bone-thinning disease called osteoporosis is a big problem for women past menopause. It causes painful spine fractures and broken hips that plunge many women into a final downward spiral.

So it seemed to make sense to monitor older women's bones on a regular basis to see when they need to start taking drugs that prevent bone loss and fractures. Since Medicare will pay for a bone-density scan every two years, that's what many women have been getting.

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4:48pm

Fri January 13, 2012
Shots - Health Blog

India Marks A Year Free Of Polio

Originally published on Fri January 13, 2012 5:08 pm

An Indian boy receives a polio vaccination from an Indian health worker in Amritsar last year.
Narinder Nanu AFP/Getty Images

A year ago today, India saw its last recorded case of polio in an 18-month-old girl in West Bengal named Rukhsar Khatoon. She recovered without lasting paralysis.

One year without another case is an impressive milestone in the decades-long effort to wipe the poliovirus from the face of the planet. Only a few years ago, India reported more polio cases than anywhere else — as many as 100,000 cases a year.

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9:55am

Wed January 11, 2012
Shots - Health Blog

A Dozen Cases Of Tuberculosis That Resists All Drugs Found In India

An image of Mycobacterium tuberculosis bacteria captured with an electron microscope.
CDC

Tuberculosis specialists in India have diagnosed infections in a dozen patients in Mumbai that are unfazed by the three first-choice TB drugs and all nine second-line drugs.

The doctors are calling them "totally drug-resistant TB," and the infections are essentially incurable with all available medicines.

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6:50am

Fri January 6, 2012
Shots - Health Blog

Monkey Experiments Boost Hope For Human AIDS Vaccine

A rendering of a key protein the simian immunodeficiency virus uses to reproduce.
Wikimedia Commons

Researchers trudging down the long and twisted path toward an AIDS vaccine are encouraged by new studies that show an experimental vaccine protects monkeys against infection with a virus that is very similar to HIV.

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12:10pm

Wed January 4, 2012
Shots - Health Blog

In US, Hospital Round Trips More Common For Heart Attack Patients

In the U.S., hospitalized heart attack patients go home sooner than in other countries. They are more likely to return to the hospital within a month of being discharged.
iStockphoto.com

If a heart attack sends you to an American hospital, you'll probably go home after only two or three nights. That's faster than virtually anyplace else in the world.

But your chances of needing to go back into the hospital within the next month are also higher than they are for heart attack patients in 16 other countries. That's the finding from a Duke University-led study in this week's JAMA, the Journal of the American Medical Association.

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12:01am

Wed December 28, 2011
Shots - Health Blog

Antiviral Drugs Sparkle In The Race To End AIDS

Eric Goosby, United States Global AIDS coordinator, says field testing is necessary and urgent to determine if HIV testing-and-treating services are feasible.
Brendan Hoffman Getty Images

2011 has been a momentous year in the 30-year-old AIDS pandemic.

The big breakthrough was the discovery that antiviral drugs can prevent someone who's infected with HIV from passing the virus to others. It's nearly 100 percent effective. That led President Obama to declare earlier this month that the U.S. will expand HIV treatment in hard-hit countries by 50 percent.

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12:01am

Mon December 26, 2011
Shots - Health Blog

Singing Therapy Helps Stroke Patients Speak Again

Originally published on Tue December 27, 2011 10:39 am

Laurel Fontaine, 16, (left) and her twin sister Heather. When Laurel was 11 years old, she suffered a stroke that destroyed 80 percent of the left side of her brain. The singing therapy helped her regain the ability to speak.
Ellen Webber for NPR

Debra Meyerson was hiking near Lake Tahoe 15 months ago when a stroke destroyed part of the left side of her brain, leaving her literally speechless. It happens to more than 150,000 Americans a year.

But now Meyerson is learning to talk again through an approach that trains the undamaged right side of her brain to "speak." Specifically, it's a region that controls singing.

For more than 100 years, it's been known that people who can't speak after injury to the speech centers on the left side of the brain can sing.

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6:33pm

Tue December 20, 2011
Shots - Health Blog

Many Police Officers Are Sleep Deprived, Risky For Them And Us

Sleepy police were likelier to fall asleep while driving, a new survey of nearly 5,000 officers in the U.S. and Canada finds. About 40 percent of officers surveyed reported sleep disorders, with various health implications.
Sean Locke iStockphoto

Harvard researchers say they've uncovered a big problem among the nation's 700,000 police officers: a serious lack of sleep.

In what's believed to be the first study of its kind, the researchers queried nearly 5,000 municipal and state police officers in the U.S. and Canada about their sleep habits and symptoms of possible sleep disorders. Then they assessed their on-duty performance for two years.

Forty percent had sleep disorders, and the vast majority of these were undiagnosed before.

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9:56am

Fri December 9, 2011
Shots - Health Blog

With Doubts, FDA Panel Votes For Yaz And Related Contaceptives

Originally published on Fri December 9, 2011 4:52 pm

Katie Anderson, shown with her mother, Beth, in 2010, suffered a life-threatening pulmonary embolism. Her symptoms started within a month of taking the birth control pill Yaz.
Jane Greenhalgh NPR

Doubts have been growing about Yasmin, Yaz and their sister contraceptives for several years now. And those doubts reached full flower at a Food Drug Administration advisory panel on Thursday.

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3:51pm

Wed December 7, 2011
Shots - Health Blog

Why Observing Prostate Cancers Is Gaining Ground On Surgery

Originally published on Wed December 7, 2011 4:26 pm

A federally convened panel of experts says most men with newly diagnosed prostate cancer should be offered the chance to put off treatment in favor of medical monitoring of their condition.

In fact, the panel went so far as to say doctors should stop calling most of these low-risk tumors cancer at all.

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4:33pm

Fri December 2, 2011
Shots - Health Blog

US AIDS Chief Says Tipping Point Is In Sight

Originally published on Fri December 2, 2011 4:51 pm

Eric Goosby, United States Global AIDS Coordinator, sees a turning point for HIV coming soon.
Brendan Hoffman Getty Images

If all goes according to plan — the plan President Obama laid out on Thursday — the HIV pandemic may reach an important tipping point by the end of 2013.

"We believe that with 2 million more people in treatment, we will reach a point where the number of new infections is less than the number going into treatment," says Dr. Eric Goosby.

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6:59pm

Thu December 1, 2011
Shots - Health Blog

Obama Embraces 'End of AIDS,' Promises To Accelerate HIV Treatment

AIDS activists haven't always been happy with Barack Obama. But many of them were on this Worlds AIDS Day.

The president used the occasion to pledge a 50 percent increase in the number of HIV-infected people getting treatment through the President's Emergency Plan for AIDS Relief, or PEPFAR — from around 4 million now to 6 million by the end of 2013.

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12:05pm

Wed November 30, 2011
Shots - Health Blog

HIV Treatment Lags In U.S., Guaranteeing More Infections

The latest numbers from CDC show that only 28 percent of the nation's 1.2 million HIV-infected people are getting effective antiviral treatment; effective treatment rates are lowest among African-American men.
Robyn Beck AFP/Getty Images

The United States is doing a pretty miserable job of treating people with HIV.

The latest numbers show that only 28 percent of the nation's 1.2 million HIV-infected people are getting effective treatment — that is, antiviral medications to keep the virus in check.

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5:01pm

Wed November 23, 2011
Shots - Health Blog

Scientists Bag Small Game In Bathroom Germ Safari

Originally published on Wed November 23, 2011 5:03 pm

Right this way, ladies and germs.
iStockphoto.com

Turns out Howard Hughes was right. The world is a very germy place, especially public restrooms.

The reclusive billionaire, who had the world's most notorious case of so-called germophobia, would go to just about any length to avoid contamination. He wore tissue boxes on his feet. He burned his clothing if someone near him got sick. He wrote careful instructions to his staff on how to open a can of peaches without contaminating them.

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