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The Takeaway: Lifestyle Choices Trump Pollutants As Breast Cancer Cause; Housing Crisis Affects Home Health Care

Lifestyle Risks Stronger: There's lots of worry out there about how environmental toxins-BPA in canned goods; preservatives in cosmetics-could be contributing to breast cancer. But a new, comprehensive study finds that substances women voluntarily expose themselves to-bad food, alcohol, cigarettes, hormone replacement drugs and oral contraceptives- are upping breast cancer risk much more than secretly lurking additives and environmental pollutants.

The research, paid for by breast cancer advocacy group Susan G. Komen for the Cure and conducted by the prestigious (and independent) Institute of Medicine, concluded that while 'endocrine-disrupting chemicals' like bisphenol A and phthalates play a 'biologically plausible' role in promoting breast and other hormone-related cancers,  the dangers posed by women's  lifestyle choices are much greater. Decisions about diet, exercise, medical care and prescription drugs play a much more 'immediate role' in breast cancer risk, the panel said.

The report cites mounting evidence that obesity and body fatness - and particularly weight gain at menopause and after - raise a woman's risk of developing invasive breast cancer, as well as a welter of research linking breast cancer to a woman's alcohol consumption, from young adulthood through after menopause, when invasive breast tumors are most likely to appear.

Hormone replacement therapy and hormonal birth control pills have also been shown to raise a woman's risk of breast cancer. But numerous studies have found that exercising regularly drives this risk down.

In a separate study published this week, researchers reported that a starchy, high-carb diet was associated with higher rates of breast cancer recurrence in survivors of the disease.

In-Home Care Becomes Necessity: We've written about how many of today's older adults are, uh,  less than eager to move into traditional retirement communities or nursing homes-driving the 'aging in place' boom and, with it, greater demand for in-home health care. Today,  Fox Business notes another factor driving growth in the home-health care industry: The housing crisis has made it hard for many older adults to sell their homes, leaving them little choice but to seek home-based alternatives.

Emma Dickison, president of in-home care company Home Helpers, told Fox her business has expanded 22% from 2008 through 2010.

She says the jump is a result of two factors: the housing market, and increased cost of assisted living and nursing home facilities. According to the MetLife survey, nursing home costs are up by 3.5% and assisted living costs have increased by 5.2%.

A home health aide that can provide medical assistance costs an average of $21 per hour; an aide to help with non-medical issues costs an average $19 per hour.

Recently, moving older and disabled residents out of nursing homes and back into community care has become a focus for Medicare and Medicaid, the NYT's New Old Age blog reports. In 1999, nearly 75 percent of Medicaid dollars went to institutional care, and only 27 percent to home- and community-based services. By 2010, spending on institutional care had declined to 55 percent, with about 45 percent going to home and community care.

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