WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

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Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

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Online:

WHO report: http://bit.ly/YDCXcb

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Stock futures begin March lower as sequester looms

NEW YORK (Reuters) - Stock index futures were lower on Friday, indicating a weak start to the month of March, as investors looked ahead to U.S. government budget cuts that were widely expected to take effect at the end of the day.

Equities have been on a tear lately, rising for four straight months to approach five-year highs while the Dow climbed to within striking distance of an all-time high. Any declines have been shallow or short-lived, with investors jumping in to buy on any dip.

The gains have come on the back of strong corporate earnings and an accommodative Federal Reserve. In that environment, many investors have shrugged off the potential impact of the sequester, $85 billion in spending cuts across federal government agencies that economists expect will shave half a percentage point off U.S. economic growth.

"Conditions are ripe for anxiety and fear to return to the market, especially given how high we've risen, and the sequester that could be a catalyst that reignites fear in the market," said James Dailey, portfolio manager of TEAM Asset Strategy Fund in Harrisburg, Pennsylvania.

Dailey said that if the market drops below lows hit earlier this week, "that could be the start of a pullback that takes us down as much as 10 percent."

The spending cuts will take effect just before midnight Friday unless there is a last-minute deal, which is considered unlikely.

The International Monetary Fund said that if the cuts take effect, it would have to reevaluate its growth forecasts for the U.S. and the global economy.

Cyclical companies like banks and materials stocks, which are closely tied to the pace of economic growth, are likely to be among the hardest hit in the short term. Bank of America fell 1.2 percent to $11.10 in premarket trading while Chevron Corp slid 0.6 percent to $116.43.

S&P 500 futures fell 7.6 points and were below fair value, a formula that evaluates pricing by taking into account interest rates, dividends and time to expiration on the contract. Dow Jones industrial average futures slid 58 points and Nasdaq 100 futures lost 12.75 points.

For the week, the Dow is up 0.4 percent while both the S&P and Nasdaq are down less than 0.1 percent. Both the Dow and S&P climbed more than 1 percent in February, slimmer gains than in January as equities grappled with uncertainties in Europe and Federal Reserve policy.

Economic data on tap for Friday includes the final Thomson Reuters/University of Michigan sentiment index, which is seen holding steady at 76.3. Personal income and spending data will also be released, along with January construction spending, which is seen rising 0.4 percent. The Institute for Supply Management's February manufacturing index is expected to dip to 52.5 from 53.1 in the previous month.

Overseas, China's factory growth cooled to multi-month lows in February as domestic demand dipped, and euro zone manufacturing activity appeared no closer to recovery last month, as a dire performance in France offset a return to growth in Germany.

"The weakness in overseas data is increasingly drawing people's attention, and as that gets worse the market will continue to struggle," Dailey said.

Groupon Inc gained 4.2 percent to $4.72 in premarket trading a day after the online coupon company fired its chief executive officer in the wake of weak quarterly results.

Gap Inc reported fourth-quarter earnings that beat expectations and boosted its dividend by 20 percent, while Salesforce.com Inc posted sales that beat consensus forecasts, sending shares up 4.6 percent to $177 before the bell.

U.S. stocks ended flat on Thursday, giving up modest gains late in the session. The Dow Jones Transportation Average <.djt>, seen as a bet on future growth, hit a record intraday high earlier in the session.

(Editing by Bernadette Baum)

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U.S. will give Syrian rebels medical, food aid, not arms

ROME (Reuters) - The United States will send non-lethal aid directly to Syrian rebels for the first time, Secretary of State John Kerry said on Thursday, disappointing opponents of President Bashar al-Assad who are demanding Western weapons.

More than 70,000 Syrians have been killed in a devastating conflict that began with peaceful anti-Assad protests nearly two years ago. Some 860,000 have fled abroad and several million are displaced within the country or need humanitarian assistance.

Kerry, speaking in Rome after a meeting of the mainly Western and Arab "Friends of Syria" group said his country would more than double its aid to the Syrian civilian opposition, giving it an extra $60 million to help provide security.

The United States would now "extend food and medical supplies to the opposition, including to the Syrian opposition's Supreme Military (Council)," Kerry said.

In their final statement, the Friends of Syria pledged more political and material support to the opposition Syrian National Coalition, a fractious group that has struggled to gain traction inside Syria, especially among disparate rebel forces.

Riad Seif, a coalition leader, said on the eve of the Rome talks that it would demand "qualitative military support", though another coalition official welcomed the shift in the U.S. stance.

"We move forward with a great deal of cautious optimism," said Yasser Tabbara. "We heard today a different kind of discourse," he said, adding the opposition need military and political support.

The modest U.S. policy shift may compound the frustration that had prompted the coalition to declare last week it would boycott the Rome talks. It changed its mind under U.S. pressure.

Many in the coalition say Western reluctance to arm rebels only plays into the hands of Islamist militants now widely seen as the most effective forces in the struggle to topple Assad.

However, a European diplomat held out the prospect of possible Western military support, saying the coalition and its Western and Arab backers would meet in Istanbul next week to discuss military and humanitarian support to the rebels.

MEALS READY TO EAT

Kerry's offer of medical aid and Meals Ready to Eat (MREs), the U.S. army's basic ration, fell far short of rebel demands for sophisticated anti-tank and anti-aircraft weapons to help tip the balance against Assad's mostly Russian-supplied forces.

It also stopped short of providing other forms of non-lethal assistance such as bullet-proof vests, armored personnel vehicles and military training to the insurgents.

The Rome talks were the latest evidence that the United States and its allies have no appetite for military intervention in Syria, after the withdrawal of U.S.-led troops from Iraq and the drawdown under way in Afghanistan.

The final communique called for an immediate halt to "unabated" arms supplies to Damascus by third countries, referring mostly to Assad's allies Russia and Iran.

It also said Syria must immediately stop indiscriminate bombardment of populated areas, which it described as crimes against humanity. NATO officials say Assad's military has fired ballistic missiles within Syria, which the government denies.

Human Rights Watch has reported that at least 171 civilians were killed in four Scud missile strikes last week.

The "Friends of Syria" pledged "more political and material support to the coalition as the sole legitimate representative of the Syrian people and to get more concrete assistance inside Syria", but gave no details on exactly what would be provided.

Kerry said earlier this week he would not leave the Syrian opposition "dangling in the wind" unsure of getting support.

But the White House continues to resist providing weaponry to the rebel forces, arguing there was no way to guarantee the arms might not fall into the hands of militants who might eventually use them against Western or Israeli targets.

"HUGE DEBATE"

U.S. officials have said that the U.S. Defense and State Departments, under former Secretary of Defense Leon Panetta and former Secretary of State Hillary Clinton, privately recommended that the White House arm the rebels but were overruled.

"It's a huge debate inside the administration between those that have to deal with Syria on an everyday basis, the State Department and DoD particularly, and the White House, which ... until now has vetoed any kind of outreach to the armed groups," said Andrew Tabler, senior fellow at the Washington Institute for Near East Policy, a think-tank in the U.S. capital.

The United States says it has already provided more than $50 million in non-lethal assistance such as communications gear and governance training to the civilian opposition.

A source in the Syrian coalition, however, said even the extra $60 million promised by Washington was a pittance compared to what he said was the $40 million a day in humanitarian aid needed for Syrian refugees and internally displaced persons.

The United States has provided some $365 million in humanitarian aid for Syrian refugees in countries such as Turkey, Jordan and Lebanon and for internally displaced people, channeling this money through non-governmental organizations.

More than 40,000 people a week are fleeing Syria and the total number of refugees will likely pass 1 million in less than a month, far sooner than the United Nations had forecast, a senior U.N. official told the Security Council on Wednesday.

U.N. High Commissioner for Refugees António Guterres said his agency had registered 936,000 Syrians across the Middle East and North Africa, nearly 30 times as many as in April last year.

"We expected to have 1.1 million Syrian refugees by June. If things continue to accelerate like this, it will take less than a month to reach that number," he told the 15-member council.

(Writing by Alistair Lyon; Editing by Jon Boyle)

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Why Jennifer Aniston Kept Her Hair Down on Oscar Night

Stylewatch
Style News Now

02/26/2013 at 02:30 PM ET

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Her longtime stylist, Living Proof’s Chris McMillan, says the star wanted to stick with what works. “She wanted to keep the makeup natural and the hair natural,” he says in the exclusive clip above. “I think it’s about, at this point, being really comfortable on the red carpet.” Amen!

To hear more on Aniston’s Oscar night look, and to hear McMillan give a how-to on the night’s hot short hairstyles (his faves were Anne Hathaway and Charlize Theron), watch the clip above. Tell us: Did you like Aniston’s natural hair and makeup on Oscar night? 

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Medicare paid $5.1B for poor nursing home care

SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

___

On the Web:

The OIG report: http://1.usa.gov/VaztQm

The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1

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Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.

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Stock futures tick higher ahead of GDP, jobless data

NEW YORK (Reuters) - Stock index futures edged modestly higher on Thursday as investors were reluctant to make big bets following a sharp two-day rally and ahead of a rash of data.

Investors will also be keeping an eye on the debate in Washington over sequestration - U.S. government budget cuts that will take effect starting on Friday if lawmakers fail to reach an agreement on spending and taxes. President Barack Obama and Republican congressional leaders arranged to hold last-ditch talks to prevent the cuts, but expectations were low that any deal would be produced.

Major indexes posted their biggest daily gains since early January on Wednesday, putting the S&P 500 back above the closely watched level of 1,500. Over the past two sessions, the index has gained 1.9 percent, lifted by strong data and comments from Federal Reserve Chairman Ben Bernanke that showed continued support for the Fed's stimulus policy.

Wall Street has largely resisted predictions it would undergo a correction, with the S&P up 6.3 percent so far this year and the Dow Jones industrial average within striking distance of an all-time high. While markets suffered steep losses earlier this week on concerns over European debt, they have since recovered and are flat on the week.

Revised gross domestic product data is expected to show that the U.S. economy grew 0.5 percent in the fourth quarter, rather than contracted 0.1 percent as initially estimated. The data is due at 8:30 a.m. (1330 GMT)

Weekly jobless claims, also on tap for 8:30 a.m., are seen dipping by 2,000 to 360,000 in the latest week, while the February Chicago PMI is seen dipping to 54.3 from 55.6 last month.

Those reports come in the wake of strong pending home sales data Wednesday and a proxy for business spending plans that was more robust than expected, which added to the positive tone in markets.

S&P 500 futures rose 2.7 points and were above fair value, a formula that evaluates pricing by taking into account interest rates, dividends and time to expiration on the contract. Dow Jones industrial average futures added 16 points and Nasdaq 100 futures rose 4.5 points.

J.C. Penney Co Inc shares slumped 15 percent to $18.01 in premarket trading a day after it reported a steep drop in sales, prompting the department store to overhaul its pricing strategy.

Groupon Inc also reported revenue that missed expectations, sending shares down 26 percent to $4.41 before the bell.

Salesforce.com Inc and Gap Inc are on tap to report results later Thursday.

With 93 percent of the S&P 500 companies having reported results so far, 69.5 percent have beaten profit expectations, compared with a 62 percent average since 1994 and 65 percent over the past four quarters, according to Thomson Reuters data.

Fourth-quarter earnings for S&P 500 companies are estimated to have risen 6.2 percent, according to the data, above a 1.9 percent forecast at the start of the earnings season.

Tim Cook, chief executive of Apple Inc , acknowledged widespread disappointment Wednesday in the performance of the tech titan's stock, which is down 16.5 percent so far this year, but urged investors to take a long-term view on the company.

(Editing by Bernadette Baum)

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Jennifer Aniston & Justin Theroux's Wedding Planning Underway

02/27/2013 at 07:50 AM EST

She conquered the Oscars, and now Jennifer Aniston is preparing for another very big day.

The actress, 44, is in the process of planning her wedding to screenwriter-actor Justin Theroux, 41 – and she has already checked off some major tasks on her to-do list, including choosing wedding bands, setting a date and narrowing down dresses.

Just don't expect the wedding, which is likely to take place soon after Aniston wraps her current film in Connecticut on March 8, to be a lavish production.

"It will be a small affair with their closest friends," a source close to Aniston tells PEOPLE in this week's cover story.

In the meantime, the bride-to-be is enjoying life with her future groom.

"Jen seems more confident than ever," says the source, "and they've become a great team."

For much more on Aniston and Theroux's wedding plans, their romantic Oscar night and look inside their relationship, pick up this week's issue of PEOPLE

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Advanced breast cancer edges up in younger women

CHICAGO (AP) — Advanced breast cancer has increased slightly among young women, a 34-year analysis suggests. The disease is still uncommon among women younger than 40, and the small change has experts scratching their heads about possible reasons.

The results are potentially worrisome because young women's tumors tend to be more aggressive than older women's, and they're much less likely to get routine screening for the disease.

Still, that doesn't explain why there'd be an increase in advanced cases and the researchers and other experts say more work is needed to find answers.

It's likely that the increase has more than one cause, said Dr. Rebecca Johnson, the study's lead author and medical director of a teen and young adult cancer program at Seattle Children's Hospital.

"The change might be due to some sort of modifiable risk factor, like a lifestyle change" or exposure to some sort of cancer-linked substance, she said.

Johnson said the results translate to about 250 advanced cases diagnosed in women younger than 40 in the mid-1970s versus more than 800 in 2009. During those years, the number of women nationwide in that age range went from about 22 million to closer to 30 million — an increase that explains part of the study trend "but definitely not all of it," Johnson said.

Other experts said women delaying pregnancy might be a factor, partly because getting pregnant at an older age might cause an already growing tumor to spread more quickly in response to pregnancy hormones.

Obesity and having at least a drink or two daily have both been linked with breast cancer but research is inconclusive on other possible risk factors, including tobacco and chemicals in the environment. Whether any of these explains the slight increase in advanced disease in young women is unknown.

There was no increase in cancer at other stages in young women. There also was no increase in advanced disease among women older than 40.

Overall U.S. breast cancer rates have mostly fallen in more recent years, although there are signs they may have plateaued.

Some 17 years ago, Johnson was diagnosed with early-stage breast cancer at age 27, and that influenced her career choice to focus on the disease in younger women.

"Young women and their doctors need to understand that it can happen in young women," and get checked if symptoms appear, said Johnson, now 44. "People shouldn't just watch and wait."

The authors reviewed a U.S. government database of cancer cases from 1976 to 2009. They found that among women aged 25 to 39, breast cancer that has spread to distant parts of the body — advanced disease — increased from between 1 and 2 cases per 100,000 women to about 3 cases per 100,000 during that time span.

The study was published Tuesday in the Journal of the American Medical Association.

About one in 8 women will develop breast cancer in their lifetime, but only 1 in 173 will develop it by age 40. Risks increase with age and certain gene variations can raise the odds.

Routine screening with mammograms is recommended for older women but not those younger than 40.

Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer, said the results support anecdotal reports but that there's no reason to start screening all younger women since breast cancer is still so uncommon for them.

He said the study "is solid and interesting and certainly does raise questions as to why this is being observed." One of the most likely reasons is probably related to changes in childbearing practices, he said, adding that the trend "is clearly something to be followed."

Dr. Ann Partridge, chair of the federal Centers for Disease Control and Prevention's advisory committee on breast cancer in young women, agreed but said it's also possible that doctors look harder for advanced disease in younger women than in older patients. More research is needed to make sure the phenomenon is real, said Partridge, director of a program for young women with breast cancer at the Harvard-affiliated Dana-Farber Cancer Institute.

The study shouldn't cause alarm, she said. Still, Partridge said young women should be familiar with their breasts and see the doctor if they notice any lumps or other changes.

Software engineer Stephanie Carson discovered a large breast tumor that had already spread to her lungs; that diagnosis in 2003 was a huge shock.

"I was so clueless," she said. "I was just 29 and that was the last thing on my mind."

Carson, who lives near St. Louis, had a mastectomy, chemotherapy, radiation and other treatments and she frequently has to try new drugs to keep the cancer at bay.

Because most breast cancer is diagnosed in early stages, there's a misconception that women are treated, and then get on with their lives, Carson said. She and her husband had to abandon hopes of having children, and she's on medical leave from her job.

"It changed the complete course of my life," she said. "But it's still a good life."

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Online:

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov/cancer/breast/index.htm

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Cheers! Hollywood Toasts the Oscars

From Elton John's celebrated bash to Vanity Fair's annual soiree, see how George & Stacy, Adele, Jennifer Lawrence and more marked Hollywood's biggest night

Credit: Kevin Mazur/VF13/WireImage

Updated: Monday Feb 25, 2013 | 11:30 AM EST
By: Kiran Hefa & Kate Hogan

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Koop, who transformed surgeon general post, dies

With his striking beard and starched uniform, former Surgeon General Dr. C. Everett Koop became one of the most recognizable figures of the Reagan era — and one of the most unexpectedly enduring.

His nomination in 1981 met a wall of opposition from women's groups and liberal politicians, who complained President Ronald Reagan selected Koop, a pediatric surgeon and evangelical Christian from Philadelphia, only because of his conservative views, especially his staunch opposition to abortion.

Soon, though, he was a hero to AIDS activists, who chanted "Koop, Koop" at his appearances but booed other officials. And when he left his post in 1989, he left behind a landscape where AIDS was a top research and educational priority, smoking was considered a public health hazard, and access to abortion remained largely intact.

Koop, who turned his once-obscure post into a bully pulpit for seven years during the Reagan and George H.W. Bush administrations and who surprised both ends of the political spectrum by setting aside his conservative personal views on issues such as homosexuality and abortion to keep his focus sharply medical, died Monday at his home in Hanover, N.H. He was 96.

An assistant at Koop's Dartmouth College institute, Susan Wills, confirmed his death but didn't disclose its cause.

Dr. Richard Carmona, who served as surgeon general a decade ago under President George W. Bush, said Koop was a mentor to him and preached the importance of staying true to the science even if it made politicians uncomfortable.

"He set the bar high for all who followed in his footsteps," Carmona said.

Although the surgeon general has no real authority to set government policy, Koop described himself as "the health conscience of the country" and said modestly just before leaving his post that "my only influence was through moral suasion."

A former pipe smoker, Koop carried out a crusade to end smoking in the United States; his goal had been to do so by 2000. He said cigarettes were as addictive as heroin and cocaine. And he shocked his conservative supporters when he endorsed condoms and sex education to stop the spread of AIDS.

Chris Collins, a vice president of amFAR, the Foundation for AIDS Research, said many people don't realize what an important role Koop played in the beginning of the AIDS epidemic.

"At the time, he really changed the national conversation, and he showed real courage in pursuing the duties of his job," Collins said.

Even after leaving office, Koop continued to promote public health causes, from preventing childhood accidents to better training for doctors.

"I will use the written word, the spoken word and whatever I can in the electronic media to deliver health messages to this country as long as people will listen," he promised.

In 1996, he rapped Republican presidential hopeful Bob Dole for suggesting that tobacco was not invariably addictive, saying Dole's comments "either exposed his abysmal lack of knowledge of nicotine addiction or his blind support of the tobacco industry."

Although Koop eventually won wide respect with his blend of old-fashioned values, pragmatism and empathy, his nomination met staunch opposition.

Foes noted that Koop traveled the country in 1979 and 1980 giving speeches that predicted a progression "from liberalized abortion to infanticide to passive euthanasia to active euthanasia, indeed to the very beginnings of the political climate that led to Auschwitz, Dachau and Belsen."

But Koop, a devout Presbyterian, was confirmed after he told a Senate panel he would not use the surgeon general's post to promote his religious ideology. He kept his word.

In 1986, he issued a frank report on AIDS, urging the use of condoms for "safe sex" and advocating sex education as early as third grade.

He also maneuvered around uncooperative Reagan administration officials in 1988 to send an educational AIDS pamphlet to more than 100 million U.S. households, the largest public health mailing ever.

Koop personally opposed homosexuality and believed sex should be saved for marriage. But he insisted that Americans, especially young people, must not die because they were deprived of explicit information about how HIV was transmitted.

Koop further angered conservatives by refusing to issue a report requested by the Reagan White House, saying he could not find enough scientific evidence to determine whether abortion has harmful psychological effects on women.

Koop maintained his personal opposition to abortion, however. After he left office, he told medical students it violated their Hippocratic oath. In 2009, he wrote to Senate Majority Leader Harry Reid, urging that health care legislation include a provision to ensure doctors and medical students would not be forced to perform abortions. The letter briefly set off a security scare because it was hand delivered.

Koop served as chairman of the National Safe Kids Campaign and as an adviser to President Bill Clinton's health care reform plan.

At a congressional hearing in 2007, Koop spoke about political pressure on the surgeon general post. He said Reagan was pressed to fire him every day, but Reagan would not interfere.

Koop, worried that medicine had lost old-fashioned caring and personal relationships between doctors and patients, opened his institute at Dartmouth to teach medical students basic values and ethics. He also was a part-owner of a short-lived venture, drkoop.com, to provide consumer health care information via the Internet.

Koop was born in the New York City borough of Brooklyn, the only son of a Manhattan banker and the nephew of a doctor. He said by age 5 he knew he wanted to be a surgeon and at age 13 he practiced his skills on neighborhood cats.

He attended Dartmouth, where he received the nickname Chick, short for "chicken Koop." It stuck for life.

Koop received his medical degree at Cornell Medical College, choosing pediatric surgery because so few surgeons practiced it.

In 1938, he married Elizabeth Flanagan, the daughter of a Connecticut doctor. They had four children, one of whom died in a mountain climbing accident when he was 20.

Koop was appointed surgeon-in-chief at Children's Hospital in Philadelphia and served as a professor at the University of Pennsylvania School of Medicine.

He pioneered surgery on newborns and successfully separated three sets of conjoined twins. He won national acclaim by reconstructing the chest of a baby born with the heart outside the body.

Although raised as a Baptist, he was drawn to a Presbyterian church near the hospital, where he developed an abiding faith. He began praying at the bedside of his young patients — ignoring the snickers of some of his colleagues.

Koop's wife died in 2007, and he married Cora Hogue in 2010.

He was by far the best-known surgeon general and for decades afterward was still a recognized personality.

"I was walking down the street with him one time" about five years ago, recalled Dr. George Wohlreich, director of the College of Physicians of Philadelphia, a medical society with which Koop had longstanding ties. "People were yelling out, 'There goes Dr. Koop!' You'd have thought he was a rock star."

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Ring reported from Montpelier, Vt. Cass reported from Washington. AP Medical Writers Lauran Neergaard in Washington and Mike Stobbe in New York contributed to this report.

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