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Richard Knox

Credit Jacques Coughlin

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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Shots - Health Blog
11:48 am
Tue April 3, 2012

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

Credit Damian Dovarganes / AP
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.
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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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Shots - Health Blog
5:50 pm
Sat March 31, 2012

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

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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.
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Originally published on Sat March 31, 2012 5:51 pm

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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Shots - Health Blog
9:41 am
Tue March 27, 2012

Bypass Surgery Edges Stents For Heart Treatment

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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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Shots - Health Blog
11:01 pm
Mon March 26, 2012

In Haiti, Bureaucratic Delays Stall Mass Cholera Vaccinations

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Credit John W. Poole / NPR
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.
Credit John W. Poole / NPR
Cots are lined up in a Port-au-Prince cholera clinic run by GHESKIO, a Haitian medical group. GHESKIO is helping to organize a huge pilot project to vaccinate some 100,000 Haitians against cholera. Tens of thousands of people have signed up to participate. The health workers have been trained, and the vaccine is waiting in coolers. But the campaign is bogged down in bureaucratic red tape.
Credit John W. Poole / NPR
A GHESKIO worker walks through a tent camp in Port-au-Prince with a megaphone, warning people about the danger of cholera and the need for sanitation and clean water.
Credit John W. Poole / NPR
A sign produced by Haiti's water authority warns about the dangers of diarrhea and shows how to treat it — lots of fluids and a trip to a health clinic.
Credit John W. Poole / NPR
Residents of the Port-au-Prince slum Cite de Dieu step gingerly over a stream of sewage. Aid workers had planned to be finished with the vaccination program before the spring rains, when widespread flooding can bring cholera directly into people's homes.
Credit John W. Poole / NPR
Nadia Simone stands in front of her house in Cite de Dieu. She says she has been trying to get a trash-clogged ditch next to her house drained because she knows it brings cholera right to her doorstep. Last year cholera made her young daughter very sick. "I don't want cholera to come back to my house," she says.
Credit John W. Poole / NPR
A lone pig roots through trash along a sewage canal that runs from the center of Port-au-Prince through Cite de Dieu. During the rainy season, the canal overflows its banks and fills nearby houses with sewage.
Credit John W. Poole / NPR
A GHESKIO worker goes door to door in Cite de Dieu. As part of the planned vaccination campaign, an army of health workers has gone out to inform Haitians about cholera and sign them up to get the vaccine.
Credit John W. Poole / NPR
A makeshift latrine hangs over Port-au-Prince Bay at the edge of Cite de Dieu.
Credit John W. Poole / NPR
Rice farmers work the fertile fields of Haiti's rural Artibonite River valley, which lies downstream from the site of the original cholera outbreak.
Credit John W. Poole / NPR
Most people in this rural part of Haiti, near Saint-Marc, get their water from the Artibonite River. Though the river is known to be contaminated with cholera, few can afford chlorine tablets to purify the water.
Credit John W. Poole / NPR
Esperante Jean-Louise, who goes by Fifi, got cholera last year. The experience was terrifying, she says: "I first felt it in my head. And then once I started vomiting, I had diarrhea at the same time. I couldn't stand up — I was near death."
Credit John W. Poole / NPR
Rice farmer Alexis Rochenel, Fifi's husband, shows his blank cholera vaccination card. People will need two doses of vaccine spread over several weeks. Health workers could have been finished with the first round of vaccinations by now. But they're still waiting for the government to sign off on the project.
Credit John W. Poole / NPR
A young girl cools off from the midday heat in an irrigation canal near Saint-Marc. People in this area were chosen for the pilot vaccination program because they draw their water from the contaminated Artibonite River.
Credit John W. Poole / NPR
Men bathe in the evening in a branch of the Artibonite River outside Saint-Marc. Haiti's cholera outbreak began about 60 miles upstream from here. Well over a half-million have gotten sick.
Credit Photos by John Poole / NPR
A makeshift latrine hangs over Port-au-Prince Bay at the edge of Cite de Dieu.
Credit John W. Poole / NPR
A young girl bathes in an irrigation canal. The canal and nearby river are the primary sources of water for most people who live in the country around Saint-Marc, Haiti.
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Originally published on Wed May 23, 2012 9:56 am

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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Shots - Health Blog
10:15 am
Mon March 26, 2012

Study Finds Female Condoms Are Cost-Effective For HIV Prevention

Credit Drew Angerer / AP
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.
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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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