Category Archives: Public health
Urban Gardeners May Be Unaware of Harmful Soil Contaminants
In their quest to consume healthier foods, urban gardeners may actually be unaware of the presence of soil contaminants and how to deal with the issue, putting both gardeners and consumers at risk, according to a new study in PLOS One. Potential contaminants include heavy metals, petroleum products and asbestos, which can result when urban soil is near pollution sources, such as industrial areas and roads with heavy traffic. “Our study suggests gardeners generally recognize the importance of knowing a garden site’s prior uses, but they may lack the information and expertise to determine accurately the prior use of their garden site and potential contaminants in the soil,” said Keeve Nachman, PhD, senior author of the study and director of the Food Production and Public Health Program with the Johns Hopkins Center for a Livable Future. “They may also have misperceptions or gaps in knowledge about how best to minimize their risk of exposure to contaminants that may be in urban soil.” Read more food safety.
Study: 1 in 10 U.S. Adults Have Diabetes
Nearly one in 10 U.S. adults had diabetes in 2010, nearly double the percentage a little more than two decades ago, in 1988, according to a new study in the Annals of Internal Medicine. The study determined that 21 million American adults—or 9.3 percent of all American adults—had either type 1 or type 2 diabetes in 2010. As many as 95 percent of diabetes cases are type 2 cases. "This study also highlights that the increase in diabetes really tracks closely with the epidemic of obesity,” said Elizabeth Selvin, the study's lead author and an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “The diabetes epidemic is really a direct consequence of the rise in obesity.” However, the report did find that cases of undiagnosed diabetes were down, indicating new screen techniques are effective. It also found that overall blood sugar control was improved. Read more on obesity.
U.S. Health Care Costs Climbed 3.2% in 2013, to $329.2 Billion
The cost of new medicines, price increases on some branded drugs and patent expirations helped cause the first rise in the overall cost of health services in the United States in three years, according to a new report from IMS Health Holdings Inc., a health care information company. Americans spent a total of $329.2 billion on health services in 2013, up from 3.2 percent from 2012, which had seen a 1 percent decline. However, the report noted that expanded use of cheaper generic drugs—86 percent of all prescription drugs—did help costs from rising even higher. Read more on access to health care.
Study: Mean Devices Approved for Pediatric Use Never Tested on Kids
The majority of medical devices recently approved for pediatric use were never actually tested on kids, but rather only on people ages 18 and older, according to a new study in the journal Pediatrics. Researchers analyzed the clinical data used to get each device approved, finding that 11 of 25 examined devices were not tested on any patient age 21 and younger, and that only four had been tested on patients under the age of 18; three devices were specifically approved for patients under age 18, while the test were approved for people ages 18 to 21. "Children are not simply 'small adults,' and a device found to be safe and effective in adults may have a very different safety and effectiveness profile when used in a pediatric population," said Brigham and Women's Hospital and Harvard Medical School research fellow Thomas J. Hwang, one of the study’s authors, according to Reuters. "Without this data, it is difficult for clinicians and parents to make informed treatment decisions that weigh the risks and benefits of a particular treatment.” Read more on pediatrics.
Kaiser Report Examines Employer-Sponsored Retiree Health Benefits
A new report from the Kaiser Family Foundation on employer-sponsored retiree health benefits for pre-65 and Medicare-eligible retirees finds that the percentage of employers sponsoring retiree health coverage has declined, while employers that offer coverage are redesigning their plans almost annually in response to rising health care costs. The report, Retiree Health Benefits At the Crossroads, also examines the effect of recent legislation on retiree health coverage, such as the Medicare drug benefit and the Affordable Care Act. Read more on aging.
Study: Fewer Blood Transfusions Would Mean Fewer Infections
The increased use of blood transfusions in hospitals also leads to the increased risk of infection, according to a new study in the Journal of the American Medical Association. In a review of 21 randomized control trials, researchers from the University of Michigan School of Public Health determined that for every 38 patients considered for a red blood cell transfusion, the reduction of transfusions would mean one patient did not develop a serious infection, with the elderly undergoing hip and knee surgeries benefiting the most. “The fewer the red blood cell transfusions, the less likely hospitalized patients were to develop infections, “ says lead author Jeffrey M. Rohde, MD, assistant professor of internal medicine in the division of general medicine at the U-M Medical School, in a release. “This is most likely due to the patient’s immune system reacting to donor blood (known as transfusion-associated immunomodulation or TRIM). Transfusions may benefit patients with severe anemia or blood loss; however, for patients with higher red blood cell levels, the risks may outweigh the benefits.” Read more on prevention.
Sebelius to Step Down as Head of HHS
Kathleen Sebelius is resigning as secretary of the U.S. Department of Health and Human Services (HHS). The formal announcement is expected to come at 11 a.m. this morning, with President Obama to name Office of Management and Budget Director Sylvia Mathews Burwell as the replacement for the former Kansas governor. Sebelius assumed the HHS position in April 2009. Read more on the HHS.
FDA Expands Approved Use of Certain Pacemakers, Defibrillators
The U.S. Food and Drug Administration (FDA) has expanded the approved application of certain pacemakers and defibrillators, allowing them to also be used for patients with atrioventricular (AV) block and less severe heart failure. Previously the devices—which provide electrical impulses to the heart through implanted leads in the ventricles—were approved only for people with more severe heart failure as evaluated by their physician using specific criteria. The expansion covers two cardiac resynchronization pacemakers (CRT-P) and eight cardiac resynchronization defibrillators produced by Medtronic. Approximately 5.1 million people in the United States have heart failure. Read more on heart health.
Study: Doctor’s ‘Bedside Manner’ Has Real Effect on Patient Health
The doctor-patient relationship can have a real and significant impact on patient health, with doctors with better “beside manner” also having patients who fare better in efforts to lose weight, lower their blood pressure or manage pain, according to a new study in the journal PLOS One. Researchers reviewed 13 clinical trials, finding that improved patient outcomes were linked directly to doctors who had undergone training to hone their people skills. "I think that intuitively, people think that if you have an open, caring relationship with your provider, that's beneficial," said Helen Riess, the senior researcher on the new study, according to HealthDay. Read more on access to health care.
HHS Releases Data Giving Consumers Greater Transparency on Costs of Medical Procedures
The U.S. Department of Health and Human (HHS) services has released of new, privacy-protected data on services and procedures provided to Medicare beneficiaries by physicians and other health care professionals. The new data—which includes payment and submitted charges, or bills, for those services and procedures by provider—provides consumers with more information on how physicians and other health care professionals practice medicine, according to HHS Secretary Kathleen Sebelius. “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice,” she said. “The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns.” The release includes information for more than 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program. Read more on access to care.
HUD Grants $1.6B to Support 7,100 Local Homeless Housing and Service Programs
The U.S. Department of Housing and Urban Development (HUD) has announced approximately $1.6 billion in grants to continue support for 7,100 local homeless housing and service programs in all 50 states, as well as Puerto Rico, Guam and the U.S. Virgin Islands. The grants, which come through HUD’s Continuum of Care Program, support programs such as street outreach; client assessment; and direct housing assistance to individuals and families with children who are experiencing homelessness. "Whether it's helping to rapidly re-house families with young children or finding a permanent home for an individual with serious health conditions, HUD is working with our local partners to end homelessness as we know it," said HUD Secretary Shaun Donovan. Read more on housing.
Study: Concussion Symptoms May Be Worse For Girls than for Boys
Concussions may have a more severe and longer-lasting effect for girls than they do for boys, according to new research. Shayne Fehr, MD, a pediatrician at Children's Hospital of Wisconsin, tracked 549 patients who sought treatment at a pediatric concussion clinic, finding that girls on average reported more severe symptoms than boys and needed an additional 22 days to recover (56 days for girls, compared to 34 for boys). Approximately 76 percent of the injuries were sports related and the top five reported symptoms were headache, trouble concentrating, sensitivity to light, sensitivity to sound and dizziness. More research is needed to determine the cause of the disparity. Read more on injury prevention.
One in Four Teen Births Are Among Younger Teens Ages 15 to 17
While births to younger teens ages 15 to 17 years have declined, they still represent over a quarter of teen births and nearly 1,700 births a week, according to this month’s Vital Signs, the monthly health indicator report from the U.S. Centers for Disease Control and Prevention (CDC). “Although we have made significant progress reducing teen pregnancy, far too many teens are still having babies,” said CDC Director Tom Frieden, MD, MPH. “Births to younger teens pose the greatest risk of poor medical, social and economic outcomes. Efforts to prevent teen childbearing need to focus on evidence-based approaches to delaying sexual activity and increasing use of the most effective methods of contraception for those teens who are sexually active.” Read more on sexual health.
Study: Rural Girls Get More Daily Exercise than Those in Suburban, Urban Communities
While the level of urbanicty—whether they live in rural, suburban or urban communities—does not seem to affect boys’ levels of moderate-to-vigorous physical activity, there is a noticeable effect for girls, according to a new study in the American Journal of Preventive Medicine. Researchers determined that girls from rural areas are 4.6 times more likely than those in suburban areas and 2.8 times more likely than those in urban areas to exceed the national physical activity recommendation of 60 or more minutes of moderate-to-vigorous physical activity each day. The study tracked the daily activity of a random selection of 1,354 youth in 20 counties in North Carolina. Read more on physical activity.
Study: Mentions of Alcohol Brands in Popular Music Increase Youth Alcohol Use
The average young person in the United States hears approximately eight alcohol brand names each day while listening to music, increasing the risk they will use and abuse alcohol, according to a new study in the journal Alcoholism: Clinical & Experimental Research. Using information collected from more than 3,400 males and females ages 15 to 23, researchers determined that the average youth in that age group listens to 2.5 hours of music per day, with 3-4 brand mentions each hour. Lisa Henriksen, senior research scientist at the Stanford Prevention Research Center, called the findings “worrisome” in a release. "It would be foolish to think that the alcohol industry is unaware of and uninvolved with alcohol-brand mentions in music," said Henriksen. "The strategy of associating products with hip culture and celebrities who are attractive to youth comes straight from a playbook written by the tobacco industry." Approximately 39 percent of U.S. teens are current drinkers and about 22 percent are binge drinkers, according to the U.S. Centers for Disease Control and Prevention. Read more on alcohol.
At this year’s Preparedness Summit, which met last week in Atlanta, the American Red Cross was a first-time partner for the annual event which brings together more than 1,000 preparedness experts from around the country.
“It was important for us to partner with the American Red Cross because they have a major role and responsibility in disasters,” said Jack Herrmann, the Summit chair and Chief of Public Health Preparedness at the National Association of County and City Health Officials (NACCHO), the lead partner for the Summit. “We felt that it was important that the public health and health care communities understand the Red Cross’ role and authority during a disaster and look for ways to foster and build partnerships [among] local health departments, state health departments and American Red Cross chapters across the country.”
Just prior to the Summit, NewPublicHealth conducted an interview by email with Russ Paulsen, Executive Director, Community Preparedness and Resilience Services of the American Red Cross.
NewPublicHealth: What are the key issues that communities should focus on now to get themselves better prepared for a disaster should it occur?
Russ Paulsen: Everyone has a role to play in getting communities better prepared for disasters.
As a first step, individuals, organizations and communities should understand the problem: What hazards are in their area? How likely are any of these hazards to become actual disasters? What have people already put in place to deal with them? Local Red Cross chapters can help with this assessment.
Once people understand the problem, the next step is to make a plan. Plan what to do in case you are separated from your family or household members during an emergency, and plan what to do if you must evacuate your home. Coordinate your household plan with your household members’ schools, daycare facilities, workplaces and with your community’s emergency plans.
HHS: Significant Improvement on Leading Health Indicators that Influence Reduction in Preventable Disease and Death
A new report from the U.S. Department of Health and Human Services (HHS), Healthy People 2020, finds that the country’s health is importing in more than half—14 of 26—of the critical measures known to have a major influence in reducing preventable disease and death. The Leading Health Indicators include categories such as access to care; maternal and child health; tobacco use; nutrition; and physical activity. “The Leading Health Indicators are intended to motivate action to improve the health of the whole population,” said Howard Koh, MD, Assistant Secretary for Health, in a release. “Today’s LHI Progress Report shows that we are doing just that.” Among the indicators that been met or are improving:
- Fewer adults smoking cigarettes
- Fewer children exposed to secondhand smoke
- More adults meeting physical activity targets
- Fewer adolescents using alcohol or illicit drugs
Read more on HHS.
Study: Americans Twice as Likely to Get Food Poisoning from Restaurants than at Home
Americans are twice as likely to get food poisoning from food at a restaurant than they are from food at home, according to a new study from the nonprofit Center for Science in the Public Interest (CSPI). The organization analyzed “solved” outbreaks over a ten-year period, finding that 1,610 outbreaks in restaurants sickened more than 28,000 people while 893 outbreaks linked to private homes sickened approximately 13,000 people. The study also determined that of the 104 outbreaks linked to milk, about 70 percent were caused by raw milk—meaning that while less than one percent of consumers drink raw milk, they account for 70 percent of the illnesses caused by milk-borne outbreaks. The researchers also expressed concern over the 42 percent drop in reported outbreaks from 2011 to 2012. "Underreporting of outbreaks has reached epidemic proportions," said CSPI food safety director Caroline Smith DeWaal. "Yet the details gleaned from outbreak investigations provide essential information so public health officials can shape food safety policy and make science-based recommendations to consumers. Despite the improvements in food safety policy in the past decade, far too many Americans still are getting sick, being hospitalized, or even dying due to contaminated food." Read more on food safety.
Study: Antipsychotic Medications for Foster Care Youth Remain High
Use of antipsychotic medications for unlabeled indications such as treatment for attention-deficit hyperactivity disorder (ADHD) is increasing among youth in foster care, according to a new study in the Journal of Adolescent Psychopharmacology. Researchers from the University of Maryland, Morgan State University and the Johns Hopkins Medical Institutions analyzed data on 266,590 youth ages 2-17 years and continuously enrolled in a mid-Atlantic state Medicaid program in 2006, finding that approximately one-third of the ADHD-diagnosed foster care youth included in the assessment received atypical antipsychotics. This study adds critical hard data to our understanding of a persistent and unacceptable trend in pediatric psychiatry," said Harold S. Koplewicz, MD, Editor-in-Chief of Journal of Child and Adolescent Psychopharmacology, and President, Child Mind Institute, in a release. "Our poorest, most vulnerable children, lacking access to evidence-based care, are receiving potentially harmful treatment with little oversight. The highlight of Burcu et al.'s paper for any reader should be the simple but necessary recommendations for antipsychotic prescribing and monitoring in these populations." Read more on prescription drugs.
On Friday, April 4, the Robert Wood Johnson Foundation held a First Friday Google+ Hangout to explore how the 2014 County Health Rankings can be used to move the needle toward healthy communities. Hosted by Susan Dentzer, RWJF senior policy advisor, the Hangout featured four panelists from various sectors working to improve the health of U.S. communities.
Marjorie Paloma, Senior Policy Advisor at the Foundation, provided viewers with an overview of the County Health Rankings and Roadmaps, explaining that the rankings continue to show that where we live matters to our health. The rankings allow each state to see how counties compare on a number of health factors, including housing, education, income and safety. The Rankings offer a look at health trends across the country in addition to county-level information. This year’s Rankings find that people who live in the least health communities are twice as likely to live shorter lives and that we are slowly seeing an uptick in the number of children living in poverty. However, there have been significant declines in smoking rates and violent crime.
“The Rankings really help us to see how we’re doing and also where we can improve on health,” said Paloma. “The Roadmaps are really a call to action. They are really helping to move communities from awareness to driving action.”
Paloma also highlighted the broad range of resources available through the County Health Rankings website for communities to find and develop health solutions.
According to Brian Smedley, Vice President and Director, Health Policy Institute, Joint Center for Political and Economic Studies, the County Health Rankings is critical in understanding the importance of place as an upstream driver of health. Transportation, housing, opportunities for experience, quality of greenspace and more can be critical in determining the health of a community and the individuals who call it home. He explained that successful Roadmaps communities are ones that have built coalitions across different sectors and have health policy strategies that are local.
“We need to look at smaller geographic areas to see how neighborhoods affect health,” said Smedley. “A lens on place can be powerful in helping us to understand how we can reduce risks at the individual level and the community level.” He also offered additional tools for acquiring even finer cuts of data, such as Community Commons, local health departments and the U.S. Census Bureau.
Mary Lou Goeke, Executive Director, United Way of Santa Cruz County, offered a look at how the County Health Rankings and Roadmaps are used to improve health in Santa Cruz by shining a light on areas that need improvement and mobilizing the community to action. In particular, Goeke highlighted Santa Cruz’s efforts to reconcile a correlation between drinking rates and violent crime with the city’s new entertainment district. By using the data, the community was able to mitigate the potential harm of the entertainment district by implementing evidence-based practices to decrease drinking and crime.
“The County Health Rankings hold us accountable for things that aren’t working and encourages us to find new approaches,” said Goeke.
Katie Loovis, Director of U.S. Partnerships and Stakeholder Engagement, GlaxoSmithKline, explained how her company uses the rankings to shape its philanthropic efforts across the country. In the past few years, GlaxoSmithKline employees have overwhelming expressed support for the company to improve health in communities.
“If you want to improve health in your community, you have to know where you’re starting,” said Loovis. “The rankings do just that.” GlaxoSmithKline relies on the roadmaps to help highlight which interventions have the science to back them up and to identify which nonprofits to partner with in their target communities.
In addition, Loovis encourages local health departments and non-profits to reach out to local businesses directly and invite them to get involved in the solutions.
Each year during the first week of April, the American Public Health Association (APHA) hosts National Public Health Week, an opportunity to help communities across the United States highlight issues that are critical to improving the health of the nation. This year’s theme is “Public Health: Start Here”—entry points for making us a healthier nation. Each day this week has its own theme and NewPublicHeatlth will have a post about each one:
- Monday, April 7: Be healthy from the start. From maternal health and school nutrition to emergency preparedness, public health starts at home. Let us show you around. (Read a previous NewPublicHealth post, County Health Rankings — Nurse-Family Partnership: Q&A with Elly Yost, about how Rockingham County, N.C. is working to improve maternal health.)
- Tuesday, April 8: Don't panic. Disaster preparedness starts with community-wide commitment and action. We're here to help you weather the unexpected.
- Wednesday, April 9: Get out ahead. Prevention is now a nationwide priority. Let us show you where you fit in.
- Thursday, April 10: Eat well. The system that keeps our nation's food safe and healthy is complex. We can guide you through the choices.
- Friday, April 11: Be the healthiest nation in one generation. Best practices for community health come from around the globe.
In observance of National Public Health Week, NewPublicHealth spoke with Georges Benjamin, MD, executive director of the American Public Health Association about National Public Health Week 2014.
NewPublicHealth: Tell us about the 2014 National Public Health Week.
Georges Benjamin: We have an overarching theme, and it’s “Public Health: Start Here.” The intent is to get people to “just do it.” Often all of us have a tendency to kind of ruminate over what we want to do to improve the public’s health, and what we’re trying to emphasize this year is that there is enormous opportunity for people just to get up and do it. The evidence base is there, the opportunity is there, and so we’re just getting people to start improving their health.
We have five themes for the week. Monday is around early health such as maternal and child health; school nutrition; and conversations at home about how to make every family healthier. Tuesday is focused on emergency preparedness and disaster preparedness. On Wednesday we’ll be on prevention, including clinical and community preventive health services. Thursday’s focus is on eating well with a focus on the nutritional aspects of health. And Friday we look at becoming the healthiest nation in just one generation. Like the Robert Wood Johnson Foundation, the American Public Health Association is focused on a creating a culture of health and creating a healthy environment for everyone.
CDC Identifies Rare U.S. Case of Lassa Fever
A severe viral disease common in West Africa has been confirmed in a person returning to the United States from the region, according to the U.S. Centers for Disease Control and Prevention (CDC) and the Minnesota Department of Health (MDH). The patient was admitted to a Minnesota hospital for Lassa fever on March 31, with the CDC confirming diagnosis on April 3 and the patient now recovering and in stable condition. The last case of Lassa fever in the United States, of which there have been seven confirmed and all related to travel, was in Pennsylvania in 2010. The virus is not transmitted through direct contact with a sick person’s blood of bodily fluids and cannot by transmitted by casual contact; there are up to 300,000 cases and 5,000 deaths each year in West Africa. “This imported case is a reminder that we are all connected by international travel. A disease anywhere can appear anywhere else in the world within hours,” said CDC Director Tom Frieden, MD, MPH. Read more on infectious disease.
Public Health Officials in Developing Countries Use Social Marketing to Promote Health Behaviors
Public health officials in developing countries are successfully using social marketing strategies to educate people about the importance of behaviors related to water and sanitation, according to a new study in the journal Social Science & Medicine. In a systematic review of 32 studies, researchers led by W. Douglas Evans, PhD, a professor of prevention and community health at Milken Institute School of Public Health at the George Washington University, looked at how public health officials utilized social marketing tools such as door-to-door visits and public education campaigns for school children to promote behaviors such as regular hand washing and water purification. Read more on global health.
Depression, Anxiety Linked to Poor Diabetes Management
Depression and anxiety can be significant impediments to proper management of diabetes, according to a new study in the journal BioMed Central. Researchers from The University of Texas School of Public Health examined 500 Mexican-American adults from the Cameron County Hispanic Cohort in Brownsville, Texas, each of whom had been diagnosed diabetes and were taking medication for diabetes. Each t was interviewed about symptoms of depression and anxiety, and researchers also took measurements for body mass index (BMI), waist circumference, physical activity, fasting glucose and average blood sugar levels over time. “Unfortunately, greater depression and anxiety are associated with higher BMI and greater waist circumference, both indicators of obesity, as well as engaging in less physical activity and having less favorable indicators of glycemic control,” said Darla Kendzor, PhD, principal investigator and assistant professor at the School of Public Health Dallas Regional Campus, part of The University of Texas Health Science Center at Houston. Eighty one percent of Mexican-Americans are obese or overweight nationwide, with a nationwide diabetes rate of 16.3 that climbs to 30 percent for those who live along the U.S.-Mexico border. Read more on obesity.