Prepared for a Disaster and Building Back Better: Terry Cline on Public Health’s Response to Oklahoma Tornados
Tornadoes that struck Oklahoma just a few weeks ago have left more than 40 people dead, scores injured and billions in losses, including whole neighborhoods wiped out. The devastating weather of the past year—including superstorm Sandy, which wreaked havoc on the Northeast, especially New Jersey and New York City—has called even greater attention to the critical need for public health departments to be ready to respond at all times. Health departments in the communities and states where disasters happen have to be nimble enough to respond to the expected and the unexpected—as you’ll see from three interviews NewPublicHealth recently conducted with the health commissioners of New Jersey and Oklahoma, as well as with the health director of Oklahoma City, the most recent area to be rocked by severe weather.
And because disasters don’t honor state lines and devastated areas may not have the capacity on their own to handle the myriad of disaster health issues, the manpower and equipment of even far-flung health departments can be critical—making preparedness a year-round, 24/7 responsibility for everyone in public health.
Read the first installment in the series, a conversation with Terry Cline, MD, the Commissioner of Health in Oklahoma.
NPH: With the recent tornadoes, what were you able to prepare for and what was unexpected?
Terry Cline: Unfortunately, in Oklahoma we have a lot of experience in dealing with disasters and we have what I consider to be a well-oiled machine in place. So overall, I think the response to this tragic situation went very well. The multiple tornados were a bit of a surprise though. It’s not unusual to have several tornados in the same area, but it’s unusual to have two significant tornados and then have one of those go through an urban area. I think a critical impact that was not anticipated was the flooding during the most recent tornado. The bottom line is that you need to have a strong infrastructure in place because Mother Nature has a way of always having the upper hand.
HHS Updates Guidelines to Prevention Disease Transmission from Organ Transplants
The U.S. Department of Health and Human Services (HHS) has updated its guidelines on reducing unexpected disease transmission through organ transplantation. The 2013 PHS Guideline for Reducing Human Immunodeficiency Virus, Hepatitis B Virus and Hepatitis C Virus Transmission through Organ Transplantation updates the 1994 U.S. Public Health Service guidelines designed to improve patient safety. The recommendations include additional screening, revised risk factors and more sensitive laboratory testing. “Transmission of infections through organ transplants is a critical concern for patients, their families and healthcare personnel involved in transplant procedures,” said HHS Assistant Secretary for Health Howard K. Koh, MD, MPH. “Putting these new recommendations into practice will allow doctors and patients to make better, more informed decisions when accepting organs for transplantation.” Read more on prevention.
HUD: $40M in Housing Counseling Grants to Improve Choices, Opportunities
The U.S. Department of Housing and Urban Development (HUD) is providing $40 million in housing counseling grants to help people find housing, to make more informed choices and to improve their ability to keep their existing homes. The grants will help more than 1.6 million households via 334 national, regional and local organizations. “Make no mistake: these grants will do a lot of good,” said HUD Secretary Shaun Donovan in a release. “The evidence is clear that housing counseling works. These grants are a smart investment to help families and individuals find and keep housing which helps promote neighborhood stability in the long term.” Read more on housing.
Majority of Adults Unaware of their Whooping Cough Vaccination Status
As the number of U.S. cases of pertussis—or whooping cough—rises, many adults are completely unaware of their need to remain up to date on their vaccinations. Only 20 percent say they’ve received the vaccine within the past decade and more than 60 percent do not even know their vaccination status. The lack of adult vaccinations can increase transmission rates to children; the majority of whooping cough deaths are children younger than 3 months. "Teens and adults who have received the [whooping cough] vaccine are less likely to get whooping cough themselves, and therefore less likely to spread whooping cough to other people, including infants who have not yet been protected by the recommended [whooping cough] vaccinations," said Matthew Davis, MD, director of the new University of Michigan National Poll on Children's Health. Read more on vaccines.
Jane Brody is the Personal Health columnist for The New York Times. She joined the newspaper in 1965 as a specialist in medicine and biology after receiving degrees in biochemistry and writing for multiple college newspapers, as well as for the Minneapolis Tribune. With her column she has seen and reported on almost 50 years in the evolution of personal and community health.
NewPublicHealth recently spoke with Brody about her take on the state of community health—and what we can all do to improve it.
NewPublicHealth: Over the years, what efforts have you seen that you think have been most effective at improving community health?
Jane Brody: Well, I think one of the most exciting things that’s happened in New York City, and possibly in other cities as well, is getting better food to people who live in food deserts. For example, collecting food that would otherwise be wasted and bringing it to communities where people get free food that is healthy, fresh, and they even have demonstrations of recipes. In fact, I got one of my favorite recipes—it’s a green bean frittata—from one of their demonstrations that I attended just to see how it all worked out.
We’ve also, as you’ve no doubt heard, been putting in all of these bike lanes and we now have introduced the Bike Share Program, which is not inexpensive, but it does at least give more people an opportunity to get off their butts and get out of their cars and maybe even not even use public transportation in some cases, but to get some exercise to and from work, which is wonderful. I remember during one of the transit strikes that we had in New York City, I rode my bicycle from Brooklyn to Times Square where I work, over the bridges and stuff, and it was just wonderful because I got my exercise in at the same time as I got to work and I didn’t have to spend an extra hour exercising. There have been improvements. We have, of course, public pools that are only open in the summer, but in summer is better than no public pools and nobody has to pay anything for a public pool, which is really great.
Regulations to Limit Youth Smoking also Lower Adult Rates
Regulation to limit youth smoking may also decrease the rate of adult smoking, according to a new study in the American Journal of Health. The study found that states with stricter regulations targeted youth tobacco use also saw lower incidence of adult use, especially among women. "In most states for many years, it has been illegal to sell cigarettes to people under 18, but few provisions are in place to prevent those sales," said study author Richard Grucza, an associate professor of psychiatry at Washington University School of Medicine in St. Louis. "This study shows that more restrictive policies can prevent teen smoking and be beneficial down the road." The most effective policies included eliminating cigarette vending machines, ID requirements to purchase cigarettes and restrictions preventing smaller packages of cigarettes. Gurzca estimated that if all states had such effective policies then smoking would be cut about 14 percent and heavy smoking would drop 29 percent. Read more on tobacco.
‘Watchful Waiting’ Approach to Prostate Cancer Can Reduce Unneeded Treatment
A “wait and see” approach to slow-growing prostate cancer—also known as “watchful waiting”—could reduce the number of unnecessary treatments, according to a new study in the Annals of Internal Medicine. The study took into account costs, side effects, quality of life and the chance of dying. "Most of the men who are diagnosed in this country these days have low-risk prostate cancer," said Julia Hayes, MD, who led the new study at the Dana-Farber Cancer Institute Boston. "There's a huge group of men out there who are probably treated unnecessarily." The slow-growing cancer “may never grow large or fast enough to threaten a man's life,” according to Reuters. Researchers estimate that men under the “watchful waiting” approach would ultimately undergo treatment in 34 percent of cases; active surveillance would lead to 78 percent. Read more on cancer.
Younger Americans Less Likely to Be Aware of their HIV, Undergo Treatment
People under age 45 who are infected with HIV are far less likely that their older counterparts to know about the infection and to be receiving treatment, according to a new study in the journal JAMA Internal Medicine. About 40 percent of people between ages 13-24 had been diagnosed and only 30 were referred for care. Those ages 25-44 also saw lower rates than people 45 and older. A total of more than 850,000 Americans with HIV have not achieved suppression. The researchers, led by H. Irene Hall of the U.S. Centers for Disease Control and Prevention, concluded that "Individuals, health care providers, health departments and government agencies must all work together to increase the numbers of people living with HIV who are aware of their status, linked to and retained in care, receiving treatment and adherent to treatment." Read more on HIV.
In Doing the Best I Can, Tim Nelson, a lecturer in public policy at Harvard, and his co-author, Kathryn Edin, a professor of policy and management at the Kennedy School of Government at Harvard, take a close look at the inaccurate stereotypes about low-income fathers and how a different approach could lead to more stable, healthier families. The book also calls for reforms in the U.S. including regularly incorporating visitation into child-support orders and improving systemic approaches to fathers with employment barriers that affect their ability to pay support. According to Nelson, these efforts could result in increased income for single-mother families, social supports for dads, and improved father-child relationships.
Just before Father’s Day, NewPublicHealth spoke with Tim Nelson about the book’s findings.
NewPublicHealth: How did you come to write the book?
Tim Nelson: My co-author, Kathryn Edin, has written several books about single mothers in Camden, New Jersey and in Philadelphia, first in the mid-1990s about how single mothers make ends meet on welfare and low wage work and then in the mid-2000s, she co-wrote a book about how single moms make decisions about marriage and childrearing. Doing the Best I Can, is kind of the companion piece to the book on marriage and childrearing, which is called Promises I Can Keep. The men we interviewed are not the partners of the women in the prior book, but they do come from the same neighborhoods and have the same low income status. It’s aimed at getting the fathers’ perspectives and experiences, which are much less well known than the mothers’.
NPH: What needs correcting about the image of low-income fathers and why is it important to correct it?
APHA, National Center for Healthy Housing Release Housing Standards to Improve Health
The National Center for Healthy Housing (NCHH) and the American Public Health Association (APHA) have released a National Healthy Housing Standard aimed at improving the health of Americans by addressing serious health and safety hazards in U.S. homes. About 30 million families live in unsafe and unhealthy housing with broken heating and plumbing; holes in walls and windows; roach and rodent infestation; falling plaster; crumbling foundations; and leaking roofs. Millions more live in housing with serious health and safety hazards that can cause allergies, asthma, injuries, cancer and lead poisoning, which add billions of dollars to health care costs and harm children’s health, development and wellbeing, according to the APHA. The new standard would not apply to new construction or housing renovation, but will be used by government agencies to ensure that the existing housing stock—with more than 100 million units across the country—is maintained to protect the health and safety of Americans. The housing standard would be implemented through adoption by federal state and local agencies. NCHH is requesting comments from health and housing practitioners, advocates and other stakeholders in healthy housing on the standard through July 31, 2013 at NCHH.org. Read more on housing.
Black, Hispanic Kids With Autism Less Likely to See Specialists
Black and Hispanic children with autism are less likely than their white counterparts to access specialists such as gastroenterologists, neurologists and psychiatrists, according to a new study in the journal Pediatrics. Study author Sarabeth Broder-Fingert, MD, a fellow in the department of pediatrics at MassGeneral and Harvard Medical School, said that while she expected to see differences, she was surprised by the extent of the disparity. Diagnosing and treating the disorders that often accompany is critical so that they do not lead to further health complications. "I do worry because autism is such a complicated disorder," she said. "The children have some sort of communication difficulty, so if they have stomach problems or sleep problems they may have difficulty expressing that. I always worry these kids are not getting all the care they need in general, and minority kids are more at [risk] of not getting the care they need." The study indicated that doctors need to be more aware of when to refer patients to specialists. About one in 50 school-age children have autism in the United States, according to the U.S. Centers for Disease Control and Prevention. Read more on health disparities.
Volunteer Time Reduces High Blood Pressure Risk in Older Adults
Time spent volunteering can help reduce the risk of high blood pressure in older U.S. adults, according to a new study in the journal Psychology and Aging. Researchers analyzed data on more than 1,100 adults, finding that those who volunteered at least 200 hours per year saw a 40 percent saw a 40 percent cut in high blood pressure risk four years down the line. Approximately 65 million American suffer from high blood pressure, or hypertension. "As people get older, social transitions like retirement, bereavement and the departure of children from the home often leave older adults with fewer natural opportunities for social interactions,” said lead author Rodlescia Sneed, a PhD candidate in psychology at Carnegie Mellon University. "Participating in volunteer activities may provide older adults with social connections that they might not have otherwise. There is strong evidence that having good social connections promotes healthy aging and reduces risk for a number of negative health outcomes." Read more on heart health.
Millions of cell phone customers might have heard their phones let out a high pitched alarm and spontaneously shake yesterday afternoon. The mobile siren is an indication that the severe weather is threatening the area—and roughly 62 million Americans were in the path of severe weather along the East Coast yesterday, as the region was wracked with severe thunder storms, tornados and flooding.
The mobile shake, rattle and siren is a free service from the Federal Emergency Management Agency and many nationwide cell phone carriers. You can find out if you’re covered by pressing 6-1-1 on your cell phone, which is your carrier’s customer service line. Earlier this week a NewPublichealth reporter, unaware of the service, suddenly felt his phone shake and was alerted to potential life-threatening flooding along his commuting route.
The service is actually two years old, but to get consumers to pay attention to the alerts, and the threats they’re warning about, FEMA recently partnered with the Ad Council on a new public service announcement.
The specific warnings come through as text messages with no more than 90 characters. Categories of alerts include extreme weather, AMBER alerts indicating a child has been abducted, and Presidential alerts during a national emergency.
One of the best features of the service is that it automatically tunes to weather where you are, not where you’re from. Go on vacation to the Outer Banks of North Carolina from Missouri, for example, and you will get alerts, if needed, about whether out on the barrier island. That’s important. Gary Cox, health director of Oklahoma City, which recently saw devastating tornadoes that killed and injured scores of people, said among those killed and injured were travelers to the area who hadn’t tuned into weather forecasts and didn’t know to take cover.
>>Bonus Link: Read an FAQ from FEMA on the wireless alerts.
American Institute of Architects, Others Launch Ideas Competition to Rebuild Sustainable Communities
The American Institute of Architects (AIA), Make It Right, St. Bernard Project and Architecture for Humanity have launched a new “Designing Recovery” ideas competition to help rebuild sustainable, resilient communities in areas hit by natural disasters. The announcement came at the annual Commitment to Action at CGI America. "The cities of New Orleans, New York and Joplin are all stark reminders of the emerging threat of severe-weather disasters brought on by a changing climate,” said Eric Cesal, Director of Reconstruction and Resiliency at Architecture for Humanity. “Every city can learn from the successes and failures of these three cities and their response to disaster. Designers and architects have a responsibility to do more — and to do better. We hope this competition will draw out the best and brightest new ideas for a world of new risks." Read more on disasters.
On World Blood Donor Day, HHS Highlights Need for More Resources
Today is World Blood Donor Day. The United States is one of only 62 countries that collect 100 percent of their blood from voluntary, unpaid donors; the World Health Organization has this goal for all countries by the year 2020. About 8 million people donate blood in the United States each year. While this number is substantial, the U.S. Department of Health and Human Services (HHS) says even more donations are needed to help surgical patients, cancer patients, victims of natural disasters and people who suffer battlefield injuries.
According to HHS:
- Forty or more units of blood may be needed for a single trauma victim
- Eight units of platelets may be required daily by leukemia patients undergoing treatment
- A single pint of blood can sustain a premature infant’s life for two weeks
Read more on global health.
Supreme Court Rules Naturally Occurring Human Genes Cannot be Patented
In a unanimous decision, the U.S. Supreme Court ruled that naturally occurring human genes cannot be patented, although synthetically produced genetic material can be. The ruling struck down Myriad Genetics Inc.’s patents on the BRCA1 and BRCA2 genes linked to breast and ovarian cancer. Robert Darnell, MD, president and scientific director of the New York Genome Center, said the ruling "sets a fair and level playing field for open and responsible use of genetic information" and that “it does not preclude the opportunity for innovation in the genetic world." Read more on research.
How many children could possibly identify with a new Sesame Street character whose dad is in prison? Close to two million, according to many experts. A White House “Champions of Change” event yesterday honored twelve men and women who have spent their careers researching and improving the lives of children who have at least one parent in prison. That explains why Sesame Street released a new video and toolkit yesterday, as part of their "Little Children, Big Challenges" series, that tells the story of Alex, whose dad is in prison. Alex’s grown up and peer friends help him talk, and sing, about his feelings about his dad and how other people speak about his dad’s prison stay. The "Challenges" series includes issues many kids face such as divorce and a parent in the military, and the resources are distributed through therapist's offices, schools, jails and other key places to reach kids.
The White House program, led off by Domestic Policy Council director Cecilia Munoz and Secretary of Health and Human Services Kathleen Sebelius, included panel discussions on the needs of kids whose parents are in jail, which is a recognized “adverse childhood experience” that can lead to poor health outcomes as children become adults. Among the problems kids of incarcerated parents can face are decreased living standards, social isolation because of the stigma they feel about having a parent in prison, and long-term or permanent separation from the incarcerated parent.
>>Watch a CBS News story on the Sesame Street program that will help support kids with incarcerated parents.
U.S. News & World Report has added a new set of rankings, “America's 50 Healthiest Counties for Kids” to its just released annual report on the Best Children’s Hospitals. The top counties have some important measures including fewer infant deaths, fewer low-birth-weight babies, fewer deaths from injuries, fewer teen births and fewer children in poverty than lower ranked counties. Most of the measures were taken from this year’s County Health Rankings, a collaboration of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
According to U.S. News, “America’s 50 Healthiest Counties for Kids,” represents the first national, county-level assessment of how health and environmental factors affect the well-being of children younger than 18 and shows that even the highest-ranking counties grapple with challenges such as large numbers of children in poverty and high teen birth rates.
>>Read the full U.S. News & World Report article.