Jul 30 2014
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Public Health News Roundup: July 30

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U.S. Surgeon General Issues ‘Call to Action’ Warning on Tanning and Skin Cancer
The U.S. Surgeon General has released the office’s first Call to Action on the dangers of tanning as it relates to skin cancer, which the Surgeon General called a “major public health problem.” The Call to Action is designed to increase awareness of skin cancer and presents five strategic goals to support its prevention:

  • Increase opportunities for sun protection in outdoor settings
  • Provide individuals with the information they need to make informed, healthy choices about ultraviolet (UV) radiation exposure
  • Promote policies that advance the national goal of preventing skin cancer
  • Reduce harms from indoor tanning
  • Strengthen research, surveillance, monitoring, and evaluation related to skin cancer prevention

Skin cancer is the most common type of cancer in the United States, with nearly 5 million people treated for all types combined annually at a cost of $8.1 billion. Melanoma is responsible for the most deaths and 90 percent of melanomas are estimated to be the result of UV exposure. Read more on cancer.

NIH, 23andMe Partner to Expand Researcher Access to Genetic Disease Data
The National Institutes of Health (NIH) has entered into a $1.4 million, two-year deal with home genetics startup 23andMe to open up the company’s stores of genetic data to external researchers. The grant will enable the creation of survey tools and other methods to help researchers access information on thousands of diseases and traits for more than 400,000 people who have use 23andMe’s services. “23andMe is building a platform to connect researchers and consumers that will enable discoveries to happen faster,” said Anne Wojcicki, co-founder and CEO of 23andMe, in a release. “This grant from the NIH recognizes the ability of 23andMe to create a unique, web-based platform that engages consumers and enables researchers from around the world to make genetic discoveries.” Read more on research.

Study: Students Increasingly Accepting Healthier School Lunches
Despite initial pushback from students wary of revised school lunch policies implemented to provide heathier meals in 2012, a nationally representative sample of 557 U.S. public elementary schools found that approximately 70 percent of respondents said that students liked the new lunches by the second half of the school year. Researchers also found that school meal sales were up for disadvantaged students, who are more likely than their peers to experience a lack of proper nutrition. Read more on school health.

Jul 29 2014
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Four States Join National Governors Association’s Prescription Drug Abuse Project

Michigan, Minnesota, North Carolina and Wisconsin have been tapped to join the second round of the National Governors Association’s (NGA) Prescription Drug Abuse Project, tasked with developing comprehensive, evidence-based statewide action plans to help combat the growing public health problem. Nevada Gov. Brian Sandoval and Vermont Gov. Peter Shumlin will lead the project, with their states also taking part.

Over the next year, the states participating in the project will accomplish the following:

  • Attend two, two-day meetings with other policy academy states;
  • Host an in-state workshop coordinated by NGA Center for Best Practices staff;
  • Develop a strategic plan for reducing prescription drug abuse;
  • Participate in regular conference calls and other meeting activities; and
  • Receive state-specific technical assistance from NGA staff and national experts.

“We are united by a common goal to reduce prescription drug abuse,” said Sandoval, in a release. “Bringing states together will help each of us learn ways to combat this growing problem. It is an honor to serve as co-lead on this timely and important issue.”

“Communities across the country continue to be affected by the abuse of prescription drugs,” added Shumlin. “That is why this initiative remains so important for governors. As the leaders of our states, our primary concern is for the health and safety of our citizens.”

According to the U.S. Centers for Disease Control and Prevention (CDC), prescription drug overdose is now the leading cause of death from injury, with approximately 113 U.S. deaths each day and 6,748 people treated daily for misuse or abuse in the nation’s emergency departments (EDs).

Additional data on prescription drug abuse from the CDC includes:

  • In 2011, among people ages 25 to 64, drug overdose caused more deaths than motor vehicle traffic crashes;
  • Drug overdose death rates have been rising steadily since 1992, with a 118 percent increase from 1999 to 2011 alone;
  • In 2011, 33,071 (80 percent) of the 41,340 drug overdose deaths in the United States were unintentional, 5,298 (12.8 percent) were of suicidal intent, 80 (0.2 percent) were homicides, and 2,891 (7 percent) were of undetermined intent;
  • In 2011, drug misuse and abuse caused approximately 2.5 million ED visits, with more than 1.4 million of these related to pharmaceuticals;
  • Between 2004 and 2005, an estimated 71,000 children were seen in EDs annually because of medication overdose (excluding self-harm, abuse and recreational drug use); and
  • Among children under age 6, pharmaceuticals account for roughly 40 percent of all exposures reported to poison centers.

>>Bonus Content: Read more of NewPublicHealth’s coverage of prescription drugs and prescription drug abuse. Below is a selection of our most recent coverage of the public health crisis:

Jul 29 2014
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Public Health News Roundup: July 29

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NCAA Reaches Preliminary Concussion Settlement, Including $70M Monitoring Program
The NCAA has reached a preliminary settlement in response to a class-action push to revise its head injury policies. The settlement includes a $70 million medical monitoring fund that would provide all former college athletes with the opportunity to receive neurological screenings, as well as a new national protocol which would require assessments by trained professionals and keep athletes from returning to games or practices the same day they suffer a head injury. “This offers college athletes another level of protection, which is vitally important to their health,” said the lead plaintiffs’ lawyer, Steve Berman, according to The New York Times. “Student-athletes—not just football players—have dropped out of school and suffered huge long-term symptoms because of brain injuries. Anything we can do to enhance concussion management is a very important day for student-athletes.” Read more on injury prevention.

Marijuana Legalization Not Linked to Rise in Teen Use
The gradual increase in marijuana use by U.S. teens over the past two decades is not linked to the legalization of medical marijuana in various states, according to a new research paper based on data from the U.S. Centers for Disease Control and Prevention. Researchers determined that the probability that a high school student had used marijuana in the previous 30 days was only 0.8 percent higher in states where use was legal. While marijuana is illegal under federal law, it has been legalized for medical purposes in 21 states and the District of Columbia, and legalized for recreational use in Colorado and Washington. "Our results are not consistent with the hypothesis that the legalization of medical marijuana caused an increase in the use of marijuana among high school students," wrote D. Mark Anderson of Montana State University, Daniel Rees of the University of Colorado and Benjamin Hansen of the University of Oregon, in the paper. Read more on substance abuse.

Study: 5-10 Minutes of Daily Running Can Add Three Years to Life Expectancy
As little as five to ten minutes of slow running every day can add up to an additional three years of life expectancy, according to a new study in the Journal of the American College of Cardiology. Researchers examined data on 55,137 adults 18-100 years of age (with a media age of 44 years), finding that running for the length of time at six miles an hour or slower was associated with markedly reduced risk of death from all causes, including heart disease. Researchers said the results should help drive inactive individuals to take up exercise programs. Read more on physical activity.

Jul 28 2014
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Recommended Reading: Life Expectancy Gains Threatened When Older Americans Have Multiple Medical Conditions

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A new study from the Johns Hopkins Bloomberg School of Public Health finds that nearly four in five older Americans are living with multiple chronic medical conditions. That’s very concerning, say the researchers, because their work shows that the more ailments a person has after retirement age, the shorter their life expectancy. The researchers say the new study is one of the first to look at the burden of multiple chronic conditions on life expectancy among the elderly and may help explain why increases in life expectancy among older Americans are slowing.

“Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States,” said Eva H. DuGoff, PhD, a researcher at the school of public health and the lead author of the new study. “The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy.”

The study found that a 75-year-old American woman with no chronic conditions will live to be an average of 92, but a 75-year-old woman with five chronic conditions will only live to an average age of 87 and a 75-year-old woman with 10 or more chronic conditions will only live to the age of 80. Women continue to live longer than men and white people live longer than black people, based on data from annual U.S. surveys.

On average, life expectancy is reduced by 1.8 years with each additional chronic condition, the researchers found. But while the first disease shaves off just a fraction of a year off life expectancy for older people, the impact grows as the diseases add up. The study is based on an analysis of the records of 1.4 million Medicare enrollees and was published in the journal Medical Care.

Other groups are also beginning to look at this issue. Healthy aging will be this year’s focus of the President’s Initiative of the Association of State and Territorial Health Officers. A year-long focus on healthy aging will begin during the association’s annual conference in September.

Read the full study.

Jul 28 2014
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Public Health News Roundup: July 28

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Study: EHRs Don’t Increase the Risk for Medicare Fraud
The use of electronic health records (EHRs) does not increase the risk of Medicare fraud, according to a new study from the University of Michigan Schools of Information and Public Health and the Harvard School of Public Health. In the study, scheduled to be published in the journal Health Affairs, researchers analyzed longitudinal data to determine whether U.S. hospitals that recently adopted EHRs also saw increases in the severity of patients’ conditions and payments from Medicare; they determined that adopters and non-adopters saw rates increase approximately equally. "There have been a lot of anecdotes and individual cases of hospitals using electronic health records in fraudulent ways. Therefore there was an assumption that this was happening systematically, but we find that it isn't," said Julia Adler-Milstein, U-M assistant professor of information, as well as an assistant professor of health management and policy in the U-M School of Public Health. Read more on technology.

Fist Bumps May Be the Best Greeting for Reducing Germ Transmission
Want to meet society’s hand-to-hand greeting expectation while also reducing the transmission of germs? Try a fist bump. Researchers from the Institute of Biological, Environmental, and Rural Sciences at Aberystwyth University in the United Kingdom used a germ-covered glove test to determine that handshakes transmit nearly twice as many bacteria as high-fives, which in turn transmit more bacteria than fist bumps. The study in the American Journal of Infection Control determined that duration and grip of a physical greeting also increased the number of bacteria transmitted. “Adoption of the fist bump as a greeting could substantially reduce the transmission of infectious diseases between individuals,” said author, David Whitworth, PhD. “It is unlikely that a no-contact greeting could supplant the handshake; however, for the sake of improving public health we encourage further adoption of the fist bump as a simple, free, and more hygienic alternative to the handshake.” Read more on infectious disease.

Fear a Greater Motivator than Data When it Comes to Using Sunscreen
Fear over developing skin cancer is a larger motivator for people’s usesof sunscreen than actual data that quantifies their risk, according to a new study in the Journal of Behavioral Medicine. Researchers analyzed data on approximately 1,500 people with no history of skin cancer, finding that for people who reported “never” using it and those who reported “always” using it, worry was a greater factor than education about risk, and the greater the worry, the more likely the use. “Most health behavior studies don’t account for the more visceral, emotional reactions that lead people to do risky behaviors, like eat junk food or ignore the protective benefits of sunscreen,” says Marc Kiviniemi, MD, lead researcher and assistant professor of community health and health behavior in the UB School of Public Health and Health Professions. “This study is important because most of what we do in public health communications focuses on spreading knowledge and information. By not addressing emotions, we are potentially missing a rich influence on behavior when interventions do not address feelings.” Read more on cancer.

Jul 25 2014
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Faces of Public Health: Lisel Loy, Bipartisan Policy Center

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Late last month, the Bipartisan Policy Center, a think tank based in Washington, D.C., released a new white paper, Teaching Nutrition and Physical Activity in Medical School: Training Doctors for Prevention-Oriented Care, that strongly recommends providing greater training in nutrition and physical activity  for medical students and physicians in order to help reduce U.S. obesity rates. The report was jointly published with the American College of Sports Medicine and the Alliance for a Healthier Generation, a nonprofit founded by the American Heart Association and the Clinton Foundation as a response to the growing rate of childhood obesity. The report found that current training for medical professionals and students in nutrition and exercise is inadequate to cope with the nation’s obesity epidemic.

A survey conducted for the new report found that more than 75 percent of physicians felt they had received inadequate training to be able to counsel their patients on changing diet and increasing activity levels. It also found that while some schools have stepped up their performance, fewer than 30 percent of medical schools meet the minimum number of hours of education in nutrition and exercise science recommended by the National Academy of Sciences.

“The health care marketplace needs to place greater value on preventive care,” said Jim Whitehead, Chief Executive Officer and Executive Vice President of the American College of Sports Medicine. “Doing so will provide medical schools with the incentive to train their students accordingly. And it will give medical professionals the leverage they need to address healthy lifestyles with their patients.”

NewPublicHealth recently spoke with Lisel Loy, director of the Nutrition and Physical Activity Initiative at the Bipartisan Policy Center, about the report and about how to improve training for medical professionals on nutrition and exercise.

NPH: What was the idea that propelled you to look into making changing to medical school education?

Loy: Well, the technical launching pad was our June 2012 policy report called Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future. And in that, my four co-chairs recommended a suite of policy changes that would improve health outcomes and lower costs for families, communities, schools and work sites. Within that community context they called out the need to improve training for health professionals—not just physicians but health professionals much more broadly defined than that—in pursuit of the goal of reducing obesity and chronic disease and cutting costs.

So that’s sort of the technical answer to your question. The more philosophical answer is as we as a country shift toward more preventive care, they really saw a gap in the education and training of health professionals in terms of being able to best support improved health outcomes. So that’s how they determined that that belonged in our report as a policy recommendation, and since we put out that report we prioritized a handful of recommendations, one of which had to do with health professional training.

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Jul 25 2014
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Public Health News Roundup: July 25

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United States, Mexico to Enhance Safety of Certain Agricultural Products
The U.S. Food and Drug Administration (FDA) and Mexico’s National Service for Agro-Alimentary Public Health, Safety and Quality and Federal Commission for the Protection from Sanitary Risks have entered an agreement to form a partnership to improve and promote the safety of fresh and minimally processed agricultural products. Each year, Mexico exports approximately $4.6 billion in fresh vegetables; $3.1 billion in fresh fruit, excluding bananas; $1.9 billion in wine and beer; and $1.5 billion in snacks to the United States.

The preventive practices and verification measures will include:

  • Exchanging information to better understand each other’s produce safety systems
  • Developing effective culturally-specific education and outreach materials that support industry compliance with produce safety standards
  • Identifying common approaches for training auditors who will verify compliance with such standards
  • Enhancing collaboration on laboratory activities as well as outbreak response and traceback activities

“To be successful as regulators, the FDA must continue developing new strategies and partnerships that allow us to more comprehensively and collectively respond to the challenges that come with globalization,” said FDA Commissioner Margaret A. Hamburg, MD, in a release. “The FDA is working with our Mexican government counterparts as well as stakeholders from industry, commerce, agriculture, and academia to ensure the safety of products for American and Mexican consumers.” Read more on food safety.

JAMA: Health Experts Call for End on Blood Donation Ban for Gay and Bisexual MenEx
perts writing in the Journal of the American Medical Association have called for the repeal of a 30-year ban on blood donations from gay and bisexual men. The U.S. Food and Drug Administration (FDA) instituted the ban for any man who had sex with another man in 1983, near the beginning of the AIDS crisis. Now, however, the experts said that technological and societal advances mean the ban should be lifted. "We think it's time for the FDA to take a serious look at its policy, because it's out of step with peer countries, it's out of step with modern medicine, it's out of step with public opinion, and we feel it may be legally problematic," said Glenn Cohen, who directs Harvard Law School's Petrie-Flom Center for Health Law Policy, Biotechnology & Bioethics, who co-wrote the article with Jeremy Feigenbaum of Harvard Law School and Eli Adashi, MD, of Brown University's medical school. They also noted that the ban is not in line with other FDA policies regarding people considered high-risk donors due to their sexual behavior. Read more on HIV/AIDS.

CDC Re-Opens Clinical TB Lab; Safety Reviews of Other Labs Continues
Less than two weeks after closing laboratories due to two serious lapses with anthrax and avian flu virus and an intensive review by its CDC’s internal Laboratory Safety Improvement Working Group, the U.S. Centers for Disease Control and Prevention (CDC) has resumed the transfer of inactivated materials out of its high-containment Clinical Tuberculosis Laboratory. The moratorium on material transfers remains in effect for BSL-3 and BSL-4 laboratories, with those supporting direct patient care receiving priority review. The working group’s ongoing lab assessments focus on two main areas:

  • Each lab must demonstrate that its protocols for key control points—such as inactivation of a pathogen—are not only being used but that they are being used by appropriately trained and supervised individuals.
  • Each lab is expected to establish redundant controls, similar to the two-key system used in other contexts for critical control points. For example, in the TB lab when heat is used to kill a pathogen, a second trained lab technician will witness the process to make sure the right temperature is used for the right amount of time. Both individuals then sign off on the process.

There will also be unannounced safety inspections by internal auditors. Read more on infectious disease and research.

Jul 24 2014
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Public Health Campaign of the Month: A Public Health Reason to Post a Selfie

NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to info@newpublichealth.org.

The March of Dimes has launched a PSA “selfie” campaign to remind women that if a pregnancy is healthy then it’s best to aim for at least 39 completed weeks of gestation before scheduling a delivery. The campaign features photos of women well into their pregnancies—bellies out to there and all with broad smiles.

According to the March of Dimes, important development of the brain, lungs and other organs occurs during the last weeks of pregnancy. The organization, along with state and local health departments, has increased its attention on the issue in the last few years.

“Every week of pregnancy is crucial to a newborn’s health,” said March of Dimes President Jennifer L. Howse, MD. “We believe that using ‘selfie’ photos will help reach today’s mothers-to-be, so they understand that healthy babies are worth the wait.”

The campaign photos all come (with permission) from women who have downloaded a free March of Dimes app, Cinemama, which lets expecting moms take and store selfies to give them a photo record of their pregnancies. Television stations across the country are giving free air time to broadcast the PSA.

>>Bonus Link: Read more on NewPublicHealth about maternal and infant health.

Jul 24 2014
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Public Health News Roundup: July 24

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FDA Approves New Oxycodone with Abuse-deterrent Properties
The U.S. Food and Drug Administration (FDA) has approved a new extended-release oxycodone with abuse-deterrent properties. Targiniq ER—which should be used to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment—contains naloxone which blocks the euphoric effects of oxycodone when crushed and snorted, or crushed, dissolved and injected. The drug is consistent with the FDA’s 2013 draft guidance for industry, Abuse-Deterrent Opioids – Evaluation and Labeling. "The FDA is committed to combatting the misuse and abuse of all opioids, and the development of opioids that are harder to abuse is needed in order to help address the public health crisis of prescription drug abuse in the U.S.,” said Sharon Hertz, MD, deputy director of the Division of Anesthesia, Analgesia and Addiction Products in the FDA’s Center for Drug Evaluation and Research. “Encouraging the development of opioids with abuse-deterrent properties is just one component of a broader approach to reducing abuse and misuse, and will better enable the FDA to balance addressing this problem with meeting the needs of the millions of people in this country suffering from pain.” Read more on substance abuse.

HHS: 10.3 Million Adults Gained Coverage in the ACA’s First Open Enrollment Period
An estimated 10.3 million uninsured adults gained health care coverage following the first open enrollment period in the Health Insurance Marketplace, according to a new study from the U.S. Department of Health and Human Services appearing the New England Journal of Medicine. The study looked at insurance trends before and after the open enrollment period, finding that the uninsured rate for adults ages 18-64 dropped from 21 percent in September 2013 to 16.3 percent in April 2014, which corresponded to a 5.2 percentage-point change, or 10.3 million adults gaining coverage. Read more on the Affordable Care Act.

Study: Parents of Obese Kids Often Don’t Realize They’re Unhealthy
Parents of obese children often don’t see their child’s weight as unhealthy and are more likely to make changes in their eating habits than to increase exercise, according to a new study in the Journal of the Academy of Nutrition and Dietetics. In a survey of more than 200 families in 2008 and 2009 to evaluate their readiness to help their children lose weight, researchers found that 28 percent of the parents did not see their child's weight as a health problem and 31 percent thought their child’s health was excellent or very good. The study also found that while 61 percent said they were trying to improve eating habits, only 41 percent were attempting to increase their child's activity level. Read more on obesity.

 

Jul 23 2014
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TEDMED Great Challenges: A Candid Conversation About Childhood Obesity

A 2012 report from the Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health concluded that if the adult and childhood obesity rates in 2011 continued to increase at their steady paces, then by 2030 nearly two-thirds of U.S. adults would be obese and every single state would have obesity rates above 44 percent.

Data now show that childhood obesity rates have stabilized. In fact, for the first time in a decade the obesity rates among young children from low-income families in many states is trending down.

Helping lead the way in this important public health issue has been the city of Philadelphia, Penn., which has worked to improve access to healthy foods and opportunities for physical activity.

“We were very fortunate in Philadelphia to have colleagues...who have developed a better understanding of childhood obesity,” said Don Schwarz, former Health Commissioner and Deputy Mayor for Health and Opportunity, City of Philadelphia, and will also soon take on the role of director for RWJF’s Demand Team. “What that has meant is that Philadelphia was able to take a body of knowledge and bring it to scale. The partnership in Philadelphia that has allowed that to happen goes across government and between government and the private sector and community organizations—just everyday Philadelphians. So that kind of partnership, that wonderful knowledge base, has I believed turned the corner on childhood obesity, particularly for children who are of disadvantaged communities.”

Schwarz’s comments came during the Tuesday, July 22 Google Hangout TEDMED Great Challenges: A Candid Conversation About Childhood Obesity. The panel was moderated by Richard Besser, Chief Health and Medical Editor for ABC News.

Every member of the panel echoed the importance of partnerships, and Besser succinctly explained their critical role in not just obesity prevention but all public health efforts.

“The more creatively you can think and the wider variety of partners you can pull in, the more likely you are to be successful,” he said.

At the heart of Philadelphia’s success has been the important role that schools play in that community partnership. According to Schwarz, for the past decade the city’s schools have worked to reshape how they approach children’s health and wellbeing, including comprehensive nutrition policies, a new food environment that emphasizes healthy choices and more opportunities for kids to be physically active. One can’t be successful without the other.

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