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Jul 10 2014
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Health Beyond Health Care: Housing

Planners, public health experts, community development leaders, architects and many others have come together over the past decade to focus on housing as a framework for a healthy life. A report released earlier this year by the Robert Wood Johnson Foundation’s (RWJF) Commission to Build a Healthier America made the link between health and housing clear:

“Living in unhealthy homes and communities can severely limit choices and resources. Healthy environments—including safe, well-kept housing and neighborhoods with sidewalks, playgrounds and full-service supermarkets—encourage healthy behaviors and make it easier to adopt and maintain them.”

Housing also impacts health when people spend so much on their rent or mortgage that they don’t have enough left over to pay for critical expenses such as food and medicine. According to the MacArthur Foundation—which released its second annual “Housing Matters” survey last month—during the past three years more than half of all U.S. adults have had to make at least one sacrifice in order to cover their rent or mortgage, including:

  • Getting an additional job
  • Deferring saving for retirement
  • Cutting back on health care and healthy foods
  • Running up credit card debt
  • Moving to a less-safe neighborhood or one with worse schools

Ianna Kachoris, a MacArthur Foundation program officer who oversees its How Housing Matters to Families and Communities research initiative, said that the quality and safety of a home make a significant impact on a person’s overall quality of life. Among the housing specifics that can impact health are lead or mold; the need to move frequently; having to live with many other people to make housing affordable; and concern over being able to affording the rent, the mortgage or needed housing repairs. The survey also found that accessing affordable quality housing in their communities is difficult for many people, including families with average income, young people just getting started in the labor force and families who want to live in quality school districts.

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Jul 10 2014
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Public Health News Roundup: July 10

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HHS, DOJ Release ‘Roadmap’ to Prevent Elder Abuse
The U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) have announced a new Elder Justice Roadmap to enhance elder abuse prevention and prosecution, while also highlighting the issue of elder abuse. An estimated one in 10 Americans over the age of 60 have experienced elder abuse or neglect. The Roadmap includes the DOJ’s development of an interactive, online curriculum to teach legal aid and other civil attorneys to identify and respond to elder abuse, as well as the HHS’ development of a voluntary national adult protective services data system. “Elder abuse is a problem that has gone on too long, but the Roadmap Report released today can change this trajectory by offering comprehensive and concrete action items for all of the stakeholders dedicated to combating the multi-faceted dimensions of elder abuse and financial exploitation,” said Associate Attorney General Tony West, in a release. “While we have taken some important steps in the right direction, we must do more to prevent elder abuse from occurring in the first place and face it head on when it occurs.” Read more on aging.

Study: Health Care Providers Must Do More to Ensure Pregnant Women Receive the Flu Vaccine
A new study finds that health care providers (HCPs) must do more to ensure pregnant women are vaccinated against influenza. After a review of 45 research papers, researchers determined that HCP influenza vaccine recommendations and on-site services would both help increase the current suboptimal vaccination rate. The study pointed to inadequate knowledge of the risks of influenza; doubts about vaccine safety, efficacy and benefits; and fear of adverse reactions for both the pregnant women and their unborn fetuses as barriers to vaccination. Many of the women in the review were also unaware that their pregnancies placed them at higher risk of complications from influenza. Read more on maternal and infant health.

Study: Younger Pro Pitchers at Higher Risk of Needing ‘Tommy John’ Surgery
Stephen Strasburg. Matt Harvey. Kerry Wood. All were or are hard-throwing Major League Baseball (MLB) pitchers who underwent “Tommy John” surgery early in their careers. Now, a new study from researchers at the American Orthopaedic Society for Sports Medicine indicates that entering the MLB at a younger age increases the risk of needing Tommy John surgery—which is a reconstruction of the ulnar collateral ligament in the elbow—at some point in a career. In a study of 168 pitchers who had Tommy John surgery and 178 age-matched pitchers who did not, approximately 60 percent of those who needed the surgery had it in the first five years of their career. They also had statistically more Major League experience, indicating that arm stress at a younger age heightens the risk of damage. “Having athletic trainers and team physicians closely look at when players’ pitching performance stats start to decrease may allow for steps to be taken before a surgery is needed. Our study also further highlights the need for kids not to overuse their arms early in their pitching careers,” said lead author Robert Keller, MD, of Henry Ford Hospital in Detroit, in a release. Read more on injury prevention.

Jul 9 2014
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Recommended Reading: The Washington Post and ‘Health Beyond Health Care’

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Last month the Washington Post held a live event, Health Beyond Health Care, that brought together doctors, bankers, architects, teachers and others to focus on health beyond the doctor’s office. The goal of the Washington, D.C., event—which was co-sponsored by the Robert Wood Johnson Foundation (RWJF) and others—was to showcase examples of novel places that are working to create cultures of health, such as a newly designed school that promotes physical activity and healthy eating in Virginia, and free outdoor exercise classes in Detroit.

Videos from the Post event are now online and include conversations with:

The Post's continuing coverage also includes articles about how city design can open up new opportunities for health; how greenways and complete streets can get people moving; and how workplaces can get a makeover for healthier employees.

Over the next few days, NewPublicHealth will report on additional efforts across the country to promote a culture of health across neighborhoods, schools, homes and workplaces.

Explore the Post’s special report on “Health Beyond Health Care” here.

Jul 9 2014
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Public Health News Roundup: July 9

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Study: Global Child TB Rates 25 Percent Higher than Previously Realized
The true number of children who develop tuberculosis (TB) each year in the 22 countries with the worst TB rates is nearly 25 percent higher than the World Health Organization (WHO) estimated as recently as 2012, according to a new study in The Lancet Global Health. Researchers used mathematical modeling to determine that approximately 650,000 children in these countries develop TB each year; the WHO estimate was 530,000. The study also determined that approximately 15 million children are exposed to TB every year and 53 million are living with latent TB infections which can become infectious active TB. While the findings are troubling, they also indicate promising ways to reduce the risk. "Our findings highlight an enormous opportunity for preventive antibiotic treatment among the 15 million children younger than 15 years of age who are living in the same household as an adult with infectious TB,” said lead author Peter Dodd, MD, from the University of Sheffield in the United Kingdom, in a release. "Wider use of isoniazid therapy for these children as a preventative measure would probably substantially reduce the numbers of children who go on to develop the disease." Read more on global health.

Severe Obesity Can Cut a Person’s Lifespan by Nearly 14 Years
Severe obesity can take nearly 14 years off a person’s life, according to a new study in the journal PLOS Medicine. Using data from 20 previous studies, researchers determined that severe obesity—defined as a body mass index (BMI) greater than 40—can cut lives short by anywhere from 6.5 to 13.7 years, due to increased risk of health problems such as heart disease, cancer and diabetes. "We found that the death rates in severely obese adults were about 2.5 times higher than in adults in the normal weight range," said lead investigator Cari Kitahara, a research fellow at the U.S. National Cancer Institute, according to HealthDay. Approximately 6 percent of U.S. adults are severely obese; severe obesity accounts for approximately 509 deaths per 100,000 men annually and 382 deaths per 100,000 women annually. Read more on obesity.

HHS: $100M for 150 New Community Health Centers
The U.S. Department of Health and Human Services (HHS) has announced approximately $100 million in available funds for communities to expand access to affordable, high-quality primary care through an estimated 150 new community health centers in 2015. Currently there are approximately 1,300 health centers with more than 9,200 service sites providing care to more than 21 million people in the United States and its territories. The centers, made possible under the Affordable Care Act (ACA), have also helped approximately 4.7 million people enroll for ACA coverage. Read more on community health.

Jul 8 2014
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Langley Park Community Needs Assessment Report: Q&A with Zorayda Moreira-Smith, CASA de Maryland

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Late last month several organizations in Washington, D.C., and suburban Maryland—including CASA de Maryland, the Urban Institute, Prince George’s County Public Schools and other Langley Park Promise Neighborhood partners—released the Langley Park Community Needs Assessment Report, a year-long community assessment supported by the U.S. Department of Education Promise Neighborhoods program.

The assessment found that few of Langley Park’s 3,700 children—nearly all of whom were born in the United States—are currently on track for a strong future and that their lives are severely impacted by poverty; poor access to health care; high rates of neighborhood crime; chronic housing instability and school mobility; and low levels of parent education and English proficiency. Fewer than half of the community’s children graduate high school in four years, often because of high rates of early pregnancy and early entry into the work force to help support their families.

Following the release of the report, NewPublicHealth spoke with Zorayda Moreira-Smith, the Housing and Community Development Manager at CASA de Maryland.

NewPublicHealth: One factor in students not finishing high school in Langley Park is that many high schools students ages 16-19 drop out so that they can go to work and help support their families. Is this especially an issue of concern in the Latino community?

Zorayda Moreira-Smith: There are a number of reasons people drop out at that age. One of them is that 35 percent are working because of family need. The safety nets that are generally there for individuals aren’t there for immigrant communities. Most of the parents in these families probably left school after 8th or 9th grade. And once you reach a certain age, you’re also seen as an adult, so there’s an expectation that you help out with the family needs. For most of the families in the area, there’s a high unemployment rate or they have temporary jobs or are day laborers. So, as soon as children reach a certain age, there’s the expectation to start helping out financially and I think it’s very common.

And most immigrant families not only support the people that make up their household here in the United States, but also support their family in the countries of their origin. And while our data doesn’t show it, some of these individuals and kids in households could be living with family members who aren’t their parents—they could be their aunts or their uncles or what not. So, also as soon as they’re working, they’re often supporting their siblings or their parents or their grandparents in their origin countries. 

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Jul 8 2014
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Public Health News Roundup: July 8

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HHS: $83.4M to Improve Community Access to Primary Health Care
The U.S. Department of Health and Human Services (HHS) is awarding $83.4 million to 60 Teaching Health Centers as part of the Affordable Care Act. The funds will go toward training more than 550 residents during the 2014-15 academic year, with the goal of strengthening primary care and improving access to health care in U.S. communities. Areas covered will include family medicine, internal medicine, pediatrics, obstetrics, gynecology, psychiatry, geriatrics and general dentistry. “This program not only provides training to primary care medical and dental residents, but also galvanizes communities,” said Health Resources and Services Administration Administrator Mary K. Wakefield, PhD, RN. “It brings hospitals, academic centers, health centers, and community organizations together to provide top-notch medical education and services in areas of the country that need them most.” Read more on access to care.

Community Preventive Services Task Force Recommends Universal Motorcycle Helmet Laws
Universal motorcycle helmet laws can prevent injuries and save lives while also saving communities the high health care costs associated with collisions, according to a new review of 69 studies and a separate economic review of 22 studies by the Community Preventive Services Task Force. Based on the conclusions, the task force—an independent, nonfederal, unpaid panel of public health and prevention experts—recommends all U.S. communities adopt universal helmet laws, with are more effective than no law or partial helmet laws at preventing severe injuries. The study found that the United States and other high-income communities saw substantial decreases in motorcycle-related deaths and injuries after enacting universal helmet laws, but the inverse when universal laws were repealed or replaced with other laws. Read more on injury prevention.

Study: Fungus Behind 2013 Yogurt Recall a Larger Threat than Previously Believed
The fungus behind an outbreak that led to the September 2013 recall of Chobani brand Greek yogurt is more dangerous than first believed, according to a new study in mBio, the online journal of the American Society for Microbiology. Initially the company believed that the Murcor circinelloides fungus was only a potential danger to people with compromised immune systems. However, as additional gastrointestinal were reported researchers continued their study, concluding that the “harmless” fungus was actually a strain with the ability to cause disease. “When people think about food-borne pathogens, normally they list bacteria, viruses, and maybe parasites. Fungal pathogens are not considered as food-borne pathogens. However, this incidence indicates that we need to pay more attention to fungi. Fungal pathogens can threaten our health systems as food-borne pathogens” said Soo Chan Lee of Duke University, an author on the study. Read more on food safety.

Jul 7 2014
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Liquor Ads Taking Aim at Young Binge Drinkers

Binge drinking is an increasing concern in the United States. A recent report from the U.S. Centers for Disease Control and Prevention (CDC) finds that one in ten adult deaths is linked to binge drinking through illnesses the binge drinker contracts—such as hepatitis—or accidents that happen to the drinker or that he or she causes—including homicide and domestic abuse. The CDC defines binge drinking as five or more drinks in a row for males and four or more drinks in a row for females.

Binge drinking also remains a concern among young adults. A new report from the Johns Hopkins Bloomberg School of Public Health and the Boston University School of Public Health finds that liquor now trumps beer as the drink of choice for underage (ages 13 to 20) binge drinkers, likely because of increased marketing by alcohol companies.

“Spirit firms have taken a page from the beer playbook in their marketing to young people,” said David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at Johns Hopkins in a conversation with NewPublicHealth.

The report on youth binge drinking was published in the Journal of Substance Use and found that spirits accounted for 43.8 percent of binge episodes, while beer accounted for less than one-third (31.4 percent) of binge episodes. “The inclusion of some relatively expensive brands in the top twenty-five binge brand list suggests that variables other than price are driving youth brand preferences with respect to binge drinking,” said Jernigan.

“Binge drinking accounts for most of the alcohol consumed by youth in the United States, and is associated with a host of negative consequences, including drunk driving, sexual assaults and suicide,” according to Timothy Naimi, MD, MPH, a lead author of the study and an associate professor at the Boston University School of Public Health.

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Jul 7 2014
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Public Health News Roundup: July 7

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CDC: One in 25 U.S. Drivers Report Falling Asleep at the Wheel in the Previous 30 Days
Approximately one in 25 U.S. drivers reported falling asleep while driving at least once in the previous 30 days, according to the latest Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention (CDC). CDC data found that, from 2009-2010, people who slept six or fewer hours per night, snored or unintentionally fell asleep during the day were most likely to fall asleep behind the wheel. They also identified binge drinking and unsafe seatbelt use as linked to a higher risk of falling asleep while driving. The report data was culled from information from the 92,102 respondents in 10 states and Puerto Rico to the 2011–2012 Behavioral Risk Factor Surveillance System surveys. Read more on transportation.

Study: Adults with Dyslexia Far More Likely to Have Been Abused as Children
Approximately one third of dyslexic adults report having been physically abused as children, according to a new study in the Journal of Interpersonal Violence. The percentage was far less—seven percent—for adults without dyslexia. Researchers say more work is needed to identify the cause or causes for this disparity. “It is possible that for some children, the presence of dyslexia and related learning problems may place them at relatively higher risk for physical abuse, perhaps due to adult frustrations with chronic learning failure" said study co-author, Stephen Hooper, professor of Psychiatry and Pediatrics, and Associate Dean and Chair of Allied Health Sciences at the University of North Carolina School of Medicine, in a release. "Alternatively, given the known association between brain dysfunction and maltreatment, it could be that the experience of physical abuse may also contribute to and/or exacerbate such learning problems, secondary to increased neurologic burden." Read more on violence.

Poultry Recall Connected to Massive Salmonella Outbreak
Sixteen months after the start of a salmonella outbreak that has sickened nearly 600 people across 27 states, Foster Farms has announced it will recall contaminated chicken that has been linked to the outbreak. The California-based poultry company said the recalled products—produced at three facilities on March 8, 10 and 11 of this year—were distributed in California, Hawaii, Washington, Arizona, Nevada, Idaho, Utah, Oregon and Alaska. "This recall is prompted by a single illness associated with specific fresh chicken product, but in the fullest interest of food safety, Foster Farms has broadened the recall to encompass all products packaged at that time. Foster Farms regrets any illness associated with its products," said the company in a statement. Read more on food safety.

Jul 3 2014
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Future of Public Health: Allison Larr, MPH, Mailman School of Public Health

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Allison Larr, 25, graduated from Columbia University’s Mailman School of Public Health a few weeks ago as a member of the 2014 Master’s in Public Health class and will soon start working at Citigroup in New York City as an analyst in the bank’s public finance division, which finances infrastructure projects.

“Infrastructure is central to maintaining a healthy population,” according to Larr. “If you don’t have a sewer system, public transportation and roads, you won’t have a healthy population.”

NewPublicHealth recently spoke with Larr about the path she took to her new career.

NewPublicHealth: How did you end up at Citigroup?

Allison Larr: As an undergraduate I studied neuroscience, and I was considering pursuing a career in academia or medicine. After my college graduation, I worked for a psychiatric research organization where I realized that I didn’t want to perform the traditional academic roles of creating and distributing knowledge or devote my life to being a physician, but I still wanted to work in a field related to health. By that time, I had developed quite an interest in the environment and in climate change, and so I thought why not connect these two by studying environmental health sciences and figuring out some sort of way that I could work in that field on large-scale problems related to health from upstream processes.

When I started my Master’s in Public Health at Mailman, I didn’t really have a clear vision of exactly what I wanted to do after graduation. I did know that I wanted to work on some bigger-picture environmental issues related to health, so I chose environmental health policy. I worked on a funding opportunity for electric vehicle infrastructure, and that was really the first time that I considered anything related to finance as related to health, because electric vehicle infrastructure would certainly increase electric vehicle uptake, which would have a positive impact on public health through reduced emissions. And in order to make that happen, you need to be able to pay for it.

That’s when the seed was planted that finance could be health related. Following that I worked at the New York City Department of Environmental Protection in the energy office, and when we were evaluating potential projects, part of my role was to evaluate how much greenhouse gas savings the projects would produce, as well as the payback period—investigating really whether it was a worthwhile investment from a financial point of view. 

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Jul 3 2014
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Public Health News Roundup: July 3

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Widely Used HIV Drug Linked to Higher Suicide Risk
People infected with HIV whose treatment includes the widely used antiretroviral drug efavirenz appear to have double the risk of suicidal thoughts, attempts and completion compared to HIV patients not taking the medication, according to a study by several researchers at the Harvard School of Public Health and the University of North Carolina at Chapel Hill. The study was published in the Annals of Internal Medicine.

“When efavirenz is used as a component of antiretroviral therapy, patients should be monitored carefully for exacerbation of depression or evidence of suicidal thoughts or behavior,” according to the study.

The drug has been previously linked to central nervous system side effects and suicide, but until now a clear link to suicidal thinking, attempted suicide, or completed suicide was not clear. The effects persist for the time patients are on the drug. The researchers recommend that patients with HIV use alternative drugs, if possible, if they are at risk for depression. Read more on HIV.

Nutrition Screenings Should Be Regular Part of Geriatric Health Assessment
Most older adults typically have one or more chronic health conditions that can affect their food intake and should be asked about their food intake during health exams, according to a new study in Nutrition in Clinical Practice. The researchers said that health care providers should also look for signs of malnutrition, such as loss of subcutaneous fat, muscle loss and fluid accumulation. Read more on aging.

Many American Teens Follow Pro-Marijuana Twitter Feeds and Receive Pro-Marijuana Tweets
Hundreds of thousands of American teens are following marijuana-related Twitter accounts and getting pro-marijuana tweets several times each day, according to researchers at the Washington University School of Medicine in St. Louis. The researchers say the tweets are cause for concern because young people are especially responsive to social media influences and because patterns of drug use tend to be established in a person’s late teens and early 20s. The study was published in the Journal of Medical Internet Research and relied on tweets sent and received between May 1 and Dec. 31, 2013, from a single popular pro-marijuana Twitter feed. During the study period, the feed posted an average of 11 pro-marijuana tweets per day. Read more on substance abuse.