FDA Approves for Marketing a Motorized Walking Suit for People with Spinal Cord Injuries
The U.S. Food and Drug Administration has approved for marketing a device called the ReWalk, which is the first motorized device intended to act as an exoskeleton for people with lower body paralysis from a spinal cord injury. According to the U.S. Centers for Disease Control and Prevention, there are about 200,000 people in the United States living with a spinal cord injury. ReWalk consists of a fitted, metal brace that supports the legs and part of the upper body; motors that supply movement at the hips, knees and ankles; a tilt sensor; and a backpack that contains the computer and power supply. Crutches provide the user with additional stability when walking, standing and rising up from a chair. Using a wireless remote control worn on the wrist, the user commands ReWalk to stand up, sit down or walk. Read more on disability.
One in 10 Deaths Among Working-Age Adults is Due to Excessive Drinking
Excessive alcohol use accounts for one in 10 deaths among working-age adults ages 20-64 years in the United States, according to a report from the U.S. Centers for Disease Control and Prevention and published in Preventing Chronic Disease. Excessive alcohol use led to approximately 88,000 deaths per year from 2006 to 2010, and shortened the lives of those who died by about 30 years. The deaths were due to health effects from drinking too much over time, such as breast cancer, liver disease and heart disease; and health effects from drinking too much in a short period of time, such as violence, alcohol poisoning and motor vehicle crashes. In total, there were 2.5 million years of potential life lost each year due to excessive alcohol use. Nearly 70 percent of deaths due to excessive drinking involved working-age adults, and about 70 percent of the deaths involved males. About 5 percent of the deaths involved people under age 21. The highest death rate due to excessive drinking was in New Mexico (51 deaths per 100,000 population) and the lowest was in New Jersey (19.1 per 100,000). Read more on substance abuse.
Men and Women Use Mental Health Services Differently
Women with chronic physical illnesses are more likely to use mental health services than men with similar illnesses, and they also seek out mental health services six months earlier than those same men, according to new study from St. Michael's Hospital in Toronto, Canada and published in the Journal of Epidemiology & Community Health. The study looked at people diagnosed with at least one of four physical illnesses: Diabetes, high blood pressure, asthma or chronic obstructive pulmonary disease. The researchers found that among those with at least one of these four illnesses, women were 10 percent more likely to use mental health services than men, and within any three-year period women with physical illness used medical services for mental health treatment six months earlier than men. The researchers say the results may imply that women are more comfortable than men with seeking mental health support; that symptoms are worse among women, requiring more women to seek help and sooner; or that men defer seeking treatment for mental health concerns. Read more on mental health.
At this week’s Spotlight: Health conference, an expansion this year of the annual Aspen Ideas Festival, angel investor Esther Dyson will be talking about “The Way to Wellville,” a contest that her nonprofit Health Initiative Coordinating Council—or “HICCup”—is organizing to encourage a rethinking of how communities produce health. The Way to Wellville is a five-year national competition among five communities to see which can make the greatest improvements in five measures of health and economic vitality.
“In the end, we hope to show that the best way to produce health is to change multiple interacting factors—diet, physical activity, preventive measures, smoking and the like—as well as more effective traditional health care,” said Dyson. “We’re less concerned with specific ‘innovations’ or digital miracles and more with simply applying what we already know at critical density.”
The five health measures have not been finalized yet, but are likely to include health impact, financial impact, social/environmental impact (such as crime rate or high school graduation rate), sustainability (such as a health financing system) and a specific “wild card” that each community will set for itself, such as teenage pregnancy or smoking rates.
NewPublicHealth spoke with Dyson ahead of the Spotlight: Health conference about the Wellville contest.
NewPublicHealth: How did the contest come about?
Esther Dyson: I had signed up to be a judge on the Health Care X Prize, but unfortunately it never materialized. For the next few years I kept thinking somebody should do this, and as I got more and more interested in health, I thought that with greater and greater enthusiasm. I had to give some remarks at a quantified self conference last year and was going to say that “someone should do this.” But I realized that would be a very lame talk and ultimately I announced that I would do it. Having appointed myself, I arranged several open-call brainstorming sessions. At one of them, a nice gentleman showed up with lots of awkward questions about metrics, funding, evaluation...the usual! So I appointed him as CEO. That’s Rick Brush, who formerly worked at Cigna and more recently has been running asthma-prevention programs with innovative financial models.
Building a Culture of Health—one where health is a part of everything we do—will not be an easy task. In fact, it will be very hard, admitted Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation.
It’s a “call to action for all of us,” said Bill Frist, “but these six communities show it can be done.” The six communities in question are the 2014 winners of the RWJF Culture of Health Prize, announced yesterday at the Aspen Ideas Festival. Each community, while different in its own way, thinks about health in a whole new way, as being impacted by all aspects of daily life—from food production to urban design.
Why were these communities chosen from more than 250 applicants from across the country? They’re harnessing the power of partnerships; focusing on lasting solutions; working on the social and economic factors that impact health, such as education and poverty; creating equal opportunities for health for everyone in the community; making the most of resources; and measuring and sharing results.
But what really sets the Prize communities apart, said Lavizzo-Mourey—the “magic ingredient” and the “secret sauce”—are passion, purpose and even joy.
‘I Got Tested’ Campaign Promotes Importance of Knowing Your HIV Status
A new public information campaign from Greater Than AIDS is using real-life stories to advocate the importance of knowing your HIV/AIDS status. The “I Got Tested” campaign will place materials in clinics to support providers in HIV outreach; provide free HIV testing in select Walgreens pharmacies; and promote hotlines and online resources provided by departments of health and agencies, as well as the U.S. Centers for Disease Control and Prevention. “Despite overwhelming evidence that early diagnosis and treatment play an important role both in the health of those who are positive and in reducing the spread of HIV, many Americans at highest risk for infection still have not been tested,” said Tina Hoff, Senior Vice President and Director of Health Communication and Media Partnerships at the Kaiser Family Foundation, a co-founding partner of Greater Than AIDS, in a release. “This campaign is about helping to reduce the stigma surrounding HIV testing, to encourage patients to ask their providers to get tested, and to connect people with services in their communities.” Read more on HIV/AIDS.
Court: NYC’s ‘Soda Ban’ is Illegal
New York City’s ban on large sugary drinks—often referred to as former Mayor Michael Bloomberg’s “soda ban”—is illegal, according to a 4-2 ruling from the state Court of Appeals. The court found that the local health board that passed the regulation overstepped its authority. "By choosing among competing policy goals, without any legislative delegation or guidance, the Board engaged in law-making and thus infringed upon the legislative jurisdiction of the City Council of New York," wrote Judge Eugene Pigott for the majority. The soda ban was one of several public health initiatives pushed by Bloomberg, along with a ban on cigarettes in certain public spaces and a ban on trans fats from restaurants. Read more on nutrition.
Study: 3 Hours of Television Per Day Can Double Risk of Early Death
Watching more than three hours of television per day may double a person’s risk of an early death, compared to someone who watches less than one hour per day, according to a surprising new study in the Journal of the American Heart Association. Researchers tracked more than 13,000 seemingly healthy adults in Spain, finding that for every two additional hours a person spent watching television, their risk of death from heart disease climbed 44 percent, their cancer death risk climbed 21 percent and their risk of premature death climbed 55 percent for all other causes. The study found no such link for other sedentary causes, including working at a computer and driving. Read more on physical activity.
Toby Cosgrove, MD, CEO of the Cleveland Clinic, spoke about bringing a business lens to health during a panel discussion this morning at the Spotlight: Health expansion program of the Aspen Ideas Festival. In an article in this month’s Harvard Business Review, he wrote that “Fixing health care will require a radical transformation, moving from a system organized around individual physicians to a team-based approach focused on patients.”
NewPublicHealth spoke to Cosgrove about this transformation just before the Spotlight: Health conference.
Toby Cosgrove: The first thing we did is that for the last decade we’ve been very transparent around our quality, and we’ve released books on quality outcomes which are available both in paperback form and on our website. The second thing that we’ve done is we’ve consolidated services. For example, we started out having six hospitals in the system that provided obstetrics care, and now we’ve got three and are about to have two. And each time we’ve consolidated we’ve increased the volume of patients and improved the quality. We’ve done consolidations with pediatrics, cardiac surgery, rehabilitation, psychiatry, trauma and obstetrics. We think that it’s called the practice of medicine—the more you practice at it, the better you get at it, and every time we’ve done that we’ve seen that happen.
In Cleveland, for example, we partnered with Metro Health, a large network of health providers. We previously had five trauma centers in Cleveland. Now we have three and as we’ve done that, the mortality rate has improved 20 percent. So there are real activities that have begun to drive the business approach.
NPH: What are other ways that the Cleveland Clinic has been able to respond to consumer needs using a business model?
Cosgrove: We think you’ve got to do three things. You’ve got to have improved access, quality and affordability. The access is not just having insurance—the access is actually getting to see a provider, and last year we provided about one million same-day appointments in addition to our scheduled ones. We also took our emergency room wait times from 43 minutes to 11 by changing the system that we use. And in our call center we’ve reduced the number of dropped calls and improved the speed of answers. All of that is aimed at giving patients access to the caregivers. We also reorganized our internal system so that when you, say, have a neurologic problem, instead of coming to see a neurologist and then a neurosurgeon, you come into the neurologic institute where you can be seen in one location under one leadership of neurology, neurosurgery and psychiatry, so that you are seamlessly seen with all the specialties right there in one location.
“What we mean by ‘building a Culture of Health’ is shifting the values—and the actions—of this country so that health becomes a part of everything we do,” said Risa Lavizzo-Mourey, MD, MBA, president and CEO of theRobert Wood Johnson Foundation (RWJF), during her keynote address at Spotlight: Health. RWJF is a founding underwriter of the two-and-a-half day expansion of the annual Aspen Ideas Festival.
“With health, each one of us can make the most of life’s opportunities,” she said. “That’s why we at the Robert Wood Johnson Foundation have made building a Culture of Health our North Star—the central aim of everything we do.”
Lavizzo-Mourey explained that the Foundation brought the Culture of Health concept to the Festival because of this year’s theme of “Imagining 2024.”
“When it comes to building a Culture of Health, I believe a decade from now we will have a powerful story of how we resolved to no longer accept that our nation spends more than $2.7 trillion dollars on health care, and yet continues to lose $227 billion dollars in productivity each year because of poor health,” she said.
Lavizzo-Mourey told the audience—which included health thought leaders from around the country—that building a true Culture of Health means changing our current understanding of health and creating a society where everyone has the opportunity to lead a healthy life. She gave the example of the Metro system in Washington, D.C., where babies born in the region of the Red Line—which intersects some of the wealthiest counties in the country—can expect to live to be 84 years old. However, babies born just a few stops away will have lives that are up to seven years shorter.
According to Lavizzo-Mourey, there are multiple ideas being practiced around the country that contribute to the emerging Culture of Health, including:
- Helping patients with things such as housing and food assistance at every medical visit.
- Changing the workplace culture to be a healthier one, including using stairs instead of elevators and holding standing or walking meetings.
She also enumerated several key ways that RWJF is working to build a sustainable Culture of Health, including committing $500 million toward reversing the U.S. childhood obesity epidemic; helping to ensure that everyone who is eligible for health care coverage knows about the benefits available to them; encouraging businesses to take the lead in investing in the wellbeing of the communities they serve; and addressing community violence.
HHS’ Million Hearts Initiative Launches Health Eating Resource Center
The Million Hearts initiative from the U.S. Department of Health and Human Services has launched a new online resource center to promote healthier eating by individuals and families. The Healthy Eating and Lifestyle Resource Center features lower-sodium, heart-healthy recipes and family-friendly meal plans, and emphasizes managing sodium intake. The searchable recipes include nutritional facts and use everyday ingredients. “This resource helps people see that it’s not about giving up the food you love, but choosing lower sodium options that taste great," said Tom Frieden, MD, Director of the U.S. Centers for Disease Control and Prevention. “Small changes can make a big difference. We can prevent 11 million cases of high blood pressure each year if everyone reduced their daily sodium intake to 2,300 mg.” The Million Hearts initiative was launched with the goal of preventing 1 million heart attacks and strokes by 2017. Read more on nutrition.
3-D Mammograms Improve Breast Cancer Detection Rate, Reduce Recall Rate
Tomosynthesis—also known as 3-D mammography—can increase the detection rate of breast cancer while also decreasing false positives that can lead to multiple and unnecessary re-tests, according to a new study in the Journal of the American Medical Association. Researchers analyzed the results of 454,850 examinations, finding that when 3-D mammography was combined with traditional digital mammograms the detection rate for breast cancer climbed 40 percent while there was a 15 percent decrease in the recall rate, or the percentage of women who needed additional screening due to inconclusive results. The findings come as more and more hospitals and physicians are turning to 3-D mammography. The researchers cautioned that more study was needed into the relatively new technology. Read more on cancer.
AAP: Reading to Young Kids Starting in Infancy Improves Literacy Later in Life
Read to your kids—aloud and every day—starting as early as their infancy. That’s the latest recommendation from the American Academy of Pediatrics' (AAP) Council on Early Childhood. The policy statement is set to appear in the August print issue of the journal Pediatrics. "This is the first time the AAP has called out literacy promotion as being an essential component of primary care pediatric practice," said statement author Pamela High, MD, director of developmental and behavioral pediatrics at Hasbro Children's Hospital in Providence, R.I., and a professor at Brown University. "Fewer than half of children are being read to every day by their families, and that number hasn't really changed since 2003. It's a public health message to parents of all income groups, that this early shared reading is both fun and rewarding." According to the AAP, reading proficiency in the third grade is the most important predictor of eventual high school graduation, but approximately two-thirds of all U.S. children and 80 percent of kids living in poverty finish third grade lacking in reading proficiency. Reading aloud to a young child can promote literacy while also strengthening family ties. Read more on pediatrics.
During this week’s Spotlight: Health at the annual Aspen Ideas Festival, Cleveland Clinic CEO Toby Cosgrove, MD, will be talking about the future of academic medicine. The topic has received a great deal of attention recently, including a white paper from the Bipartisan Policy Center (BPC) and a pilot program from the American Medical Association (AMA) to give $1 million each to eleven medical schools redesigning their teaching programs—many of which include a focus on prevention, wellness and population health.
Teamwork is a recent and critical emphasis at the Cleveland Clinic Lerner College of Medicine, said Cosgrove in a conversation with NewPublicHealth ahead of the Aspen conference.
“When a lot of us went to medical school we were all taught to be rugged individuals, and so [now] we’re trying to teach teamwork...at the very beginning of health care education,” he said. To that end, instruction at the medical school now emphasizes team-based learning and the students will begin doing some of their work with nursing and dental students in the same physical facility “so we begin to break down the silos that are going on right now and encourage team play.”
The 11 medical schools that received the recent AMA grants were chosen from among 119 schools that submitted proposals. “Their bold, transformative proposals [are] designed to close the gaps between how medical students are trained and how health care is delivered,” said former AMA President Jeremy A. Lazarus, MD, when the AMA awarded the grants last year. Among the winners:
- The Alpert Medical School of Brown University, which has proposed establishing a dual MD-MS degree program in primary care and population health. A clerkship during the third year of medical school will integrate care of the individual patient and population health, and the fourth year will include population health course content and require a Master's thesis. The admissions process will include required interviews with stakeholders and patients.
- The University of California-Davis School of Medicine is partnering with Kaiser Permanente to create the Accelerated Competency-based Education in Primary Care (ACE-PC) program, which will require all students to work in the Kaiser Health system so that they can learn by experiencing the patient-centered medical home model. Changes to curriculum include population management, chronic disease management, quality improvement, patient safety, team-based care and preventive health skills, with a special emphasis on diverse and underserved populations.
The eleven schools won’t be working in silos, either. Susan Skochelak, MD, the AMA’s group vice president for medical education, told NewPublicHealth that the initiative was designed “very specifically to bring the schools together in a consortium, because we wanted to disseminate the best practices rapidly.”
Public Health Campaign of the Month: National Crime Prevention Council, AAP Campaigns Urge Firearm Safety
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 firstname.lastname@example.org.
Two national multimedia campaigns are urging precautions and safe practices when it comes to firearms and children.
The National Crime Prevention Council (NCPC)—in partnership with the Ad Council and funded by the Bureau of Justice Assistance—has launched the Safe Firearms Storage campaign to encourage owners to make safe firearms storage a priority. According to a study by the RAND Corporation, about 1.4 million homes have firearms stored in a way that makes them accessible to children, at–risk youth, potential thieves and people who could harm themselves or others.
“We teach all drivers to buckle up in case of accidents and to lock their cars,” said Ann M. Harkins, President and CEO of the NCPC. “The same logic applies to this campaign; we want owners to lock up their firearms to prevent accidents and keep them out of the wrong hands. Safe storage ensures that owners are doing their part to increase public safety.”
In addition to a website, the NCPC campaign features television, radio, print, outdoor and online PSAs that call on firearms owners to use safety devices such as trigger locks, as well as to store ammunition in a separate locked container. A “Snapguide” illustrates options for properly storing a firearm in a household, and the website also offers resources to help firearm owners talk with their children about firearm safety.
The American Academy of Pediatrics (AAP), in partnership with the Brady Center to Prevent Gun Violence, is also making a beginning-of-summer push as part of its ongoing ASK campaign—“Asking Saves Kids”—to remind parents to ask whether there is an unlocked, loaded gun in a home before a child goes on a play date. A response of “yes” should be followed with questions about where the gun is and whether the children will be supervised. Concerned parents should then not be afraid to suggest the children play somewhere else, such as a playground or another home without a gun.
Follow NewPublicHealth this Week for News from ‘Spotlight: Health’ at the Aspen Ideas Festival and the Winners of the RWJF Culture of Health Prize
The Robert Wood Johnson Foundation (RWJF) is a lead sponsor for this week’s Spotlight: Health meeting, a two-and-a-half day expansion of the Aspen Ideas Festival, convened annually by the Aspen Institute in Colorado.
Spotlight: Health will bring together world leaders, corporate executives, innovators, entrepreneurs, policy experts, media, philanthropists and thought leaders from many sectors to showcase what health and health care can look like a decade from now.
On Wednesday, RWJF CEO Risa Lavizzo-Mourey will deliver a keynote address: “We Will Have A Powerful Story to Tell: Building a Culture of Health in America,” which will be live-streamed at 10 a.m. (EDT). She will also announce the six winners of the RWJF Culture of Health Prize, which honors communities working at the forefront of health improvement.
NewPublicHealth will live tweet and live blog from the event, as well as post interviews with key thought leaders presenting at the conference. They will include investor/entrepreneur Esther Dyson on “The Way to Wellville,” a wellness competition that’s looking for the key metrics to help improve population health; Cleveland Clinic CEO Toby Cosgrove, MD, on bringing business best practices to health care; and Michael Murphy, of the Boston-based MASS Design Group, on better design ideas for hospitals and health systems.
Follow RWJF and NewPublicHealth coverage of Spotlight: Health using the hashtag #AspenIdeas.