Category Archives: News roundups
Study: Family Stress Can Impact Mortality Risk
Stressful family situations can significantly increase the risk of death, according to a new study in the Journal of Epidemiology and Community Health. Using health data on 9,875 men and women aged 36-52 years from The Danish Longitudinal Study on Work, Unemployment and Health, researchers determined that frequent worries and/or demands from a partner or children were linked to a 50-100 percent increase in mortality risk, and that frequent conflicts with any type of social relation were linked to a 2-3 times increase in mortality risk. Researchers also concluded that people outside the labor force were at higher risk of exposure to stress family situations. Read more on mortality.
National Task Force Recommends Regular Hep B Screening for People at Highest Risk
The U.S. Preventive Services Task Force is recommending regular screening for all people at high risk for contracting hepatitis B virus. If left untreated, the chronic illness can lead to liver cancer. Among the groups that the national panel says should be screened are:
- People born in countries with a high rate of infection, mainly in Asia, sub-Saharan Africa, the Pacific Islands, the Middle East and Eastern Europe.
- Those who share risk factors similar to those for HIV, including injection drug users, men who have sex with men, and people living with or having sex with someone with a hepatitis B infection.
- Patients with a weakened immune system or who are undergoing treatment for kidney failure.
"We have treatments that are effective at suppressing the virus and at improving abnormalities in the liver, so we can prevent some of the damage that occurs due to chronic hepatitis B," said Roger Chou, MD, an assistant professor at Oregon Health & Science University in Portland and director of the Pacific Northwest Evidence-based Practice Center, as well as lead author for the evidence review that formed the basis of the task force's recommendation. Read more on infectious disease.
Fewer Smokers See E-cigarettes as a Safer Smoking Alternative
While the national profile of e-cigarettes continues to increase, smokers are also increasingly less likely to view them as safer than traditional cigarettes, according to a new study in the American Journal of Preventive Medicine. Using data collected from the Health Information National Trends Survey (HINTS), researchers determined that awareness of e-cigarettes rose to 77.1 percent in 2013 from 16.4 percent in 2009. However, while 84.7 percent of smokers in 2010 viewed e-cigarettes as less harmful than traditional cigarettes, that number was down to 65 percent in 2013. Current estimates are that c-cigarette sales will soon reach $1.7 billion annually, or approximately 1 percent of all U.S. cigarette sales. Read more on tobacco.
Mental Health Patients with Primary Care Physicians are Better at Managing their Health
Mental health patients who receive primary care from a physician’s office are generally more engaged in the active management of their mental health than are people who rely on outpatient clinics or emergency departments, according to a new study in the journal Health Education & Behavior. Using data from a large nationally representative survey, researchers assessed patient activation among patients diagnosed with depression in relation to variables such as the site of their usual source of care, community characteristics and other demographic characteristics. “Patients with mental disorders are less engaged in their health care than patients with other chronic diseases, so it is important to activate this group,” said Jie Chen, PhD, assistant professor in the department of health services administration at the University of Maryland School of Public Health. “In communities where patient activation is low, such as low-income communities with a large population of foreign-born individuals, there is an even greater need for interventions at mental health care institutions to engage residents in their health.” Read more on mental health.
Study: Low Cost of Food a Contributor to U.S. Obesity Epidemic
One of the driving factors in America’s growing obesity epidemic may very well be the increased access to cheap food, according to a new study. The average American spends only about one-tenth of their disposable income on food, compared to the 1930s, when the rate was about one-quarter. In addition, the average per capita consumption of calories has climbed approximately 20 percent since 1970. “Not only has food been getting cheaper, but it is easier to acquire and easier to prepare,” said Roland Sturm, lead author of the report and a senior economist at RAND, a nonprofit research organization. “It's not just that we may be eating more high-calorie food, but we are eating more of all types of food.” Possible public health solutions for this trend include imposing taxes on foods with low-nutritional value, as well as subsidies or discounts for healthier foods, according to the researchers. Read more on nutrition.
Expensive Co-pays a Barrier for Some Kids to Proper Asthma Treatments
Parents with higher health insurance co-pays report using less expensive asthma drugs, giving their children less medication than prescribed and even putting off doctor visits or trips to the emergency department for the respiratory disorder, according to a new study in the journal JAMA Pediatrics. Approximately 1 in 10 U.S. children suffer from asthma, and the prevalence of the illness is greater in low-income populations. "It is concerning that the children we deal with are sometimes more vulnerable in areas we didn't recognize," said Jefry Biehler, MD, chairman of pediatrics at Miami Children's Hospital in Florida. "We have to be careful that we don't create a void for those families that can't afford all the things they need for their child, but who are above the financial level that gives them government insurance that will provide everything at no or minimal cost.” Read more on pediatrics.
Faster Mass Vaccination Response Could Save Lives, Costs in a Flu Pandemic
A faster response of mass vaccinations after the start of a severe flu outbreak would save both lives and health care costs, according to a new study in Annals of Internal Medicine. Researchers created a computer model of a how an outbreak of H7N9 or H5N1 would affect a U.S. metropolitan city with characteristics similar to New York City, depending on when public health officials were able to vaccinate 30 percent of the population. They determined that reaching that vaccination target in 12 months would mean 48,254 persons would die; at 9 months would save an additional 2,365 lives; at 6 months would save an additional 5,775 lives and $51 million at a city level; and at 4 months would save an additional 5,633 lives and $50 million. Read more on the flu.
Study: Current Weight at 25 a Better Indicator of Later Obesity Risk than Duration of Obesity
In a study of the relationship between body mass index (BMI) at age 25, obesity later in life and biological indicators of health, researchers determined current weight—and not the duration of obesity—was a more effective indicator of cardiovascular and metabolic risk, according to a new study in the American Journal of Preventive Medicine. They did also note that people who were obese by age 25 were in fact at higher risk of more severe obesity later in life. Using data from the 1999-2010 U.S. National Health and Nutrition Examination Survey (NHANES), the study found that men who were obese at age 25 had a 23.1 percent estimated probability of class III obesity (BMI greater than 40) after age 35, compared to a 1.1 percent chance for men of a normal weight at age 25. For women who were obese at age 25 the risk of later class III obesity was 46.9 percent, compared to only 4.8 percent for women of a normal weight. “This is good news in some respects, as overweight and obese young adults who can prevent additional weight gain can expect their biological risk factors to be no worse than those who reach the same level of BMI later in life,” said study lead author Jennifer B. Dowd, MD, associate professor, epidemiology and biostatistics, City University of New York (CUNY) School of Public Health, Hunter College. Read more on obesity.
Higher High School GPAs Linked to Greater Earnings in Adulthood
A one-point increase in high school grade point average (GPA) can raise annual earnings in adulthood by approximately 12 percent for men and 14 percent for women, according to a new study in the Eastern Economic Journal. Researchers also determined that a 1-point increase in GPA increased the likelihood of completing college from 21 percent to 42 percent for both genders. “Conventional wisdom is that academic performance in high school is important for college admission, but this is the first study to clearly demonstrate the link between high school GPA and labor market earnings many years later,” said Michael T. French, director of the Health Economics Research Group (HERG) in the Department of Sociology at the UM College of Arts and Sciences, and corresponding author of the study, adding, “High school guidance counselors and teachers can use these findings to highlight the importance of doing well in high school for both short term (college admission) and longer term (earnings as an adult) goals.” Read more on education.
New NCHH, APHA Standards to Improve U.S. Housing Health
A new report from the National Center for Healthy Housing (NCHH) and the American Public Health Association (APHA) establishes new standards to help improve housing for all Americans. The new National Healthy Housing Standard outlines a health-focused property maintenance policy for the nation’s 100 million existing homes—single family, multifamily, rental and owner occupied. Approximately 40 percent of metropolitan homes have one or more health and safety hazards, according to the NCHH, while the American Housing Survey determined that approximately 6.3 million housing units are considered to be substandard. “While we have made great strides in improving the quality of housing nationwide, too many Americans are left making the false choice between affordable or quality housing. Families deserve access to quality and affordable housing that allows them to put down roots in a community, build wealth, put kids through college and start businesses,” said U.S. Department of Housing and Urban Development Secretary Shaun Donovan, in a release. Read more on housing.
Red Cross Campaign Will Work to Cut Drowning in Half in 50 U.S. Cities
As part of its celebration of 100 years of swimming safety education, the Red Cross is launching a new national campaign to reduce the drowning rate by 50 percent in 50 U.S. cities. The 3-5 year campaign will target 50,000 people across 19 states. A new survey from the organization’s drowning prevention campaign found that while 80 percent of Americans said they could swim, only about 56 percent of those people exhibited “water competency”—meaning that they could perform these five critical water safety skills:
- Step or jump into the water over your head
- Return to the surface and float or tread water for one minute
- Turn around in a full circle and find an exit
- Swim 25 yards to the exit
- Exit from the water
“We're asking every family to make sure that both adults and children can swim and that parents make water safety a priority this summer,” said Connie Harvey, director of the Red Cross Centennial Initiative. Read more on injury prevention.
CDC Releases Vaccine Schedule App for Clinicians, Health Care Professionals
The U.S. Centers for Disease Control and Prevention (CDC) has launched a new app that provides clinicians and other health care professionals access to the CDC’s latest recommended immunization schedules. The CDC Vaccine Schedules app replicates the appearance of the printed schedules that are reviewed and published each year, and includes information such as the correct vaccine and dosage. The schedules include:
- Child and adolescent schedules with immunization recommendations from birth through age 18
- Catch-up schedule for children 4 months through 18 years
- Adult schedule, including recommended vaccines for adults by age group and by medical condition
- Contraindications and precautions table, with all footnotes that apply to schedules
The app is available in the iTunes App Store and will be released for Android devices in a few months. Read more on vaccines.
Census: Bicycle Commuting Up 60 Percent in Past Decade
U.S. cities across the country are seeing increases in bicycle commuters, according to a recent report from the U.S. Census Bureau. The report found that the total number of people who use a bike to get to work jumped by approximately 60 percent in the past decade, to about 786,000 during the 2008-2012 period, making the largest percentage increase of all commuting modes tracked by the 2000 Census and the 2008-2012 American Community Survey. Portland, Ore. had the highest bicycle-commuting rate at 6.1 percent; the overall national rate was 0.6 percent. "In recent years, many communities have taken steps to support more transportation options, such as bicycling and walking," said Brian McKenzie, a Census Bureau sociologist and the report's author, in a release. "For example, many cities have invested in bike share programs, bike lanes and more pedestrian-friendly streets." Read more on physical activity.
May 19 is ‘Hepatitis Testing Day’
Approximately 5.3 million Americans live with chronic viral hepatitis, although many don’t even realize they’re infected, according to the U.S. Department of Health and Human Services. Today, May 19, marks the third national Hepatitis Testing Day, founded to work to increase the number of people who know their hepatitis B and hepatitis C status; what severe—or even fatal—complications they may face if they’re infected; and their risk of spreading it to others. The U.S. Centers for Disease Control and Prevention (CDC) offers an online Hepatitis Risk Assessment, which utilizes brief questions to determine risk, and then prints out recommendations based on CDC’s testing and vaccination guidelines to discuss with their health care provider. Read more on prevention.
Current, Former Smokers May Have Harder Time Becoming Pregnant
Current and former smokers may face more difficulty when trying to become pregnant, according to a new study in the journal Fertility and Sterility. Researchers at the Boston University School of Public Health (BUSPH) analyzed the chances of getting pregnant among 686 current smokers, 741 former smokers and 2,346 women who never smoked, finding that among the former smokers with the highest level of exposure, the chance of getting pregnant was reduced on average by 26 percent per menstrual cycle. “Pregnant women are already encouraged to quit smoking because of the risks to the mother and baby. Some women might not be aware that current regular smoking also harms female fertility, as concluded by the U.S. Surgeon General based on observational studies and animal studies,” said Rose Radin, a doctoral student in the BUSPH Department of Epidemiology and the lead author of the study, in a release. “Our study also found that current regular smokers take longer to get pregnant than never smokers.” Read more on tobacco.
FDA Requires Lunesta Manufacturer to Lower Recommended Dosage
The U.S. Food and Drug Administration (FDA) is requiring the manufacturer of Lunesta to lower the current recommended starting dose. The current recommended dose of the sleep drug, also known as eszopiclone, may be high enough to impair activities that require alertness the following morning, even if the user feels fully awake, according to the agency. Any patient currently taking the 2 mg or 3 mg doses should contact their physician for instructions. “To help ensure patient safety, health care professionals should prescribe, and patients should take, the lowest dose of a sleep medicine that effectively treats their insomnia,” said Ellis Unger, MD, director, Office of Drug Evaluation I in the FDA's Center for Drug Evaluation and Research. Read more on prescription drugs.
CDC: Nearly 5,000 Preventable Injuries Related to Pool Chemicals in 2012
There were nearly 5,000 emergency department visits related to preventable injuries from pool chemicals in 2012, according to the U.S. Centers for Disease Control and Prevention (CDC). Almost half of the injuries were to children and teenagers; the injuries were most common during the summer swim season, from Memorial Day to Labor Day. The CDC provided these tips to help pool owners and operators prevent pool chemical injuries:
- Read and follow directions on product labels.
- Wear appropriate safety equipment, such as goggles and masks, as directed, when handling pool chemicals.
- Secure pool chemicals to protect people and animals.
- Keep young children away when handling chemicals.
- NEVER mix different pool chemicals with each other, especially chlorine products with acid.
- Pre-dissolve pool chemicals ONLY when directed by product label.
- Add pool chemical to water, NEVER water to pool chemicals.
“Chemicals are added to the water in pools to stop germs from spreading. But they need to be handled and stored safely to avoid serious injuries,” said Michele Hlavsa, chief of CDC’s Healthy Swimming Program. Read more on injury prevention.
Study: Hookahs Not a Safe Alternative to Smoking
Hookahs produce significant amounts of nicotine and compounds that can cause cancer, heart disease and other health problems, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention. "Water pipe smoking is generally perceived to be a safe alternative to cigarette smoking, even for children and youths. Our study shows that water pipe use, particularly chronic use, is not risk-free," said study author Gideon St. Helen, a postdoctoral fellow in the division of clinical pharmacology and the Center for Tobacco Control Research and Education at the University of California, San Francisco, according to HealthDay. In the study, researchers examined the urine of 55 men and women, who were regular hookah smokers, once after they avoided all smoking for a week and then again after an evening of smoking hookahs. After that single evening the found that the urine samples had: 73 times higher nicotine levels; four times higher levels of cotinine; two times higher levels of NNAL, a breakdown product of a tobacco-specific chemical called NNK; and 14 percent to 91 percent higher levels of breakdown products of volatile organic compounds such as benzene and acrolein. Read more on tobacco.
Study: Kids’ Cereals Average 40 Percent More Added Sugar than Adult Cereals
One bowl of kids’ cereal every morning would total as much as 10 pounds of sugar in a year, according to a new study from the Environmental Working Group (EWG). The organization assessed the sugar content of 1,500 cereals. While almost all had added sugar, the levels were higher in the 181 cereals specifically marketed to children—an average of 40 percent higher. “When you exclude obviously sugar-heavy foods like candy, cookies, ice cream, soft and fruit drinks, breakfast cereals are the single greatest source of added sugars in the diets of children under the age of eight,” said nutritionist and EWG consultant Dawn Undurraga, co-author of the organization’s new report, Children’s Cereals: Sugar by the Pound, in a release. “Cereals that pack in as much sugar as junk food should not be considered part of a healthy breakfast or diet. Kids already eat two to three times the amount of sugar experts recommend.” Read more on nutrition.
HHS, EU Making Progress in Fight Against Antimicrobial Resistance
This week the U.S. Department of Health and Human Services (HHS) and the European Commission released a progress report of the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR), a joint effort to combat antimicrobial resistance. In 2009, TATFAR identified and adopted 17 recommendations; the progress report includes one new recommendation to go along with 15 existing recommendations.
Notable TATFAR activities from 2011-2013 include:
- Adoption of procedures for timely international communication of critical events that might indicate new resistance trends with global public health implications
- Publication of a report on the 2011 workshop, “Challenges and solutions in the development of new diagnostic tests to combat antimicrobial resistance” to the TATFAR website
- Joint presentations to the scientific community to increase awareness about the available funding opportunities on both sides of the Atlantic
There are an estimated 25,000 deaths in Europe and 23,000 deaths in the United States linked to drug-resistant infections each year. Such infection also cost the United States and the European Union billions of dollars annually in avoidable health care costs and productivity losses. Read more on global health.
Women with Unintended Pregnancies Take the Shortest Maternity Leaves
Women with unintended pregnancies also take the shortest maternity leaves, according to a recent study from the University of Maryland School of Public Health published in the journal Women’s Health Issues. “We know that it’s better for women to take time off after childbirth to take care of their physical and mental health,” said Rada K. Dagher, MD, assistant professor of health services administration. “Returning to work soon after childbirth may not be good for these women or for their children.” Dagher’s previous research has indicated that six months of maternity leave is optimal for reducing a woman’s risk of postpartum depression. In addition to policies that enable women to take longer maternity leaves, she said there is also a need to counsel both women and men who are at risk for unintended pregnancies about effective contraceptive methods. Read more on maternal and infant health.
CDC: Half of Americans Reported Prescription Drug Use in the Past Month
A new report from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics takes a comprehensive look at the use of prescriptions drugs in the United States from 2007 to 2010. Prepared for the Secretary of the U.S. Department of Health and Human Services, the report compiled health data from state health agencies, federal health agencies and the private sector. Among the findings:
- About half of all Americans in 2007-2010 reported taking one or more prescription drugs in the past 30 days
- Cardiovascular agents (used to treat high blood pressure, heart disease or kidney disease) and cholesterol-lowering drugs were two of the most commonly used classes of prescription drugs among adults aged 18-64 years and 65 and over in 2007-2010.
- The use of antidepressants among adults aged 18 and over increased more than four-fold, from 2.4 percent to 10.8 percent between 1988-1994 and 2007-2010.
- Drug poisoning deaths involving opioid analgesics among those aged 15 and over more than tripled in the past decade, from 1.9 deaths per 100,000 population in 1999-2000 to 6.6 in 2009-2010.
- The annual growth in spending on retail prescription drugs slowed from 14.7 percent in 2001 to 2.9 percent in 2011.
Read more on prescription drugs.
Study: Emergency Department Visits for TBIs Jumped Nearly 30 Percent from 2006 to 2010
Emergency department visits for traumatic brain injuries (TBIs) jumped nearly 30 percent from 2006 to 2010, with researchers pointing to increased awareness as a potential explanation for the increase, according to a new study in JAMA. The past few years has seen growing awareness about the dangers and realities of TBIs, including public campaigns and legislation to help prevent injuries. Researchers used data from the Nationwide Emergency Department Sample database, finding that in 2010 there were approximately 2.4 million emergency department visits for TBIs, up 29 percent from 2006, with children younger than three and adults over the age of 60 seeing the highest increases. Researchers noted that this disparity may indicate that current TBI awareness and prevention efforts do not benefit the very young and the old. Read more on injury prevention.
WHO: MERS-CoV Not Yet a Public Health Emergency of International Concern
While saying that its concerns have greatly increased, the Middle East respiratory syndrome coronavirus (MERS-CoV) does not yet constitute a Public Health Emergency of International Concern, according to a statement released today by a World Health Organization’s emergency committee. According to the statement, their concerns center on the “recent sharp rise in cases; systemic weaknesses in infection prevention and control, as well as gaps in critical information; and possible exportation of cases to especially vulnerable countries.” Thirteen countries have reported cases since December 2013: Egypt, Greece, Jordan, Kuwait, Lebanon, Malaysia, Oman, Philippines, Qatar, Saudi Arabia, United Arab Emirates, United States of America and Yemen. The United States has so far reported two cases—both this month. Read more on global health.
Living Near Foreclosed Property is Linked to Higher Blood Pressure
Living near foreclosed property may increase the risk of higher blood pressure, according to new research published in the American Heart Association journal Circulation. Researchers reviewed data from 1,740 participants (mostly white, 53 percent women) in 1987-2008 in the Framingham (Massachusetts) Offspring Cohort, which is part of the Framingham Heart Study. The researchers distinguished between real-estate-owned foreclosures, which are owned by lenders and typically sit vacant, and foreclosures purchased by third-party buyers, which are generally put into housing use. The researchers found each additional foreclosed property within 100 meters (328 feet) of participants’ homes was associated with an average increase of 1.71 mm Hg in systolic blood pressure. The association only applied to properties that were real-estate owned and there was no effect from foreclosed properties more than 100 meters from participants’ homes.
“The increases in blood pressure observed could be due in part to unhealthy stress from residents’ perception that their own properties are less valuable, their streets less attractive or safe and their neighborhoods less stable,” said Mariana Arcaya, Sc.D., M.C.P., study lead author and a research fellow at the Harvard Center for Population and Development Studies in Cambridge, Mass. “Safety could also be a concern that affects their ability to exercise in these neighborhoods.”
Research on different populations in urban and rural settings is needed, says Arcaya. The study was funded by the Robert Wood Johnson Foundation, the Harvard School of Public Health and the National Institutes of Health and the Robert Wood Johnson Foundation funded the study. Read more on prevention.
Underage College Men Downplay Danger of Driving after Using Marijuana
Underage male college students who report using marijuana in the month before they were surveyed had a high prevalence of driving under the influence of marijuana and of riding with a marijuana-using driver, at a rate more than double that of driving or riding after alcohol use, according to a recent study by researchers from the University of Massachusetts Amherst School of Public Health and Health Sciences and University of Washington pediatrics department. The researchers also found that among marijuana-using students, 44 percent of males and 9 percent of females drove after using the drug, and 51 percent of males and 35 percent of females rode as a passenger with a marijuana-using driver. The researchers say the study results reflect the widespread belief that driving after using marijuana is safe and that strategies to dispute that belief are needed to help change social norms and encourage using a designated driver not only after alcohol use, but after a driver has used any risky substance. The study was published in JAMA Pediatrics. Read more on substance abuse.
Moderate Exercise Reduces Premature Death Risk in Older Men
Older men with hypertension can lower their risk of premature death with even moderate levels of exercise, according to a new study in Hypertension. The researchers say the needed level of fitness can be achieved by a brisk twenty to forty minute walk on most days. The researchers reviewed the fitness levels of 2,153 men, aged 70 years and older with high blood pressure by a standard treadmill exercise test, using a standard measure of fitness called metabolic equivalents (METs.) An MET is equal to the amount of oxygen the body uses per kilogram of body weight per minute. The peak MET level of a sedentary 50-year-old is about five to six METs; for a moderately fit individual it’s about seven to nine METS; and for a highly fit person it’s 10 to 12 METs. (Marathon runners, cyclists and other long distance athletes often have MET levels of 20 or higher.)
After an average follow-up of nine years, researchers found that the risk of death was 11 percent lower for every one-MET increase in exercise capacity:
- Those in the low-fit category (4.1 to 6 peak METs) had an 18 percent lower risk of death.
- Moderately-fit men (6.1 to 8 peak METs) had a 36 percent lower risk of death.
- High-fit men with peak METs of more than 8 reduced the risk of death by 48 percent.
Read more on heart health.
U.S. Cervical Cancer Rates Higher than Previously Reported
Cervical cancer rates in the United States are higher than previously reported, especially among women ages 65-69 and African-American women, according to a study published in the journal Cancer. Previous research showed about 12 cases of cervical cancer per 100,000 women in the United States, with the incidence reaching a peak at age 40-44 and then leveling off. However, those estimates included women who had hysterectomies in which the cervix had been removed and the authors of the new study say excluding these women—who are no longer at risk of developing this cancer—from their analysis, changes the rate to 18.6 cases of cervical cancer per 100,000 women. The new study also found that incidence increased steadily with age and peaked at a higher rate and at an older age—in women 65-69. Read more on cancer.
ADHD Treatment Linked to Lower Smoking Rates
Treating attention deficit hyperactivity disorder (ADHD) with stimulant medication may reduce smoking risk, especially when the medication is taken consistently, according to an analysis of 14 studies published in Pediatrics. The studies evaluated by the researchers were longitudinal studies of cigarette smoking and ADHD treatment which included 2,360 individuals with ADHD; this is the largest meta-analysis on the issue to date, according to the study authors. The researchers looked at data on nicotine dependence, smoking frequency and whether study participants smoked at the time of the study, and found a significant association between stimulant treatment and lower smoking rates. The effect was larger in those with more severe ADHD and when participants took stimulant medications continuously. The researchers say more studies are needed to determine the recommended timing and duration of stimulant treatment to help lower smoking risk. Read more on tobacco.
Number of Nurse Practitioners Working in Primary Care Increases
Almost half of recently licensed U.S. nurse practitioners (NPs) have become part of the U.S. primary care workforce, according to a report released today by the Health Resources and Services Administration. The National Sample Survey of Nurse Practitioners shows that in 1992 approximately 59 percent of graduating NPs worked in primary care, decreasing to 42 percent between 2003 and 2007. However, the new survey shows that 47 percent of NPs graduating since 2008 have entered primary care. According to the report, 76 percent of the NP workforce has certification in a primary care specialty, including family, adult, pediatric, or gerontology care, and nearly half have a family NP certification. More than half of the NP workforce works in ambulatory care settings, while nearly a third work in hospitals. Read more on prevention.