Search Results for: stroke

Apr 30 2014
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Harvard School of Public Health Special Report: The Financial Crisis as a Public Health Crisis

“Five years after the Great Recession officially came to an end, the United States has yet to fully recover from the economic devastation sparked by the collapse of an $8 trillion housing bubble and the ensuing turmoil that saw global financial systems teetering on the brink of collapse. But while the economic costs of the downturn have drawn the lion’s share of attention, the damage to our bodies could end up far surpassing the damage to our bank accounts.”

Those are the opening lines of a new special report from the Harvard School of Public Health (HSPH), “Failing Economy, Failing Health: The Great Recession’s Toll on Body and Mind,” detailing how poverty and inequality resulting from the economic maelstrom pulled down so many—and what that will mean for public health in the long term.

“Health is a long-run thing, but the methods we use to analyze current data only estimate short-term effects,” says SV Subramanian, HSPH professor of population health and geography. “It may take awhile for the health impact of the Great Recession to kick in, but once it does, it could be dramatic.”

The data is strong on the links between employment and health—people who are unemployed, underemployed or laid off are less healthy and don’t live as long. 

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A 2009 study found that in the 12 months after men lost their jobs in mass layoffs, they saw their chances of dying nearly double. While over time the risk lessened it was still significant two decades later. Another study that same year found that losing a job when a business shuts its doors increases the odds of fair or poor health by 54 percent among workers with no preexisting health conditions while also increasing the risk of new health conditions by 83 percent. The stress of the situation, according to the researchers, heightens the odds of stress-related conditions such as stroke, hypertension, heart disease, arthritis, diabetes and psychiatric problems.

Yet another study, this one in 2010, found that about 4 in 10 Americans with heart disease or diabetes and 1 in 5 with cancer said the stress of the Great Recession made it more difficult to manage their illnesses.

What’s more complex is unearthing the pathways behind why this is the case. The HSPH article outlines some of the mechanisms by which unemployment affects health.

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Apr 17 2014
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Public Health News Roundup: April 17

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Study: Banning Chocolate Milk in Elementary Schools Also Decreases Overall Sales, Increases Waste
Banning chocolate milk in 11 Oregon elementary schools and replacing it with healthier fat-free white milk had the unintended consequence of reducing milk consumption overall, according to a recent study in the journal PLOS One. The study determined that the chocolate milk ban led to a 10 percent overall drop in milk sales; a 29 percent increase in the amount of wasted milk; drops in calcium and protein intake; and a 7 percent decrease in the number of students taking part in the Eugene School District's lunch program. "Given that the role of the federal school meal program is to provide nutritious meals to students who may otherwise have no access to healthy foods, I wouldn't recommend banning flavored milk unless you have a comprehensive plan in place to compensate for the lost nutrients when kids stop drinking milk altogether,” said Nicole Zammit, former assistant director of nutrition services at the Eugene School District in Oregon, in a Cornell University news release. The study was conducted by the Cornell Food and Brand Lab. Read more on nutrition.

CDC: Significant Drops in Five Major Diabetes-related Complications
The last two decades has seen declines in five major diabetes-related complications, according to a new study in the New England Journal of Medicine. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found declining rates of lower-limb amputation (about 50 percent), end-stage kidney failure (about 30 percent, heart attack (more than 60 percent) , stroke (about 50 percent) and deaths due to high blood sugar (more than 60 percent). “These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes,” said Edward Gregg, Ph.D., a senior epidemiologist in CDC’s Division of Diabetes Translation and lead author of the study. “While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes.” A recent study determined that approximately one in 10 U.S. adults have either type 1 or type 2 diabetes. Read more on diabetes.

FDA Sees Rising Number of Cases of Injuries Linked to E-cigarettes
The rising use of e-cigarettes has been accompanied by a rising number of injury complaints linked to e-cigarettes, including burns, nicotine toxicity, respiratory problems and cardiovascular problems, according to new data. From March 2013 to March 2014 there were more than 50 such complaints filed with the U.S. Food and Drug Administration (FDA), roughly the total reported over the previous five years. The findings come as the FDA prepares to regulate e-cigarettes and other "vaping" devices for the first time. Read more on injury prevention.

Apr 10 2014
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PHLR Infographics: A Look at How Research is Improving Public Health Laws

Happy National Public Health Week! All week we've been sharing stories on the value of public health across all aspects of life, and all ages and stages.

Public Health Law Research (PHLR), a grantee of the Robert Wood Johnson Foundation, has also been participating in the week by contributing graphics and posts on the particular role of public health law—when backed by evidence and grounded in research—to save lives and make a difference. Below, we are highlighting some of the critical statistics PHLR has shared, along with some context on the research behind the numbers.

Child Seat Safety

Today, every state has a law requiring children to be restrained in federally-approved child safety seats while riding in motor-vehicles. These laws differ from state to state based on number of factors (e.g., age, height and weight of the children requiring safety seats). All current child safety seat laws allow for primary enforcement, meaning a police officer can stop a driver solely for a violation of such laws.

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Lead Laws

In 1990 approximately 20 percent of all U.S. children had elevated levels of lead in their blood. However, only a decade later that percentage was down to 1.6 percent, thanks to public health laws researched and crafted to look out for the wellbeing of children. One of the most significant pieces of legislation was The Lead Contamination Control Act of 1988, which was already on the path to improving public health in 1990.

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Watch this video on Philadelphia's lead court.

Sodium Laws

Eating too much sodium can cause high blood pressure, which raises the risk for heart disease and stroke—the first- and fourth-leading causes of death in this country. A variety of laws and legislatively enabled regulations attempt to reduce sodium in the food supply, including lowering the amount of salt in foods served in schools and child care facilities or purchased by state-regulated elder and health care facilities and prisons. Almost half of all U.S. states have laws to help reduce tghe sodium in processed foods.

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Sports-Related Traumatic Brain Injuries

As many as 300,000 kids suffer traumatic brain injuries (TBIs) from playing sports each year. TBIs can have serious short- and long-term health effects. Can public health law make a difference? The latest study finds that while all 50 states have laws in place to combat this problem, they haven't helped stop kids with concussions from playing. However, the research does help provide some context on how those laws have been implemented and how they might be revamped to work better.

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Mar 24 2014
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Public Health News Roundup: March 24

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Some Will Be Able to Enroll After March 31 Affordable Care Act Deadline
Some people will be able to enroll for coverage under the Affordable Care Act after the official enrollment deadline of March 31, according to new guidelines expected to be issued by the Obama administration. The new guidelines would allow people had previously tried to enroll by were prevented by systems problems such as technical difficulties, according to Reuters. "Open enrollment ends March 31. We are preparing for a surge in enrollment, and if consumers are in line on the 31st and can't finish, we won't shut the door on them. To be clear, if you don't have health insurance and do not start to sign up by the deadline, you can't get coverage again until next year," said U.S. Department of Health and Human Services spokeswoman Joanne Peters in a statement. Read more on the Affordable Care Act.

Study: Alcohol-Related Vehicle Crashes Greatly Underreported
Alcohol is a far greater factor in U.S. motor vehicle deaths than has been reported, according to a new study in the Journal of Studies on Alcohol and Drugs. Using  Fatality Analysis Reporting System (FARS) data from the U.S. National Highway Traffic Safety Administration, researchers determined that in the decade from 1999 to 2009 while only a little more than 3 percent of the death certificates for traffic deaths included alcohol as a contributing cause, about 21 percent of the deaths were legally drunk. Approximately 450,000 Americans were killed in traffic crashes during the period. The time that it takes coroners to take and process blood alcohol tests could be a reason for the underreported figures. Ralph Hingson, Sc.D., of the U.S. National Institute on Alcohol Abuse and Alcoholism, said the vast discrepancy demonstrates the need for more reliable data. "We need to have a handle on what's contributing to the leading cause of death among young people," he said in a release. "You want to know how big the problem is, and if we can track it. Is it going up, or going down? And what policy measures are working?" Read more on alcohol.

NIH Identifies Genetic Markers Tied to Stroke, Cardiovascular Disease
Researchers and the National Institutes of Health have identified a genetic variant linked to increased risk for stroke, as well as a metabolic pathway tied to several common diseases, which taken together could improve how doctors identify and treat major diseases. “Our findings have the potential to identify new targets in the prevention and treatment of stroke, cardiovascular disease and many other common diseases,” said Stephen R. Williams, PhD, a postdoctoral fellow at the University of Virginia Cardiovascular Research Center and the University of Virginia Center for Public Health Genomics, Charlottesville. The genetic markers were found through the analysis of nearly 5,000 genomes. The results were published in the journal PLoS Genetics. About 600,000 Americans die of heart disease each year—one in every four deaths—and stroke is the fourth-leading cause of death in the United States. Read more on heart health.

Mar 14 2014
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Public Health News Roundup: March 14

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Teens who Leave Gangs Still Face Consequences as Adults
A new study in the American Journal of Public Health finds that joining a gang during teen years has significant consequences in adulthood beyond criminal behavior, even after a person leaves the gang.

The study authors followed 808 fifth-grade students from 18 elementary schools in high-crime neighborhoods in Seattle, beginning in 1985. Participants were interviewed every year until the age of 18, then every three years until the age of 33.

Researchers used 23 risk factors, including poverty and associating with kids with problem behaviors, to calculate a child’s propensity for joining a gang, and then compared 173 youth who had joined a gang with 173 who did not but showed a similar propensity for doing so. The average age of joining a gang was just under 15 years old and the majority (60 percent) were in a gang for three years or less.

The study found that subjects between ages 27 and 33 who had joined a gang in adolescence were:

  • Nearly three times more likely to report committing a crime,
  • More than three times more likely to receive income from illegal sources
  • More than twice as likely to have been jailed in the previous year
  • Nearly three times more likely to have drug-abuse problems
  • Nearly twice as likely to say they were in poor health
  • Twice as likely to be receiving public assistanÎ
  • Half as likely to graduate from high school.

The study was funded by the National Institute on Drug Abuse the Robert Wood Johnson Foundation, and the National Institute on Mental Health.

Read more on poverty

Stroke Survivors May Lose a Month of Healthy Life for Every 15-Minute Delay in Treatment
Every 15-minute delay in delivering a clot-busting drug after stroke takes away about a month of a healthy life for stroke survivors, according to a new study in the journal Stroke. Researchers at the University of Melbourne in Australia analyzed data from clot-busting trials and applied the time to efficacy to over 2,000 stroke cases in Australia and Finland to calculate what the patient outcomes would have been if they had been treated faster or slower. They found that for every minute the treatment could be delivered faster, patients gained an average 1.8 days of extra healthy life. The researchers also found that while all patients benefited from faster treatment, younger patients with longer life expectancies gained more than older patients

Read more on access to health care

One in Five Older Americans Take Medications that Work Against Each Other
More than 20 percent of older Americans take Medicines that work at odds with each other, and in some cases the medication being used for one condition can actually make the other condition worse, according to a new study in the online journal PLUS One by researchers at Oregon State University and the Yale School of Medicine. The study was conducted by researchers from OSU and Yale with 5,815 community-living adults over a two year period.  

“Many physicians are aware of these concerns but there isn’t much information available on what to do about it,” says David Lee, an assistant professor in the Oregon State University/Oregon Health & Science University College of Pharmacy. “As a result,” says Lee, “right now we’re probably treating too many conditions with too many medications. There may be times it’s best to just focus on the most serious health problem, rather than use a drug to treat a different condition that could make the more serious health problem even worse.”

The chronic conditions in which competing therapies are common include coronary artery disease, diabetes, COPD, dementia, heart failure, hypertension, high cholesterol and osteoarthritis and others.

Read more on prescription drugs

Feb 21 2014
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Public Health News Roundup: February 21

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HHS, Heart Disease Organizations Join Forces to Vastly Reduce Premature Death Linked to Heart Conditions by 2025
Leaders from the World Heart Federation , the American Heart Association, the U.S. Department of Health and Human Services, and the American College of Cardiology are joining together to help cut premature mortality from cardiovascular disease by at least 25 percent by 2025.
 Key strategies will include secondary prevention efforts for people who have already experienced a heart incident, or have established heart disease, as well as primary prevention strategies in the United States and around the world. “Heart disease can touch anyone, no matter where you live,” said Nancy Brown, chief executive officer of the American Heart Association.  “It will take the collective efforts of everyone from community leaders to healthcare professionals, educators and business leaders to stop this No. 1 killer at the national and global level...” Read more on heart health.

New Guidelines for Stroke Risk, Prevention in Women
The American Heart Association/American Stroke Association has published the first ever set of guidelines dedicated to stroke risk and prevention in women. The 86-page document appears in the journal Stroke and address risk factors distinct to women, including pregnancy, oral contraceptives, menopause and hormone replacement. It also covers factors that affect women more than men, including atrial fibrillation and migraine with aura. “We reviewed a large body of research to be able to summarize our current understanding of stroke risk and stroke prevention in women, information that is critically important for care providers and researchers in the field,” according to Judith Lichtman, MD, associate professor at the Yale School of Public Health and co-author of the study. “The guidelines are also important to empower women and their families to better understand their risk for stroke and be aware of ways they can minimize their likelihood of having a one.” Strokes are the third-leading cause of death among women in the United States. Read more on strokes.

Study: Indicators of Potential Heart Disease as Early as Age 18
Indicators of potential heart disease can be seen as early as age 18, according to a long-term study recently published in the Journal of the American Medical Association. Researchers found that elevated blood pressure at that age, as well as found distinct blood pressure patterns from ages 18-55, indicate people at high risk for calcification of coronary arteries by middle age. “This shows that your blood pressure in young adulthood can impact your risk for heart disease later in life,” said Norrina Allen, PhD, lead study author and assistant professor of Preventive Medicine at Northwestern University Feinberg School of Medicine, in a release. “We can’t wait until middle age to address it. If we can prevent their blood pressure from increasing earlier in life we can reduce their risk of future heart attacks and stroke.” Approximately one in three U.S. adults have hypertension. Read more on prevention.

Feb 20 2014
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Public Health News Roundup: February 20

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CDC: H1N1 Flu Killing at Epidemic Levels
The H1N1 flu virus has been killing at epidemic levels since mid-January, according to new data from the U.S. Centers for Disease Control and Prevention (CDC). While flu is known to disproportionately affect the very young and very old, this strain—also known as the swine flu and the cause of the 2009 global pandemic that killed tens of thousands—has so far caused 243 deaths of residents younger than 65 this year in California alone, with an additional 41 unconfirmed cases. In the 2012-13 season there were 26 deaths at this point and in the 2011-12 season there were nine. According o the CDC the average age of someone diagnosed with flu this season is 28.5 years. “These severe flu outcomes are a reminder that flu can be a very serious disease for anyone, including young, previously healthy adults,” CDC spokesman Jason McDonald said to The Washington Post. Read more on influenza.

Teens Who Text About Condoms, Birth Control More Likely to Use Them
Teens who talk about condoms and other types of birth control over text message and other technology are more likely to use them, according to a new study in the Journal of Adolescent Health. Researchers studied 176 high school juniors and seniors, finding that half of the 64 who reported being sexually active also failed to use condoms consistently. According to the U.S. Centers of Disease Control and Prevention, close to 40 percent of the 47 percent of high school students who reported having sex did not use a condom the last time. However, the study found that students who texted or used other private electronic technology to discuss condoms or other forms of birth control were approximately four times more likely to use them. It also found that the odds of consistently using condoms doubled among students reporting discussions of pregnancy or sexual limits. "Although prior research and media attention has focused on the risks of technology use, like sexting, we found that adolescents might also use electronic tools to communicate about ways they might promote their sexual health," said study lead author Laura Widman, who studies adolescent sexuality at the University of North Carolina at Chapel Hill. "It's not all about risky behavior. It might be another way that teens can have these conversations that can be a little bit awkward.” Read more on sexual health.

Study: Average Obese Woman Gets Only One Hour of Vigorous Exercise Each Year
The average obese woman in the United States gets only one hour of vigorous exercise each year, and the average obese man gets only 3.6 hours, according to a new study in Mayo Clinic Proceedings. The study utilized the results of a 2005-2006 government survey of adults aged 20 to 74, which covered areas such as weight, diet and sleep patterns of the nearly 2,600 adults and use accelerometer devices to track their movements. The study defined "vigorous" exercise as fat-burning activities such as jogging and jumping rope. “They're living their lives from one chair to another," said Edward Archer, a research fellow with the Nutrition Obesity Research Center at the University of Alabama at Birmingham. "We didn't realize we were that sedentary. There are some people who are vigorously active, but it's offset by the huge number of individuals who are inactive." According to the U.S. Centers for Disease Control and Prevention (CDC), approximately one in three U.S. adults is obese, which increases the risk of cardiovascular problems such as heart disease and stroke, diabetes and some cancers. Read more on obesity.

Feb 14 2014
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Public Health News Roundup: February 14

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Public Health Wants to be Your Valentine

Looking for powerful ways to save I love you?

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American Society of Clinical Oncology Weighs in on Mammography
In response to a study published this week in the British Medical Journal which called into question the benefit of mammography, the American Society of Clinical Oncology (ASCO) issued a statement today saying that because mammography is similar to many other tests that can detect a condition that may never cause harm, the benefits of screening are likely to be greater for women who are at increased risk of developing breast cancer based on factors such as age and family history, than for women at average risk. It also stated no single study should be used to change screening policy and that all women should be encouraged to speak with their doctors about their personal risk for breast cancer, as well as the potential benefits and harms of mammography screening. ASCO and other cancer advocacy and women’s health groups have announced that they will be monitoring additional mammography studies now being conducted, and the American Cancer Society is expected to release new mammography recommendations later this year. Read more on cancer.

NHTSA Announces New Mandatory Label to Help Owners Instantly Identify Recall Mailings
The U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) today announced that starting February 18, all manufacturers must use a distinctive label on the agency’s required mailings that notify owners of recalled vehicles or equipment.

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The requirement was introduced to help owners instantly distinguish important recall notices arriving in their mailboxes from other mail and hopefully avoid mistakenly discarding the safety notices. NHTSA has also just launched the SaferCar app for Android devices that will provide information for car owners and shoppers, including recalls and safety performance. There is already a SaferCar app for iPhone, iPad and iPod Touch users. Other safety notification options from NHTSA include:

  • Register Your Cars, Tires and Car Seats: Receive NHTSA email notifications when there is a recall by the federal government. There is no way to locate or notify individual owners of car seats or tires if the product is not registered with the manufacturer or NHTSA.
    Check for Open Recalls on Used Cars: Verify with the previous owner or dealer whether a used car has been fixed by using www.safercar.gov, which provides a general search tool to help consumers identify recalls that may affect their vehicle.

Read more on transportation.

Feb 11 2014
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Public Health News Roundup: February 11

AHA Releases Stroke Prevention Guidelines for Women
For the first time, the American Heart Association (AHA) has released stroke prevention guidelines for women. The guidelines outline stroke risks unique to women and provide evidence-based recommendations on how best to treat them, including:

  • Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower preeclampsia risks.
  • Women who have preeclampsia have twice the risk of stroke and a four-fold risk of high blood pressure later in life. Therefore, preeclampsia should be recognized as a risk factor well after pregnancy, and other risk factors such as smoking, high cholesterol, and obesity in these women should be treated early.
  • Pregnant women with moderately high blood pressure (150-159 mmHg/100-109 mmHg) should be considered for blood pressure medication; expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated.
  • Women should be screened for high blood pressure before taking birth control pills because the combination raises stroke risks.
  • Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.
  • Women over age 75 should be screened for atrial fibrillation risks; a risk factor for stroke.

Read more on prevention.

New Study Predicts Flu Severity
Researchers at St. Jude Children’s Research Hospital in Memphis say flu patients, regardless of age, who have elevated levels of three particular immune system regulators, called cytokines, early in the infection were more likely to develop severe flu symptoms and to be hospitalized than patients with lower levels of the same regulators. Study participants ranged in age from 3 weeks to 71 years.

The study, published in the American Journal of Respiratory and Critical Care Medicine, found that cytokine levels early in the infection were predictive of flu-related complications regardless of patient age, flu strain, the ability of the virus to replicate and other factors. The cytokines studied help to regulate inflammation caused by the body’s immune response to the flu until antibodies and T cells take over. Patients with the elevated cytokines seem to develop airway distress as a reaction to the immune response, a development separate from the effects of the flu virus. “We need to explore targeted therapies to address this problem separately from efforts to clear the virus, says study author Paul Thomas, PhD, an assistant member of the St. Jude Department of Immunology. Read more on flu.

Community Health Worker Model Can Reduce Hospital Readmissions
A new study in JAMA Internal Medicine reports on a community health worker (CHW) program developed at the University of Pennsylvania School of Medicine that hired people from the local community to help discharged patients navigate the health care system and address key health barriers, such as housing instability or food insecurity. The study found that the intervention improved patient experiences and health outcomes and reduced hospital readmissions.

The Penn team tested the model in a randomized trial with 446 hospitalized patients who were either uninsured or on Medicaid, and lived in low-income communities in which more than 30 percent of the population lived below the Federal Poverty Level. More than one-third of all readmissions to the hospitals participating in the study come from a five-zip code region. Patients in the trial received support from CHWs hired for traits such as empathy and active listening. The CHWs connected during a patient's hospital stay and continued after they were discharged to help with issues including scheduling doctor appointments, accessing medications, or finding child care or shelter. The control group received routine hospital care, medication reconciliation, written discharge instructions, and prescriptions from the hospital. The CHW group had a 52 percent greater chance of seeing a primary care physician within two weeks after being discharged from the hospital and scores measuring a patient's confidence in managing their own care in the future more than doubled in the CHW group. While the two groups had similar rates of at least one hospital readmission (15 percent vs 13.6 percent), the CHW group was less likely to have multiple readmissions (2 percent vs 6 percent in the control group). Read more on health disparities.

Feb 10 2014
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Public Health Campaign of the Month: Air Pollution and Heart Health

>>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.

In honor of American Heart Month, held each February, the U.S. Environmental Protection Agency (EPA) has created a new Public Service Announcement (PSA) to educate the public and health care providers about the risks of air pollution to the heart.

"Over more than four decades of EPA history, we've made tremendous progress cleaning up the air we breathe by using science to understand the harmful effects of air pollution," said EPA Administrator Gina McCarthy. “While EPA continues to fight for clean air, Americans can take further action to protect their heart health by following the advice in our new PSA.”

One of EPA’s commitments in the U.S. Surgeon General’s National Prevention Strategy is to educate health care professionals on the health effects of air pollution, including heart risks. This PSA supports the Million Hearts Initiative, launched by the U.S. Department of Health and Human Services in September 2011, to prevent one million heart attacks and strokes by 2017. 

Research has shown that air pollution can trigger heart attacks, stroke and worsen heart conditions, especially in people with heart disease—that’s one in three Americans. According to the EPA, very small particles are the pollutants of greatest concern for triggering health effects from exposure to air pollutants. These particles are found in transportation exhaust, haze, smoke, dust and sometimes even in air that looks clean. Particle pollution can also be found in the air at any time of the year. 

The new PSA advises people with heart disease to check the daily, color-coded Air Quality Index forecast. At code orange or higher, particle pollution can be harmful to people with heart disease. On bad air quality days, it is recommended to reschedule outdoor exercise or to exercise indoors instead, and avoid exercising near busy roads.

Air Quality Index forecasts for more than 400 cities are available on the forecast map through a free AirNow app for iPhone and Android phones, and through the free EnviroFlash e-mail service. To sign up, visit here and click on the “Apps” or “EnviroFlash” icons.

>>Bonus Links
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