While a growing number of major league sports teams have policies on concussion assessment and return to play, many youth and school sports leagues and teams do not have similar rules, despite thousands of sports-related traumatic brain injuries (TBIs) reported in children and adolescents every year.
Hosea H. Harvey, PhD, JD, Assistant Professor of Law in Temple University’s Beasley School of Law, has just published an article in the American Journal of Public Health analyzing how this health issue is being addressed across the country. He found that there are laws dealing with concussions in youth sports in 44 states and D.C.—but none are focused on preventing the injuries. The laws only address detecting the injuries or preventing an additional injury after one has already occurred.
The study also revealed that many laws don’t draw on evidence around what works. For example, most state laws establish a minimum 24-hour period of youth athlete removal, but there is no scientific agreement about the optimal minimal time someone who has suffered a sports-related TBI should be removed from play. The study utilized an open source dataset from Robert Wood Johnson Foundation grantee Public Health Law Research called LawAtlas.
>>Read the full study.
NewPublicHealth previously spoke with Harvey and Kerri McGowan Lowrey, JD, MPH, Senior Staff Attorney with the Public Health Law Network, about legal and legislative approaches to addressing concussions in youth sports. The previous interview is included below:
Psychiatrist "Bible" Gets a Numeric Overhaul
The American Psychiatric Association will release the latest version of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) this Saturday at its annual meeting, according to Reuters. The current version is the DSM-IV, which was released a full 10 years ago -- the new version will be recast as DSM-5 (not DSM-V), with an eye toward updating the catalog of psychiatric conditions much more frequently with intermediate versions (DSM-5.1, DSM-5.2 and so on). The newest version also aims to introduce more scientific rigor and clinical confirmation of mental illness, such as, "using neuroscience in particular to tell the difference between, say, normal sadness and major depression." Though some criticize that the science just isn't there yet, and that the current version could lead to overdiagnosis. Read more on mental health.
Most Adults Enforce Smoke-Free Rules in Homes, Cars
Four out of five U.S. adults report having voluntary smoke-free rules in their homes and three out of four report having voluntary smoke-free rules in their vehicles, according to a study published in the journal Preventing Chronic Disease, a publication of the Centers for Disease Control and Prevention. Despite the high prevalence of voluntary smoke-free rules in homes and vehicles, the study found that almost 11 million non-smoking adults continue to be exposed to secondhand smoke in their home, and almost 17 million non-smoking adults continue to be exposed to secondhand smoke in a vehicle. The study also showed that voluntary smoke-free rules were more prevalent in states with comprehensive smoke-free laws and tobacco control programs. Read more on tobacco.
Living Near Fast-Food Outlets Might Boost Obesity Risk
Black Americans who live within two miles of a fast food outlet have a higher body-mass index than those living farther away -- and that link especially holds true for those with lower incomes, according to a new study published in the American Journal of Public Health. The study involved more than 1,400 black adults divided into two groups: those making less than $40,000 per year and those making $40,000 or more per year. Read more on what it takes to create healthy communities.
How can we put a stop to violence? Gary Slutkin, MD, believes the key is treating it as we would any contagious disease. The epidemiologist and Founder/Executive Director of Cure Violence recently spoke at TEDMED 2013 about utilizing public health and science-based strategies to prevent violence in communities.
“The greatest predictor of a case of violence is a preceding case of violence,” said Slutkin.
And as with an epidemic such as cholera, the way to stop violence is to find those “first cases” and interrupt the transmission. Cure Violence’s model involves violence interrupters who play a similar role as health workers during epidemics, going into communities to help re-frame issues and cool down situations that could lead to violence. At the same time, outreach workers help people change their behavior and—in time—change the social norms of a community.
>> Watch the full TEDMED presentation.
>>Read more about the public health approach to public safety from Cure Violence.
WHO Reports First Patient-to-Nurse Transmission of SARS-like Virus
The World Health Organization (WHO) is reporting that two health care workers in Saudi Arabia have become infected with a potentially fatal new SARS-like virus after catching it from patients, which represents the first case of the virus spreading this way within a hospital. Novel coronavirus, or nCoV, is thought to be spread through close contact, but, "scientists are on the alert for any sign that nCoV is mutating to become easily transmissible to multiple recipients, like SARS -- a scenario that could trigger a pandemic," according to Reuters. Read more on infectious disease.
Repeated Head Injuries Raise Soldiers' Suicide Risk
Soldiers who sustain multiple traumatic brain injuries, even if they are mild, are at greater risk for suicide, according to a study published in the journal JAMA Psychiatry. Researchers found that the risk for suicidal thoughts or behaviors increased for soldiers with such injuries over the course of a lifetime -- not just in the short term after the injuries occur. Suicide is the second-leading cause of death among U.S. military personnel, and researchers say this study provides further guidance on assessing risks and supporting wounded soldiers. Read more on military health.
HHS Announces $1 Billion to Fuel Health Care Innovation
The U.S. Department of Health and Human Services (HHS) launched a nearly $1 billion initiative -- the Health Care Innovation Awards -- that will fund work to transform the health care system by demonstrating better care and lower costs. This is the second round of the award. In the first round, the Centers for Medicare & Medicaid Services awarded 107 Awards out of nearly 3,000 applications. Round one awardees included a medical home for people with disabilities that showed a 71 percent reduction in hospitalization rates. Read more on access to health care.
The Three Rivers district health department in Owenton, Kentucky was one of three health departments in that state and eleven in the country to receive national public health accreditation from the Public Health Accreditation Board. NewPublicHealth has been speaking with directors from accredited health departments about the value of the credential; how it can change their operations and outcomes; and what they’d like to share with departments considering applying for the credential. We recently spoke with Georgia Heise, DrPH, Three Rivers’ health director and a vice president of the National Association of County and City Health Officials, about the benefits she sees from both the application process and the new status accreditation confers.
NewPublicHealth: What has the reaction been from community members and policymakers to the news that you’re now accredited?
Georgia Heise: It has been wonderful. Our health department has talked about accreditation from the day we started working on it, so people have been waiting to see what the decision was going to be. We’ve gotten flowers, cards, letters, and emails and there have been celebrations hosted by us and by others. And we did get some attention from policymakers, which was wonderful.
We have, for the past three years now, introduced into the Kentucky legislative process a bill that would require health departments in Kentucky to be accredited by 2020. We haven’t got that bill approved yet, but we continue to work on it and we think we will eventually. But that effort means that the legislators are familiar with the concept of accreditation. While maybe they haven’t paid that much attention to it before, they’re paying more attention now because Kentucky had three health departments receive accreditation in the first round and that’s gotten some attention statewide.
NPH: In terms of the process, what has been harder than you thought and what was easier
IOM: Low Sodium Intake May Also Cause Adverse Health Effects
While multiple studies have shown that the average daily sodium intake for U.S. adults is far too high, lowering the intake too much could also lead to health problems, according to a new report from the Institute of Medicine. The average daily intake is 3,400 mg, or about 1.5 teaspoons. The Dietary Guidelines for Americans call for a maximum of 2,300 mg, and even 1,500 mg for certain demographics. However, there is also some evidence suggesting low sodium levels could be harmful to people such as those with mid- to late-stage heart failure. “These studies make clear that looking at sodium’s effects on blood pressure is not enough to determine dietary sodium’s ultimate impact on health,” said committee chair Brian Strom, George S. Pepper Professor of Public Health and Preventive Medicine at the University of Pennsylvania Perelman School of Medicine. “Changes in diet are more complex than simply changing a single mineral. More research is needed to understand these pathways.” Read more on heart health.
CDC Guidelines Help Cut Bloodstream Infections from Dialysis
Following the U.S. Centers for Disease Control and Prevention’s (CDC) prevention guidelines helped reduce overall bloodstream infection due to dialysis by 32 percent and vascular access-related bloodstream infections by 54 percent, according to a new study in the American Journal of Kidney Disease. There are approximately 37,000 bloodstream infections each year related to dialysis with central lines; in 2010 about 380,000 U.S. patients used hemodialysis for treatment of end-stage kidney disease, with 8 in 10 of utilizing central lines. "Dialysis patients often have multiple health concerns, and the last thing they need is a bloodstream infection from dialysis,” said CDC Director Tom Frieden, MD, MPH. “These infections are preventable. CDC has simple tools that dialysis facilities can use to help ensure patients have access to the safe healthcare they deserve.” Read more on prevention.
Study: Teen’s Use of Smokeless Tobacco Steady Over Past Decade
Despite a myriad of efforts to combat tobacco use by U.S. teens, their usage rate of “smokeless” tobacco products such as chew or snuff has remained steady since 2000, according to a new study in the Journal of the American Medical Association. The rate was 5.3 percent in 2000 and just barely lower in 2011, at 5.2 percent. While younger teens in the 9-14 age range have decreased their use, those in the 15-17 range have increased. The study suggests that the relatively low prices of smokeless tobacco products may be a contributor. About 9 million Americans used smokeless tobacco in 2012. Read more on tobacco.
A recent Opinionator column in The New York Times by Nancy DiTomaso, vice dean for faculty and research at Rutgers Business School in New Jersey, suggests that some of the reason for the 13 percent unemployment rate among African-Americans—double the rate for whites—may stem from the fact that whites are more able to rely on their social networks for an edge when finding out about and applying for higher-wage jobs.
“Getting an inside edge by using help from family and friends is a powerful, hidden force driving inequality in the United States,” says DiTomaso, who adds that whites helping other whites is not the same as discrimination, and it is not illegal, “yet it may have a powerful effect on the access that African-Americans and other minorities have to good jobs, or even to the job market itself.”
Income—and lack of it—impact every aspect of health, from being able to afford safe housing to being able to purchase nutritious food to accessing high-quality healthcare. A study published in the British Medical Journal earlier this year found that there were nearly 40,000 extra hospital readmissions over a three-year period in states with the greatest income inequality.
NewPublicHealth illustrated the link between jobs and health in a recent infographic.
>> Read the post from The New York Times.
FDA’s New Food Defense Tool Helps Stop Intentional Contamination
The U.S. Food and Drug Administration (FDA) has developed a new Food Defense Plan Builder tool to help owners and operators of food facilities create plans to minimize intentional contamination. While rare, intentional contamination, intentional contamination can be a serious public health problem. For example more than 40 people in Kansas became sick in 2009 when an employee put pesticide in salsa. Based on FDA’s food defense guidance documents, the tool uses a series of pointed questions to develop a customized food defense plan, including a vulnerability assessment; broad and focused mitigation strategies; and an action plan. Read more on food safety.
Text4baby Programs Gives Pregnant Women, Mothers Critical Information
The 2013 Text4baby State Enrollment Content will promote the mobile health tool while providing pregnant women with important information on their pregnancy and their child’s first year of life. By texting “BABY” (or “BEBE” for Spanish) to 511411, they will receive three free weekly text messages addressing issues such as labor signs and symptoms; prenatal care; developmental milestones; immunizations; nutrition; birth defect prevention; and safe sleep. The program is supported by more than 950 health departments, academic institutions, health plans, businesses and the U.S. Department of Health and Human Services. Under the contest, the states with the highest enrollment percentages will be recognized at the American Public Health Association Annual Meeting in Boston, Mass. in early November. Read more on maternal and infant health.
Citing High Cancer Risk, Angelina Jolie Undergoes Preventive Double Mastectomy
A mutated BRCA1 or BRCA2 gene makes a woman five times more likely to develop breast cancer in her life. On Tuesday in an op-ed in The New York Times, Angelina Jolie — who carries a “faulty” BRCA1 — announced she has undergone a double mastectomy to reduce her risk of developing the cancer. Her physicians had estimated an 87 percent risk of breast cancer and 50 percent risk of ovarian cancer. "I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer,” she wrote. “It is my hope that they, too, will be able to get gene tested." A woman with one of the faulty genes is at an average 60 percent risk of developing breast cancer; a woman without a mutated gene is at an average 12 percent risk. Today CNN anchor Zoraida Sambolin also announced she is getting a double mastectomy. Read more on cancer.
In February, the Robert Wood Johnson Foundation honored six communities with the inaugural RWJF Roadmaps to Health Prize, which recognizes outstanding community partnerships that are helping people live healthier lives.
Recently, NewPublicHealth spoke with Claude-Alix Jacob, chief public health officer at the Cambridge, Mass., department of health, one of the six prize-winning communities to be recognized by the Foundation. Mr. Jacob spoke to NPH about how collaborating around and winning the Prize has impacted the community, including resilience in the face of tragedy.
>>Apply to become a winner of the 2013-2014 RWJF Roadmaps to Health Prize. This year's application deadline is May 23, 2013.
NewPublicHealth: What did winning the RWJF Roadmaps to Health Prize mean to your community?
Claude Jacob: It has been great and exiting news for our community. Over the course of the last few months and through National Public Health Week last month we’ve had a chance to celebrate. We’ve been able to share our public health plans and community partnerships, but also under the aegis of the Robert Wood Johnson Foundation, we now have more credibility for all of our efforts. The Foundation is associated with promoting important health improvement efforts nationwide and just to be linked to the Foundation will open doors, especially now that we’re one of the six inaugural prize winning communities.
During National Public Health Week we invited our community stakeholders to celebrate to thank them for their hard work in helping us to prepare for the site visit that was required of prize finalists. So it’s been a phenomenal few weeks.
NPH: How has winning the prize impacted the health improvements of your community?
Urban Farming, founded by recording artist Taja Sevelle, is a nonprofit organization with a goal of reducing hunger and increasing access to fresh, healthy foods by encouraging people in urban, rural and suburban areas to plant gardens on unused land. There are now over 66,600 community, residential and partner gardens that are part of the Urban Farming Global Food Chain around the world.
NewPublicHealth recently spoke with Taja Sevelle about the group and its plans for the future.
NewPublicHealth: How did you become interested in the issue of Urban Farming?
Taja Sevelle: I was recording a CD for Sony Records in Detroit, Mich., when I began to see the vast amounts of unused land in the city. I knew that numerous jobs were being shipped overseas and a lot of people who had lost their jobs were suffering. So, in 2005 I put my music career on the back burner and started Urban Farming with three gardens and a pamphlet. It was always a global vision that grew rapidly and started to get international coverage quickly.
Even though this seems like a new idea, it really is just reacquainting people with the age-old act of planting food. The World War II victory gardens, for example, are a great model because during that time, 20 million Americans planted gardens and grew almost half of the U.S. produce supply. Recently, when the economic downfall hit around the world, planting a garden became a necessity for many people who may not have been thinking about it previously.
NPH: What are the key goals for Urban Farming?