As we learn more about the long-term effects of traumatic brain injuries (TBI), the public health focus is increasingly on prevention in youth sports. A recent study funded by the Robert Wood Johnson Foundation and published in the American Journal of Public Health found that while 44 states and Washington, D.C. have enacted youth sport TBI laws, they all deal with identifying and responding to the injuries—not preventing them.

NewPublicHealth recently spoke with Robert Faherty, VP and Commissioner of the Babe Ruth League Inc., about what the baseball league in particular—and youth sports in general—are doing to improve the prevention of and response to traumatic brain injuries. The league includes about 1 million players across its Cal Ripken and Babe Ruth divisions.

NewPublicHealth: How is the Babe Ruth League working to prevent primary traumatic brain injuries in youth baseball?

Robert Faherty: One of the things that we really pride ourselves on— and, first of all, our organizations are entirely made up of volunteers, from the league administration level right down to the coach—is providing that league with the best insurance program we possibly can. Through Babe Ruth League, you have the opportunity to buy a $250,000 accident, million dollar liability, $2 million liability. The difference in our program compared to most of them is that it’s a primary policy, so not getting into any politics and where the insurance industry is heading, we wanted to make sure that there would be no reason that a player wouldn’t go get checked out or a league wouldn’t send a player to a doctor or to an emergency room, or for any reason they thought. We weren’t worried about the parents having insurance, we weren’t worried about somebody’s liability being in question or homeowner’s policy—you can go to the doctor and have it covered.

The second part of that would be, obviously, our ongoing attempt to educate and prevent injuries right down to the simplest practices. In our coaching certification and coaching education courses, which are mandated, not only are there portions of safety issues and we include that in our score books that we provide to the teams, but it’s the smallest things about how to run a practice. You know, one of the most common injuries is being hit by a baseball, but it’s not the batter being hit by a baseball or a fielder being hit by a baseball—it’s an overthrow by kids warming up improperly, not throwing all in the same direction

As school winds down and camps and sports prepare for the summer season, a new study funded by the Robert Wood Johnson Foundation and published in the American Journal of Public Health on sports-related traumatic brain injuries in youth sports, is generating deserved attention.

The study, by Hosea Harvey, JD, PhD, Assistant Professor of Law at the Temple University Beasley School of Law, found that while forty four states and Washington, D.C.,  passed youth sport TBI laws  between 2009 and 2012, none of the laws focus on preventing the injuries in the first place. The laws on the books deal primarily with increasing coaches’ and parents’ ability to identify and respond to traumatic brain injuries and reducing the immediate risk of multiple brain injuries.

Harvey’s conclusion is that continued research and evaluation is needed to develop a more comprehensive reduction in youth sport traumatic brain injuries.

NewPublicHealth: What did your study address?

Hosea Harvey: I looked at traumatic brain injury (TBI) laws that were passed at the state level that purported to deal with the problem of youth TBIs in sports statewide. I looked at every related state law passed between 2009 through the end of 2012, though most states only had one law that they passed that dealt with youth sports TBIs during that period.

NPH: And your study found that no state that right now has a law that says this is what you have to do in order to prevent these concussions in the first place?

USDA and HUD Offer Housing Help for People Affected by the Tornadoes in Oklahoma
The U.S. Department of Agriculture (USDA) and the U.S. Department of Housing and Urban Development (HUD) have announced efforts to help find housing for Oklahoma residents displaced by the recent tornadoes. The USDA is offering help through its Rural Development portfolio, which has programs designed to help improve life in rural communities. HUD is offering help through foreclosure assistance, temporary housing, and federally guaranteed loans for repair. Click here for more information on HUD assistance following a disaster. Read more on disasters.

New CDC Campaign Encourages Smokers to Talk with their Doctor about Quitting
The U.S. Centers for Disease Control (CDC) and Prevention has launched a new campaign to urge smokers to speak with their doctors about strategies for quitting. CDC research finds that getting help from a physician can double the odds of quitting smoking. To help promote the campaign, CDC is partnering with five physician groups: the American Medical Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Congress of Obstetricians and Gynecologists. The campaign also encourages clinicians to ask patients if they smoke and offer assistance in helping them to quit. Almost 70 percent of smokers say they want to quit, according to the National Health Interview Survey. Through the physician group partnerships, doctors will be offered training on cessation interventions. Read more on tobacco.

DOT 2013 ‘Click It or Ticket’ Campaign Focuses on Night Time Driving
The annual Click It or Ticket Campaign to increase seat belt use from the U.S. Department of Transportation (DOT) takes place around Memorial Day weekend and this year will focus attention especially on night time driving—although police officers will be on the lookout for unbuckled drivers during the day and night this weekend. While DOT data shows that daytime seat belt use is up to 86 percent, night time use of seat belts continues to be lower. According to National Highway Traffic Safety Administration, the risk of being involved in a serious crash is greater at night than during the day. In 2011, 62 percent of motorists who died in a crash that occurred at night did not have their seat belts on, buckled compared to 43 percent of those who died in a crash during the day. Read more on safety.

Baltimore public schools are receiving a new $1 billion infrastructure investment—the first funding the school district has seen to actually build new schools in almost 40 years, according to a recent interview on the Tom Joyner Morning Show with Bishop Douglas Miles, co-chair of BUILD and co-founding member of Baltimore Education Council. Maryland Governor Martin O’Malley last week signed a law authorizing the funds for school construction and renovation. Eventually, 15 schools will be built and 35 will be repaired and renovated.

“The conditions in the schools have deteriorated,” said Miles. “Boilers breaking down annually in the middle of the winter, buildings lacking windows, water undrinkable because it’s lead-tainted—and our children deserve better than that.”

A growing wealth of data shows a positive relationship between the quality of school buildings and student outcomes. Also, about 85 percent of the 85,000 students in Baltimore schools receive free or reduced-cost lunch, the city has the lowest graduation rates in the state and nearly 140 of its 162 public schools are in very poor condition.

This infusion of funds will help promote academic success for the city’s students by decreasing education disparities. In the long-term it also has the potential to help improve the health of all Baltimore residents, as better education leads to better jobs, higher incomes, and longer, healthier lives. NewPublicHealth has previously illustrated the connection between education and health outcomes in an infographic.

>> Listen to the Tom Joyner Morning Show interview.

March of Dimes Establishes Research Collaborative on Causes of Preterm Births
Three universities and four hospitals in Ohio have joined with the March of Dimes Foundation to establish a collaborative research program aimed at finding the unknown causes of premature birth. According to the March of Dimes, preterm birth is the most common and costly newborn health problem in the United States, affecting nearly half a million babies each year. It is also the leading cause of newborn death, and babies who survive an early birth often face the risk of lifelong health issues, including vision and breathing problems. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants. “The transdisciplinary approach will increase dramatically the rate of progress in understanding why some babies are born too soon. Ultimately our goal is to use this knowledge to develop effective therapies to prevent preterm birth and enable all pregnancies to proceed to full term,” said ” said Sam Mesiano, PhD, Site Director for the Case Western Reserve University, University Hospitals, and MetroHealth component of the collaborative. One of the focus aims of the research includes the sociobiology of racial disparities in preterm birth. African-American and Hispanic mothers have higher rates of preterm births than do whites. Read more on maternal and infant health.

House, Senate Consider Cuts to SNAP in Farm Bill Reauthorization
The U.S. House and Senate are each considering versions of the five-year Farm Bill reauthorization that would save money in part by cutting the budget for the supplemental Nutrition Assistance Program (SNAP), which helps nearly 48 million Americans purchase food each year. The House version would cut $2 billion and the Senate version would cut $400 million, according to The Washington Post. The House version would also stop certain forms of automatic SNAP benefits. James S. Marks, Senior Vice President of the Robert Wood Johnson Foundation Health Group, said cutting SNAP benefits would violate the fundamental tenet of medicine to “first, do no harm.” “Cutting SNAP is precisely the wrong prescription for our children and the nation's economic recovery. The notion that SNAP benefits are an overly generous handout could not be further from the truth,” he wrote in The Huffington Post, adding “SNAP has the potential to be a public health tool that can help address the complex problems of hunger and obesity.” Read more on nutrition.

CDC: High Rates of Unhealthy Behavior Persist
A new report from the U.S. Centers for Disease Control and Prevention finds that, overall, Americans aren’t making much improvement in their health. About 60 percent are overweight or obese, about 60 percent drink, about 20 percent smoke and about 80 percent don’t meet federal guidelines for exercise. "Changes have not been enormous," said report author Charlotte Schoenborn, a health statistician at the CDC's National Center for Health Statistics. "It's been a very, very slow process of changing awareness of personal choices for healthier ways of life.” Added Rich Hamburg, deputy director of Trust for America's Health: "I think we're in a situation now where we're at a crossroads. We have two paths to go. We're hopeful that if we continue to invest in community-based prevention, if we promote healthy eating and active living, these rates will begin to decrease." Read more on CDC.

May is Stroke Awareness Month, a good time to bump up the percentage of Americans who recognize the most common symptoms of a stroke from only 38 percent, according to a Centers for Disease Control and Prevention (CDC) survey. Speedily identifying stroke symptoms and calling for an ambulance is essential because people who get to an emergency room for treatment within three hours are healthier three months later than people for whom stroke care was delayed, according to the CDC.

New this year to help increase symptom awareness is a free smartphone app from the American Heart Association/American Stroke Association called F.A.S.T. The acronym stands for common stroke symptoms and a critical call to action: Face drooping; Arm weakness; Speech difficulty; and Time to call 9-1-1. The app also includes a link to additional symptoms that bystanders and caregivers can access and a 9-1-1 button to call an ambulance. Using the 9-1-1 button saves time by not having to back out of the app to dial the number manually. And using the button also generates an automatic time stamp, which gives emergency room staff a good indication of when symptoms began. Some treatments can only be given within a specific time window.

A community needs assessment of a Chinese-American community in New York City several years ago found multiple barriers to physical activity for children and teens including parents unable to supervise kids at play because of long work hours, unsafe neighborhoods, limited knowledge or access to existing programs, financial hardship, inadequate support for physical activity in schools, limited time due to competing priorities such as academics, and too much time in front of video games, computer screens and television. To increase exercise time and options and help to reduce obesity rates among Chinese-American youth, public health professionals from the Charles B. Wang Community Health Center sought out funding from the New York State Department of Health and Mental Hygiene to create the Chinatown JUMP (Joining Urban Partners for More Physical Activity) program.

>>Read more on New York's Health Improvement Plan, which sets out a plan for similar community health assessments and cross-sectoral collaborations in response to these findings.

Chinatown JUMP currently works with eight afterschool programs to incorporate daily physical activity into the curriculum of these academic programs, blending activity with learning. Program goals include:

• Promote healthier and fit children by educating them and their families about the correlation between exercise and staying healthy.
• Increase staff capacity to support students’ healthier lifestyle through training and technical assistance.
• Establish an afterschool culture that supports physical activity as well as academic achievement.

The program works hard to incorporate parents’ support and involvement as well. Participating students in iMove receive a community resource guide with information about free and low-cost recreational centers and public spaces in the neighborhood to share with their parents. Parents are also invited to workshops on the importance of physical activity and healthy eating habits.

NewPublicHealth recently spoke with Susan Yee, Associate Director of Programs at the Charles B. Wang Community Health Center, about Chinatown JUMP.

NewPublicHealth: What is the Chinatown JUMP program and what do you think sets it apart from other programs with similar goals?

Susan Yee: Chinatown JUMP’s goal is to try to improve opportunities for more physical activity in the Manhattan Chinatown area in order to create sustainable changes within the community.

Devastation in Oklahoma, More Storms Possible
Following tornadoes in Oklahoma yesterday that killed and injured scores of people and leveled whole communities, the National Weather Service is warning that that severe weather could move eastward as far as the Gulf Coast and Northeast on Tuesday and Wednesday. “These are dangerous storms and we urge people to monitor the situation closely and be alert for severe weather warnings in their community,” said Trevor Riggen, vice president of Disaster Operations and Logistics for the Red Cross. The Red Cross has created a free tornado app, available in English or Spanish, whose features include a high-pitched siren tornado warning alert that signals when an alert from a National Oceanic and Atmospheric Agency (NOAA) tornado warning has been issued. The app, found in the Apple App Store and the Google Play Store for Android by searching for American Red Cross, also includes an all-clear alert that lets users know when a tornado warning has expired or has been cancelled. The app also includes one-touch “I’m safe” messaging to alert family and friends through social media outlets. Read more on preparedness.

Cost, Other Factors May Keep African-Americans from Calling 911 when they have Stroke Symptoms
African-Americans often know the signs of stroke, but concerns about medical cost, ambulance response time and lack of familiarity with the need for prompt hospital care impacted whether they called 9-1-1 immediately, according to a new study of 77 African American community members in Flint, Michigan by researchers at the University of Michigan. The study was published in Circulation: Cardiovascular Quality and Outcomes. To encourage 9-1-1 calls even if a stroke victim is concerned about cost, the study authors recommended highlighting the reduction in post-stroke disability if treatment is given quickly. Read more on access to health care.

Report: High SPF Sunscreens Not Any More Effective
Just in time for the Memorial Day Weekend, the Environmental Working Group has released its 7th annual Sunscreen Guide,  which rates the safety and efficacy of more than 1,400 sunscreens, lotions, lip products and makeups that advertise sun protection. EWG researchers found that only 25 percent of products on the market in 2013 offer strong and broad protection and pose few safety concerns. “The vast majority of sunscreens available to the consumer aren’t as good as most people think they are, but there are a handful of products that rise above the rest,” said Sonya Lunder, senior research analyst at EWG and lead author of the report. Lunder says that’s important because “despite an increasing awareness of the sun’s risks, rates of melanoma have tripled over the past 35 years, with an annual increase of 1.9 percent per year since 2000.” EWG says it thinks the U.S. Food and Drug Administration (FDA) should push companies to stop selling high-SPF sunscreens (above 50+), which account for 1 in 7 products on the market. The FDA has said that it cannot vouch for any sunscreen above 30. According to Lunder, as a result of misleading and confusing marketing claims, consumers frequently misuse sunscreens and spend more time in the sun than they should, putting them at greater risk. Read more on cancer.

The Second National Health Impact Assessment (HIA) Meeting takes place September 24-25 in Washington, D.C., and the deadline for abstract submissions is fast approaching. The conference will bring together policymakers, public health professionals, HIA practitioners; community-based organizations; researchers and decision makers from non-health agencies all who may use or rely on the results of HIAs in the fields of planning, transportation, housing, agriculture, energy, environment, and education.

The planning committee for this year’s meeting is currently seeking abstracts for a variety of sessions, particularly from presenters who will be releasing new research. Abstracts, due by Wednesday, May 29, should clearly state what new information will be presented and its impact on a specific sector or the field of HIA more generally.

Aside from the typical poster sessions and presentations, the HIA Meeting will also feature opportunities to dive deep on specific and cross-cutting topics.

CDC Issues First Comprehensive Report on Children’s Mental Health in the United States
As many as one in five American children under the age of 17 has a diagnosable mental disorder according to a new report from the Centers for Disease Control and Prevention. The report is the first expansive report on children's mental health ever done by the U.S. government and looked at six conditions:

• attention-deficit/hyperactivity disorder (ADHD)
• behavioral or conduct disorders
• mood and anxiety disorders
• autism spectrum disorders
• substance abuse
• Tourette syndrome

The most common disorder for children age 3 through 17 is ADHD (7 percent) followed by behavioral or conduct problems (3.5 percent), anxiety (3 percent), depression (2 percent), and  autism spectrum disorders (1 percent).

Five percent of teens reported abusing or being dependent on illegal drugs, 4 percent abused alcohol and 3 percent reported smoking cigarettes regularly. Boys were more likely than girls to have the disorders. Read more on mental health.

New PSAs Help Parents Talk to Younger Kids about the Dangers of Underage Drinking
“Talk. They Hear You,” is a new national public service announcement (PSA) campaign from the Substance Abuse and Mental Health Services Administration (SAMHSA) to empower parents to talk to children as young as nine about the dangers of underage drinking. SAMHSA research shows that more than a quarter of American youth engage in underage drinking, and  though there has been progress in reducing the extent of underage drinking in recent years, particularly among those aged 17 and younger, the rates of underage drinking are still unacceptably high, according to SAMHSA. A report from late last year shows that 26.6 percent of 12-20 year-olds report drinking in the month before they were surveyed and 8.7 percent of them purchased their own alcohol the last time they drank, despite the fact that all fifty states and the District of Columbia currently have laws prohibiting the purchase and use of alcoholic beverages by anyone under age 21.  

“Even though drinking is often glamorized, the truth is that underage drinking can lead to poor academic performance, sexual assault, injury, and even death,” said said SAMHSA Administrator Pamela S. Hyde.

The goal of the new PSA is to help parents start a conversation about alcohol before their children become teenagers. Read more on addiction.

Advocacy Groups Petition FDA to Ban Menthol Flavored Cigarettes
In response to a Citizen Petition by close to twenty health and tobacco control advocacy groups, the Food and Drug Administration has opened a docket for public comment on banning menthol in cigarettes. In 2009, according to the Tobacco Control Legal Consortium, the lead group on the petition, Congress banned all flavors in cigarettes except menthol, and directed the FDA to decide whether continued sale of menthol cigarettes is “appropriate for public health." According to the petition, menthol cigarettes are the source of addiction for nearly half of all teen smokers. Read more on tobacco.