In Doing the Best I Can, Tim Nelson, a lecturer in public policy at Harvard, and his co-author, Kathryn Edin, a professor of policy and management at the Kennedy School of Government at Harvard, take a close look at the inaccurate stereotypes about low-income fathers and how a different approach could lead to more stable, healthier families. The book also calls for reforms in the U.S. including regularly incorporating visitation into child-support orders and improving systemic approaches to fathers with employment barriers that affect their ability to pay support. According to Nelson, these efforts could result in increased income for single-mother families, social supports for dads, and improved father-child relationships.
Just before Father’s Day, NewPublicHealth spoke with Tim Nelson about the book’s findings.
NewPublicHealth: How did you come to write the book?
Tim Nelson: My co-author, Kathryn Edin, has written several books about single mothers in Camden, New Jersey and in Philadelphia, first in the mid-1990s about how single mothers make ends meet on welfare and low wage work and then in the mid-2000s, she co-wrote a book about how single moms make decisions about marriage and childrearing. Doing the Best I Can, is kind of the companion piece to the book on marriage and childrearing, which is called Promises I Can Keep. The men we interviewed are not the partners of the women in the prior book, but they do come from the same neighborhoods and have the same low income status. It’s aimed at getting the fathers’ perspectives and experiences, which are much less well known than the mothers’.
NPH: What needs correcting about the image of low-income fathers and why is it important to correct it?
APHA, National Center for Healthy Housing Release Housing Standards to Improve Health
The National Center for Healthy Housing (NCHH) and the American Public Health Association (APHA) have released a National Healthy Housing Standard aimed at improving the health of Americans by addressing serious health and safety hazards in U.S. homes. About 30 million families live in unsafe and unhealthy housing with broken heating and plumbing; holes in walls and windows; roach and rodent infestation; falling plaster; crumbling foundations; and leaking roofs. Millions more live in housing with serious health and safety hazards that can cause allergies, asthma, injuries, cancer and lead poisoning, which add billions of dollars to health care costs and harm children’s health, development and wellbeing, according to the APHA. The new standard would not apply to new construction or housing renovation, but will be used by government agencies to ensure that the existing housing stock—with more than 100 million units across the country—is maintained to protect the health and safety of Americans. The housing standard would be implemented through adoption by federal state and local agencies. NCHH is requesting comments from health and housing practitioners, advocates and other stakeholders in healthy housing on the standard through July 31, 2013 at NCHH.org. Read more on housing.
Black, Hispanic Kids With Autism Less Likely to See Specialists
Black and Hispanic children with autism are less likely than their white counterparts to access specialists such as gastroenterologists, neurologists and psychiatrists, according to a new study in the journal Pediatrics. Study author Sarabeth Broder-Fingert, MD, a fellow in the department of pediatrics at MassGeneral and Harvard Medical School, said that while she expected to see differences, she was surprised by the extent of the disparity. Diagnosing and treating the disorders that often accompany is critical so that they do not lead to further health complications. "I do worry because autism is such a complicated disorder," she said. "The children have some sort of communication difficulty, so if they have stomach problems or sleep problems they may have difficulty expressing that. I always worry these kids are not getting all the care they need in general, and minority kids are more at [risk] of not getting the care they need." The study indicated that doctors need to be more aware of when to refer patients to specialists. About one in 50 school-age children have autism in the United States, according to the U.S. Centers for Disease Control and Prevention. Read more on health disparities.
Volunteer Time Reduces High Blood Pressure Risk in Older Adults
Time spent volunteering can help reduce the risk of high blood pressure in older U.S. adults, according to a new study in the journal Psychology and Aging. Researchers analyzed data on more than 1,100 adults, finding that those who volunteered at least 200 hours per year saw a 40 percent saw a 40 percent cut in high blood pressure risk four years down the line. Approximately 65 million American suffer from high blood pressure, or hypertension. "As people get older, social transitions like retirement, bereavement and the departure of children from the home often leave older adults with fewer natural opportunities for social interactions,” said lead author Rodlescia Sneed, a PhD candidate in psychology at Carnegie Mellon University. "Participating in volunteer activities may provide older adults with social connections that they might not have otherwise. There is strong evidence that having good social connections promotes healthy aging and reduces risk for a number of negative health outcomes." Read more on heart health.
Millions of cell phone customers might have heard their phones let out a high pitched alarm and spontaneously shake yesterday afternoon. The mobile siren is an indication that the severe weather is threatening the area—and roughly 62 million Americans were in the path of severe weather along the East Coast yesterday, as the region was wracked with severe thunder storms, tornados and flooding.
The mobile shake, rattle and siren is a free service from the Federal Emergency Management Agency and many nationwide cell phone carriers. You can find out if you’re covered by pressing 6-1-1 on your cell phone, which is your carrier’s customer service line. Earlier this week a NewPublichealth reporter, unaware of the service, suddenly felt his phone shake and was alerted to potential life-threatening flooding along his commuting route.
The service is actually two years old, but to get consumers to pay attention to the alerts, and the threats they’re warning about, FEMA recently partnered with the Ad Council on a new public service announcement.
The specific warnings come through as text messages with no more than 90 characters. Categories of alerts include extreme weather, AMBER alerts indicating a child has been abducted, and Presidential alerts during a national emergency.
One of the best features of the service is that it automatically tunes to weather where you are, not where you’re from. Go on vacation to the Outer Banks of North Carolina from Missouri, for example, and you will get alerts, if needed, about whether out on the barrier island. That’s important. Gary Cox, health director of Oklahoma City, which recently saw devastating tornadoes that killed and injured scores of people, said among those killed and injured were travelers to the area who hadn’t tuned into weather forecasts and didn’t know to take cover.
>>Bonus Link: Read an FAQ from FEMA on the wireless alerts.
American Institute of Architects, Others Launch Ideas Competition to Rebuild Sustainable Communities
The American Institute of Architects (AIA), Make It Right, St. Bernard Project and Architecture for Humanity have launched a new “Designing Recovery” ideas competition to help rebuild sustainable, resilient communities in areas hit by natural disasters. The announcement came at the annual Commitment to Action at CGI America. "The cities of New Orleans, New York and Joplin are all stark reminders of the emerging threat of severe-weather disasters brought on by a changing climate,” said Eric Cesal, Director of Reconstruction and Resiliency at Architecture for Humanity. “Every city can learn from the successes and failures of these three cities and their response to disaster. Designers and architects have a responsibility to do more — and to do better. We hope this competition will draw out the best and brightest new ideas for a world of new risks." Read more on disasters.
On World Blood Donor Day, HHS Highlights Need for More Resources
Today is World Blood Donor Day. The United States is one of only 62 countries that collect 100 percent of their blood from voluntary, unpaid donors; the World Health Organization has this goal for all countries by the year 2020. About 8 million people donate blood in the United States each year. While this number is substantial, the U.S. Department of Health and Human Services (HHS) says even more donations are needed to help surgical patients, cancer patients, victims of natural disasters and people who suffer battlefield injuries.
According to HHS:
- Forty or more units of blood may be needed for a single trauma victim
- Eight units of platelets may be required daily by leukemia patients undergoing treatment
- A single pint of blood can sustain a premature infant’s life for two weeks
Read more on global health.
Supreme Court Rules Naturally Occurring Human Genes Cannot be Patented
In a unanimous decision, the U.S. Supreme Court ruled that naturally occurring human genes cannot be patented, although synthetically produced genetic material can be. The ruling struck down Myriad Genetics Inc.’s patents on the BRCA1 and BRCA2 genes linked to breast and ovarian cancer. Robert Darnell, MD, president and scientific director of the New York Genome Center, said the ruling "sets a fair and level playing field for open and responsible use of genetic information" and that “it does not preclude the opportunity for innovation in the genetic world." Read more on research.
How many children could possibly identify with a new Sesame Street character whose dad is in prison? Close to two million, according to many experts. A White House “Champions of Change” event yesterday honored twelve men and women who have spent their careers researching and improving the lives of children who have at least one parent in prison. That explains why Sesame Street released a new video and toolkit yesterday, as part of their "Little Children, Big Challenges" series, that tells the story of Alex, whose dad is in prison. Alex’s grown up and peer friends help him talk, and sing, about his feelings about his dad and how other people speak about his dad’s prison stay. The "Challenges" series includes issues many kids face such as divorce and a parent in the military, and the resources are distributed through therapist's offices, schools, jails and other key places to reach kids.
The White House program, led off by Domestic Policy Council director Cecilia Munoz and Secretary of Health and Human Services Kathleen Sebelius, included panel discussions on the needs of kids whose parents are in jail, which is a recognized “adverse childhood experience” that can lead to poor health outcomes as children become adults. Among the problems kids of incarcerated parents can face are decreased living standards, social isolation because of the stigma they feel about having a parent in prison, and long-term or permanent separation from the incarcerated parent.
>>Watch a CBS News story on the Sesame Street program that will help support kids with incarcerated parents.
U.S. News & World Report has added a new set of rankings, “America's 50 Healthiest Counties for Kids” to its just released annual report on the Best Children’s Hospitals. The top counties have some important measures including fewer infant deaths, fewer low-birth-weight babies, fewer deaths from injuries, fewer teen births and fewer children in poverty than lower ranked counties. Most of the measures were taken from this year’s County Health Rankings, a collaboration of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
According to U.S. News, “America’s 50 Healthiest Counties for Kids,” represents the first national, county-level assessment of how health and environmental factors affect the well-being of children younger than 18 and shows that even the highest-ranking counties grapple with challenges such as large numbers of children in poverty and high teen birth rates.
>>Read the full U.S. News & World Report article.
Racial and Ethnic Minorities Face Greater Subtle Housing Discrimination
Blatant acts of housing discrimination faced by minority prospective home buyers are declining in the United States, but more subtle forms of housing denial persist, according to a new study by the U.S. Department of Housing and Urban Development (HUD) and the Urban Institute. The study found that African-Americans, Hispanics and Asians learn about fewer housing options than equally qualified whites. According to the study, which sent out pairs of “mystery home buyers” — one white and one minority — to contact real estate agents and rental housing providers, the minority pairs were recommended and shown fewer available homes and apartments, which can increase their costs and restrict housing options, according to HUD. “Fewer minorities today may be getting the door slammed in their faces, but we continue to see evidence of housing discrimination that can limit a family’s housing, economic and educational opportunities,” said HUD Secretary Shaun Donovan. Read more on housing.
After Second or Third Concussion Kids Take Longer to Recover
Children and adolescents who suffer a concussion have a much longer recovery time if they have had a concussion in the past, according to a new study in Pediatrics. The study authors evaluated 280 patients between the ages of 11 and 22 who were treated for concussion symptoms in emergency departments. Children who had a second concussion within a year had nearly three times the average duration of symptoms compared to children whose concussions occurred more than one year apart. The number of previous concussions also affected recovery time. Two or more prior concussions resulted in a much longer duration of symptoms compared to those who experienced no or one previous concussion. Other factors that resulted in a longer recovery time included being age 13 or older and having more severe symptoms at the time of the emergency room visit. Read more on injury prevention.
Hearing Loss in Seniors Can Increase Hospitalizations and Poor Health
A new study published in JAMA finds that seniors with hearing loss are at increased risk for hospitalization, illness, injury and depression. The study authors reviewed records of more than 1,000 men and women age 70 and older with hearing loss, finding that over a four-year period they were 32 percent more likely to have been admitted to the hospital than a comparison group the same age with normal hearing. The hearing-impaired seniors in the study were also 36 percent more likely to have extended stretches of illness or injury and 57 percent more likely to have extended episodes of stress, depression or bad mood. According to the researchers, hearing loss affects two-thirds of men and women aged 70 and older. Among their recommendations to reduce the health burdens of hearing loss are expanding Medicare and Medicaid reimbursement for hearing-related services; increased installation of amplification technology in more facilities; and more accessible and affordable approaches for treating hearing loss. Read more on aging.
Britain to Regulate, Improve Quality of E-Cigarettes
The British government plan to regulate electronic cigarettes as non-prescription medicine starting in 201, according to Reuters. E-Cigarettes are battery-operated devices that contain cartridges filled with nicotine, flavor, and other chemicals. They turn nicotine, which is highly addictive, and other chemicals into a vapor that can be inhaled. The U.S. Food and Drug Administration (FDA) has warned that, "As the safety and efficacy of e-cigarettes have not been fully studied, consumers of e-cigarette products currently have no way of knowing:
- whether e-cigarettes are safe for their intended use,
- how much nicotine or other potentially harmful chemicals are being inhaled during use, or
- if there are any benefits associated with using these products."
The devices do not contain any health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes. Currently, e-cigarettes that are marketed for therapeutic purposes are regulated by the FDA. According to Reuters, "Under the new British system, manufacturers will have to prove the quality of their products and demonstrate that they deliver the correct amount of nicotine. But they will not need to conduct clinical trials." Read more on tobacco and nicotine.
Even Hands-Free Devices Create Unsafe, Distracted Driving Conditions
A new report from AAA finds that even hands-free mobile devices create mental distractions that can drain attention away from focusing on the road and safe driving. The study found that mentally-distracted drivers—those who may not have even taken their eyes off the road but were distracted by speaking with someone through a hands-free device—missed visual cues, had slower reaction times, and even exhibited a sort of "tunnel vision" by not checking side- and rear-view mirrors or actively scanning the full roadway for potential hazards. Activities like listening to the radio or an audio book was mildly distracting (but likely not enough to effect driving safety); conversing with others (whether with fellow passengers, with someone via hand-held device or with some via hands-free device) was moderately but significantly distracting; and using a device with speech-to-text technology to send text messages or e-mails was highly distracting. Researchers hope these findings can be used to help craft science-based policies on driver distraction. Read more on safety.
CDC Partners with 104 Businesses to Improve Employee Health
The Centers for Disease Control and Prevention (CDC), through its partner Viridian Health Management, has identified 104 employers in eight counties across the nation that have voluntarily chosen to participate in the National Healthy Worksite Program, a new initiative aimed at reducing chronic disease and building a healthier, more productive U.S. workforce—while also cutting health care costs. The initiative primarily focuses on small and mid-sized employers. a national evaluation will document best practices and models on how to successfully implement workplace health programs in small worksites more broadly. Read more on what businesses are doing to create healthier communities.
Last week, a lunch briefing hosted by Women’s Policy, Inc., a national nonprofit that focuses on women’s issues, brought together a packed house of policymakers, public health leaders, academics, and legislative staff in key Congressional offices to discuss how data can inform action around women's and population health.
The briefing focused on the County Health Rankings & Roadmaps, a collaboration between the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute that measures the health of every county in the United States and provides tools to help create solutions that make it easier for people to be healthy in their own communities. Measuring health outcomes like length and quality of life along with health factors like education, income, and obesity rates, the Rankings provide an annual snapshot of where counties are doing well and where they can improve.
In turn, the Roadmaps to Health program helps counties partner with other local leaders to use that data to improve the health of residents. One of the featured speakers at the briefing was Claude-Alix Jacob, Chief Public Health Officer of Cambridge, Mass., one of six inaugural winners of RWJF’s Roadmaps to Health Prize.
Jacob pointed out the value of having data to work with determining where to put resources in order to improve community health. Women’s health data points of in Cambridge include:
- Girls reported slightly higher rates of smoking and binge drinking than boys
- Girls reported rates three times higher than boys of verbal abuse.
- Girls reported being three times more likely to hurt themselves than boys
- 87 percent of eligible women have had Pap smears, and 85.5 have had mammograms
- One-third of single mothers live in poverty
One key program that Jacob pointed to that Cambridge has begun is Baby University, a free 16-week innovate program designed for parents with children from birth to age 3. The goal is to increase parents’ knowledge about child-rearing topics, strengthen parent-child relationships and connect parents to community resources. “While the first few cycles have largely included only moms,” said Jacob, “ the two most recent cycles have included more dads.”
The program includes childcare and transportation costs for enrolled parents, as well as home visits by professional staff. Parents who complete the program become part of an alumni association that continues the relationship between the parents and the program staff. So far, the program has had 140 graduates.
>>Read more about the briefing from the County Health Rankings blog.
>>Bonus Link: Among the resources for improving community health discussed at the Women Policy Inc. briefing was the “Town Hall Meeting in a Box” to help facilitate community conversations. The toolkit includes invitation samples, venue ideas and presentation documents. See more County Health Rankings & Roadmaps resources here.
Emergency Contraception Age Restrictions to be Dropped
The White House administration announced Monday that it will comply with a U.S. District Court ruling to remove the age restrictions on the emergency contraception pill Plan B One-Step, making it available to all women and girls without a prescription. The pill is most effective when taken within 72 hours after unprotected intercourse. The court ruling came in April, with a judge referring to the U.S. Food and Drug Administration’s decision to reject a citizen petition related to the restrictions as "arbitrary, capricious and unreasonable." According to Reuters, Planned Parenthood Federation of America President Cecile Richards said the decision "will make emergency contraception available on store shelves, just like condoms, and women of all ages will be able to get it quickly in order to prevent unintended pregnancy." Read more on sexual health.
CDC Toolkit to Help Health Care Departments, Facilities Make Patient Notifications on Potential Exposures
More than 150,000 patients may have been exposed to hepatitis B, hepatitis C and HIV since 2001 because of unsafe health care practices, and last year almost 14,000 people were notified in relation to a national fungal meningitis outbreak and other infections. In order to help health departments and facilities going forward, the U.S. Centers for Disease Control and Prevention has created a new online toolkit to facilitate the notification of patients in the event of potential infections or disease transmissions during medical care. The kit includes key steps on notifying patients, resources to help create notification documents, and media communications strategies. The kit was presented at the APIC Annual Conference in Ft. Lauderdale, Fla., on June 9. Read more on infectious diseases.
Reducing CT Scans for Kids Could Cut Later Rates of Cancer
Cutting back on the number of unneeded, high-dose computed tomography (CT) scans on children could reduce their lifetime risk of certain cancers by more than 60 percent, according to a new study in the journal JAMA Pediatrics. CT scans utilize x-rays; the approximately 4 million annual CT scans of kids’ most commonly imaged organs may lead to as many as 4,900 cancers, according to the researchers. "There are potential harms from CT, meaning that there is a cancer risk—albeit very small in individual children—so it's important to reduce this risk in two ways," said lead author Diana Miglioretti, a professor of biostatistics in the department of public health sciences at the UC Davis Health System. "The first is to only do a CT when it's medically necessary, and use alternative imaging when possible. The second is to dose CT appropriately for children." Read more on cancer.