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.

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 Network for Public Health Law — Eastern Region, 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