Category Archives: Disability
New EPA Tool Helps Communities Become More Flood Resilient
The U.S. Environmental Protection Agency (EPA) has released a new tool, the Flood Resilience Checklist, to help communities prepare for, deal with and recover from floods. The checklist includes strategies that communities can consider, such as conserving land in flood-prone areas; directing new development to safer areas; and using green infrastructure approaches, such as installing rain gardens, to manage storm water. “Flooding from major storms has cost lives and caused billions of dollars in damage,” said EPA Administrator Gina McCarthy. “With climate change, storms are likely to become even more powerful in many regions of the country. Where and how communities build will have long-term impacts on their flood resilience, and on air and water quality and health and safety. This checklist will help flood-prone communities think through these issues and come up with the solutions that work best for them.” Find more resources on EPA’s Disaster Recovery and Resilience page.
Home Blood Pressure-Monitoring Devices Lower Health Care Costs
A new study in the journal Hypertension finds that home blood pressure monitors can improve health care quality and save money. In the United States, more than 76 million adults have been diagnosed with hypertension and many more are undiagnosed. The researchers analyzed 2008-11 data from two health insurance plans—a private employer plan and a Medicare Advantage plan where 60 percent of members had high blood pressure. Net savings associated with home blood pressure monitoring ranged from $33 to $166 per member in the first year, and $415 to $1,364 over 10 years. Researchers found reasons for the savings differed by age groups and whether the monitors were used for treatment or diagnosis. In people 65 and older, home monitoring saved more when used to track high blood pressure treatment, by helping them avoid future adverse cardiovascular events. In people younger than 65, savings were higher in diagnostic use of the monitors, with fewer false positive diagnoses and fewer people starting unnecessary treatment. Read more on prevention.
New Mobile App Helps Parents Discuss Underage Drinking with their Kids
The Substance Abuse and Mental Health Services Administration (SAMHSA) has launched a new mobile app that features a simulated video game-like tool to help parents practice having conversations about underage drinking. SAMHSA experts say the timing of the release is intentional, as the rate of youth alcohol use rises during the summer. The mobile app is the newest component of “Talk. They Hear You,” SAMHSA’s underage drinking prevention campaign that launched last year to provide parents and caregivers with information and tools to start talking to youth early—as early as nine years old—about the dangers of alcohol. The new app uses avatars to engage in interactive conversations and each virtual role-play conversation is structured as a 10- to 15-minute interactive, video game-like experience. Users engage in a conversation with an intelligent, fully animated, emotionally responsive avatar that models human behavior and adapts its responses and behaviors to the user’s conversation decisions. Read more on substance abuse.
FDA Approves for Marketing a Motorized Walking Suit for People with Spinal Cord Injuries
The U.S. Food and Drug Administration has approved for marketing a device called the ReWalk, which is the first motorized device intended to act as an exoskeleton for people with lower body paralysis from a spinal cord injury. According to the U.S. Centers for Disease Control and Prevention, there are about 200,000 people in the United States living with a spinal cord injury. ReWalk consists of a fitted, metal brace that supports the legs and part of the upper body; motors that supply movement at the hips, knees and ankles; a tilt sensor; and a backpack that contains the computer and power supply. Crutches provide the user with additional stability when walking, standing and rising up from a chair. Using a wireless remote control worn on the wrist, the user commands ReWalk to stand up, sit down or walk. Read more on disability.
One in 10 Deaths Among Working-Age Adults is Due to Excessive Drinking
Excessive alcohol use accounts for one in 10 deaths among working-age adults ages 20-64 years in the United States, according to a report from the U.S. Centers for Disease Control and Prevention and published in Preventing Chronic Disease. Excessive alcohol use led to approximately 88,000 deaths per year from 2006 to 2010, and shortened the lives of those who died by about 30 years. The deaths were due to health effects from drinking too much over time, such as breast cancer, liver disease and heart disease; and health effects from drinking too much in a short period of time, such as violence, alcohol poisoning and motor vehicle crashes. In total, there were 2.5 million years of potential life lost each year due to excessive alcohol use. Nearly 70 percent of deaths due to excessive drinking involved working-age adults, and about 70 percent of the deaths involved males. About 5 percent of the deaths involved people under age 21. The highest death rate due to excessive drinking was in New Mexico (51 deaths per 100,000 population) and the lowest was in New Jersey (19.1 per 100,000). Read more on substance abuse.
Men and Women Use Mental Health Services Differently
Women with chronic physical illnesses are more likely to use mental health services than men with similar illnesses, and they also seek out mental health services six months earlier than those same men, according to new study from St. Michael's Hospital in Toronto, Canada and published in the Journal of Epidemiology & Community Health. The study looked at people diagnosed with at least one of four physical illnesses: Diabetes, high blood pressure, asthma or chronic obstructive pulmonary disease. The researchers found that among those with at least one of these four illnesses, women were 10 percent more likely to use mental health services than men, and within any three-year period women with physical illness used medical services for mental health treatment six months earlier than men. The researchers say the results may imply that women are more comfortable than men with seeking mental health support; that symptoms are worse among women, requiring more women to seek help and sooner; or that men defer seeking treatment for mental health concerns. Read more on mental health.
Earlier this week the White House honored eleven transportation “Champions of Change” for their roles in ensuring that transportation facilities, services and jobs help individuals and their communities.
- Wanda Vazquez, a mentor and trainer in Chicago who helps Hispanic advocates in the Chicago area become certified child passenger safety technicians, and help families understand the importance of safe transportation for their children.
- Daphne Izer, head of the twenty-year-old Parents Against Tired Truckers.
- Marilyn Golden, a senior policy analyst with the Disability Rights Education & Defense Fund, based in Berkeley, California, where she has advocated for greater access to public and private transportation for people with disabilities.
Research from the U.S. Department of Transportation has found that poor transportation access is a factor preventing lower income Americans from gaining higher income levels than their parents. “Transportation plays a critical role in connecting Americans and communities to economic opportunity through connectivity, job creation, and economic growth,” said U.S. Secretary of Transpiration Anthony Foxx at the event recognizing the Champions. “Recognizing social mobility as a defining trait of America’s promise, access to reliable, safe and affordable transportation is critical.”
Following the awards ceremony, NewPublicHealth spoke with Marilyn Golden about her work.
NewPublicHealth: How much more is there to be done to help people with disabilities to get easier access to transportation to take them where they need to go, whether it’s recreational, medical, or work?
Marilyn Golden: We should acknowledge that a lot has been done under the Americans with Disabilities Act (ADA) by transit agencies, with a lot of thank you to the U.S. Department of Transportation, particularly the Federal Transit Administration for enforcing the ADA in a sufficiently robust manner that transit agencies do respond.
I shouldn’t suggest that every transit agency only acts because of an enforcement action. It’s much more diverse than that, and some are very proactive on their own and really leaders in the industry, and then there are transit agencies that trail behind. We do have many challenges that remain.
In the wake of disasters communities often share stories of resiliency, not just to show how far they have come, but to model for others the critical need for an infrastructure of planning and preparedness when disaster hits. When the bombs went off at the Boston Marathon last year, Achilles International, a non-profit group that pairs able-bodied runners with disabled people, already had a chapter in place in the Boston area.
The group reached out using social media, as well as bright yellow banners and shirts during twice-weekly training sessions along the Charles River, to help attract attention and encourage Bostonian volunteers and potential athletes to join up. One survivor did. Thirty-one-year old Mery Daniel, a single mother of a five-year-old, who is close to completing her medical boards to become a general practitioner physician, lost one leg and suffered damage to the other during the blast. She joined up with Achilles and ran its 5K Hope and Possibility race—her first race ever—using a hand cycle last June.
The community rallying around the Boston Marathon over the last year has resulted in several new competitors joining up to compete in the Boston Marathon. A team of thirty differently abled Achilles runners, each with at least one guide for the race, will be wearing yellow Achilles shirts in today’s marathon. Their disabilities—ranging from Dwarfism and scoliosis to visual impairment—have not held them back.
“The stories about the survivors’ recoveries brought attention to the fact that people with disabilities have opportunities to do things they enjoy and learn new skills,” said Eleanor Cox, director of chapter development for Achilles. “So when the chapter put extra effort this past year into outreach through social media, word of mouth and the bright yellow banners on the Charles—matched up with people wanting to volunteer and people with disabilities wondering what was possible—it turned a previously quieter Achilles chapter into a strong one. Boston Strong.”
>>Bonus Link: Read more from Boston Marathon Survivor Adrianne Haslet-Davis on Recovery, Care, and Collaboration on the RWJF Culture of Health blog.
The final plenary session at this year’s NACCHO Annual included a talk by Christopher Murray, MD, DPhil, director of the Institute for Health Metrics and Evaluation at the University of Washington on how data is used to measure health, evaluate interventions and find ways to maximize health system impact. Dr. Murray was a lead author on three pivotal studies published last week that used data to assess the state of health in the United States compared with 34 other countries and county level data on diet and exercise. One of the key findings is that Americans are living longer, but not necessarily better—half of healthy life years are now lost to disability instead of mortality; and dietary risks are the leading cause of U.S. disease burden.
NewPublicHealth spoke with Dr. Murray about the study findings, their impact and upcoming research that can add to the data public health needs to improve the health of all Americans.
NewPublicHealth: Tell us about the three studies that were published this week using the Institute’s research.
Dr. Murray: The study in JAMA [Journal of the American Medical Association] is an analysis of a comprehensive look at the health of the United States in comparison to the 34 OECD [Organisation for Economic Co-operation and Development] countries. The study looks at both causes of death and premature mortality through over 290 different diseases and puts them all together in a comprehensive analysis of what the contributors are to lost healthy life. That study also looks at the contribution to patterns of health in the U.S., from major environmental, behavioral, and metabolic risk factors. In each of those categories, there are important findings:
- The U.S. spends the most on healthcare but has pretty mediocre outcomes and ranks about 27th for life expectancy among its peer countries.
- For many large, important causes of premature death, the U.S. does pretty poorly. And we also see a big shift towards more and more individuals having major disability—from mental disorders, substance abuse, and bone and joint disease.
- On the risk factor front, the big surprise is that diet is the leading risk factor in the U.S. It is bigger than tobacco, which is second and then followed by obesity, high blood pressure, high blood sugar, and physical inactivity. Diet in this study is made up of 14 subcomponents, each analyzed separately and then put together.
“Death is an inevitable part of life. But death from preventable causes like cervical cancer, early heart disease, or gun violence is a tragedy. Whether expressed in dry, cold numbers or by the images of first graders smiling at the camera for their school picture, these tragedies will continue to motivate us to use both left-brain science and right-brain passion to improve human health and prevent unnecessary death.”
That paragraph is from the foreword by Michael Klag, MD, MPH, dean of the Johns Hopkins Bloomberg School of Public Health (JHSPH) in the current issue of the school’s magazine. The issue is devoted to how public health researchers and practitioners probe, investigate, understand and fight death.
The full issue is well worth reading. A few notable pieces include:
- An interview with Vladimir Canuda Romo, PhD, a demographer and assistant professor at the school who says his research shows American life expectancy is on the rise.
- A critical article on making palliative care a public health issue.
- A summary of a recent forum at the school on dealing with gun violence.
- A piece on prescription drug abuse, which the author calls the “biggest public health issue you’ve never heard of."
Perhaps most poignant are a collection of essays by JHSPH alumni including a thoughtful look at the last minutes of a deer.
>>Bonus Link: In a new book, Happier Endings , Erica Brown, PhD, the scholar in residence at the Jewish Federation of Greater Washington, tells her readers: “we are all going to die, but some of us will die better.” The book, which Dr. Brown calls “a meditation on life and death,” looks at the deaths of several people and shares intimate details of last months, last weeks, last seconds—sometimes peaceful, sometimes not. It’s an important reminder that communities and populations, the building blocks of public health, are made up of individuals who are loved, and missed when they pass away, and that death is indeed a public health issue worth attention.
Study: No Link Between Hospital Deaths, Readmission Rates
Hospital readmission rates—which Medicare can use to penalize health care providers—and death rates are not linked, according to a new study in the Journal of the American Medical Association. Researchers, who looked at rates for heart attack and pneumonia patients, say this means hospitals can still keep the number of returning patients down without increasing the number who die. "The concern was that their performance in one area is going to compromise their performance in another," said Harlan Krumholz, MD, lead author from the Yale University School of Medicine in New Haven, Connecticut. The U.S. Centers for Medicare and Medicaid Services reduces payments to hospitals with high readmission rates. Read more on access to health care.
HUD, HHS Grants to Provide Housing for Low-income People with Disabilities
The U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Health and Human Services (HHS) is granting approximately $98 million in funding to help prevent homelessness and unnecessary institutionalization of extremely low-income people with disabilities. Thirteen state housing agencies will use the grants to provide rental assistance. “By working together, HUD and HHS are helping states to offer permanent housing and critically needed supportive services to offer real and lasting assistance to persons who might otherwise be institutionalized or living on our streets,” said HUD Secretary Shaun Donovan in a release. “We’re helping states reduce health care costs, improving quality of life for persons with disabilities, and ending homelessness as we know it.” Read more on housing and disability.
High-calcium Diets, Supplements May Increase Death from Heart Disease for Women
High-calcium diets and supplements may increase the risk of death by heart disease for women, according to a new study in BMJ. Another recent study found a similar link among men. Calcium supplements are taken to prevent bone loss and had been speculated to also improve cardiovascular health. Instead, researchers found diets very low or very high in calcium can causes changes in blood level. Most adults should intake 1,000 to 1,200 milligrams of calcium daily, according to the U.S. Office of Dietary Supplements. Read more on heart health.
Disabled Adults Have Very High Rates of Emergency Room Use
A review of medical expenditure data by researchers at the National Institutes of Health finds that disabled adults account for a disproportionately high amount of annual emergency room (ER) visits.
The study found that despite representing 17 percent of the working age U.S. population, adults with disabilities accounted for 39.2 percent of total emergency room visits. The researchers say the higher ER use is a problem not just because of the higher costs, but also because many disabled adults have non-urgent needs that are not met by the ER visits.
Recommendations to improve care for disabled adults include prevention and chronic condition management programs tailored for the functional limitations and service needs of people with disabilities, wider use of coordinated care systems for the disabled that provide case management, integration of psychosocial care and 24/7 access to medical assistance.
Read more on disability.
Change in Color of their Pills Keeps Some Patients from Taking Generic Drugs
A new study in JAMA Internal Medicine finds that some people stop taking their medicines when a generic becomes available if the color of the dispensed generic drug is different than the brand name drug they received previously.
The authors say the study shows the need for a reconsideration of the FDA’s current regulations that allow wide variation in the appearance of generic drugs.
Read more news about the Food and Drug Administration.
Mental Health Disorders Increase the Risk of Becoming a Victim of Domestic Violence
People diagnosed with mental illness are more likely than those who are not to be victims of domestic violence, according to a new study in PLoS One.
The researchers say the causality may run in both directions. Domestic violence can result in mental health problems and people with mental health problems are more likely to experience domestic violence. The researchers say studies they reviewed show that the link between domestic violence and mental health problems is a concern for both men and women.
Read more on mental health.
Last year, a new center to help promote physical activity among individuals with disabilities opened at the University of Alabama at Birmingham. NewPublicHealth spoke with James Rimmer, PhD, the center’s director, who has spent decades promoting the importance of people who are disabled engaging in physical activity for both their health and for fun.
NewPublicHealth: Tell us about the new center.
Rimmer: When I moved here from the University of Illinois/Chicago, there was a large donation made to support the needs of people with disabilities in all areas of physical activity, sport and recreation, by the Lakeshore Foundation, a non-profit organization that provides health and fitness services to people with disabilities. They brought me in to build an enterprise between the University of Alabama at Birmingham and the foundation, which is called the UAB Lakeshore Research Collaborative. Subsumed under that are two national centers that have been funded by the Centers for Disease Control and Prevention and the National Institute on Disability and Rehabilitation Research. The first center is the National Center Health, Physical Activity and Disability. The second center is the Rehabilitation Engineering Research Center.
NPH: You have been working in this field for decades. What will be new about your initiatives and efforts in 2013?
Non-profit Achilles International connects physically and mentally disabled individuals with able-bodied amateur athletes to help build physical strength and confidence through their sense of accomplishment, which often impacts other parts of their lives. Since its start in the 1970′s, Achilles has also added training programs for children and disabled veterans. Achilles Kids provides training, racing opportunities, and an in-school program for children with disabilities; the Freedom Team of Wounded Veterans program brings running programs and marathon opportunities to disabled veterans returning from Iraq and Afghanistan.
Richard Traum, Achilles’ founder, says sports are simply the tool for accomplishing the group’s main objective: to bring hope, inspiration and the joys of achievement to people with disabilities.
NewPublicHealth recently spoke with Richard Traum about the organization and its accomplishments over the years.
NewPublicHealth: How did Achilles get started?
Richard Traum: In 1976, as an above the knee amputee, I ran in the New York City Marathon on my artificial leg. I didn’t know it at that time, but I became the first amputee to run that kind of a distance. In 1982 we started the Achilles Track Club, which was an eight week course to encourage people with disabilities to participate in long distance running and after the eight week program was over, the question was what do we do next? And the thought was move it from a course to a track club and that’s how Achilles got started, which was in January of 1983.
NPH: Tell us a bit about the mission.
Richard Traum: Well, the mission is really to help people with all types of disabilities to participate in sports with a particular focus on running in the mainstream environment. What we do most is have disabled people participate in marathons. I’ve always felt that it was very important for people with disabilities to integrate with people who aren’t disabled. One reason is that if you are disabled, it makes you feel more comfortable in the able-bodied community, but it also works in the other direction—people who are not disabled increase their comfort level by seeing folks who are disabled competing with them in a sport.
NPH: What are some of the successes?
Richard Traum: Well, one is Donald Arthur. Donald had a heart transplant and he joined us shortly thereafter. He started to work out and he built up to doing a marathon and as he progressed, he would send the t-shirts to his doctor who would then send them to the family of the heart donor. He eventually did the marathon, sent his medal to the family and told them that their son’s heart had just done a marathon. The next year, Donald ran with a brother of the donor and during the last several years, Donald has done several marathons a year in different states; to focus awareness on organ donation.