Category Archives: Health Literacy
More than 5,000 Lives Lost to Ebola So Far
Ebola has now killed at least 5,160 people and infected at least 14,098, mostly in West Africa, since the outbreak started last spring, according to the World Health Organization. New cases have increased sharply in Sierra Leone, while the incidence of new cases is declining in Guinea and Liberia. Read more on Ebola.
Seniors Need Resources Beyond the Internet for Health Information
Seniors are less likely than others to search for health informtion on the Internet, making it necessary for health providers to provide other health information resources, according to a new study in the Journal of General Internal Medicine. The study found that while huge amounts of money and attention have been invested recently in health information technology in the United States—for example, by providing electronic medical records online—it’s unclear whether older patients are willing and able to use those for personal and general health information. The researchers analyzed data from the 2009 and 2010 Health and Retirement Study, a nationally representative survey of more than 20,000 Americans 65 years and older. About 1,400 of the participants were asked how often they used the Internet in general and, in particular, how often they searched for health and medical information. Just over thirty percent used the Internet regularly and only 9.7 percent identified as having low health literacy used the internet at all. Read more on health literacy.
Predicting Which U.S. Soldiers Could Predict Suicide
A study that looked at predicting suicides in U.S. soldiers after hospitalization for a psychiatric disorder suggests that nearly 53 percent of post-hospital suicides occurred following the 5 percent of hospitalizations with the highest predicted suicide risk. The study, in JAMA Psychiatry, finds that the suicide rate in the U.S. Army has increased since 2004 and now exceeds the rate among civilians, and that a predictive model would help prevent some of the military suicides. The strongest predictors for suicide in this group include being male, late-age of enlistment, criminal offenses, weapons possession, prior suicidality, the number of antidepressant prescriptions filled in the previous year and psychiatric disorders diagnosed during the hospitalizations. Read more on mental health.
Several heart disease associations—including the American Heart Association and the American College of Cardiology—have released a report that calls on patients to take responsibility for following doctor’s orders when it comes to improving heart heath. The report authors say that while performance measures for improvements in heart disease have traditionally been doctor-focused, patient actions are also needed.
Those actions can include:
- Following treatment plans
- Taking medications as prescribed
- Going to follow-up appointments
- Maintaining lifestyle changes such as weight loss and regular exercise
The report calls on doctors to facilitate shared goal setting; shared decision making; and shared care planning and monitoring with their patients. It also pushes doctors to look at not just short-term measures, but long-term goals for patients and how they do on those goals.
One example from the report is tracking how well a patient adheres to a medication regimen—not just whether a drug was prescribed—and whether the prescribed treatment actually achieved its goal, such as lowering blood pressure or preventing a subsequent heart attack.
“The goal of performance measurement is to improve patient outcomes, including improving the patient’s health status, and reducing their morbidity and mortality. Therefore, it is important to engage everyone that can have an impact on these goals including patients, family members or caregivers, clinicians, and the healthcare system,” said Eric D. Peterson, MD, MPH, director at the Duke Clinical Research Institute and writing committee co-chair. “Shared-accountability performance measures explicitly acknowledge these interdependencies so that everyone can work together towards the improved health of the patient.”
“Hypertension affects nearly one in three adults and kills more people around the world than anything else. It is both too common and too often poorly controlled.”
So said Tom Frieden, MD, MPH, director of the U.S. Centers for Disease Control and Prevention (CDC), during a panel discussion at the annual meeting of the American Society of Hypertension (ASH) this past weekend. The panel was convened by ASH, the American Heart Association and the CDC to launch a project supporting improved control of hypertension worldwide. According to the panel an estimated 970 million people have hypertension worldwide, and the disease is responsible for more than nine million deaths, as hypertension can lead to heart disease and stroke.
Data from the groups finds that rates of hypertension have increased in both developed and developing nations, due in part to an aging population and lifestyles that include high salt diets and low physical activity.
For the developing world, the CDC; the Pan American Health Organization; and other regional and global stakeholders are identifying both cost effective medicines and inexpensive delivery strategies for the drugs to help patients afford and receive them.
In the United States, the Affordable Care Act is expected to increase the number of people on hypertension medications, but despite the availability of coverage for hypertension diagnosis and treatment there remains concern over disparities. A study of more than 16,000 members of the Hispanic community published in the American Journal of Hypertension earlier this year found that while the prevalence of hypertension among Hispanics is nearly equal to that of non-Hispanic whites, diagnosis of the disease is much lower, as is general awareness of its symptoms and treatment options.
"Given the relative ease of identifying hypertension and the availability of low-cost medications, enabling better access to diagnostic and treatment services should be prioritized to reduce the burden of cardiovascular disease on Hispanic populations,” said Paul Sorlie, MD, the lead author of the study and an epidemiologist with the National Heart, Lung and Blood Institute. “This study gives us the information needed to support the development of policies that can improve this access and, subsequently, the overall health of countless US citizens.”
- A new infographic from the Measure Up/Pressure Down initiative of the American Medical Group Association provides some key patient information about hypertension, including normal and dangerous ranges of blood pressure—numbers patients should be familiar with.
- A map from the Institute for Health Metrics and Evaluation at the University of Washington shows hypertension levels for 2001 to 2009 by race and gender.
University of Maryland Study Shows Need for Improved Communication by Dental Professionals
New research from the University of Maryland School of Public Health found that a majority of dentists and dental hygienists are not regularly using recommended communication techniques with their patients that can contribute to improved oral health literacy and prevention of oral disease. The researchers, who published their findings in the Journal of Dental Hygiene, surveyed 540 Maryland dental hygienists to determine the frequency of the use of 18 recommended communication techniques to effectively communicate science-based information to patients. Only one basic technique—use of simple language—was used by more than 90 percent of dental offices, according to survey responders. The survey also found that dental professionals who had taken a communication course in a non-dental educational setting were more likely to regularly use varying types of communication techniques. Read more on health literacy.
Study: Online Medical Searches Not a Good Idea for People Who Struggle With Uncertainty, Anxiety
People who struggle with uncertainty and anxiety might want to stay away from online health information searches, according to a new study in the journal Cyberpsychology, Behavior and Social Networking. The study, which included 512 healthy men and women with a mean age of about 33, analyzed how online searchers affected their anxiety, as well as their reactions to statements such as "I always want to know what the future has in store for me" and "I spend most of my time worrying about my health." "If I'm someone who doesn't like uncertainty, I may become more anxious, search further, monitor my body more, go to the doctor more frequently—and the more you search, the more you consider the possibilities," said Thomas Fergus, an assistant professor of psychology and neuroscience at Baylor University. "If I see a site about traumatic brain injuries and have difficulties tolerating uncertainty, I might be more likely to worry that's the cause of the bump on my head." These persistent worries can increase the likelihood of worrying about potential medical bills, disability and job loss, which in turn can lead to even more online searches, doctors visits, unnecessary medical tests and stress. Read more about technology.
Study: TV Drug Ads Are Often Misleading
A study on the veracity of television drug ads by researchers at Dartmouth and the University of Wisconsin-Madison found that six out of 10 claims could potentially mislead a viewer. The study was published in the Journal of General Internal Medicine. The researchers found misleading claims among television ads for both prescription and nonprescription drugs, and that some of the ads omitted or exaggerated information. The researchers studied the 6:30 to 7 p.m. portion of nightly news broadcast, which often contains drug ads, and reviewed 168 different drug advertisements that aired between 2008 and 2010. Trained researchers classified the ads as truthful, potentially misleading or false. The researchers found only one in ten claims were false, while six in ten were misleading and included errors such as leaving out important information, exaggerating information, providing opinions or making meaningless associations with lifestyles. Read more on prescription drugs.
A recent survey by the American Institute of Certified Public Accountants (AICPA) found that more than half of about 1,000 American adults polled could not correctly define common health insurance financial terms such as premium, deductible or copay. That’s concerning considering that opening day to sign up for health insurance under the Affordable Care Act is October 1. “Half of Americans would fail health insurance 101,” said Ernie Almonte, CPA, chair of the Institute’s National CPA Financial Literacy Commission. “That’s critical insight as consumers prepare to make important decisions with implications for both their physical and fiscal well-being,” says Almonte. “Americans need to take time in the coming weeks to familiarize themselves with key terms and assess their needs so they make the best decisions for their health and financial situations.”
Knowing what the terms mean can help people make informed choices when they sign up for health insurance. For example, a copay is the out of pocket cost to a patient for a health service. Choosing a plan with lower co-pays can help individuals save money, according to the Institute.
The survey found that people with high school diplomas or less education were significantly more likely than those with a college education to be unable to define financial health terms. The survey also found that 41 percent of responders said they were not at all knowledgeable about the Affordable Care Act; just under half of responders said they thought they were somewhat knowledgeable.
International Making Cities Livable Conference: UCLA’s Richard Jackson on Shaping Healthy Suburban Communities
"We have medicalized what is in fact an environmental-driven set of diseases," said Richard Jackson, MD, MPH, professor and chair of environmental health science at the UCLA School of Public Health, in a keynote presentation that energized and galvanized discussion among the diverse audience of city planners, architects and public officials at this week’s International Making Cities Livable Conference. This year’s conference focuses on bringing together a vision— across sectors—of how to shape healthy suburban communities.
Jackson, a prominent pediatrician and host of the “Designing Healthy Communities” series that aired on PBS, told an all-too-familiar story of a child who comes into a doctor’s office overweight and with alarming cholesterol and blood pressure results even at a young age. So the doctor prescribes behavior change: No soft drinks in the house. No screens in the bedroom. Exercise, do more, and come back in two months. In two months, what’s changed? Nothing. The food at school is still unhealthy, the neighborhood is still unsafe to play in and the family still uses the car to get absolutely everywhere because there is no other choice. The likely outcome for that child and so many others, said Jackson, is to end up on costly cholesterol medication just two months later when the child’s vital statistics continue to spiral out of control.
"It’s a 20th century idea that our minds are separated from our bodies, and our communities are separated from ourselves,” he Jackson, who reminded the crowd that the most critical health advancements in the last century took place because of changes in infrastructure, not medicine—primarily new sanitary standards to curb out-of-control infectious disease.
Now, said Jackson, “We’ve built America around the car” and we need a whole new set of infrastructure changes to re-build communities that offer better opportunities for health as part of everyday life. “The built environment is social policy in concrete.”
“We know PSA campaigns can make a big impact; that they can improve people’s lives.”
The Advertising (Ad) Council has just launched a new version of its digital distribution platform, PSA Central, which is geared toward PSA directors and media outlets, but is also valuable for anyone who wants to share the messages including educators and public health practitioners. The site offers easy access to video, print, radio, online, mobile and outdoor media public service advertisements that range from bullying prevention to food safety education.
Public Service Advertisements (PSAs) may actually date back to the civil war when newspapers offered free advertising space to the U.S. government to advertise bonds whose revenues were used to pay for the war effort. These days, PSAs are much more likely to be public safety messages such as a United Kingdom video PSA, downloaded over 2 million times on YouTube, reminding people just why they should buckle up in a car. And more importantly, these efforts are being measured and tracked to show impact on health behavior change and health outcomes, such as the Ad Council’s drunk driving prevention campaign that has encouraged 70 percent of Americans to take action to stop a friend from driving drunk.
NewPublicHealth recently spoke with Peggy Conlon, president and CEO of the Ad Council, about the public health messages PSAs can convey and how new media has expanded their reach.
NewPublicHealth: How have PSAs evolved over the years?
Peggy Conlon: PSAs have evolved quite a bit. The Ad Council is 71 years old and back in the earliest days PSAs were seen in newspapers and heard over the radio. Since then they have been showcased on just about all media platforms. In the 90s we were introduced to the Internet and everything changed forever. The Internet added another new dimension to our ability, in a very tangible and personal way, to engage communities around social issues.
NPH: What are some of the most effective and iconic campaigns in public service advertising?
In an interview with NewPublicHealth last year, Yvette Roubideaux, MD, MPH, head of the Indian Health Service, spoke about the need for "cultural humility" as stakeholders and partners work to improve healthier lifestyles in cultural and ethnic communities throughout the United States. A five-year-old program in Prince Georges County, Md., does just that. Building on the quinceañera, the traditional coming of age party for many fifteen-year-old girls of Latino heritage, Mis Quince Años (“My Fifteen Years”) is a program run by the county’s Parks and Recreation Department that offers writing and speaking seminars and teaches the girls about health and fitness, their culture, college preparation and provides service programs in their communities.
>>Read more about the program in the Washington Post.
Students at the Yale School of Public Health teamed up with fellow classmates at the university’s School of Art to develop original public health posters. The goal was to provoke awareness, stimulate thought and change behavior on health issues such as obesity, breast cancer screening, and self-respect and child development.
The posters were the idea of School of Public Health Assistant Professor Catherine Yeckel, who challenged students to apply and translate theoretical scientific knowledge into a public health campaign to educate the public on a specific health topic.
“The progression from complex to simple communication, letting the image speak, was probably the most powerful insight for all the groups,” says Yeckel. “In my mind, gaining this insight becomes the launching point for tackling a public-health campaign and movement.”
Fourteen pairs of public health/art students worked together. The Connecticut State Office of Health Reform and Innovation will display the posters beginning in July, and a tour of other communities is expected after that.
Bonus view: The World Health Organization has just released a video to raise awareness about malaria called T3 (Test. Treat. Track) that, like the Yale posters, uses few words but imparts a powerful message.
Weigh In: What messages have been effective in your community?
Investigators from The Centers for Disease Control and Prevention boarded a plane to examine—and then release—a woman with a rash who arrived back in the US from Uganda late last week. The immediate concern had been monkey pox, a sometimes fatal infectious disease that is similar to smallpox, but CDC investigators say her symptoms were not consistent with the illness. News sources say her rash was likely the result of bed bug bites
Parents with math skills at the third grade level or below were five times more likely to measure the wrong dose of medication for their child than those with skills at the sixth grade level or higher, according to a study presented at the Pediatric Academic Societies (PAS) annual meeting in Boston.
Researchers say dosing liquid medications correctly can be especially confusing because parents have to read and understand dosing for different ages and weights and understand the measurement markings on dosing cups, droppers and syringes.
A new study by researchers at the Columbia University Mailman School of Public Health found that text message reminders to parents about flu vaccinations may help boost the number of children vaccinated. The study was published in the Journal of the American Medical Association and followed 9,213 children and adolescents ages six months to 18 years—primarily from minority households. Parents of children assigned to the text-message intervention received up to five weekly texts providing educational information and instructions on where the vaccinations were administered. Everyone in the study received an automated telephone reminder, and access to informational flyers posted at the study sites.
At the end of the study, a higher proportion of children and adolescents in the intervention group (43.6 percent) than in the control group (39.9 percent) had been vaccinated against the flu.