Category Archives: Mortality
Strokes Fall Among Older Americans
Fewer older Americans are having strokes and those who do have a lower risk of dying from them, according to researchers at the Johns Hopkins Bloomberg School of Public Health. The study, published in JAMA, followed close to 15,000 stroke-free patients ages 45 to 64, beginning in the 1980s and ending in 2011. It found a 24 percent overall decline in first-time strokes in each of the last two decades and a 20 percent overall drop per decade in deaths after stroke. However, the decline was found mainly in people over age 65, with little progress in reducing the risk of strokes among younger people. The researchers say the decrease in stroke incidence and mortality is partly due to more successful control of risk factors such as blood pressure, smoking cessation and use of statin medications for controlling cholesterol, but that more efforts are needed to reduce strokes in younger people, including reducing obesity and diabetes and increasing physical activity. Read more on mortality.
Study: Insufficient Sleep Can Harm Memory
Lack of sleep, currently considered a public health epidemic in the United States, can also lead to errors in memory, according to a new study in Psychological Science. The study found that participants who didn’t get a full night’s sleep were more likely to make mistakes on the details of a simulated burglary they were shown in a series of images. “We found memory distortion is greater after sleep deprivation,” said Kimberly Fenn, an associate professor of psychology at Michigan State University and a co-investigator of the study. “And people are getting less sleep each night than they ever have.” The U.S. Centers for Disease Control and Prevention has linked the insufficient sleep epidemic to car crashes, industrial disasters and chronic diseases such as hypertension and diabetes. Read more on mental health.
The U.S. Environmental Protection Agency (EPA) has recently released a new graphic design available for use by insect repellent makers to more easily show how long the product is effective. “We are working to create a system that does for bug repellents what SPF labeling did for sunscreens,” said Jim Jones, Assistant Administrator of the Office of Chemical Safety and Pollution Prevention. “By providing vital information to consumers, this new graphic will help parents, hikers and the general public better protect themselves and their families from serious health threats caused by mosquitoes and ticks.” The release of the graphic design was accompanied by a joint statement from the EPA and the U.S. Centers for Disease Control and Prevention (CDC) urging the public to use insect repellents and take other precautions to avoid biting insects that carry serious diseases, including Lyme and West Nile virus. Incidence of insect-borne diseases is on the rise, according to the CDC. In order to place the new graphic on their labels, manufacturers must submit a label amendment, including test results on effectiveness. The public could see the graphic on repellent products early next year. Read more on infectious disease.
Study: Family Stress Can Impact Mortality Risk
Stressful family situations can significantly increase the risk of death, according to a new study in the Journal of Epidemiology and Community Health. Using health data on 9,875 men and women aged 36-52 years from The Danish Longitudinal Study on Work, Unemployment and Health, researchers determined that frequent worries and/or demands from a partner or children were linked to a 50-100 percent increase in mortality risk, and that frequent conflicts with any type of social relation were linked to a 2-3 times increase in mortality risk. Researchers also concluded that people outside the labor force were at higher risk of exposure to stress family situations. Read more on mortality.
National Task Force Recommends Regular Hep B Screening for People at Highest Risk
The U.S. Preventive Services Task Force is recommending regular screening for all people at high risk for contracting hepatitis B virus. If left untreated, the chronic illness can lead to liver cancer. Among the groups that the national panel says should be screened are:
- People born in countries with a high rate of infection, mainly in Asia, sub-Saharan Africa, the Pacific Islands, the Middle East and Eastern Europe.
- Those who share risk factors similar to those for HIV, including injection drug users, men who have sex with men, and people living with or having sex with someone with a hepatitis B infection.
- Patients with a weakened immune system or who are undergoing treatment for kidney failure.
"We have treatments that are effective at suppressing the virus and at improving abnormalities in the liver, so we can prevent some of the damage that occurs due to chronic hepatitis B," said Roger Chou, MD, an assistant professor at Oregon Health & Science University in Portland and director of the Pacific Northwest Evidence-based Practice Center, as well as lead author for the evidence review that formed the basis of the task force's recommendation. Read more on infectious disease.
Fewer Smokers See E-cigarettes as a Safer Smoking Alternative
While the national profile of e-cigarettes continues to increase, smokers are also increasingly less likely to view them as safer than traditional cigarettes, according to a new study in the American Journal of Preventive Medicine. Using data collected from the Health Information National Trends Survey (HINTS), researchers determined that awareness of e-cigarettes rose to 77.1 percent in 2013 from 16.4 percent in 2009. However, while 84.7 percent of smokers in 2010 viewed e-cigarettes as less harmful than traditional cigarettes, that number was down to 65 percent in 2013. Current estimates are that c-cigarette sales will soon reach $1.7 billion annually, or approximately 1 percent of all U.S. cigarette sales. Read more on tobacco.
AAP: Children Should Be Immunized Against Influenza As Soon As Possible this Season
Parents and caregivers should have all children ages 6 months or older immunized against influenza as soon as possible, according to new updated recommendations from the American Academy of Pediatrics (AAP). Immunization options include the trivalent vaccine that protects against three influenza strains and the new quadrivalent vaccine that protects against four strains. “Parents should not delay vaccinating their children to obtain a specific vaccine,” said pediatrician Henry Bernstein, DO, FAAP, the lead author of the flu recommendations. “Influenza virus is unpredictable, and what’s most important is that people receive the vaccine soon, so that they will be protected when the virus begins circulating.” Other vulnerable groups that should definitely be vaccinated include children with chronic health conditions, children of American Indian or Alaskan Native heritage, health care workers, pregnant women, women who may become pregnant or are breastfeeding and people who have contact with children in high-risk populations. The U.S. Centers for Disease Control and Prevention estimates that between 135 million and 139 million doses of vaccine will be manufactured for the 2013-14 influenza season. Read more on influenza.
HUD: $37M to Oklahoma for ‘Unmet Needs’ of Disaster Recovery
The U.S. Department of Housing and Urban Development (HUD) has allocated approximately $37 million in disaster recovery funds for the state of Oklahoma and the City of Moore, Okla., which were severely damaged by extreme storms—including an EF5 tornado—on May 20. Dozens were killed and more than $1 billion in property damage was caused. The grants are part of HUD’s Community development Block Grant Program, which supports long-term disaster recovery efforts in places of “unmet need.” “The May storms cost the lives of dozens of Oklahomans and over $1 billion in property damage. “We are steadily rebuilding, but many families are still struggling to get back on their feet,” said Oklahoma Governor Mary Fallin. “The disaster relief grants provided by HUD—along with continued work from state and local governments and non-profits—will make a big difference in the lives of those affected by this year’s tornadoes. They will be particularly helpful as we work to provide assistance to low income Oklahomans, many of whom are uninsured.” About $26.3 million of the funds will go toward Moore, with the rest going toward the state. Read more on disasters.
Boys Faced Higher Death Risk than Girls from Multiple Causes
Boys on average face a higher risk of death than girls—not just from traumatic events such as accidents, homicides and suicides, but also from cancers and diseases of the heart, lungs and nervous system. The study found that from 1999 to 2008 there were about 76,700 more deaths among boys than girls, and that boys from infancy to age 20 were 44 percent more likely to die. The findings appear in the latest edition of the journal Pediatrics. The findings are not entirely surprising, as past research has indicated that girls have a certain survival advantage and experts already knew that boys are at increased risk of developing certain chronic health conditions. Still, the question is why. "This could be a story of resilience and ability to overcome," said study author Chris Feudtner, MD, a pediatrician at the Children's Hospital of Philadelphia. "Maybe there's some robustness factor that males are missing." Feudtner said that learning why boys faced these higher risks—and for chronic diseases in particular—could help health care experts better understand and treat the conditions. Read more on mortality.
Much Like Television, Excessive Cell Phone Use Lowers Fitness Levels
Are you reading this on your smartphone? If so, it’s probably not doing your weight any good. A new study in the International Journal of Behavioral Nutrition and Physical Activity has linked cell phone use by college students to decreased physical activity and fitness levels. Much like watching television, cell phone use is a largely sedentary activity that is easy to get lost in. It can also lead to casual overeating. Researchers found the average student spent about five hours on the phone each day and sent hundreds of text messages. "We have to look at this similar to what happened in the industrial revolution and how it changed us," said Nancy Copperman, director of public health initiatives at North Shore-LIJ Health System, in Great Neck, N.Y. "A study like this raises the importance of how this technology affects how we move, eat and sleep. We have to look at the impact of technology on our health." Read more on technology.
Study Links Bipolar Disorder, Early Death
A new study showing that people with bipolar disorder are more likely to die early and from a variety of causes also illustrates the difficulty of treating the physical effects of the illness. "Whatever we're doing, these people are not dying (just) because of suicide. That's not the reason for increased mortality. That's a hard thing to get across," said David Kupfer, PhD, a professor of psychiatry at the University of Pittsburgh School of Medicine, who was not a part of the study. The study found that people with bipolar disorder—an estimated 1 to 5 percent of the global population—die about nine years earlier and are at higher risk for heart disease, diabetes, chronic obstructive pulmonary disorder, the flu and pneumonia. However, people who knew they were bipolar had the same death rates as those who were not, which suggests "that timely medical diagnosis and treatment may effectively reduce mortality among bipolar disorder patients to approach that of the general population," according to the study. Read more on mental health.
One Dose of ADHD Medication Improves Balance in Older Adults
A single dose of an attention deficit/hyperactivity disorder (ADHD) medication can improve the balance of older adults who have difficulty walking, according to a new study in The Journals of Gerontology. Methylphenidate (MPH) is also used to treat narcolepsy. Researchers at Ben-Gurion University of the Negev found that it can reduce the number and rate of step errors in both single and dual tasks. "Our results add to a growing body of evidence showing that MPH may have a role as a therapeutic option for improving gait and reducing fall risk in older adults," said Itshak Melzer of BGU's Schwartz Movement Analysis and Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences. "This is especially true in real-life situations, where the requirement to walk commonly occurs under more complicated, 'dual task' circumstances with cognitive attention focused elsewhere (e.g., watching traffic, talking) and not on performing a specific motor task." Read more on aging.
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.
A new analysis of mortality data from the University of Washington School of Public Health has found that the life span for women in the United States is improving at a much slower rate than men’s. Researchers analyzed population data by gender, race and county from 1989 to 2009 and found that in 661 counties, primarily in the southeast, the life spans of women had stopped increasing or actually decreased. There are about 3,000 U.S. counties in total.
According to the review, men on average now live to 76.2 years while women live to 81.3 years. That was a gain of 4.6 years for men over the last 20 years, but a gain of only 2.7 years for women. Factors cited by the researchers for the reported changes include high blood pressure, high cholesterol, obesity and tobacco and alcohol use. Read about related county-level data from the County Health Rankings, which ranks the health of nearly every county in the nation and shows that much of what affects health occurs outside of the doctor’s office.
The Campaign for Disability Employment, a collaborative of disability and business organizations, has selected the winners in a contest that called for videos to showcase skills offered by people with disabilities, and common misconceptions about disability employment. Among the winners: a video about a disabled school cafeteria employee, Margaret, who helped a child who was choking. Watch the videos and vote for your favorites. The two top winners receive $250 each. Read more on disability.
Poison centers throughout the nation are reporting an uptick in calls about young children swallowing single-use packets of laundry detergent. Some children have become very ill and required hospitalization. “The rapid onset of significant symptoms is pretty scary,” said Dr. Michael Beuhler, medical director of the Carolinas Poison Center. “Other laundry detergent [products] cause only mild stomach upset or even no symptoms at all. Although we aren't certain what in the product is making the children sick, we urge all parents and caregivers to make sure laundry detergent packs are not accessible to young kids.”
- Read a fact sheet from the Association of Poison Control Centers on the growing concern, which includes a photo of the packaging.
- Read a use guide on the single-use products, including several warnings, from a laundry product trade association.
Read more on product safety.
People with higher levels of education and income have lower rates of many chronic diseases compared to those with less education and lower income levels, according to Health, United States, 2011—the annual report on Americans’ health, produced by the National Center for Health Statistics.
This year’s report includes a special section on socioeconomic status and health. Findings include:
- In 2007-2010, higher levels of education among the head of household resulted in lower rates of obesity among boys and girls ages two through 19, compared to families where the heads of households who had less than a high school education.
- In 2007-2010, women 25 years of age and over with less than a bachelor’s degree were more likely to be obese (39 percent-43 percent) than those with a bachelor’s degree or higher (25 percent).
- In 2010, 31 percent of adults 25-64 years of age with a high school diploma or less education were current smokers, compared with 24 percent of adults with some college and 9 percent of adults with a bachelor’s degree or higher.
- Between 1996-2006, the gap in life expectancy at age 25 between those with less than a high school education and those with a bachelor’s degree or higher increased by 1.9 years for men and 2.8 years for women.
Read more on poverty and health.
The Arthritis Foundation has released a new report, Environmental and Policy Strategies to Increase Physical Activity among Adults with Arthritis, to help increase physical activity among people with arthritis. The new report is aimed at health agencies, businesses, recreation facilities, and others to help meet the exercise needs of people with the condition.
Arthritis affects 50 million adults in the United States—more than 20 percent of the adult population and that number is expected to grow. According to the report, people with arthritis have disease-specific barriers to being physically active including pain, fear of making their arthritis worse, lack of knowledge about the best type and amount of exercise, and fear of injury. Physical activity, however, has been shown to help decrease pain, delay the onset of disability, improve physical functioning and independence, and enhance the mood and quality of life for adults with arthritis. Read more on physical activity.
Residents in 25 states and the District of Columbia are breathing a little easier these days.
Since 2000, their governments have enacted smoke-free laws that apply to all workplaces, restaurants and bars, according to a report released last week by the Centers for Disease Control and Prevention.
“The new report underscores the strong momentum across the country to pass smoke-free workplace laws that protect all workers and the public from the serious health hazards of secondhand smoke,” says Matthew Myers, president of the Campaign for Tobacco-Free Kids.
The report projects that, at the current rate of progress, the entire nation could have laws banning smoking in all indoor areas of private sector worksites, restaurants and bars by 2020. These places are major sources of secondhand smoke exposure.
“As the U.S. Surgeon General and numerous scientific studies have found, smoke-free laws protect health without harming business,” said Myers.
In addition, polls and ballot initiatives repeatedly have shown that the public strongly supports smoke-free laws that apply to all workplaces and public places and protect everyone’s right to breathe clean air. (RELATED: See our interactive tobacco control map.)
“Every state should enact such a law,” Myers said.
For additional perspective on the CDC report, NewPublicHealth spoke with Maggie Mahoney, Deputy Director of the Tobacco Control Legal Consortium. The Consortium is a partner of the Public Health Law Network and is funded by the Robert Wood Johnson Foundation.
NewPublicHealth: Are all the laws that have been enacted the best they can be, or could some be strengthened?
Maggie Mahoney: As the CDC's report notes, the U.S. Surgeon General found in 2006 that no level of exposure to secondhand smoke is safe. It is for this reason that the public health community strives to pass smoke-free laws that — at a minimum — prohibit smoking in enclosed public places and in enclosed places of employment. A number of jurisdictions have gone beyond this minimum level of protection and have passed laws that prohibit smoking in certain outdoor areas where people gather or work, due to evidence that secondhand smoke does not necessarily dissipate quickly in outdoor areas where people are smoking.
A number of the existing laws were passed before the 2006 Surgeon General's Report [on secondhand smoke] was released, and could be strengthened to reflect the current science on this issue.
NPH: How hopeful are you that states that have not yet passed smoke-free laws will do so, and soon?
Mahoney: The public health community is dedicated to reducing tobacco use — the single most preventable cause of disease, disability and death in the United States — as well as reducing exposure to secondhand smoke, which causes 3,000 nonsmoking Americans to die of lung cancer and 46,000 to die of heart disease each year. Those facts alone should compel all — and have caused many — lawmakers to pass strong smoke-free laws. Other lawmakers have been persuaded by data showing that tobacco use results in medical costs of $96 billion per year and lost productivity costs of $97 billion per year; that smoke-free laws do not negatively impact business revenues; and that courts have found that passing smoke-free laws is an appropriate use of the government's police power. In some jurisdictions where lawmakers have hesitated to act, the public has gone to the ballot to demand to be free of exposure to secondhand smoke. There has been tremendous progress in passing smoke-free laws, especially in recent years. This turning of the tide shows that it is only a matter of time before the remainder of the United States population is protected from exposure to secondhand smoke.
NPH: And are there any concerns that states with smoke-free laws could weaken or repeal them?
Mahoney: Any law that is passed has the threat of being repealed. Additionally, weak laws are still being passed in some jurisdictions — and some strong laws currently are facing the threat of being watered down — due to misperceptions by legislative bodies about the dangers of secondhand smoke; the desire of their constituents to breathe smoke-free air in their workplaces and in places they visit; or the potential effects on business revenues.
We've seen a couple of instances at the local level where smoke-free ordinances were repealed before they went into effect, and a few attempts at the state level to put repeal measures on the ballot. For example, in Campbell County, Ky., the ordinance was passed shortly after an election, but before the new county officials took office. The new county officials repealed the ordinance before it went into effect. And in South Dakota a smoke-free law was scheduled to go into effect in 2009, but implementation was put on hold after opponents put a repeal measure on the ballot. In November 2010, the citizens of South Dakota voted against the repeal attempt and decided to keep the smoke-free law. These situations are rare. It is more typical to see attempts to reopen smoke-free laws to add language allowing smoking in certain types of venues.
NPH: What are the sorts of questions you’ve been fielding on smoke-free laws recently?
Mahoney: Just in the last two weeks, we've reviewed draft amendment language that is being considered by a state legislature and discussed the ramifications of those possible amendments with public health advocates; researched penalty provisions in a draft local ordinance, to see whether they are consistent with state law; and conducted research to help a governmental attorney prepare her brief in a court case where a bar owner is arguing that a smoke-free law should be overturned.
A YMCA survey of over 1,500 U.S. parents of children ages 5-10 finds that only 15 percent make their kids' physical fitness a top priority.
Preliminary study by researchers at the Kansas City University of Medicine and Biosciences finds babies of women who did aerobic exercise during pregnancy had healthier hearts compared to babies of moms who didn’t.
Beyond BPA: Could 'BPA-Free' Products Be Just as Unsafe? (The Atlantic)
There are the new plastics on the market for BPA-free bottles, can liners, and other such products. But because the U.S. system of regulating chemicals relies primarily on information supplied by a material's manufacturer, we know relatively little about these new plastics.
A Lancet study finds that U.S. stillbirth rate has dropped, but is still high.
Preliminary study by researchers at University Hospitals Rainbow Babies and Children's Hospital in Cleveland finds a higher rate of non-accidental head trauma in babies for the 31 months of the recession period (December 2007 to June 2010) compared with 72 non-recession months (December 2001 to November 2007).
Health Cost Containment Options Might Save $480 Billion (Kaiser Health News)
Details from the president's deficit reduction speech from yesterday concerning health care.
Weight loss is an important goal, but it’s only part of the health equation. The National Center for Health Statistics (NCHS) has released new data that gives an even more compelling reason to get the public moving — it may extend lives.
A study published today (pdf) in the American Journal of Preventive Medicine found that following federal guidelines for physical activity may lead to longer life. The NCHS study examined the exercise habits of nearly 250,000 Americans and covered how often they did aerobic and strength-training activities.
The risk of dying prematurely was 27% lower for healthy adults who followed the activity guidelines. For adults suffering from chronic disease, following the activity guidelines had an even stronger impact — helping reduce the risk of dying prematurely by almost half.
The guidelines call for adults to do moderate-intensity aerobic exercise at least 150 minutes per week or vigorous-intensity aerobic exercise at least 75 minutes per week. In addition, they call for strength-training activities at least twice a week.
The recently released 2011 County Health Rankings include increased physical activity as one of the action items that counties can implement to improve the overall health of their community.
The Rankings – in their second year – help counties understand what influences how healthy residents are and how long they will live. The Rankings look at a variety of measures that affect health, such as the rate of people dying before age 75; high school graduation rates; access to healthier foods; air pollution levels; income; and rates of smoking, obesity and teen births.
Lincoln County, Neb., – for example – made increased physical activity a priority after the 2010 County Health Rankings placed it 54th out of 55 counties on the important measure of health behaviors.
QUESTION: Now that spring has arrived, what plans do you and your community have to encourage physical activity?