Category Archives: Prevention
Construction Workers Frequently Impacted by Pain and Stress
Construction workers are frequently stressed about work-related injuries and pain, but often fail to get help for either, putting themselves at risk for additional injuries and mental health issues, according to a new study in the Journal of Occupational and Environmental Medicine. The researchers, based at the Harvard School of Public Health, reviewed data compiled by the School’s Center for Work, Health and Wellbeing and found that the construction industry has one of the highest rates of work-related injuries and suicides in the U.S. workplace, as well as a high prevalence of musculoskeletal pain among its workers. The researchers also conducted a mental health survey of 172 New England construction workers at four construction sites. Sixteen percent of the workers reported being distressed, 75 percent had experienced musculoskeletal pain over the previous three months and 42 percent reported one or more work injuries in the preceding month. A follow-up survey found that more than half of those who previously said they felt distressed had not sought professional help—likely, say the researchers, because of fear of stigmatization or job loss. Read more on injury prevention and mental health.
USPSTF: Cannot Recommend For, or Against, Vitamin Supplements to Help Prevent Cancer, Heart Disease
Citing the fact that there is simply too little evidence to make a conclusion either way, the U.S. Preventive Services Task Force (USPSTF) has concluded at this time that it can’t recommend for or against taking vitamin and mineral supplements to help prevent cancer and heart problems. In a draft statement, the panel also ruled that neither beta-carotene nor vitamin E should be taken to prevent heart disease or cancer; beta-carotene was previously found to exacerbate the risk of lung cancer for people who were already at high risk. The researchers analyzed data from 26 studies between January 2005 and January 2013, which included people across an array of demographics, finding no difference between those who took the supplements and those who took placebos. Vitamin supplements are a $12 billion per year industry in the United States. Read more on prevention.
Study: Simple Urine Test Could Identify Young Type 1 Diabetes Patients with Highest Risk of Heart, Kidney Disease
A basic urine test could help doctors prevent heart and kidney disease in kids who are at higher risk due to their type 1 diabetes, according to a new study in the journal Diabetes Care. As many as 40 percent of youth with type 1 diabetes may be at increased risk for the health problems. Researchers at the University of Cambridge, in England, analyzed data on more than 3,300 diabetes patients between the ages of 10 and 16; an estimated 490,000 kids worldwide have type 1 diabetes. "Managing type 1 diabetes is difficult enough without having to deal with other health problems," study lead author David Dunger. "By using early screening, we can now identify young people at risk of heart and kidney disease. The next step will be to see if drugs used to treat heart and kidney disease—such as statins and blood-pressure-lowering drugs—can help prevent kidney and heart complications in this young, potentially vulnerable population.” Read more on pediatrics.
In the face of health care reform, funding challenges, and increased collaboration, public health faces a promising yet unclear future in terms of both financial support and program reach. On Saturday, the Robert Wood Johnson Foundation co-hosted a forum with the American Public Health Association (APHA) in advance of the APHA 2013 Annual Meeting to discuss these issues – and more. Leading minds from the fields of public health, government and business met to get to the bottom of a crucial question: how do we move public health forward?
In the opening session, Paul Kuehnert, Director of the Public Health Team at the Robert Wood Johnson Foundation, explained that the field’s challenge lies in “skating where the puck is going to be.” APHA Executive Director Georges Benjamin echoed that sentiment, nothing that the forum was “an opportunity to figure out where the public is going and then, when the wave comes, be right there to catch it.” The ensuing breakout sessions furthered this overarching theme with panels that discussed both the challenges they’ve faced -- and the opportunities they’ve found for success.
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Follow the coverage here.
Re-Thinking How We Pay for Public Health and Prevention
One panel discussed funding challenges that public health departments face and solutions that have been reached across the country. John Auerbach of Northeastern University’s Institute on Urban Health Research, and former health commissioner of Massachusetts, touched on health care reform as a vehicle for preventive care. “Nearly 75 percent of those insured in Massachusetts have had a preventive care visit in the last 12 months,” he explained. In other words, people who are insured are twice as likely to get care that could actually prevent them from getting sick, instead of having a treat a more serious illness. Auerbach also discussed development of the state’s Prevention and Wellness Trust Fund — a four-year, $60 million public health trust supported by a one-time assessment on health insurers and largest clinical providers. Auerbach stressed that this source of funding was important, particularly because it’s insulated from the variability of public funding and political tides.
By focusing on the critical services and programs that are truly necessary for the public health system to work, the Seattle and King County Health Department has developed a minimum package of public health services needed for all projects to success. David Fleming, Director and Health Officer in the Seattle/King County Health Department, and his staff determined the money needed to fund such a package in both per capita and overall costs. Washington State is now working with RWJF and other stakeholders to determine the feasibility of defining and costing these foundational services at the national level.
Study: Improved Layperson CPR Education Increases Bystander Intervention, Saves Lives
As many as 80 percent of cardiac arrests occur outside of a hospital, meaning that improving the layperson’s knowledge of cardiopulmonary resuscitation (CPR) could improve the odds of effective bystander intervention—and along with it the chances of survival, according to a new study in the Journal of the American Medical Association. "In many cases, time from recognition of cardiac arrest to the arrival of emergency medical services is long, leaving bystanders in a critical position to potentially influence patient prognosis through intervention before EMS arrival," according to the study. "However, only a minority of cardiac arrests receive bystander CPR." The study authors looked at a 10-year period of about 19,400 out-of-hospital cardiac arrests in Denmark, finding that as the percentage who received bystander CPR rose from about 21 percent to 45 percent, the rate of people who arrived alive to the hospital also rose from about 8 percent to 22 percent. Read more on heart health.
Post-menopausal Hormone Therapy Ineffective at Long-term Disease Prevention
Post-menopausal hormone therapy is not effective at the long-term prevention of heart disease and other chronic conditions, according to a new study in the Journal of the American Medical Association. The study a review of the Women's Health Initiative (WHI), which is a collection of U.S. trials established to assess the role of hormone therapy in preventing chronic diseases in more than 27,000 healthy, older women. They found that the benefits were minimal and were offset by concerns over complications such as elevated rates of blood clots and strokes. However, the findings do support the continued use of hormone therapy for the short-term treatment of hot flashes, as well as for “relatively younger women who use it for a finite time,” according to HealthDay. Read more on prevention.
Study: Exercise as Effective as Drugs at Treating Heart Disease
When it comes to treating heart disease, exercise may be just as effective as medication, according to a new study in the British Medical Journal. The researchers from Britain's London School of Economics and Harvard and Stanford universities said this means physical activity should also be included as a comparison during the development and testing of new medications, as the lack of its inclusion "prevents prescribers and their patients from understanding the clinical circumstances where drugs might provide only modest improvement but exercise could yield more profound or sustainable gains." Cardiovascular disease accounts for 17 million global deaths each year. Another recent study also reinforced the ability of exercise to help prevent high blood pressure. Read more on physical activity.
Public Health Accreditation Board Awards National Accreditation to Five High-Performing Health Departments
The Public Health Accreditation Board (PHAB) this week awarded five-year national accreditation status to five more public health departments. The decisions bring the number of public health agencies now recognized by PHAB as high-performing health departments to 19. PHAB is the independent organization that administers the national public health accreditation program, which aims to improve and protect the health of the public by advancing the quality and performance of the nation’s Tribal, state, local and territorial health departments.
Accreditation status was awarded Aug. 20 to:
- Central Michigan District Health Department, Mount Pleasant, Mich.
- Chicago Department of Public Health, Chicago, Ill.
- El Paso County Public Health, Colorado Springs, Colo.
- Kansas City Missouri Health Department, Kansas City, Mo.
- Tulsa Health Department, Tulsa, Okla.
Read more on accreditation.
Needlestick, Sharps-related Injuries Cost Health Care Industry $1B Every Year
Improved safety-engineered devices, combined with better education and techniques, could save the health care industry more than $1 billion in preventable costs every year, according to a Safe in Common review of U.S. healthcare industry statistics. With approximately 1,000 skin puncture injuries per day in U.S. hospitals, needlestick and sharps-related injuries affect more than half a million health care personnel every year—both physically and emotionally. "The desperate need for attention to the risk of needlestick injuries and their dangerous implications for both patients and personnel are startling when you look directly at the impact to healthcare costs," said Safe in Common chairperson Mary Foley, PhD, RN. "Learning how to permanently prevent these types of injuries—with more education and the introduction of advanced safety devices—will ultimately reduce a significant cost burden and, most importantly, the pain and emotional trauma that the needlestick victims and their families are enduring." Read more on prevention.
Study: Volunteering Linked to Greater Happiness, Longer Lives
Volunteering is not only linked to greater happiness and improved mental health, but could also help people live longer, according to a new study in the journal BMC Public Health. The analysis of 40 published studies found that volunteers had a 20 percent lower risk of death, as well as lower levels depression and increased satisfaction with their lives. "It is still unclear whether biological and cultural factors and social resources that are often associated with better health and survival are also associated with a willingness to volunteer in the first place,” said leader Suzanne Richards, PhD, of the University of Exeter Medical School in England. "The challenge now is to encourage people from more diverse backgrounds to take up volunteering, and then to measure whether improvements arise for them," she explained. People often cite a desire to give back to their community as a reason for volunteering; gaining work experience and meeting new people are also popular reasons. Approximately 27 percent of U.S. adults and 23 percent of European adults actively volunteer. Read more on aging.
The United Nations Foundation believes that, for the biggest public health obstacles facing the world, it will take all nations and all sectors working toward solutions to succeed. So the Foundation works to make that a reality, bringing together partnerships, growing constituencies, mobilizing resources and advocating policies that can help everyone—in both the developing and developed world.
NewPublicHealth recently spoke with Kathy Calvin, President and Chief Executive Officer of the United Nations Foundation, about the organization’s many efforts to improve health both globally and locally—and how these two goals can support each other.
NewPublicHealth: What changes have you seen in global health during your time in the field?
Kathy Calvin: The number of nonprofits dedicated to health issues has quadrupled it seems, and real progress has been made, which is the most important point—that we’re actually seeing a reduction in maternal deaths and newborn deaths and preventable diseases such as measles and diarrhea and pneumonia. I mean, there’s just been enormous progress, with still much more to happen. But it’s been an exciting time after what I think has been a pretty discouraging period where no amounts of foreign aid seemed to be making a difference. I attribute that partly to some innovations in research and financing, but also to the fact that a lot of governments in Africa actually have prioritized women and prioritized health in some pretty significant ways. And I think we’ve had a very enlightened government in the last five years here, too, in terms of what we’re doing overseas.
So, it’s been exciting to see it. Health is not my background. I’ve really been privileged to see both how serious and significant the challenges are, but also how much good can be done with just a little bit of organized effort.
NPH: When you talk about enlightened government, what are some examples? What is making the difference now?
Calvin: Well ironically it isn’t all that political. In fact, some of the biggest shifts took place under President George W. Bush’s administration with his creation of the President’s Malaria Initiative—until then, there had been zero real depth of interest and progress on malaria—as well as PEPFAR, which some people criticized because it was so bilateral, but it had a huge impact in allowing the current administration to really set some ambitious goals for reducing and eliminating parent-to-child transmission and setting that audacious goal of an AIDS-free generation.
Who better to offer up advice on summer sun protection than the Los Angeles County Health Department? Recently the department warned its residents to “practice summer sun smarts” to protect themselves from skin cancer, which, at 1 million diagnoses per year according to the Environmental Protection Agency, is now the most common form of cancer among Americans.
July is recognized as "UV Safety Month" to encourage everyone—not just those in Los Angeles—to protect themselves from ultraviolet (UV) rays, a major risk factor for most skin cancers, by using sunscreen and avoiding prolonged sun exposure during peak hours. “Simple sun safeguards can go a long way in protecting the health of you and your family this summer,” says Jonathan E. Fielding, MD, MPH, the departments’ director of public health.
In other summer sun safety news, this week the National Highway Traffic Safety Administration (NHTSA) and SAFE KIDS Worldwide partnered up to promote National Heatstroke Prevention Day this past Wednesday, July 31. NHTSA and their partners used this opportunity to educate parents on the dangers of leaving children in unattended vehicles in the summer heat, as there have already been over 20 heat-related deaths of children in cars this summer. Children’s body temperatures can spike three to five times faster than an adult’s, and even cool temperatures in the 60s can cause the temperature in the car to rise well above 110 degrees Fahrenheit—so safety steps are critical at all times.
Task Force Calls for Regular Lung Cancer Screening for Older, High-risk Patients
New recommendations from the U.S. Preventive Services Task Force call for annual lung cancer screenings for people ages 55-79 who smoked at least a pack of cigarettes a day for 30 years, or the equivalent (e.g., two packs a day for 15 years). Low-dose computed tomography (CT) scans utilize an X-ray machine to take a series of detailed pictures that can help identify smaller tumors earlier, allowing for earlier treatment and improved health outcomes. “Lung cancer is the leading cause of cancer death in the United States and a devastating diagnosis for more than two hundred thousand people each year,” says Task Force chair Virginia Moyer, MD, MPH. “Sadly, nearly 90 percent of people who develop lung cancer die from the disease, in part because it often is not found until it is at an advanced stage. By screening those at high risk, we can find lung cancer at earlier stages when it is more likely to be treatable.” Lung cancer kills about 160,000 Americans each year. Read more on tobacco.
Study Links Breastfeeding, Higher Intelligence in Kids
Children who breastfeed score higher on intelligence tests later in life, according to a new study in JAMA Pediatrics. Researchers found that for each month spent breastfeeding there were slightly higher results on the intelligence tests at ages three and seven, though not on tests of motor skills or memory. Mandy Belfort, MD, who led the study at Boston Children's Hospital, said the study accounted for parental intelligence and other home factors and provides parents with one more piece of important information when making a decision on the complex question of whether to breastfeed. "Given the size of the benefit, I think this should be helpful for women who are trying to make decisions about how long to breastfeed… because there are many factors that go into that decision," said Belfort. "You have to weigh that against the time that it takes, maybe the time that it takes away from work and your other family duties." Previous studies have linked breastfeeding to lower risk of ear and stomach infections, as well as eczema. Read more on infant and maternal health.
NCI: ‘Cancer’ May Need to Be Redefined
The dramatic increase in cancer screenings over the past few decades has resulted in overdiagnosis and overtreatment, in part because of confusion—by both patients and physicians—over which types of cancer are actually lethal and require immediate treatment. As a result, a panel of experts commissioned by the U.S. National Cancer Institute has recommended that the word “cancer” may need to be redefined to differentiate between lethal and indolent cancers. The recommendations were published in the Journal of the American Medical Association. "We're still having trouble convincing people that the things that get found as a consequence of mammography and PSA testing and other screening devices are not always malignancies in the classical sense that will kill you," said Harold Varmus, MD, director of the National Cancer Institute, to The New York Times. "Just as the general public is catching up to this idea, there are scientists who are catching up, too." Over the past several years the U.S. Preventive Services Task Force has also called for an end to regular mammography screening for women under 50, as well as the widespread use of PSA tests to identify prostate cancer. Read more on cancer.
This week’s International Making Cities Livable Conference brings together city officials, practitioners and scholars in architecture, urban design, planning, urban affairs, health, social sciences and the arts from around the world to share experience and ideas. We spoke with some of those diverse attendees to find out: what do they want the public health community to know about working across sectors to make communities healthier and more livable?
Alain Miguelez, City of Ottawa, Program Manager for Zoning, Neighbourhoods and Intensification
NewPublicHealth: What do you want public health to know about making communities more livable?
Miguelez: I want public health to know they’re at the heart of what we do. Usually urban planning is a pretty arcane thing. We’ve done a good job of making it tough for people to understand and relate to. They don’t have the patience. Public health brings it home. As we heard in a session this week, it’s not necessarily people who are disabled—it's the built environment that’s disabling.
It comes down to how you see yourself functioning in your daily life. We've made it impossible to function any way other than with a car. For some people that’s okay, but for those who’ve had a taste of something different, there’s no going back. As planners people don't trust us anymore. We’ve done a lot of things in the name of progress. We’ve disconnected people from the built environment and forced them into places that make people fat and depressed and disconnected and not well-functioning. People coo about Portland and its trams and light rail and walkability. That’s how cities are supposed to be. Everywhere else has got to come up to that standard.
When you see statistics on obesity or depression, it becomes critical, especially with kids. I have two kids and I see very clearly how the environment we build around us impacts how they grow up. It gives kids the tools to function as independent human beings. The right type of city building and suburban repair [with an eye toward public health] can do that.
HHS Updates Guidelines to Prevention Disease Transmission from Organ Transplants
The U.S. Department of Health and Human Services (HHS) has updated its guidelines on reducing unexpected disease transmission through organ transplantation. The 2013 PHS Guideline for Reducing Human Immunodeficiency Virus, Hepatitis B Virus and Hepatitis C Virus Transmission through Organ Transplantation updates the 1994 U.S. Public Health Service guidelines designed to improve patient safety. The recommendations include additional screening, revised risk factors and more sensitive laboratory testing. “Transmission of infections through organ transplants is a critical concern for patients, their families and healthcare personnel involved in transplant procedures,” said HHS Assistant Secretary for Health Howard K. Koh, MD, MPH. “Putting these new recommendations into practice will allow doctors and patients to make better, more informed decisions when accepting organs for transplantation.” Read more on prevention.
HUD: $40M in Housing Counseling Grants to Improve Choices, Opportunities
The U.S. Department of Housing and Urban Development (HUD) is providing $40 million in housing counseling grants to help people find housing, to make more informed choices and to improve their ability to keep their existing homes. The grants will help more than 1.6 million households via 334 national, regional and local organizations. “Make no mistake: these grants will do a lot of good,” said HUD Secretary Shaun Donovan in a release. “The evidence is clear that housing counseling works. These grants are a smart investment to help families and individuals find and keep housing which helps promote neighborhood stability in the long term.” Read more on housing.
Majority of Adults Unaware of their Whooping Cough Vaccination Status
As the number of U.S. cases of pertussis—or whooping cough—rises, many adults are completely unaware of their need to remain up to date on their vaccinations. Only 20 percent say they’ve received the vaccine within the past decade and more than 60 percent do not even know their vaccination status. The lack of adult vaccinations can increase transmission rates to children; the majority of whooping cough deaths are children younger than 3 months. "Teens and adults who have received the [whooping cough] vaccine are less likely to get whooping cough themselves, and therefore less likely to spread whooping cough to other people, including infants who have not yet been protected by the recommended [whooping cough] vaccinations," said Matthew Davis, MD, director of the new University of Michigan National Poll on Children's Health. Read more on vaccines.
While the U.S. Departments of Health and Human Services, Labor and the Treasury jointly released rules about workplace wellness programs under the Affordable Care Act (ACA) last week, the financial and health improvement value of the programs has not yet been proven, according to several panelists at a briefing late last week co-sponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation.
How effectively these programs work is especially important now: beginning in 2014, employers will be allowed to charge their workers up to 30 percent more for health insurance premiums if they don't meet certain health goals. Currently, nearly half of large companies offer wellness programs, which can range from smoking cessation programs to penalties for employees who don’t meet employer-defined health targets in such areas such as cholesterol, blood pressure, and Body Mass Index.