U.S. Spends More on Dementia than Either Heart Disease or Cancer
At as much as $215 billion annually, the cost of dementia care in the United States is now higher than the costs for either heart disease or cancer, according to a new study in the New England Journal of Medicine. That includes the costs for both professional and family care. And the costs will only rise as the population ages, with as many as 14 million Americans expected to have Alzheimer’s by 2050, according to HealthDay. "It's not a happy situation," said lead researcher Michael Hurd, a senior principal researcher at the nonprofit research institute RAND. "A lot of the costs fall on families, and right now, there's no solution in sight." Read more on aging.

Brain Stimulation Could ‘Turn Off’ Compulsive Drug-Taking
Targeting a specific region of the brain could help turn off addictive behavior, according to a new study in the journal Nature. Researchers at the Intramural Research Program of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and the University of California, San Francisco were able to reduce compulsive cocaine-seeking in rates by stimulating their prefrontal cortexes. They believe this technique could ultimately be used to stop compulsive drug-taking in humans. “We already knew, mainly from human brain imaging studies, that deficits in the prefrontal cortex are involved in drug addiction,” said NIDA Director Nora D. Volkow, MD. “Now that we have learned how fundamental these deficits are, we feel more confident than ever about the therapeutic promise of targeting that part of the brain.” Read more on addiction.

Study: Black Men Wait Longer to Begin Prostate Cancer Treatment
Black men wait longer than white men to begin prostate cancer treatment after diagnosis, according to a new study in the journal Cancer. Researchers at the University of North Carolina found a delay of seven days with early prostate cancer and nine days with aggressive prostate cancer. As the study looked at Medicare data, the researchers know all the men were insured so it wasn’t a lack of insurance stopping them from seeking treatment earlier. Multiple studies also show that black men in general are less likely to be screen for cancers and to receive aggressive treatment. "Now we have shown that African American patients also wait longer for treatment,” said study leader Ronald Chen, MD, an assistant professor at UNC's Lineberger Comprehensive Cancer Center. “I think all of these disparities together add up to contribute to worse long-term survival outcomes for African American patients." Read more on health disparities.

Folic Acid Supplements Early in Pregnancy May Reduce Risk of Autism by 40%
Prenatal folic acid supplements appear to reduce the risk for autistic spectrum disorders, according to a study in the Journal of the American Medical Association. The study included more than 85,000 babies born in Norway. Researchers noted prenatal eating habits of the mothers and followed up with families for three to ten years after birth to measure the development of autism spectrum disorders. A total of 270 cases were identified among the children in the study and a review by the researchers found that mothers who took folic acid supplements in early pregnancy had a 40 percent reduced risk of having children with autistic disorders. The researchers say that the timing of a mother’s intake of folic acid appears to be a critical factor. A child’s risk of autism was reduced only when the supplements were taken between 4 weeks before to 8 weeks after the start of pregnancy. Read more on maternal and infant health.

Prescription Drug Abuse Programs in Middle School Reduce Abuse Later in Life
A new study by researchers at the National Institutes of Health (NIH) found that middle school students from small towns and rural communities who were involved in community-based prevention programs were less likely to abuse prescription medications in late adolescence and young adulthood. The study was published in the American Journal of Public Health. According to the NIH, prescription drug abuse is one of the most serious public health problems in the United States.  In 2011, about 1.7 million people ages 12 to 25 abused a prescription drug for the first time, according to the National Survey on Drug Use and Health . “The intervention effects were comparable or even stronger for participants who had started misusing substances prior to the middle school interventions, suggesting that these programs also can be successful in higher-risk groups,” said Richard Spoth, PhD, of the Partnerships in Prevention Science Institute at Iowa State University and the lead author of the study. Those findings contrast with a recent study published by the Substance Abuse and Mental Health Administration that found that 12th grade dropouts have higher rates of cigarette, alcohol and illegal drug use. Read more on addiction.

New Study Shows Significant Health Benefits of Americans Reducing Their Sodium Intake
Hundreds of thousands of lives could be saved over 10 years if Americans reduced their sodium consumption to the levels recommended in federal guidelines, which would prevent many heart attacks and strokes, according to a new study by researchers at UC San Francisco, Harvard Medical School and Simon Fraser University in Canada. The study was published in the journal Hypertension. The study resulted from a workshop conducted by the U.S. Centers for Disease Control and Prevention which brought together scientists from the three universities. Each university group used different computer models to estimate the risk reduction of lowering sodium, but all found consistent, substantial benefits of reducing U.S. sodium consumption to a level close to the upper limit of the federal guideline of 2,300 mg/day.  According to the study, the overall average sodium consumption in the United States has been estimated at 3,500 mg/day, well above the upper limit of the level recommended by federal agencies and the Institute of Medicine. American men consume twice the recommended level on average. Read more on nutrition.

New York Announces Companies Reducing their Sodium Content
Earlier this week, the city of New York announced that  21 companies met one or more of their voluntary commitments to reduce sodium content  in pre-packaged or restaurant foods. Those reductions were the result of the National Salt Reduction Initiative (NSRI), the first-ever nationwide partnership to reduce sodium in the U.S. food supply. The NSRI is a nationwide partnership of more than 90 city and state health authorities and organizations coordinated by New York City since 2009. The NSRI’s goal is to cut excess salt in packaged and restaurant foods by 25 percent over five years through voluntary corporate commitments. Support for the initiative has come from the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, the W.K. Kellogg Foundation, the Robert Wood Johnson Foundation, the New York State Health Foundation and the National Association of County & City Health Officials. The project funding is administered by the Fund for Public Health in New York, a private non-profit organization that supports innovative initiatives of the New York City Department of Health and Mental Hygiene. Read more on prevention.

New Report Finds Underage Drinking in all States
More than a quarter of Americans who are legally too young to drink are doing so anyway, according to a new report issued today by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report says there has been progress in reducing the extent of underage drinking in recent years, especially among youth ages 17 and younger, but that the rates of underage drinking “are still unacceptably high.” Over 25 percent of people ages 12-20 report drinking in the month before they were surveyed, and 8.7 percent of them purchased their own alcohol the last time they drank. “Underage drinking should not be a normal part of growing up. It’s a serious and persistent public health problem that puts our young people and our communities in danger,” says SAMHSA Administrator Pamela S. Hyde. “Even though drinking is often glamorized, the truth is that underage drinking can lead to poor academic performance, sexual assault, injury, and even death.” All 50 states and the District of Columbia currently have laws prohibiting the purchase and use of alcoholic beverages by anyone under age 21. Find resources to prevent and treat underage drinking here. Read more on addiction.

Helmets Can Save Lives on the Slopes
Wearing a helmet while skiing or snowboarding can prevent injuries and reduce injury severity, according to a review article of 16 published studies in the Journal of Trauma and Acute Care Surgery. About 600,000 skiing and snowboarding injuries occur each year, according to reporting by Johns Hopkins researchers who wrote the new report. Up to 20 percent of those are head injuries, and 22 percent of those head injuries are severe enough to cause loss of consciousness, concussion or more serious injuries. Read more on injury prevention.

Study: Low-Level Air Pollution Impacts Fetal Growth
Exposure to low levels of air pollution seems to have a small effect on fetal growth, according to a study in the Puget Sound area by the University of Washington Schools of Public Health and Medicine and the Seattle Children’s Research Institute. The study looked at more than 367,000 births between 1997 and 2005 in the four-county Puget Sound region, including metropolitan areas Seattle and Tacoma, and estimated prenatal exposure to traffic-related air pollutants such as nitrogen oxide. The researchers found associations between increased levels of nitrogen dioxide exposures and an increased risk of small-for-gestational-age birth. Health problems for low birth weight babies can include decreased oxygen levels and low blood sugar, according to the researchers. Read more on maternal and infant health.

Third Vaccine Dose May Help Prevent Mumps Outbreaks
A third dose of measles-mumps-rubella (MMR) vaccine may have helped to control a mumps outbreak in a highly vaccinated New York community during 2009 and 2010, according to a new study, the first on the effects of a third MMR dose, published recently in Pediatrics. Most of the people in the community had received the two MMR doses currently recommended in the United States. In the outbreak community, a third-dose of MMR vaccine was offered to eligible 11 to 17-year-olds. After that intervention, mumps declined by 96 percent in the age group and by 75.6 percent in the community overall. Read more on vaccines.

Proximity to Bars May Increase Alcohol Consumption
A recent study in the journal Addiction finds that living close to a bar may increase the amount of alcohol that people drink. The study, conducted in Finland, found that when a person moved one kilometer (0.6 mile) closer to a bar, the odds of becoming a heavy drinker rose 17 percent. Read more on addiction.

Kid Screen Time Study Helped to Reduce Meals Eaten In Front of the TV
A new Pediatrics study finds that a program aimed at reducing the number of hours kids spend in front of televisions, computers and video games did not reach its goal of cutting screen time, but did reduce the number of meals children ate in front of the television. That may reduce childhood obesity rates, say the researchers from the Hospital for Sick Children in Toronto. Read more on obesity.

Young Blacks Living in Public Housing More Likely to be Smokers
A recent survey in three urban cities by a University of Missouri researcher found that young African-Americans who live in public housing communities are 2.3 times more likely to use tobacco than other African-American youth. The researchers say crime, poorer social relationships and high levels of stress may contribute to the increased smoking rate. The study was published in the journal, Addictive Behaviors. Read more on tobacco.

Study: Medicaid Expansion Improves Health
A new study in the New England Journal of Medicine by researchers at the Harvard School of Public Health found that expanding Medicaid to low-income adults leads to widespread gains in coverage, access to care, improved health and mortality reduction.

In the past decade, several states expanded Medicaid from its traditional coverage of low-income children, parents, pregnant women and disabled persons to include poor adults without any children living at home. The researchers analyzed data from three states—Arizona, Maine and New York—that had expanded their Medicaid programs to childless adults (aged 20-64) between 2000 and 2005 and compared outcomes with four neighboring states without major Medicaid expansions—New Hampshire (for Maine); Pennsylvania (for New York); and Nevada and New Mexico (for Arizona).

The researchers looked at data from five years before and after each state’s expansion. They found that, compared to the states that did not expand Medicaid, the Medicaid expansions in the three states were associated with a mortality reduction of 6.1%, which corresponds to 2,840 deaths prevented per year for every 500,000 adults gaining Medicaid coverage. Mortality reductions were greatest among older adults, non-whites and residents of poorer counties. Expansions also were associated with increased Medicaid coverage, decreased uninsurance, decreased rates of deferring care due to costs and increased rates of “excellent” or “very good” self-reported health. Read more on access to health care.

Use of Imaging as a Diagnostic Tool has Slowed
A new study published in Health Affairs finds that demand for new radiologists began declining in 2007 because of a decreased demand for imaging studies. The study authors found that use of magnetic resonance imaging (MRI) and computed tomography (CT) for patients in the United States slowed between 1 and 3 percent per year between 2006 and 2009, ending a decade of growth that had exceeded 6 percent annually. The authors say reasons for the decrease include the need for prior authorization for the tests, reduced reimbursement, increased cost sharing for patients and fears associated with radiation. Read more on radiation.

FDA Launches New Safety Measures for Extended-Release and Long-Acting Opioid Medications

The Food and Drug Administration has released a strategy for physician and patient education on extended-release and long-acting opioids.

The strategy is part of a federal initiative to address prescription drug abuse, misuse, and overdose. “The FDA’s goal is to ensure that health care professionals are educated on how to safely prescribe opioids and that patients know how to safely use these drugs,” said Margaret Hamburg, MD, who is head of the FDA.

More than 20 drug companies will be required to make education programs available to prescribers based on an FDA Blueprint, as well as FDA-approved patient education materials on the safe use of the drugs. The companies will be required to conduct periodic assessments of the programs which will be reviewed by the FDA.

Materials for physicians are expected to be introduced in March 2013. Read more on addiction.

Most Schools Don’t Train Staff about Teen Dating Violence

A new study in Pediatrics looks at the first national assessment of school counselors’ practices and perceptions of adolescent dating violence prevention and found that the majority of school counselors (81.3 percent) reported that they did not have a protocol in their schools to respond to an incident of dating violence. Ninety percent of school counselors reported that in the past two years, there had been no staff training to assist survivors of dating violence, and their school did not have a committee to address health and safety issues including dating violence. The schools did report that dating violence is an issue in their schools, however: the majority of school counselors (61 percent) reported that they had assisted a survivor of dating violence—usually female--in the past two years. The study researchers also found that school personnel who received formal training perceived dating violence to be a serious problem, and were significantly more likely to assist victims. Read more on violence.

Early Contact With a Dog or Cat Makes Kids Healthier

Children who have a dog or cat or are around dogs and cats during the first year of life are reported to be healthier and have fewer respiratory infections than children who don’t’ have contact to with these animals, according to a new study in Pediatrics. Researchers followed 397 children in Finland from pregnancy to the age of 1 year and found that children with early dog contact seem to have fewer respiratory infectious symptoms and diseases, especially ear infections, and needed a shorter course of antibiotics. Kids in houses with cats also showed benefit from contact with the pet, though not as much as with dogs.

The authors say contact with animals may have an influence on the maturation of the immune system which may lead to shorter infection periods and better resistance to respiratory infections during early childhood. Read more on maternal and child health.

American Cancer Society Requests Surgeon General Report on Health Impact of Sugary Drinks

The American Cancer Society Cancer Action Network has sent a letter to the Department of Health and Human Services requesting a report by the Surgeon General to examine how the consumption of sugar-sweetened beverages impacts the health of Americans. Read more on obesity.

New SAMHSA Report: Drug-Related Emergency Room Visits Down; Teen Drug, Tobacco Use Increases in Summer

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released two new reports on substance abuse. One finds that youth between the ages of 12 and 17 are far more likely to start using most substances during the summer than during other parts of the year. The second shows the rate of increase in drug-related emergency department visits slowed from an average annual rate of 18.2 percent in the years between 2005 and 2008, to an average annual rate of 6.1 percent in the years 2009 and 2010.

The youth and substance report also found that in June and July, an average of 5,000 youths smoke cigarettes for the first time, compared with the daily average of about 3,000 to 4,000 adolescents during the rest of the year. The same pattern holds true for first time use of cigars and smokeless tobacco among youth. Read more on substance abuse.

Recently Discharged Heart Patients Often Make Serious Mistakes with their Drugs

Many heart patients make mistakes with their medications after leaving the hospital that can lead to serious health risks, according to a new study in the Annals of Internal Medicine. The most vulnerable patients, according to the study, are older people, those with impaired cognitive function or low health literacy, or patients who are prescribed many, or high-risk drugs. Read more on heart health.

Methadone Linked to 30 percent of Prescription Painkiller Overdose Deaths

The prescription drug methadone accounted for 2 percent of painkiller prescriptions in the United States in 2009, but was involved in more than 30 percent of prescription painkiller overdose deaths, according to a Vital Signs report released by the Centers for Disease Control and Prevention (CDC).

CDC researchers analyzed national data from 1999-2010, and 2009 data from 13 states. According to the researchers, methadone carries more risks than other painkillers because it tends to build up in the body and can disrupt a person’s breathing or heart rhythm. According to the report, 4 of every 10 overdose deaths from a single prescription painkiller involved methadone--twice as many as any other prescription painkiller.

The researchers say that methadone has been used safely and effectively for decades to treat drug addiction, but in recent years it has been increasingly used as a pain reliever and as methadone prescriptions for pain have increased, so have methadone-related nonmedical use and fatal overdoses. CDC researchers found that six times as many people died of methadone overdoses in 2009 compared to methadone-related deaths in 1999.

Measures to help prevent prescription painkiller overdoses include:

• Screening and monitoring patients for substance abuse and other mental health problems, when considering methadone as treatment.
• Prescribing only the quantity needed based on the expected length of pain.
• Using patient-provider agreements combined with urine drug tests for people taking methadone long term.
• Using prescription drug monitoring programs to identify patients who are misusing or abusing methadone or other prescription painkillers.
• Educating patients on how to safely use, store and dispose of prescription painkillers and how to prevent and recognize overdoses.

Read more on addiction.

Even Modest Walking Linked to Lower Risk of Diabetes

A new study, published in the journal Diabetes Care, examined number of steps walked on average and diabetes risk, and found that people who walked the most were 29 percent less likely to develop diabetes than those who walked the least. This study builds on research linking even limited physical activity to lower diabetes risk, and helps to quantify the effect with number of steps taken on average. The association held when accounting for age, smoking status and other diabetes risk factors, but not BMI. Read more on diabetes.

Fewer Women Got Mammograms After New Guidelines Released

Preventive mammography rates in women in their 40s have dropped nearly 6 percent nationwide since the U.S. Preventive Services Task Force recommended against routine mammograms for women in this age group, according a Mayo Clinic analysis. The study was presented at the AcademyHealth Annual Research Meeting this week. Read more NewPublicHealth coverage from the AcademyHealth meeting.

Sixteen Percent of U.S. Population Addicted to Cigarettes, Alcohol or Drugs

Forty million Americans ages 12 and older have an addiction involving nicotine, alcohol or other drugs, according to a five-year national study released this week by The National Center on Addiction and Substance Abuse at Columbia University. The study authors say only about 1 in 10 people who need treatment for addiction involving alcohol or other drugs receive it. Read more on substance abuse.

New Pilot Program Aimed at Reducing Prescription Drug Abuse

The Office of the National Coordinator for Health Information Technology has announced a pilot program in Ohio and Indiana that will make existing prescription drug use information available to doctors and pharmacists in outpatient and emergency settings. The goal is to allow providers to intervene in cases of suspected prescription drug abuse.

“The PDMP pilot projects being launched today will help hospital staff identify a patient’s controlled substance history at the point of care to enable better targeting appropriate treatments and reduce the potential of an overdose or even death,” said Farzad Mostashari, MD, ScM, national coordinator for health IT.

According to the Centers for Disease Control and Prevention, deaths from prescription drugs now outnumber deaths from heroin and cocaine combined, and over the past decade, prescription drug-induced deaths have approached motor vehicle deaths as the leading cause of all injury deaths. Read a Q&A with Farzad Mostashari on the potential for health IT to support public health.

Traffic Noise May Increase Heart Attack Risk for People Living Nearby

High levels of traffic noise put people who live nearby at an increased risk for a heart attack, according to a new study in the journal PLoS One. Researchers followed more than 50,000 people in Denmark, ages 50 to 64, for ten years and found that for every 10 decibel rise in traffic noise near a person's home, there was a 12 percent increased risk of a first heart attack. Read more on community health.

Mouse Study Links High-Fat, High Calorie Diet to Development of Pancreatic Cancer

In a study presented at the American Association for Cancer Research's Pancreatic Cancer: Progress and Challenges conference, UCLA researchers fed mice that had a genetic mutation that predisposed them to pancreatic cancer a diet high in fat and calories, and found that this diet triggered and accelerated increased pancreatic inflammation and pancreatic cancer development for many. The researchers say that the mutation was not sufficient for the mice to develop the cancer, but that the high-fat, high-calorie diet could provide an “environmental secondary hit and trigger cancer development." Read more on cancer.

Quitting Smoking Even at Older Age Can Help People Live Longer

People who quit smoking, even when they’re older, tend to live longer than people who never give up the habit, according to a new study in the Archives of Internal Medicine. The reviewers looked at data from 17 studies and found that smokers age 60 and older were 83 percent more likely to die at any given age compared with people who never smoked. One study that followed doctors for fifty years found that 59 percent of non-smokers were alive at age 80 compared to 26 percent of smokers. Read more on tobacco.

June is Posttraumatic Stress Disorder Month

Posttraumatic Stress Disorder (PTSD) affects one in 29 Americans, including members of the military, abused children and adults, and survivors of rape, domestic violence and natural disasters. The U.S. Department of Health and Human Services created Posttraumatic Stress Disorder month, observed each June, to let people know about effective treatments.

Resources include:

• Veterans and their families can call 1-800-273-8255 (press “1”) or visit the website.
• SAMHSA’s Military Families Strategic Initiativehas an online home here.
• Veterans Chat is a tool for veterans, family members or friends in crisis.

Community resources include:

• SAMHSA’s Mental Health Services Locator, which helps locate local treatment services and support for those with PTSD.
• NIMH and National Institutes of Health fact sheets and information on clinical trials and scientific studies on PTSD can be found here.
• National Child Traumatic Stress Networkprovides tools and resources to assist health care providers, educators, and families.
• National Center for Trauma Informed Care provides education and training for supporting recovery and identifying specific treatment practices to address trauma.

Read more on mental health.

Massachusetts Insurer to Limit Length of Some Pain Reliever Prescriptions

Kaiser Health News (KHN) is reporting that beginning July 1, Blue Cross Blue Shield (BCBS) of Massachusetts will prevent doctors from prescribing 60 days of a painkiller such as OxyContin, for example, for a minor problem such as a sprained ankle. Patients with serious or chronic conditions such as cancer will be able to receive larger quantities. Reviews will be required for many painkillers prescribed for longer than 15 days.

According to KHN, by limiting the drugs, the insurer hopes to reduce the risk of addiction and also to keep the drugs from teenagers and others for whom they weren't prescribed. BCBS of Massachusetts is believed to be the first insurer in the nation to adopt this approach for doctors who treat patients for pain.

Critics of the plan say it will make it difficult for people with serious pain to easily get the drugs they need, and will increase the time doctors have to spend on paperwork when prescribing pain medication. Read more on addiction.