Mammography Rates Remained Steady After Change in Guidelines
The proportion of women undergoing screening for breast cancer every year did not change after U.S. Preventive Services Task Force released recommendations saying there wasn't enough evidence to support routine mammograms for women in their 40s, according to a new study published in the journal Cancer. In 2009, the Task Force changed their recommendations to state that women aged 50 to 74 should have a mammogram every other year, and screenings for women under age 50 should be evaluated by each woman with her doctor, according to individual risk factors. "When there are conflicting versions of guidelines, providers may err on the side of screening," said David Howard, a health policy researcher from Emory University in Atlanta, in an interview with Reuters. Read more on cancer.

Latest HIV Vaccine Study Halted
The National Institutes of Health halted a study testing an experimental HIV vaccine after an independent review board found the vaccine did not prevent HIV infection and did not reduce the amount of HIV in the blood. The trial, started in 2009, is the latest in a series of failed HIV vaccine trials, according to Reuters. The halted study included more than 2,500 volunteers in 19 U.S. cities. Study populations included men who have sex with men and transgender people who have sex with men. Read more on HIV.

CDC's Food Safety Report Card: Some Foodborne Illnesses Spiked in 2012
The Centers for Disease Control and Prevention (CDC) recently released the "nation’s annual food safety report card," and it shows that 2012 rates of infections from two types of foodborne bacteria—campylobacter and Vibrio—have increased significantly when compared to a baseline period of 2006-2008, while rates of most others have not changed during the same period. The data are part of the Foodborne Diseases Active Surveillance Network report. Campylobacter infections have been linked to tranmission in many foods, including poultry, raw milk and produce. These infections were at their highest level since 2000, up 14 percent since 2006-2008. Vibrio infections, often associated with raw shellfish, were up 43 percent.

“The U.S. food supply remains one of the safest in the world,” said CDC Director Tom Frieden, MD, MPH. “However, some foodborne diseases continue to pose a challenge. We have the ability, through investments in emerging technologies, to identify outbreaks even more quickly and implement interventions even faster to protect people from the dangers posed by contaminated food.” Read more on food safety.

Three years after a devastating earthquake took the lives of 200,000 Haitians, displaced millions more and disrupted the public health infrastructure of the country, two new public health buildings opened yesterday in the country’s capital city of Port-Au-Prince with funding by the CDC Foundation and several partners including the Robert Wood Johnson Foundation, the GE Foundation and Kaiser Permanente. The CDC Foundation was established by Congress to forge partnerships between the Centers for Disease Control and Prevention (CDC) and corporations, foundations and individuals to support CDC's work in the U.S. and abroad.

“‘Building back better’ isn't just a slogan, it's a reality in public health. These buildings represent an important step forward to save lives in Haiti,” said CDC director Thomas Frieden, MD, MPH, at the opening in Port-Au-Prince. "These new buildings have an importance far beyond their physical presence—they will serve as a basis and catalyst for programs that will save literally tens of thousands of lives,” Frieden said.

One building replaces the Haiti Health Ministry, which was destroyed in the earthquake. The second building will house some of the ministry’s surveillance, epidemiology and laboratory staff as well as Haiti-based CDC staff, who are now working side-by-side in the country.

Representatives of the partners critical to the funding of the new buildings were on hand in Port-Au-Prince for the buildings’ ribbon cutting ceremony, including Susan Mende, senior program officer at the Robert Wood Johnson Foundation. “The earthquake in Haiti wrought great destruction and suffering to some of the most vulnerable in society as well as to the health and public health infrastructure so critical to the nation’s health,” said Mende. “The Robert Wood Johnson Foundation made a $500,000 grant to help build a public health laboratory research center to be used by Haiti’s Ministry of Public Health and Population. The Foundation recognizes that a stronger public health system is the network that protects communities, saves lives and directly improves people’s health and well being.”

To learn about the significance of the new buildings and the continuing efforts to improve public health in Haiti, NewPublicHealth spoke with Charles Stokes, president of the CDC Foundation, and Justin Tappero, MD, MPH, Director for the Health Systems Reconstruction Office in the Center for Global Health at CDC. Both were on hand for the ceremonies this week.

U.S. Adults with Mental Illness Have Higher Smoking Rates
Adults with mental illness have a smoking rate 70 percent higher than adults with no mental illness, according to the February 2013 Vital Signs report released yesterday by the U.S. Centers for Disease Control and Prevention. The report was done in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA) and found that 36 percent of adults with a mental illness are cigarette smokers, compared with only 21 percent of adults who do not have a mental illness. Among adults with mental illness, smoking prevalence is especially high among younger adults, American Indians, Alaska Natives, those living below the poverty line, and those with lower levels of education. Differences also exist across states. Smoking prevalence for people with mental illness ranges from 18.2 percent in Utah to 48.7 percent in West Virginia. The data used to determine the smoking rates in the Vital Signs report comes from 2009–2011 National Survey on Drug Use and Health. Mental illness was defined as having a diagnosable mental, behavioral, or emotional disorder, excluding developmental and substance use disorders, in the past 12 months. The report also found that, on average, adult smokers with mental illness smoke more cigarettes per month than those without mental illness (331 vs. 310 cigarettes) and are less likely to quit smoking. “Special efforts are needed to raise awareness about the burden of smoking among people with mental illness and to monitor progress in addressing this disparity,” said SAMHSA administrator, Pamela S. Hyde. Read more on tobacco.

NIH Announces Three Major Clinical Trials for Influenza Treatments
Three clinical trials aimed at finding more effective flu treatments are enrolling volunteers who have the virus at the National Institutes of Health’s Clinical Center in Bethesda, Md., as well as at several dozen other domestic and international sites.

• One study will look at whether the drug Tamiflu reduces the time that infected people continue to produce virus in the upper airway.
• The second trial will test whether a combination of three licensed antiviral drugs works better than Tamiflu in people with influenza that have chronic health conditions, such as heart or lung disease, which put them at greater risk of severe illness.
• The third trial will test whether treatment with plasma enriched with anti-influenza antibodies improves the condition of hospitalized influenza patients compared to standard antiviral treatment on its own.

“This year’s flu season came earlier than usual and has been particularly hard on the elderly,” said Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious diseases. “Despite our best efforts to prevent influenza through vaccination, people still get sick every year with the flu. At best, influenza infection is a miserable experience. At worst, it can be a deadly one. We need better ways to treat people with influenza, which kills thousands of people in the United States each year, and clinical research supported by NIAID helps to address that need.” Read more on flu.

Doctors Miss Opportunities for Underage Alcohol Screening
A new survey of more than 2,500 10th grade students published in Pediatrics found that 34 percent reported drinking alcohol in the past month and 26 percent said they had binged, defined as five or more drinks per occasion for males, and four or more for females. However, while more than 80 percent of those surveyed said they’d seen a doctor in the past year, just 54 percent of that group was asked by their physicians about drinking, and only 40 percent were advised about dangers associated with alcohol. In addition, of those students who had been seen by a doctor in the past year and who reported drinking in the past month, only 23 percent said they were advised to reduce or stop drinking. The survey was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAA). The researchers say studies have shown that screening and brief interventions by health care providers, such as asking patients about alcohol use and advising them to reduce risky drinking, can result in significant, lasting reductions in drinking levels and alcohol-related problems among adults.  “Alcohol is by far the drug of choice among youth," says NIAAA acting director Kenneth R. Warren, PhD. “The findings reported [in this study] indicate that we must redouble our efforts to help clinicians make alcohol screening a routine part of patient care for young people in the United States.” Read more on alcohol.

The Robert Wood Johnson Foundation has announced the nominees for its 2012 Year in Research campaign — a look at the most influential Foundation-supported research that has changed the field of health and health care in a valuable way. There are 20 finalists, selected for being the most popular research articles among RWJF.org readers. Now it’s time to choose the “Final 5.”

UPDATE: The winner has been chosen! Congratulations to the research team behind the Graduated Driver Licensing Decal Law. Go here to see the full rankings and read interviews with all five finalists.

Graduated Driver Licensing Decal Law: Effect on Young Probationary Drivers
Teen drivers may not like it, but New Jersey's pioneering graduated driving license decal law is estimated to have prevented more than 1,600 crashes. New Jersey, which already had rigorous graduated driving laws (GDLs), enacted in April 2009 the nation’s first law to require probationary drivers to display small decals on their license plates, which allowed for more rigorous enforcement of restrictions on young drivers, such as bans on cell phone use. Researchers analyzed the success of the law by linking information from two databases: one for licensing and registration, and one for crash records. The law appears to have enhanced police officers’ ability to enforce GDLs, as well as probationary driver’s willingness to comply with them. Read more about the research and its effects in “Keeping Teen Drivers Safe Through Public Health Law: Allison Curry Q&A.”

USDA Releases New Regulations on Snack Foods Sold at Schools
New rules proposed by the U.S. Department of Agriculture would require snacks sold at schools to be lower in fat, salt and sugar and include more nutritious items such as whole grains, vegetables and fruits. The rules also require a limit of 200 calories on food items not sold in the school cafeteria. According to Reuters, the rules would apply to about 50 million children who are part of the school lunch program. “These proposed nutrition standards, the first update in more than 30 years, are long overdue and badly needed,” said Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation. The proposed regulations will be open for public comment once the rule is published in the Federal Register, which is likely to be this week. The final rule would probably not take effect before the fall of 2015. Read more on obesity.

Flu Shot May Protect Older People Against Heart Attacks
A new study from researchers at the University Of Iowa College Of Public Health suggests that the flu vaccine may provide protection against heart attacks in older adults, especially people over age 80. The researchers suspected acute infection caused by flu may trigger events leading to heart attacks and strokes, so they created a set of time-series models using inpatient data from a national sample of more than 1,000 hospitals and used flu activity to predict the incidence of heart attack and stroke. The team produced national models, as well as models based on four geographical regions and five age groups and across all models, and found consistent significant associations between heart attacks and influenza activity.

Flu Season 2013 Update: The most recent report from the U.S. Centers for Disease Control and Prevention finds that while there is still widespread flu activity in much of the country, an increasing number of states are starting to see a decline in reported flu cases.

Read more on flu.

Public Health School Partners with Churches to Improve Healthier Living
As part of a project led by the University Of South Carolina Arnold School Of Public Health, about 1,250 members of 74 African Methodist Episcopal churches in South Carolina participated in a program to help members lead healthier lifestyles through increased physical activity and healthier food choices. The five-year project was funded by the National Institutes of Health and found that members of churches who were part of the healthier lifestyle training were more likely to engage in physical activity and eat more fruits and vegetables than members from churches that did not undergo the training. The study's findings were published in the American Journal of Preventive Medicine. “Churches are natural partners to help eliminate health disparities in the African-American community, says Sara Wilcox, PHD, director of the school’s prevention research center. “For many, especially in the South, the church is the center of their life and is a trusted institution.” Read more on prevention.

Many ‘Facts’ About Weight Loss Not Supported by Science
Many pieces of common weight-loss advice have in fact little-to-no supporting evidence, according to a study in the New England Journal of Medicine. These include the “facts” that small dietary and exercise changes lead to steady and sustained weight loss, as well as that slow, gradual weight loss is better than large, rapid weight loss. Study author David Allison, director of the nutrition obesity research center at the University of Alabama, Birmingham, said that while these ideas makes sense, researchers and physicians still need to make sure that health advice is backed up by data so that patients receive the best care possible. "It's an ethical obligation to be honest,” he said. “It's great to be enthusiastic, as long as you're promoting something you know is true.” Read more on obesity.

Study: Pairing Yoga with Meds Could Improve Irregular Heartbeat
Pairing yoga with traditional medications could help people with atrial fibrillation (AF) better manage the problem while also feeling better in general, according to a new study in the Journal of the American College of Cardiology. AF causes an irregular heartbeat that disrupts the flow of blood, according to the U.S. Centers for Disease Control and Prevention. Researchers found that the addition of yoga cut down heart quivering, lowered the heart rate and reduced anxiety. "People feel more empowered, they feel better, they feel stronger," said W. Todd Cade, a physical therapy researcher from Washington University School of Medicine in St. Louis. Researchers noted that people with AF should consult with their physicians before starting yoga. Read more on heart health.

New IRS Affordable Care Act Regulations Makes Health Insurance Too Costly for Some Families
Under final rules released by the Internal Revenue Service yesterday, some families who have access to employer-based health insurance may not be eligible for federal subsidies to help them buy less expensive coverage through the new insurance exchanges to be set up under the Affordable Care Act (ACA). That’s because the new rules base the eligibility on the cost of health insurance for the employee only, not on the generally higher cost of covering a spouse and/or children. Penalties set to kick in for families and individuals who don’t buy health insurance under the ACA may not apply to people who find themselves ineligible for the subsidies, but unable to afford employer-based coverage. Read more on access to health care.

Add electronic health records to the critical weapons health professionals have against the flu, as 48 states currently deal with widespread flu activity and the U.S. Centers for Disease Control and Prevention (CDC) reports at least 30 pediatric deaths so far. At least half of those children had not received a flu shot, according to CDC Director Thomas Frieden.

A CDC report from September 2012 found that about 128 million people, or about 42 percent of the U.S. population, got the flu shot during the 2011-2012 season, which started later and proved milder than the one we’re in now. That number has been holding steady for several years, but is below the CDC’s goal of 80 percent of the U.S. population receiving a flu shot.

Kaiser Permanente in Northern California, however, has seen a 6 percent increase in its two-million plus members getting the 2012-2013 flu shot over previous years, for which it gives credit to HealthConnect, the largest civilian health record data base in the United States. Randy Bergen, MD, the vaccine lead at Kaiser in Northern California, says the system lets Kaiser Staff “proactively reach out to all its members and even identify those at greatest risk from contracting the flu [which includes children, the elderly and people with chronic diseases] to give them an extra nudge.”

New York Declares Public Health Emergency for Flu
The state of New York has declared a public health emergency due to the increasingly severe flu season, which has reached epidemic levels. The declaration allows pharmacists to administer flu vaccinations to patients between six months and 18 years of age and suspends for the next 30 days the state’s law that limits the authority of pharmacists to administer vaccinations only to people 18 and older. "We are experiencing the worst flu season since at least 2009, and influenza activity in New York state is widespread, with cases reported in all 57 counties and all five boroughs of New York City," said Governor Andrew Cuomo, according to Reuters. According to the U.S. Centers for Disease Control and Prevention, nine of the ten regions of the United States have “elevated” flu activity. Last week the city of Boston, Ma., declared a public health emergency in response to the flu. Read more on influenza.

High Noise Levels in Sports Stadiums Hurts Workers, Spectators
High noise levels in the workplace—especially in nontraditional workplaces such as sports stadiums—are often unappreciated and can lead to permanent hearing loss, according to two new studies in the Journal of Occupational and Environmental Hygiene (JOEH). The can also be damaging to spectators. “While severe traumatic injuries and degenerative brain disorders due to concussive blows are recognized as severe hazards among athletes, exposure to high noise likely affects far more individuals (spectators and referees), and the resulting permanent hearing loss decreases the quality of life of those affected,” said JOEH Editor in Chief Mark Nicas, PhD, CIH. Read more on business.

Simple Traffic Changes Make Streets Safer, Save Pedestrian Lives
Traffic changes around schools in New York City helped cut child pedestrian injuries by 44 percent during “school travel” hours, according to the results of the National Safe Routes to School program published in the journal Pediatrics. "The study shows that safety programs really do work," said Kate Carr, president and CEO of Safe Kids Worldwide, according to HealthDay. "Making common sense improvements around schools by adding sidewalks and speed bumps, improving signage, and creating more visible crosswalks prevents injuries and saves lives." Safer streets also encourage kids and their parents to get more physical activity. Read more on safety.

The first Vital Signs health indicators report of 2013 from the U.S. Centers for Disease Control (CDC) and Prevention finds that binge drinking is too often not recognized as a women’s health problem. The report found that nearly 14 million U.S. women binge drink about three times a month, and consume an average of six drinks per binge. CDC researchers determined the rate of binge drinking among U.S. women and girls by looking at the drinking behavior of approximately 278,000 U.S. women aged 18 and older for the past 30 days through data collected from the 2011 Behavioral Risk Factor Surveillance System, and for approximately 7,500 U.S. high school girls from the 2011 National Youth Risk Behavior Survey.

For women and girls, binge drinking is defined as consuming four or more drinks on one occasion. Drinking excessively, including binge drinking, causes about 23,000 deaths among women and girls in the United States each year. About 1 in 8 women and 1 in 5 high school girls report binge drinking, with the practice most common among women ages 8-34, high school girls, whites, Hispanics and women with household incomes of $75,000 or more. Half of all high school girls who drink alcohol report binge drinking.

As we end the year and head into 2013, NewPublicHealth spoke with U.S. Centers for Disease Control and Prevention director Thomas Frieden, MD, MPH, about public health in 2012—and what’s ahead for 2013.

NewPublicHealth: What were the high points for public health in 2012?

Dr. Thomas Frieden: Two really stand out. First, public health got even better at finding outbreaks quickly and stopping them. We saw that with Listeria, E. Coli, Salmonella and with the fungal meningitis outbreak. That is important because we are seeing that there are an ever-increasing number of ways that outbreaks can start and spread and we need to be on our guard. The second highlight that comes to mind immediately was the Tips from Former Smokers Campaign. This is the first-ever federally funded national anti-tobacco campaign and it was a stunning success. We had very ambitious goals for it. We hoped that half a million people would try to quit and at least 50,000 people would succeed for good. Based on calls to quitlines—and we will know more in the next few months—it looks like the campaign probably had at least twice that impact. This is a campaign that will have saved tens of thousands of lives and probably paid for itself in pretty short order in terms of reduced medical and societal expenses. It shows that when you invest in tobacco control you can make a big difference and save a lot of lives.

NPH: And your hopes for public health in 2013?

Frieden: There are a lot of things that are important and we can make progress on in the coming year. First is to be safer from threats whether they are from this country or abroad, and public health works 24/7 to keep us safe both at the federal level as well as the state and local level. We do have challenges, though, in terms of the fiscal climate that we are in, and we need to ensure that we have the resources needed to keep Americans safe from threats.