Many students staring or returning to college this fall may find something missing—exposure to tobacco products.

Last September the U.S. Department of Health and Human Services (HHS), together with several key partners, launched the National Tobacco-Free College Campus Initiative to promote and support the adoption and implementation of tobacco-free policies at universities, colleges, and other institutions of higher learning across the U.S. Initiative partners include the American College Health Association and the University of Michigan. Initiative staff members work closely with academic leaders, public health advocates, students, researchers, and others to help speed up the elimination of tobacco use on college campuses. “This is a lofty goal, but an attainable one, as we are witnessing exponential growth in the adoption of these policies by academic institutions in all regions of the country,” says Howard Koh, MD, MPH, the U.S. Assistant Secretary for Health who helped launch the initiative last year at the University of Michigan, which included an internationally webcast symposium at the University of Michigan School of Public Health.

The initiative includes a website created to serve as a clearinghouse of key information to assist educational communities in establishing tobacco-free environments. The University of Michigan’s comprehensive smoke-free policy went into effect in 2011.

Smoke-free and tobacco-free policies are not the same, according to HHS. Smoke-free policies refer to any lighted or heated tobacco or plant product intended for inhalation—including cigars, cigarettes and pipes. Tobacco-free policies cover these and all other forms of tobacco (although e-cigarettes are still exempt on some campuses due to the still-evolving nature of the regulations). HHS officials point out that although some campuses are smoke-free while others are tobacco-free, the ultimate goal is for all campuses to eventually be 100 percent tobacco-free.

With the start of the fall college imminent or already underway at most universities, NewPublicHealth spoke with Dr.Koh about the success of the Tobacco-Free College Campus Initiative so far, and what’s ahead in tobacco control efforts for young adults by the Department of Health and Human Services.

NewPublicHealth: What success has the initiative seen since it was launched last year?

Dr. Koh: We’re very proud that the Tobacco-Free College Campus Initiative has accelerated rapidly. When we formally announced this in September of 2012, there were 774 colleges and universities that were tobacco or smoke-free and as of right now, the number has risen to 1,159—that’s an increase of more than one-third in less than a year. We are gratified by the positive response from colleges and universities and leaders from across the country who want to make their environments healthier.

NPH: What are the short-term and long-term goals for the initiative?

Dr. Koh: The ultimate goal is to have all colleges and universities in the U.S. choose to become 100 percent tobacco-free and we’re making steady progress towards that goal because we fully understand that prevention efforts must focus not just on children, but also young adults. The number of smokers who are starting to smoke after age 18 has increased. That number was a million in 2010 when it used to be 600,000 in 2002. We have figures that show that one out of four full-time college students were current smokers in 2010, which is higher than the national prevalence of 19 percent. These numbers underscore why college is a critical age to influence health habits of young adults.

Six States to Split $89.2M for Early Learning Programs
Six states will split approximately $89.2 million in federal funding as supplemental awards from the 2013 Race to the Top-Early Learning Challenge (RTT-ELC), which works to expand and improve early learning programs. The six states are California, Colorado, Illinois, New Mexico, Oregon and Wisconsin. Each must now submit detailed budgets, budget narratives, revised performance measures and signed assurances. The funds will go toward developing new programs and strengthening existing programs that help close the “opportunity gap,” according to U.S. Department of Education Secretary Arne Duncan. Added U.S. Department of Health and Human Services Secretary Kathleen Sebelius: “Kids who attend high-quality early learning and pre-school programs are more likely to do well in school. They're more likely to secure a good job down the road; and they're more likely to maintain successful careers long-term.” Read more on education.

A Single Fight-related Injury Can Reduce Adolescent IQ by Equivalent of One Lost School Year
A single fight-related injury can reduce an adolescent or teen girl’s IQ by about 3.02 points, according to a new study in the Journal of Adolescent Health. For a boy it can mean a loss of 1.62 points. Studies have measured the effect of missing a year of school as about a 2-4 point decrease in IQ. IQ loss is generally associated with poorer school and work performance; mental disorders; behavioral problems; and longevity, according to the researchers from the Florida State University researchers noted. About 4 percent of U.S. high school students suffer from fight-related injuries annually. "We tend to focus on factors that may result in increases in intelligence over time, but examining the factors that result in decreases may be just as important," said study co-author Joseph Schwartz, a doctoral student in the College of Criminology and Criminal Justice, in a release. "The first step in correcting a problem is understanding its underlying causes. By knowing that fighting-related injuries result in a significant decrease in intelligence, we can begin to develop programs and protocols aimed at effective intervention.” Read more on violence.

Study Links Sugary Drinks, Obesity in Preschoolers
Even though the percentage as a calorie source is relatively minor, preschoolers who drink sugar-sweetened soda, sports drinks or juices every day are at greater risk for obesity, according to a new study in the journal Pediatrics. The findings parallel studies on teens and adults, which show a link between sugary drinks and extra weight. Kids who consumed at least one of the drinks each day were 43 percent more likely to be obese than their counterparts. They were also more likely to have an overweight mother and to watch at least two hours of television daily from ages four to five; researchers adjusted for these factors, as well as socioeconomic status. Potential reasons include the possibility that the sugary drinks were not filling, so did not replace other calories in the children’s diets. The study did not account for other eating habits or physical activity. Read more on nutrition.

In 2011, Sonoma County in California established the division of Health Policy, Planning and Evaluation (HPPE) in an effort to move the county up in the County Health Rankings, toward a goal of becoming the healthiest in the state by 2020. As the director of the division, Peter Rumble, MPA, has played a critical role in the development of numerous programs and policy efforts to help create opportunities for everyone in Sonoma County to be healthy. Rumble has worked on programs and policies that go beyond traditional public health activities and aim to address the root causes of poor health, including the local food system, education and poverty.

Following his presentation at the International Making Cities Livable Conference, NewPublicHealth was able to speak with Rumble about the ways in which his work with HPPE is pushing to achieve health equity in Sonoma County. Rumble will soon move into a position as Deputy County Administrator of Community and Government Affairs for the County of Sonoma, where he plans to continue his commitment to a vision of health and quality of life for the county.

NewPublicHealth: Sonoma is making a concerted effort to help address the root causes of poor health, like poverty and lack of education. Tell us about some of those efforts.

Peter Rumble: Health Action is our real heartbeat of addressing social determinants of health, and it’s a roadmap for our vision of being the healthiest county in California by 2020. Health Action is a community council that advises the Board of Supervisors. There are 45 seats on the council, including elected officials, individual community leaders, nonprofit leaders, and representative from the business, financial, labor, media, transportation and environmental sectors. If you pick a name out of the hat for all of the sectors in the community, we’ve got somebody who either directly or tangentially represents that sector. That group began talking about needing to do something around health in 2007. 

If we’re going to be the healthiest county in California by 2020, what do we need to do to achieve our ten goals based on the best evidence available? We certainly have goals associated with the health system, but predominantly, we’re focused on influencing the determinants of health. Our first goal is related to education. We want all of our children to graduate from high school on time and ready to either enter a thriving workforce or go into college or a technical career academy.

We started with some grassroots initiatives. Being a real strong agricultural community, iGROW was a good place to start. It was a movement to develop community gardens—for people to tear up their front lawns and plant a garden there, and increasing access to healthy food. That was a huge hit. We set a goal of a few hundred community gardens, and we’re up to a thousand now—it’s just caught fire.  

That was all great, but a community garden is not going to make us the healthiest county in California, right? You can see the beautiful posters out on shop windows, you can see your neighbor tore up their front lawn and is growing this beautiful zucchini and has an edible lawn now and all that’s wonderful, but we only have a graduation rate of 70 percent. We’ve got nearly one in four kids living in poverty by the federal poverty standards and if you look at what actually it takes to raise a family in Sonoma County, about half of all families can’t make ends meet. 

NPH: Does that surprise people to hear about Sonoma?

Jane Brody is the Personal Health columnist for The New York Times. She joined the newspaper in 1965 as a specialist in medicine and biology after receiving degrees in biochemistry and writing for multiple college newspapers, as well as for the Minneapolis Tribune. With her column she has seen and reported on almost 50 years in the evolution of personal and community health.

NewPublicHealth recently spoke with Brody about her take on the state of community health—and what we can all do to improve it.

NewPublicHealth: Over the years, what efforts have you seen that you think have been most effective at improving community health?

Jane Brody: Well, I think one of the most exciting things that’s happened in New York City, and possibly in other cities as well, is getting better food to people who live in food deserts. For example, collecting food that would otherwise be wasted and bringing it to communities where people get free food that is healthy, fresh, and they even have demonstrations of recipes. In fact, I got one of my favorite recipes—it’s a green bean frittata—from one of their demonstrations that I attended just to see how it all worked out.

We’ve also, as you’ve no doubt heard, been putting in all of these bike lanes and we now have introduced the Bike Share Program, which is not inexpensive, but it does at least give more people an opportunity to get off their butts and get out of their cars and maybe even not even use public transportation in some cases, but to get some exercise to and from work, which is wonderful. I remember during one of the transit strikes that we had in New York City, I rode my bicycle from Brooklyn to Times Square where I work, over the bridges and stuff, and it was just wonderful because I got my exercise in at the same time as I got to work and I didn’t have to spend an extra hour exercising. There have been improvements. We have, of course, public pools that are only open in the summer, but in summer is better than no public pools and nobody has to pay anything for a public pool, which is really great.

Special Family Court Systems Limit Kids' Time in Foster Care, Improve School Performance
With families who went through a special unified family court system that deals with divorce, child custody, juvenile delinquency, drug abuse and alcohol abuse, children spent less time in foster care and performed better in school (also an indicator of better emotional health), according to a new study in Evaluation Review. Kids whose families went through these courts were more likely to be reunited with their parents or other primary caregivers. Researchers found that children spent an average of 29 days fewer in foster care placements in counties with unified family courts, and kids were 11 percent more likely to be reunited with their parents or other caregivers. “The shortened time in foster care seen in this study can be attributed to the efficiency of unified family courts, which translates into savings for the court system and benefits to children seen through improved educational outcomes,” said Frank Sloan, PhD, of Duke University. The study was funded by the Robert Wood Johnson Foundation’s Public Health Law Research Program. Read more on education.

Diets High in Vegetables and Low in Meats Lead to Fewer Chronic Diseases, Longer Lives
Vegetarians and people with diets low in meat and high in vegetables are less likely to die from heart disease or any other chronic conditions over any particular period of time, according to a new study in JAMA Internal Medicine. In a study of more than 73,000 people from 2002 to 2007, researchers found that by December 31, 2009 about seven in 1,000 meat eaters and about five to six in 1,000 vegetarians died each year. However, researchers noted that there were a variety of contributions to this result. "It's important to note that the vegetarians in this study were more highly educated, less likely to smoke, exercised more and were thinner," said Alice Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tufts University in Boston, who was not involved with the new study, to Reuters Health. About 5 percent of Americans are vegetarian. Read more on nutrition.

CDC: Fewer Americans Struggling with Medical Bills, But Many Skipping Care Altogether
While overall fewer Americans are having difficulty paying their medical bills, the uninsured and other people who would have difficulty paying are increasingly skipping medical care completely, according to the U.S. Centers for Disease Control and Prevention (CDC). According to CDC's National Center for Health Statistics, the percentage of people under age 65 in families struggling to pay bills dropped from 21.7 to 20.3 percent from the first half of 2011 to the first half of 2012. For families with children up to 17 years old, the share dropped from 23.7 percent to 21.8 percent. Still, families of more than 54 million people are unable to pay their medical bills. "During this time period, those who were uninsured or who had public coverage were about twice as likely as those with private coverage to have problems paying medical bills," said study author Robin Cohen, a CDC health statistician. Read more on access to health care.

Around the Globe Anti-Smoking Ads Work
Awareness of anti-smoking messages on television, radio, billboards, newspapers and magazines significantly increased the odds that current smokers intend to quit in 14 of the 17 countries surveyed, according to a study of thousands of adults smokers published by the by the U.S. Centers for Disease Control and Prevention. The survey was released today in observance of World No Tobacco Day. It is sponsored by the World Health Organization (WHO), which is calling on countries to ban all forms of tobacco advertising, promotion and sponsorship to help reduce the number of tobacco users. Tobacco use kills nearly 6 million people every year worldwide. According to WHO, countries that have introduced bans have seen smoking drop by an average of 7 percent. WHO research has found that about a third of youth tobacco use occurs as a result of exposure to tobacco advertising, promotion and sponsorship. Worldwide, 78 percent of teens ages 13 to 15 say they regularly see some form of tobacco promotion. Read more on tobacco.

Google Adds Nutrition Information to Search Function
Just as the tool includes shortcuts to finding places and even the local time for the sunrises and sunsets, Google is now adding nutrition information to its search function. Simply typing basic questions such as “how many carbs are in an apple?” will bring up not only the answer to that particular question, but also additional relevant nutrition information and the ability to search by different foods and serving sizes. More than 1,000 fruits, vegetables, meats and meals will be covered by the new online tool. Read more on nutrition.

HUD: $32M in Grants to Support Housing for People, Families Living with HIV/AIDS
Thirty local HIV/AIDS housing programs will share $32 million in U.S. Department of Housing and Urban Development funds to provide more stable living environments. More than 1,300 extremely low-income people and families dealing with HIV/AIDS will helped under the program, which includes housing assistance and access to supportive services such as job readiness and employment training programs. “These grants will provide our local partners with crucial funding that is necessary to provide individuals and families living with HIV/AIDS a place to call home,” said Secretary Shaun Donovan.  “The comfort of knowing that you have a roof over your head makes a huge difference in the wellbeing of families and gives hope to those who might otherwise end up living on the streets.” Read more on HIV/AIDS.

Survey: Math, Reading ‘Summer Slumps’ Puts Kids at Disadvantage in Classrooms
A new survey from PBS KIDS shows that while 84 percent of parents say they see the importance of supporting their child’s learning in the home, the average teacher must spend four to six weeks re-teaching forgotten material at the beginning of each school year—with the loss of knowledge even more severe in low-income communities. Parents’ anxiety over math makes them even less likely to support math learning at the earliest ages, and these deficits and deterioration in math and literacy skills can put kids at a distinct disadvantage in the classroom. A Q&A from PBS has tips on how parents can prevent this “summer slump” when it comes to reading. Read more on education.

“We know PSA campaigns can make a big impact; that they can improve people’s lives.”

The Advertising (Ad) Council has just launched a new version of its digital distribution platform, PSA Central, which is geared toward PSA directors and media outlets, but is also valuable for anyone who wants to share the messages including educators and public health practitioners. The site offers easy access to video, print, radio, online, mobile and outdoor media public service advertisements that range from bullying prevention to food safety education.

Public Service Advertisements (PSAs) may actually date back to the civil war when newspapers offered free advertising space to the U.S. government to advertise bonds whose revenues were used to pay for the war effort. These days, PSAs are much more likely to be public safety messages such as a United Kingdom video PSA, downloaded over 2 million times on YouTube, reminding people just why they should buckle up in a car. And more importantly, these efforts are being measured and tracked to show impact on health behavior change and health outcomes, such as the Ad Council’s drunk driving prevention campaign that has encouraged 70 percent of Americans to take action to stop a friend from driving drunk.

NewPublicHealth recently spoke with Peggy Conlon, president and CEO of the Ad Council, about the public health messages PSAs can convey and how new media has expanded their reach.

NewPublicHealth: How have PSAs evolved over the years?

Peggy Conlon: PSAs have evolved quite a bit. The Ad Council is 71 years old and back in the earliest days PSAs were seen in newspapers and heard over the radio. Since then they have been showcased on just about all media platforms. In the 90s we were introduced to the Internet and everything changed forever. The Internet added another new dimension to our ability, in a very tangible and personal way, to engage communities around social issues.

NPH: What are some of the most effective and iconic campaigns in public service advertising?

Sesuagno Mola of Ethiopia, married at five, never went to school and had her first child at 14. More children would have followed in quick succession, but Sesuagno got involved with a program in her town run by Girl Up developed by the UN Foundation that empowers young girls to create a life for themselves and their families well beyond poverty and illiteracy.

In Sesuagno’s case, she joined a program developed to help teach literacy, and provide information about family planning, gardening and life skills to help reduce food contamination.

Through the program, Sesuagno learned to build shelves to keep her family’s food off the floor, built a stove that sends the smoke out of the house instead of into her lungs—a cause of pneumonia and death for thousands of girls and women in the developing world—and jointly decided with her husband, because of her time in the program, that they would wait to have their next child.

“What we support are comprehensive services for adolescent services for girls to help improve access to health services, education and safe spaces,” says Andrea Austin, a spokesperson for the UN Foundation.

Baltimore public schools are receiving a new $1 billion infrastructure investment—the first funding the school district has seen to actually build new schools in almost 40 years, according to a recent interview on the Tom Joyner Morning Show with Bishop Douglas Miles, co-chair of BUILD and co-founding member of Baltimore Education Council. Maryland Governor Martin O’Malley last week signed a law authorizing the funds for school construction and renovation. Eventually, 15 schools will be built and 35 will be repaired and renovated.

“The conditions in the schools have deteriorated,” said Miles. “Boilers breaking down annually in the middle of the winter, buildings lacking windows, water undrinkable because it’s lead-tainted—and our children deserve better than that.”

A growing wealth of data shows a positive relationship between the quality of school buildings and student outcomes. Also, about 85 percent of the 85,000 students in Baltimore schools receive free or reduced-cost lunch, the city has the lowest graduation rates in the state and nearly 140 of its 162 public schools are in very poor condition.

This infusion of funds will help promote academic success for the city’s students by decreasing education disparities. In the long-term it also has the potential to help improve the health of all Baltimore residents, as better education leads to better jobs, higher incomes, and longer, healthier lives. NewPublicHealth has previously illustrated the connection between education and health outcomes in an infographic.

>> Listen to the Tom Joyner Morning Show interview.

“Death is an inevitable part of life. But death from preventable causes like cervical cancer, early heart disease, or gun violence is a tragedy. Whether expressed in dry, cold numbers or by the images of first graders smiling at the camera for their school picture, these tragedies will continue to motivate us to use both left-brain science and right-brain passion to improve human health and prevent unnecessary death.”

That paragraph is from the foreword by Michael Klag, MD, MPH, dean of the Johns Hopkins Bloomberg School of Public Health (JHSPH) in the current issue of the school’s magazine. The issue is devoted to how public health researchers and practitioners probe, investigate, understand and fight death.

The full issue is well worth reading. A few notable pieces include: 

• An interview with Vladimir Canuda Romo, PhD, a demographer and assistant professor at the school who says his research shows American life expectancy is on the rise.
• A critical article on making palliative care  a public health issue.
• A summary of a recent forum at the school on dealing with gun violence.
• A piece on prescription drug abuse, which the author calls the “biggest public health issue you’ve never heard of."

Perhaps most poignant are a collection of essays by JHSPH alumni including a thoughtful look at the last minutes of a deer.

>>Bonus Link: In a new book, Happier Endings , Erica Brown, PhD, the scholar in residence at the Jewish Federation of Greater Washington, tells her readers: “we are all going to die, but some of us will die better.” The book, which Dr. Brown calls “a meditation on life and death,” looks at the deaths of several people and shares intimate details of last months, last weeks, last seconds—sometimes peaceful, sometimes not. It’s an important reminder that communities and populations, the building blocks of public health, are made up of individuals who are loved, and missed when they pass away, and that death is indeed a public health issue worth attention.