NIH Grants $40M to Combat Racial, Ethnic Disparities in Stroke Risk
The National Institutes of Health (NIH) has awarded $40 million in grants over five years to help four research centers investigate and develop strategies to reduce the risk of stroke in racial and ethnic minorities. The funds come from NIH’s National Institute of Neurological Disorders and Stroke (NINDS). Racial and ethnic minorities are at higher risk than non-whites due to higher prevalence of cardiovascular risk factors, according to said Walter J. Koroshetz, MD, deputy director, NINDS. "A few of the grantees are working closely with at-risk populations to develop interventions that give people tools to achieve blood pressure control," he said. "These research efforts will give us the traction we need to control the greatest modifiable stroke risk factor. Together, the Stroke Prevention /Intervention Research Programs represent a much needed effort to address stroke disparities in the United States." Read more on stroke.

People With Congenital Heart Disease Need Physical Activity
A new scientific statement from the American Heart Association serves to remind health professionals and patients that regular physical activity is important for people with congenital heart disease and should be promoted. Congenital heart disease (heart structural problems existing since birth) impacts close to 1 million children and 1 million adults in the United States. Specifics of the new statement include:

• While some irregular heart beat conditions may require a restriction in physical activity, “for most, physical activity can be unlimited and should be strongly promoted.”
• Most patients with congenital heart disease are relatively sedentary.  But the physical, psychological and social health benefits of physical activity are important for this population which is at risk for exercise intolerance, obesity and other diseases. .
• These are general recommendations and physicians may have to tailor some specific guidelines for individual patients.

Read more on heart health.

DOT Announces Funds to Help Improve Road Safety on Tribal Lands
The U.S. Department of Transportation (DOT) has announced the availability of more than $8.6 million in Tribal Transportation Program Safety Funds from the Federal Highway Administration (FHWA). According to Transportation Secretary Ray LaHood, the funds will help improve roads on tribal lands, which have consistently ranked among the nation’s highest road fatality rates. DOT will hold a webinar on May 8 from 4-5 p.m. EDT to provide information on the grants to potential applicants. Find a link to the webinar here. Read more on transportation.

CDC, SAMHSA and Red Cross Resources Help Individuals and Communities Cope with Disaster
Immediately after the explosions at the Boston Marathon yesterday, both the U.S. Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) updated their crisis management resources and moved the information to the top of their home pages. CDC’s “Tips for Self Care” includes advice on dealing with stress and suggestions for connecting socially after a traumatic event, avoiding drugs and alcohol, as well as links to SAMHSA’s disaster distress helpline  which can be accessed by phone, text, twitter and Facebook. SAMHSA’s site also includes resources for students, parents, teachers, caregivers, children, first responders and health professionals.

Following the explosions, families and friends found that cell phone and in some cases even texting communication was jammed, making it difficult for people to know whereabouts of those involved in the explosion. The American Red Cross offers a free service called the Safe and Well website which is a central site for people in disaster areas in the United States to register their current status, and for their loved ones to access that information. The Red Cross says the site helps provide displaced families with relief and comfort during a stressful time. The site is easy to use:

• If you are currently being affected by a disaster somewhere in the United States, click List Myself as Safe and Well, enter your pre-disaster address and phone number, and select any of the standard message options.
• If you are concerned about a loved one in the United States, click Search Registrants and enter the person’s name and pre-disaster phone number OR address. If they have registered, you will be able to view the messages they have posted.

The site is available 24 hours a day, 365 days a year and is accessible in both English and Spanish. Read more on preparedness.

Mortality Rates Highest at Small Rural Hospitals
A new study by researchers at the Harvard School of Public Health (HSPH) finds that a failure to stay up to date in the treatments they provide may be a factor in climbing death rates at rural hospitals. The study appeared in the JAMA. The HSPH researchers reviewed data from small, rural hospitals that receive government reimbursements and are exempt from participation in national quality improvement programs. The researchers looked at data on 10 million Medicare patients who were admitted to these small rural hospitals or other hospitals with a heart attack, congestive heart failure, or pneumonia—and compared 30-day mortality rates for each of the three conditions over a nine-year period. While ten years ago, mortality rates for each of these conditions were about the same at hospitals, the researchers found that between 2002 and 2010, mortality rates at CAHs increased at a rate of 0.1% per year, while at non-CAHs they decreased 0.2% per year. By 2010, CAHs had higher overall mortality rates—13.3% versus 11.4% at non-CAHs. “Small rural hospitals are being left behind,” says Karen Joynt, MD, MPH, the lead author on the study. “By creating a separate category for these hospitals, we’ve really left them out of many of the advances in medical care over the past decade, and we need systems-level solutions to help improve healthcare in these rural areas.” Read more on health disparities.

High Resting Heart Rate Indicates Increased Risk of Early Death
Faster than normal heart rates—even in men who exercise—could indicate a higher risk of early death, according to a new study in the journal Heart. While previous studies have shown a connection between heart rate and life expectancy, this study looked specifically at whether that was also true for healthy people who got regular exercise; the results indicate that resting heart rate is a risk factor independent of other health markers. Each 10-beat-per-minute resting heart rate increase corresponded to a 16 percent increase in the likelihood of death. Gregg Fonarow, MD, a professor of cardiology at the University of California, Los Angeles, said there are ways to improve resting hear rate. "Increasing physical activity and decreasing periods of sitting can lower heart rate and lower cardiovascular risk," he said, adding that stopping smoking can also lower heart rate. Read more on heart health.

FDA Budget Includes Funds for Food, Medical Product Safety Improvements
The U.S. Food and Drug Administration’s (FDA) requested $4.7 billion budget will include funds to support the Food Safety Modernization Act and to help ensure the safety of medical products. However, the budget will also include a $15 million cut related to human drug, biologics and medical device programs. “Our budget increases are targeted to strategic areas that will benefit patients and consumers and overall strengthen our economy,” said Margaret A. Hamburg, M.D., Commissioner of Food and Drugs. “Through the good work of the FDA, Americans will receive life-saving medicines approved as fast as or faster than anywhere in the world, confidence in the medical products they rely on daily, and a food supply that is among the safest in the world.” Read more on food safety.

Study: No Link Between Fertility Drugs, Increased Ovarian Cancer Risk
There is no link between fertility drugs and an increased risk of ovarian cancer, according to a new study in the journal Fertility and Sterility. While previous studies have suggested a connection, Albert Asante, MD, lead author of the study and a clinical fellow in the division of reproductive endocrinology at the Mayo Clinic, said the results show that “women who need to use fertility drugs to get pregnant should not worry about using these fertility drugs." The study looked at the medical information of approximately 1,900 women who participated in an ovarian cancer study at the Mayo Clinic. Approximately 13 out of every 100,000 women will develop ovarian cancer in their lives. Read more on cancer.

Unemployment Stress Can Lead to Severe Cardiovascular Troubles
The stress and anxiety of unemployment can cause both immediate and long-lasting cardiovascular problems. There’s even a possibility of something called “broken heart syndrome.” "In a very stressful situation, you can actually get a severe release of adrenaline and sympathetic nerve discharges that cause the heart to beat irregularly," said John Higgins, MD, a sports cardiologist at the University of Texas Health Science Center in Houston, according to HealthDay. In the most severe cases this can lead to heart attack. However, Kavitha Chinnaiyan, MD, director of cardiac imaging at Beaumont Hospital in Royal Oak, Mich., said steps can be taken to reduce the damage. "We know from studies that behaviors such as meditation, yoga and tai chi work specifically to reduce our response to stress," she said, noting that meditation in particular “helps you see your choices and have a clearer perspective of what to do next. Stress may still be around us, but meditation gives us a better ability to cope with it." Learn more on the connection between stable employment and health in an INFOGRAPHIC.

CDC: Nearly 1 in 3 Americans Suffers from High Blood Pressure
Nearly one in three Americans have high blood pressure, according a new study in the journal Morbidity and Mortality Weekly Report. The number climbed 10 percent from 2005 to 2009, demonstrating an increased need to focus on prevention and treatment. "What we are really concerned about as well is that people who have high blood pressure are getting treated. Only about half of those with hypertension have it controlled," said Fleetwood Loustalot, a researcher at the National Center for Chronic Disease Prevention and Health Promotion, part of the U.S. Centers for Disease Control and Prevention. "Uncontrolled hypertension can lead to negative health consequences like heart attacks and strokes." A recent study in the journal BMJ found that even a small reduction in sodium intake can significantly reduce blood pressure, which in turn lessens the risk of heart disease. Read more on heart health.

Court Orders FDA to Make ‘Morning-After’ Pill Available to All Without a Prescription
Calling it the agency’s decision "an excuse to deprive the overwhelming majority of women of their rights to obtain contraceptives without unjustified and burdensome restrictions," a U.S. District Court judge has ordered the U.S. Food and Drug Administration (FDA) to reverse its stance on “morning-after” contraception pills and make them available to all women without a prescription. The pills are currently available without a prescription only to women age 17 and older. "Women all over the country will no longer face arbitrary delays and barriers just to get emergency contraception," said Nancy Northup, president of the Center for Reproductive Rights, which was one of the groups that petitioned FDA to remove the restrictions. Read more on sexual health.

Teen Vogue, Toyota Campaign to Emphasize Safe Driving for Teenage Girls
With automobile collisions the leading cause of teenage deaths, Teen Vogue and Toyota are partnering on the “Arrive in Style” safe driving campaign targeting teenage girls and their mothers. The print, digital, video and social media campaign is set to run through early next year. Teen Vogue will also have monthly features with advice on safe driving. “Teen Vogue’s influential young readers are the perfect ambassadors not only to participate in this initiative, but also to help build awareness and educate their peer groups on the importance of driver safety,” said Jason Wagenheim, Teen Vogue Vice President and Publisher. Read more on safety.

CDC Vital Signs: 1 in 5 Teen Births is a Repeat Birth
Although teen births have fallen over the past 20 years, nearly one in five is a repeat birth, according to a Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). More than 365,000 teenage girls ages 15-19 years gave birth in 2010, and almost 67,000 (18.3 percent) of those were repeat births. A repeat birth is a second (or more) pregnancy resulting in a live birth before the mother turns 20. “Teen birth rates in the United States have declined to a record low, which is good news,” said CDC Director Tom Frieden, MD, MPH. “But rates are still far too high. Repeat births can negatively impact the mother’s education and job opportunities as well as the health of the next generation. Teens, parents, health care providers, and others need to do much more to reduce unintended pregnancies.” Data from CDC’s National Vital Statistics System show that repeat teen births in the United States decreased by more than 6 percent between 2007 and 2010. Despite this decline, the number of repeat births remains high and there are substantial racial/ethnic and geographic differences. Repeat teen births were highest among American Indian/Alaska Natives (21.6 percent), Hispanics (20.9 percent), and non-Hispanic blacks (20.4 percent), and lowest among non-Hispanic whites (14.8 percent). Read more on maternal and child health.

Health Impact Project Announces Eight New Funded Projects
The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, has recently added eight more grantees who will receive funding to conduct health impact assessments, or HIAs. The projects will bring health considerations into upcoming decisions on topics including education, sanitation infrastructure, and energy. “Our new grantees will use health impact assessments to uncover opportunities to improve health in a wide range of policy decisions, as well as to identify and avoid potential unintended consequences,” said Aaron Wernham, MD, director of the Health Impact Project. “These eight HIAs are the latest in a fast-growing field, as more cities and states find them a useful way to bring health into decisions in other sectors.” By the end of 2007, there were 27 completed HIAs in the United States. There are now more than 225 completed or in progress, according to the Health Impact Project map of HIA activity in the United States. Read more on health impact assessment.

Post-ER Visit for Chest Pain Reduces Heart Attack Risk
Seeing a doctor within a month of an emergency room visit for chest pain significantly reduced the risk of a heart attack or death among high risk patients, according to a recent study in the journal Circulation. Researchers analyzed data on 56,767 adults (average age 66, 53 percent men) in Ontario, Canada, who were diagnosed with chest pain in an emergency room between April 2004 and March 2010 and had been previously diagnosed with heart disease or diabetes. They tracked data for a median 3.7 years and accounted for differences in key patient characteristics such as age, gender, health status and location. According to the study, only 17 percent of high risk chest pain patients seen in the emergency room were evaluated by cardiologists within a month; 58 percent saw a primary care physician and 25 percent had no physician follow-up within a month. Patients who followed up with a cardiologist within 30 days were 21 percent less likely to have a heart attack or die within one year, compared with patients who failed to seek additional care within that time. Patients seen by a primary care physician were 7 percent less likely to have a heart attack or die compared to those patients who sought no follow up care. Read more on heart health.

Study: Minor Injuries in Some Children May Indicate the Possibility of More Serious Child Abuse Later On
A study in Pediatrics finds that relatively minor abuse injuries often precede more serious abuse of children. The study refers to “sentinel” injuries—a previous injury reported in a child’s medical history that was suspicious or had an implausible explanation. Researchers examined records of infants seen by the child protection team at Children’s Hospital of Wisconsin between March 2001 and October 2011. Of the 200 children who were definitely abused, 55 (27 percent) had a sentinel injury. Of those, 80 percent had a bruise, 11 percent had an injury inside the mouth, and 7 percent had a fracture. Of 100 children where abuse was suspected but not confirmed, 8 had a sentinel injury. None of the infants in the control group—who had no history of abusive injuries—had a sentinel injury. The study authors say their findings suggest that in more than a quarter of cases of definite physical abuse, there may be escalating and repeated violence toward the infant instead of a single event of momentary loss of control by a frustrated or angry caregiver. Improved recognition of sentinel injuries and interventions would prevent additional cases of child abuse, according to the researchers. Read more on injury prevention.

HUD Renews Grants for Local Communities’ Response to Homelessness
The U.S. Housing and Urban Development Department (HUD) is renewing funding for 7,000 local homeless housing and service programs across the country. The funding ensures the programs will remain open for at least the coming year, according to HUD, which has challenged local communities to review their response to homelessness and to emphasize proven strategies including “rapid re-housing” for homeless families and permanent supportive housing for people who experience chronic homelessness. The amount of renewed funding is $1.5 billion in grants that will support programs including street outreach, client assessment and direct housing assistance. HUD expects to award additional grants later this year. HUD recently announced its 2012 “point in time” estimate of the number of homeless persons in America. Approximately 3,000 cities and counties reported 633,782 homeless persons on a single night in January of 2012. Read more on housing.

Policy and Practice Changes Needed to Improve Survival in People who have Heart Attacks in the Hospital
Policy and practice changes by healthcare institutions, providers and others could greatly improve survival for people who have a have a heart attack in the hospital, according to an American Heart Association (AHA) consensus statement in its journal, Circulation. Each year, more than 200,000 adults and 6,000 children have in-hospital cardiac arrests, and survival has remained essentially unchanged for decades, according to the AHA. Only 24.2 percent of in-hospital cardiac arrest patients survive to hospital discharge.

Key recommendations include:

• Establishing competency of all hospital staff in recognizing a cardiac arrest, performing chest compressions and using an automated external defibrillator or AED.
• Ensuring that best practices are used in all stages of care for cardiac arrest.
• Requiring that all in-hospital cardiac arrests be reported, with survival data, using consistent definitions across hospitals. Definitions currently are not standardized, according to the researchers.
• Modifying billing codes to allow collection of more specific and accurate data for in-hospital cardiac arrest.
• Separate guidelines for in-hospital versus out-of-hospital cardiac arrests.

Read more on heart health.

NIH: Cardiovascular Benefits Outweigh Small Weight Gain for Former Smokers
When it comes to health, the small amount of weight someone can gain after quitting smoking is inconsequential compared to the improvement in cardiovascular health, according to a new study in the Journal of the American Medical Association. Researchers from the National Institutes of Health found that current smokers were at twice the risk of developing cardiovascular disease as were former smokers without diabetes. “Our findings suggest that a modest weight gain, around 5-10 pounds, has a negligible effect on the net benefit of quitting smoking,” said study co-author Caroline Fox, MD, MPH, senior investigator in the Laboratory for Metabolic and Population Health at the NIH’s National Heart, Lung, and Blood Institute (NHLBI). “Being able to quantify to some degree the relationship between the benefits and side effects of smoking cessation can help in counseling those who have quit or are thinking about quitting.” Read more on tobacco.

FDA: Antibiotic Azithromycin Can Cause Fatal Irregular Heart Rhythm
The antibiotic azithromycin, also known as Zithromax, can lead to a potentially fatal irregular heart rhythm by changing the heart’s electrical activity, the U.S. Food and Drug Administration (FDA) has warned. The FDA is cautioning physicians to be wary of certain risk factors when prescribing the antibiotic, including low levels of potassium or magnesium, a slower-than-normal heart rate and the presence or other drugs to treat abnormal heart rhythms. Read more on heart health.

Study: Breast-feeding has No Effect on Weight Later in Life
Despite previous studies suggesting a possible link, breast-feeding does not reduce the chances that a child will grow up to be overweight or obese, according to a new study in the Journal of the American Medical Association. Still, breast-feeding does bring several health benefits, including a reduced risk of gastrointestinal and respiratory infections; a higher IQ; and lower incidence of eczema. It also reduces the risk of breast and ovarian cancer in the mother. "Although breast-feeding is unlikely to stem the current obesity epidemic, its other advantages are amply sufficient to justify continued public health efforts to promote, protect and support it," said the study's lead author, Richard Martin, a professor of clinical epidemiology at the University of Bristol in England. Read more on infant and maternal health.

AAP: Out-of-school Suspensions, Expulsions Harmful to Kids
Out-of-school suspensions and expulsions are generally counterproductive and can have profound long-term negative effects, according to the American Academy of Pediatrics (AAP). Data shows the youth are more likely to drop out of school, more likely to be involved in the juvenile justice system and will earn $400,000 less over a lifetime than a high school graduate. Such discipline also does not address potential underlying issues, such as drug abuse, racial tension, violence and bullying, according to AAP. AAP recommends early intervention programs to recognize and address behavioral and other problems. Recommendations also include a Positive Behavior Intervention and Support program to teach proper behavior at both the individual and school-wide levels. Read more on violence.

Study: 1 in 4 Admit to Bizarre Late-night Snacking
Approximately one in four students admit to creating and eating late-night crazy food concoctions, according to a new report in the International Journal of Eating Disorders. Researchers defined the relevant snacks as “strange food mixtures that you would be too embarrassed or ashamed to share with others” (e.g. sugar-covered scrambled eggs or mayo-smothered vegetables). While there is no inherent health danger in such mixing, health professionals recommend that people try to make healthy choices when selecting late-night snacks. About one-third of U.S. adults and nearly one in five youth ages 2-19 are obese, according to the U.S. Centers for Disease Control and Prevention. Read more on nutrition.

Study: Mediterranean Diet Good for Heart Health
A Mediterranean diet—rich in olive oil, nuts, fresh fruits, fresh vegetables and even red wine—is more effective than a low-fat diet at helping at helping people at high risk for cardiovascular disease to ward off health problems, according to a new report in the New England Journal of Medicine. Researchers found a 30 percent greater reduction in relative risk of a heart attack, stroke or death, according to lead author Miguel Angel Martinez-Gonzalez, MD, MPH, PhD, chairman of preventive medicine and public health at the Universidad de Navarra in Spain. He said the findings are likely to due to the good-quality fats and wide array of nutrients. The findings give further support to the effectiveness of a Mediterranean diet at preventing heart disease. Read more on heart health.

Public health departments and schools of public health across the country are showing the love this Valentine’s Day. Many have loaded great ideas for healthy hearts and happy lives on their home pages, Twitter feeds and  Facebook pages:

• The Massachusetts Department of Health offers (somewhat) healthy  Valentine’s Day chocolate ideas.  
• The Lexington-Fayette County (Kentucky) Health Department wants to salute American Heart Month (February) by having people wear red for Valentine’s Day and share photos through the department’s  Twitter feed or Facebook page.
• A community health clinic in Yolo County, Calif., is holding its annual Valentine’s Day diaper drive.
• Our Favorite: A Valentine’s Day infographic from the Ohio State University College of Public Health gives healthy AND romantic tips for the day. Best idea—take romantic walks! [See full infographic below.]
  

>>Bonus Link: Whether you mailed a card or not, the Centers for Disease Control and Prevention has a virtual rack full of Valentine’s Day health-e (get it?) cards, with all the gush, and plenty of heart-healthy ideas.

Study: No Link Between Hospital Deaths, Readmission Rates
Hospital readmission rates—which Medicare can use to penalize health care providers—and death rates are not linked, according to a new study in the Journal of the American Medical Association. Researchers, who looked at rates for heart attack and pneumonia patients, say this means hospitals can still keep the number of returning patients down without increasing the number who die. "The concern was that their performance in one area is going to compromise their performance in another," said Harlan Krumholz, MD, lead author from the Yale University School of Medicine in New Haven, Connecticut. The U.S. Centers for Medicare and Medicaid Services reduces payments to hospitals with high readmission rates. Read more on access to health care.

HUD, HHS Grants to Provide Housing for Low-income People with Disabilities
The U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Health and Human Services (HHS) is granting approximately $98 million in funding to help prevent homelessness and unnecessary institutionalization of extremely low-income people with disabilities. Thirteen state housing agencies will use the grants to provide rental assistance. “By working together, HUD and HHS are helping states to offer permanent housing and critically needed supportive services to offer real and lasting assistance to persons who might otherwise be institutionalized or living on our streets,” said HUD Secretary Shaun Donovan in a release. “We’re helping states reduce health care costs, improving quality of life for persons with disabilities, and ending homelessness as we know it.” Read more on housing and disability.

High-calcium Diets, Supplements May Increase Death from Heart Disease for Women
High-calcium diets and supplements may increase the risk of death by heart disease for women, according to a new study in BMJ. Another recent study found a similar link among men. Calcium supplements are taken to prevent bone loss and had been speculated to also improve cardiovascular health. Instead, researchers found diets very low or very high in calcium can causes changes in blood level. Most adults should intake 1,000 to 1,200 milligrams of calcium daily, according to the U.S. Office of Dietary Supplements. Read more on heart health.