Even Healthy Weight Adults with High Body Fat at Increased Risk of Heart Disease
Even older adults with healthy body weights can be at increased risk of cardiovascular diseases if they have high percentages of body fat, according to a new study The American Journal of Cardiology. "Just because someone has a normal BMI does not necessarily mean they are metabolically normal," said lead researcher Dr. John Batsis, a geriatrician at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. The study found that women with excess body fat (above 35 percent) were 57 percent more likely to die from heart-related causes within 11 years than were women with healthy body fat levels. Javier Salvador, MD, an endocrinologist at the University Clinic of Navarra in Pamplona, Spain, who was not involved in the study, said the findings demonstrate the limits of body mass index (BMI), which measures weight in relation to height. Read more on heart health.

‘Image Discrepancies’ of Job Roles Can Hurt Job Satisfaction, Performance and Pay
The lack of client understanding of the actual job roles of nurse practitioners and other professionals can negatively impact job satisfaction, performance and pay, according to a recent study in the Academy of Management Journal. "If people don't understand what you do, they tend to devalue what you do," study co-author Michael Pratt, a professor of management and organization at Boston College. "They don't understand why you're making all this money—'Why should I pay you all this money?' is a common question these professionals keep hearing." The study looked at “image discrepancies” in four professions—nurse practitioners, architects, litigation attorneys and certified public accountants—finding a noticeable and negative lack of understanding by clients for each. For example, many patients don’t realize that nurse practitioners can examine patients and prescribe medicine, and instead insist on seeing a doctor. "I assumed professionals would actually get over it, that there would be frustration, it would be an interpersonal problem, and that would be the extent of it," Pratt said. "I didn't think it would have such a big impact on how they did their job, how it affected their pay and how they performed. I was surprised at the depth of how this affected job performance. It's not simply annoying -- it has real impact.” Read more on mental health.

CDC Emphasizing Electronic Laboratory Reporting to Improve Public Health’s Response to Disease Outbreaks
The U.S. Centers for Disease Control and Prevention’s (CDC) emphasis on the widespread adoption of electronic laboratory reporting (ELR) has helped improve public health’s response to dangerous infections, according to data from CDC’s Morbidity and Mortality Weekly Report (MMWR). ELRs enable labs to report disease outbreak information quickly and in a usable format. The number of labs that utilize ELRs has more than doubled since 2005, and CDC has helped fund their increased use since 2010 in 57 state, local and territorial health departments. Current estimates are that about 62 percent of lab reports were received electronically. “Electronic laboratory reporting can give health officials better, more timely and complete information on emerging infections and outbreaks than they have ever received before,” said Robert Pinner, MD, associate director for surveillance, programs and informatics in CDC’s National Center for Emerging and Zoonotic Diseases. “Implementing these systems is a complex task that requires substantial investment, but ELR will provide health departments the tools they need to quickly identify and respond to disease threats and monitor disease trends now and in the future.” Read more on technology.

Report: U.S. Poverty, Uninsured Rates Remain Stagnant
Despite an improving economy that included the creation of more than 2 million jobs last year, the U.S. poverty rate in 2012 remained relatively equal to the previous year, according to a new report from the U.S. Census Bureau, Income, Poverty, and Health Insurance Coverage in the United States: 2012. About 46.5 million people lived at or below the poverty line in 2012, or about 15 percent of the nation. That’s about 2.5 percentage points higher than 2007, right before the economic recession. About 48 million people were without health insurance in 2012, only slightly lower than the 48.6 million in 2011. While the recession seems to have leveled out, the fact that poverty rates have yet to truly rebound has many experts concerned. “We’re supposed to be in recovery,” said Austin Nichols, a researcher at the Urban Institute. “Poverty rates should be falling because long-term unemployment is falling. And they're not.” Read more on poverty.

Economic, Mental Toll of Economic Crisis Likely Responsible for Global Jump in Men’s Suicide Rates
The economic and mental toll of the 2008 global economic crisis was likely a major contributor to the surprising increase in the U.S. and global male suicide rates in 2009, according to a new study in the journal BMJ. There were about 5,000 more suicides than expected that year. The male suicide rate in the United States climbed almost 9 percent in the United States in 2009; the overall global rate climbed 3.3 percent, with the largest increases seen in the European Union and North and South American countries. Depression and stress can lead to increased alcohol and drug abuse, which are also suicide risk factors. The study concluded that immediate action, such as job-creation programs, may help prevent a continued increase in suicides. "Unemployment appears to lead to an increase in anxiety and depression -- two psychiatric symptoms that might be intermediate steps toward suicide," said Robert Dicker, MD, associate director of the division of child and adolescent psychiatry at North Shore-LIJ, in New Hyde Park, N.Y., who was not a part of the study. "More unemployment, more family distress, more losses [of status and friends] also most likely are involved." Read more on mental health.

Study: Two Simple Questions on Mobility Can Help Assess, Treat Older Adults’ Physical Declines
Two simple questions about mobility could help doctors more accurately assess and treat an older adult’s physical decline, according to a new study in the Journal of the American Medical Association:

• For health or physical reasons, do you have difficulty climbing up 10 steps or walking a quarter of a mile?
• Because of underlying health or physical reasons, have you modified the way you climb 10 steps or walk a quarter of a mile?

The answers could help determine whether physical therapy or mobility-assistance devices are needed. The findings emphasize the importance of increased physical activity and exercise in health aging, according to Cynthia Brown, MD, of the division of gerontology, geriatrics and palliative care at the University of Alabama at Birmingham. "With an increasing older population in the United States, it is incumbent on us to find ways to help older Americans continue to live well and independently,” she said. “The major barriers—lack of physical activity, obesity and smoking—are all risk factors that can be successfully overcome with appropriate treatment and assistance." Read more on aging.

Higher Education Linked to Better Obesity Rates for Women in Poorer Areas
Higher education is a key factor that helps protect women in economically disadvantaged areas from obesity, according to a new study in the American Journal of Health Promotion. “It is possible that education is a marker of an individual’s access to health information, capacity to assimilate health-related messages, and ability to retain knowledge-related assets, such as nutrition knowledge,” wrote the study’s authors. Previous studies have shown that women living in area with fewer economic resources have higher body mass index (BMI) than other women. The results indicate that both low education and personal income should be addressed by obesity prevention initiatives. Read more on obesity.

Regular Exercise May Help Decrease Depression
Increases in exercise may be linked to decreases in depression, according to a new review of existing research by The Cochrane Library. The researchers found people with depression who also exercised saw a “moderate” reduction in their symptoms when compared to people who did instead used relaxation techniques or received no treatment. Antidepressant medications and psychotherapy are the most common treatments for depression, which affects about 10 percent of Americans, according to the U.S. Centers for Disease Control and Prevention. More research is needed to better understand the relationship between exercise and depression symptoms. Still, Madhukar Trivedi, MD, a professor of psychiatry at the UT Southwestern Medical Center in Dallas, who was not a part of the study, said one of the keys is making sure patients stick with the exercise regimen. "Once people are prescribed exercise or they choose exercise, the big challenge is to make the exercise real," he said. "If the recommendation from the treating clinician is that you should be exercising with some frequency and intensity…it's important that the patient follow that regimen week after week.” Read more on mental health.

Predominantly Black Nursing Homes Deliver Lower Levels of Care, Perform Worse Financially
Nursing homes that are predominantly populated by black residents deliver overall poorer care and are less successful financially than homes with few or not minority residents, according to a new study in Health Services Research. The study looked at issues such as the ratio of nursing staff to patients, success in preventing pressure ulcers, help with walking, help with getting out of bed, prevention of urinary tract infections, the incidence of medication errors and citations by governmental agencies. However, the study noted that black and white patients living in the same facilities received equal treatments, meaning the disparity is not due to any biases of health care workers. One factor leading to the disparity could be the fact that older black Americans are more likely to rely on Medicaid, which means lower reimbursement rates. Still, Latarsha Chisholm, assistant professor at the University of Central Florida and study author, believes something more must be at play. "It isn't only the financial performance [of nursing homes] that affects performance," she said. "There has to be something else affecting quality. I want to understand what management practices promote improved care in nursing homes with high proportions of minorities that don't have disparities in care.” Read more on health disparities.

Study: 60 Percent of Uterine Cancer Cases are Preventable
Approximately 60 percent of U.S. uterine cancer cases are preventable thorough regular physical activity and maintaining a healthy weight, according to a new study from the American Institute for Cancer Research (AICR) and World Cancer Research Fund International. That comes out to nearly 30,000 cases per year; endometrial cancer is the most common cancer of the female reproductive system, ahead of both ovarian cancer and cervical cancer. "Body fat can produce hormones that promote cancer development," said Alice Bender, nutrition communications manager for AICR. "We also know that body fat is linked to chronic inflammation, which produces an environment that encourages cancer development." The study also found various dietary choices that influence cancer risk because of the way they influence hormones such as estrogen and insulin. For example, drinking one cup of coffee a day can reduce the risk of endometrial cancer by 7 percent, while eating sugary items and processed grains can increase it. Read more on cancer.

Overweight, Obese People More Likely to Suffer from Migraines
Migraines can now be added to the long list of medical conditions more likely in people who are overweight or obese, according to a new study in the journal Neurology. Researchers found the painful, often-debilitating headaches were twice as common for obese people as they were for people of normal weight. As many as 15 percent of people suffer from episodic migraines and approximately 32 percent of people with the migraines were obese. "This suggests patients and doctors need to be aware that obesity is associated with an increased risk of episodic migraine and not wait until a patient has chronic migraine to address healthy lifestyle choices, such as diet and exercise, and to choose medications that impact weight with care," said lead researcher Lee Peterlin, MD, from the Johns Hopkins University School of Medicine, according to Reuters. While further research is needed to determine causation, the study results do provide yet one more reason to make healthy lifestyle changes. Read more on obesity.

Anger, Irritability May Be Signs of More Severe, Chronic Depression
Irritability and anger may indicate more complex, chronic and severe forms of major depression, according to a new study in JAMA Psychiatry. Symptoms of irritability and anger during a major depressive episode (MDE) appear to be clinical markers for a significantly more complex, chronic, and severe form of major depressive disorder, a new study indicates. Researchers found that people with MDEs who also exhibit anger and irritability were more likely to have increased severity of their depression, longer bouts of depression, lower impulse control and a more chronic long term course of illness. The findings indicate that people who exhibit these behaviors need closer clinical monitoring that "should include specific strategies to address anger management issues, as well as the frequently associated problems of comorbid anxiety disorder, substance abuse disorder, poor impulse control, and psychosocial impairment when these are present." Read more on mental health.

It’s been more than forty years since a U.S. vice presidential candidate, Senator Thomas Eagleton, was forced to withdraw his name from the ticket after it was revealed he’d been treated for depression. Medical science and understanding have come a long way since then. Still, for many there is still a stigma surrounding mental illness—a stigma that can leave people, already hurting, feeling even more alone.

This is a clear and major public health issue which dramatically reduces the likelihood that someone with a mental health condition will seek out and have access to effective health care and social services. In fact, only 38 percent of U.S. adults with diagnosable mental illnesses receive the treatment they need. The numbers are even worse for children and adolescents, with less than 20 percent getting treatment.

September is Suicide Prevention Month and Sept. 10 is the 11th-annual World Suicide Prevention Day. This year’s theme is “Stigma: A Major Barrier for Suicide Prevention.” Suicide is one of the top ten leading causes of death in the United States—with more than 38,000 deaths each year—and many of those people suffered in silence rather than reaching out to loved ones and available avenues of help.

As part of the collective effort to combat this barrier to full and compassionate care, the American Psychiatric Association (APA) is working to raise awareness so that people with mental illnesses and substance use disorders can feel more confident in seeking treatment, just as anyone with most any other medical concern would be.

APA’s new Public Service Advertisements (PSAs) series, called “A Healthy Minds Minute,” features a number of celebrities and prominent figures calling for equal access to quality care and insurance coverage for people with mental illness and substance use disorders. Below is a video with Former Congressman Patrick Kennedy.

>>Watch the APA’s “A Healthy Minds Minute” online video series.

U.S. Circumcision Rate Down 10 Percent over Past Three Decades
The circumcision rate of U.S. newborns dropped approximately 10 percent from 1979 to 2010, according to new date from the National Center for Health Statistics. In 2010 about 58.3 percent of boys born in U.S. hospitals were circumcised; the rate was 64.5 percent in 1979. While beginning as a religious ritual, the use of circumcision expanded due to potential health benefits such as reduced risk of urinary tract infections in infants and reduced risk of sexually transmitted diseases. Last August the American Academy of Pediatrics said that these benefits outweigh any risks. However, the procedure also has many opponents. While the report did not go much into the reasons for the decline, possible explanations include the fact that Medicaid has stopped paying for circumcisions in 18 U.S. states, some insurers are not covering procedures without strong medical justifications and shorter hospital stays for new mothers means some circumcisions are performed later as outpatient procedures. Read more on maternal and infant health.

Eating Fruit Helps Prevent Certain Aneurysms
An apple—or any other fruit—a day may lower a person’s risk of an abdominal aneurysm, according to a new study in the journal Circulation. The thirteen year study of 80,000 people ages 48 to 64 in Swede found that people who reported eating more than two servings of fruit daily had a 25 to 31 percent lower risk of abdominal aortic aneurysm than those who ate little or no fruit. High levels of antioxidants in fruits might protect against abdominal aortic aneurysm by preventing oxidative stress that can promote inflammation, according to the researchers, who found no similar association for vegetables, which are also rich in antioxidants, but may lack some of the components in fruits. However, vegetables remain important to a person’s diet, say the study authors. Combined with fruit they may help decrease the risk of cardiovascular diseases, type 2 diabetes, high blood pressure and several cancers. The American Heart Association advises the average adult to eat four to five servings each of fruits and vegetables daily, based on a 2,000 calorie diet. Read more on nutrition.

Study: CTE Victims First Present with Impaired Mood or Thinking
People suffering from chronic traumatic encephalopathy (CTE)—a neurodegenerative disease that can only be diagnosed after death—will likely first begin exhibiting either impaired behavior and mood or impaired memory and thinking abilities, according to a new study in the journal Neurology. CTE is characterized by impulsivity, depression and erratic behavior. "The study itself is relatively preliminary, [but] we found two relatively distinct presentations of the disease," said study co-author Daniel Daneshvar, a postdoctoral researcher at the university's Center for the Study of Traumatic Encephalopathy. "So little is known about the clinical presentation of CTE that anything we found is not necessarily surprising, simply because there's a dearth of information about CTE." Researchers emphasized that far more study is needed. CTE and other head trauma have become increasingly prominent issues over the last several years, with cases linked to both sports injuries and battlefield injuries. There is currently a lawsuit by almost 4,000 former NFL players claiming the league did not properly inform them of the dangers of concussions or adequately protect their health. Read more on injury prevention.

Kids’ Chronic Stomach Pain Could Be Sign of Anxiety Disorder
Kids with chronic stomach pain without a clear medical explanation— such as inflammatory bowel disease or celiac disorder—are more likely to suffer from an anxiety disorder, according to a new study in the journal Pediatrics. Previous research indicates as many as one in four youth have what is known as functional abdominal pain. Lynn Walker, from the Vanderbilt University School of Medicine in Nashville, Tenn., and researchers found that about 51 percent of people with stomach pain as children had experienced an anxiety disorder and 30 percent at the present met the diagnostic criteria for a diagnosis; only 20 percent of people without stomach pain had experienced an anxiety disorder and 12 percent currently had one. In addition to helping identify present and later anxiety disorders, knowing and treating the issue is also critical for kids because of how the chronic pain can impact their lives and education. "It's very prevalent, and it's one of the most common reasons that children and adolescents end up in their pediatrician's office. It's one of the most common reasons kids are missing school," said Eva Szigethy, MD, head of the Medical Coping Clinic at the Children's Hospital of Pittsburgh Inflammatory Bowel Disease Center. Read more on pediatrics.

Study: Genetic Overlap in Common Mental Disorders
A shared, common inherited genetic variation was seen in an analysis of five major mental disorders, which could ultimately help improve the classification and treatment of the disorders, according to a new study in the journal Nature Genetics. The greatest overlap was between schizophrenia and bipolar disorder with about 15 percent, followed by bipolar disorder and depression with about 10 percent; attention-deficit/hyperactivity disorder and depression with about 10 percent; and schizophrenia and autism with about 3 percent. Researchers noted that as they only looked at common gene variants, the actually genetic overlap could be much greater. "Such evidence quantifying shared genetic risk factors among traditional psychiatric diagnoses will help us move toward classification that will be more faithful to nature," said Bruce Cuthbert, director of the U.S. National Institute of Mental Health's (NIMH) adult translational research and treatment development division, as well as coordinator of an NIMH project to develop a mental disorders classification system for research based more on underlying causes. Read more on mental health.

FDA: Nationwide Voluntary Recall of Drug to Treat Low Calcium
The U.S. Food and Drug Administration has announced a nationwide voluntary recall of all products for sterile use manufactured by Specialty Compounding, LLC, of Cedar Park, Texas, related to possible bacterial bloodstream infections due to calcium gluconate infusions. The drug, which is used to treat low calcium levels, has been linked to 15 infections in two Texas hospitals. Facilities, health care providers and patients who have received the products after May9 should immediately quarantine them and return them to the manufacturer. The products were shipped to patients, hospitals and physicians’ offices, depending on the area of the country. “The FDA believes that use of these products would create an unacceptable risk for patients," said Janet Woodcock, M.D., director of FDA’s Center for Drug Evaluation and Research. "Giving a patient a contaminated injectable drug could result in a life-threatening infection.” Read more on infectious disease.

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.

Much Like Television, Excessive Cell Phone Use Lowers Fitness Levels
Are you reading this on your smartphone? If so, it’s probably not doing your weight any good. A new study in the International Journal of Behavioral Nutrition and Physical Activity has linked cell phone use by college students to decreased physical activity and fitness levels. Much like watching television, cell phone use is a largely sedentary activity that is easy to get lost in. It can also lead to casual overeating. Researchers found the average student spent about five hours on the phone each day and sent hundreds of text messages. "We have to look at this similar to what happened in the industrial revolution and how it changed us," said Nancy Copperman, director of public health initiatives at North Shore-LIJ Health System, in Great Neck, N.Y. "A study like this raises the importance of how this technology affects how we move, eat and sleep. We have to look at the impact of technology on our health." Read more on technology.

Study Links Bipolar Disorder, Early Death
A new study showing that people with bipolar disorder are more likely to die early and from a variety of causes also illustrates the difficulty of treating the physical effects of the illness. "Whatever we're doing, these people are not dying (just) because of suicide. That's not the reason for increased mortality. That's a hard thing to get across," said David Kupfer, PhD, a professor of psychiatry at the University of Pittsburgh School of Medicine, who was not a part of the study. The study found that people with bipolar disorder—an estimated 1 to 5 percent of the global population—die about nine years earlier and are at higher risk for heart disease, diabetes, chronic obstructive pulmonary disorder, the flu and pneumonia. However, people who knew they were bipolar had the same death rates as those who were not, which suggests "that timely medical diagnosis and treatment may effectively reduce mortality among bipolar disorder patients to approach that of the general population," according to the study. Read more on mental health.

One Dose of ADHD Medication Improves Balance in Older Adults
A single dose of an attention deficit/hyperactivity disorder (ADHD) medication can improve the balance of older adults who have difficulty walking, according to a new study in The Journals of Gerontology. Methylphenidate (MPH) is also used to treat narcolepsy. Researchers at Ben-Gurion University of the Negev found that it can reduce the number and rate of step errors in both single and dual tasks. "Our results add to a growing body of evidence showing that MPH may have a role as a therapeutic option for improving gait and reducing fall risk in older adults," said Itshak Melzer of BGU's Schwartz Movement Analysis and Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences. "This is especially true in real-life situations, where the requirement to walk commonly occurs under more complicated, 'dual task' circumstances with cognitive attention focused elsewhere (e.g., watching traffic, talking) and not on performing a specific motor task." Read more on aging.

In several recent and upcoming posts, NewPublicHealth is connecting with communities that have faced severe weather disasters in the last year. New York City, for example, is continuing to regroup and rebuild after Hurricane Sandy struck the region eight months ago. The city, and its health department, recently announced several initiatives aimed at “building back better” while supporting residents still facing housing as well as mental health problems since the storm last October. Some examples are detailed below.

• The New York City Building Resiliency Task Force, an expert panel convened after Hurricane Sandy to help strengthen buildings and building standards, recently issued a report with recommendations for buildings and homes of all sizes in the city. The report recommends establishing backup power in the event that primary networks fail; protecting water supplies and stabilizing interior temperatures if residents need to shelter in place. ”Making our city’s buildings more resilient to coastal flooding and other climate hazards is a challenge that requires collaboration among government, designers, engineers, and building owners, among others,” said City Planning Commissioner Amanda M. Burden. “The Task Force's work exemplifies the kind of innovation and cooperation necessary to prepare our city for a changing climate.”  To create the report, the Task Force convened over 200 volunteer experts in architecture, engineering, construction, building codes and real estate.