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.

FDA Approves Plan B One-Step for Women 15 and Older
The U.S. Food and Drug Administration (FDA) has approved over-the-counter use of the Plan B One-Step emergency contraceptive for women age 15 years or older. The single dose pill previously required a prescription. “Research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States,” said FDA Commissioner Margaret A. Hamburg, MD “The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly, and that it does not prevent the transmission of a sexually transmitted disease.” Last month a federal judge in New York ordered the FDA to make Plan B available to all women and/or make Plan B One-Step available “without age or point of sale restrictions,” according to an FDA release. Read more on teen pregnancy.

Study: Amusement Rides Injure 4,000 U.S. Kids Annually
As the weather warms and families start to plan summer vacations, it’s important for parents to remember to use caution when selecting amusement park rides. More than 4,000 kids are injured on an amusement ride each year in the United States, according to researchers at the Center for Injury Research and Policy at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio. Injuries sent about 93,000 children to emergency rooms between 1990 and 2010, with about 70 percent of those coming May through September. Researchers say the numbers demonstrate the need for standardized safety regulations. "Although the U.S. Consumer Product Safety Commission has jurisdiction over mobile rides, regulation of fixed-site rides is currently left to state or local governments, leading to a fragmented system," said senior author Gary Smith, MD, director of the Center for Injury Research and Policy, in a release. "A coordinated national system would help us prevent amusement-ride-related injuries through better injury surveillance and more consistent enforcement of standards." The study includes safety tips for parents. Read more on safety.

Prevention App Wins HHS Challenge
The winner of the a recent mobile app challenge from U.S. Department of Health and Human Services (HHS) Office of Disease Prevention and Health Promotion is the myfamily app developed by Lyfechannel, a company that translates evidence-based health behavior and adherence studies into mobile applications. App users can find prevention information and tips for each member of their family; create personal health alerts; and keep track of medical check-ups and vaccinations. HHS research shows that patients who are better engaged in their own health care have better health outcomes and that electronic tools can help them be better health consumers. Read more on prevention.

USPSTF Recommends HIV Screening for All Americans 15-65
The U.S. Preventive Services Task Force (USPSTF) now recommends that all Americans ages 15 to 65 be screened for HIV, according to new guidelines appearing in the Annals of Internal Medicine. USPSTF’s previous 2005 guidelines recommended screening for only those people categorized as high-risk. The U.S. Centers for Disease Control and Prevention already recommends this course of action. "We do hope the fact that the guidelines are all very similar will provide an impetus for people to offer screening because it is a very critical public-health problem,” said task force member Douglas Owens, MD, a medical professor at Stanford University. Experts noted that the change will likely mean that testing will be covered as a preventive service under the Affordable Care Act. Read more on HIV/AIDS.

HUD’s $1.83B Plan Will Help Rebuild New Jersey, Prepare for Future Disasters
The U.S. Department of Housing and Urban Development’s (HUD) $1.83 billion New Jersey disaster recovery plan will help residents continue to recover from the damage caused by Hurricane Sandy and better prepare for future extreme weather events. “This infusion of federal funding will help New Jersey continue to recover from Superstorm Sandy and ensure that our state is rebuilt stronger and better prepared for future storms,” said Senator Frank Lautenberg (D-NJ). “Families that are rebuilding their homes, small businesses that are getting back on their feet, and communities that are repairing damaged public infrastructure will all benefit from this federal grant program.” The plan is funded through HUD’s Community Development Block Grant Program. The infrastructure restoration efforts will including elevating some homes to guard against future flooding. Read more on Hurricane Sandy.

Early Obesity Dramatically Increases Men’s Risk of Poor Health, Death
Obesity in the early 20’s can dramatically increased a man’s chance of suffering from serious health problems or even dying by the age of 55, according to a new study in the journal BMJ Open. A study tracking Danish men found that approximately half of the participants who were obese at the age of 22 had developed diabetes, developed high blood pressure, had a heart attack, had a stroke, or experienced blood clots or died by age 55. Men of a normal weight at age 22 saw only a 20 percent risk of developing these problems by age 55. Each unit increase in body mass index raised the risk of heart attack by 5 percent; high blood pressure and clots by 10 percent; and diabetes by 20 percent. In the United States approximately 35.7 percent of adults and 17 percent of children are obese, according to the U. S. Centers for Disease Control and Prevention. Read more on obesity.

Survey: Many Americans Still Unaware of or Confused About the Affordable Care Act
Signup for the Affordable Care Act (ACA) Health Insurance Marketplace begins in October, but a new poll from the Kaiser Family Foundation finds that many Americans are still confused about the law, which will require virtually all Americans to sign up for health insurance coverage that will take effect January 1, 2014.

Key poll findings include:

• More than 40 percent of Americans aren’t aware that the ACA is the law of the land.
• Of those who aren’t aware that the ACA is now law, 12 percent think the law was repealed by Congress and 7 percent think the law was overturned by the Supreme Court.
• About half of the respondents said they did not have enough information about the health reform law to understand how it will impact their family.

The poll findings also showed that people who are currently uninsured and those in low-income households were the most likely groups to say they did not understand how the ACA benefits them and their families. Read more on access to health care.

Study: Single Can of Sugary Soda Can Increase Diabetes Risk 22 Percent
Drinking even a single 12-ounce can of sugary soda once a day can up the risk of diabetes by 22 percent, according to a new study out of Imperial College London. Researchers looked at the data of approximately 350,000 European residents. "Given the increase in sweet beverage consumption in Europe, clear messages on the unhealthy effect of these drinks should be given to the population," said study leader Dora Romaguera, according to Reuters. Previous studies have also shown a link between sugary drinks and increased risk of obesity and type 2 diabetes, which affects approximately 310 million people, according to the World Health Organization. Read more on diabetes.

Teen Years in the ‘Stroke Belt’ Ups Risk of Stroke Later in Life
Growing up as a teenager in the U.S. “stroke belt”—an area in the country’s southeast—can increase the risk of stroke later in life by as much as 17 percent, according to a new study in the journal Neurology. Risk factors including high blood pressure and diabetes are only partially responsible for the increase risk. "Many social and behavioral risk factors, such as smoking, are set in place during the teenage years, and teens are more exposed to external influences and gain the knowledge to challenge or reaffirm their childhood habits and lifestyle," said study author Virginia Howard, with the School of Public Health at the University of Alabama at Birmingham, in a release. Across all age groups the risk was double for black Americans when compared to white Americans. Researchers were careful to note that the findings do not demonstration causation. Read more on strokes.

Poultry Probably Source of China’s New Bird Flu Strain
Researchers believe that poultry-to-human transmission from “wet” markets is likely responsible for the new H7N9 bird flu strain that has killed 22 people in China and infected more than 100. Wet markets sell and immediately slaughter poultry. So far the strain does not seem to pass easily between people, so the researchers feel relatively confident that closing the markets and slaughtering the birds will control the outbreak. “Overall, the evidence, in terms of epidemiology and virology, suggests that it is a pure poultry to human transmission, and that controlling [the epidemic in humans] will therefore depend on controlling the epidemic in poultry,” said Kwok-Yung Yuen of the University of Hong Kong, according to MSNBC. The findings were published in the journal Lancet. Read more on infectious disease.

New York City Moves to Ban Cigarette Sales to People Under 21
A bill introduced to the New York City Council would ban cigarette sales to anyone under the age of 21. The current age limit is 18. "Too many adult smokers begin this deadly habit before age 21," City Council Speaker Christine Quinn said. "By delaying our city's children and young adults access to lethal tobacco products, we're decreasing the likelihood they ever start smoking, and thus, creating a healthier city." Though not introduced by Mayor Michael Bloomberg, he does support the bill. New York City also has the highest taxes on cigarettes of any U.S. city, with a city tax of $1.50 on top of a state tax of $4.35. Read more on tobacco.

Insurance Authorization Delays Trap Psychiatric Patients in ERs
Thousands of hours of physician time is lost each year caring for emergency department patients in need of psychiatric care, but waiting for insurance authorization to be admitted into the hospital, according to a letter to be published in the May issue of Annals of Emergency Medicine. Researchers found that about half of authorizations were completed in less than 20 minutes, but 10 percent took at least an hour. About 2.5 million people are admitted to hospitals for psychiatric care each year. "Psychiatric care is really the poor stepchild in the world of insurance coverage," said lead author Amy Funkenstein, MD, of Brown University in Providence, R.I.. "Insurance carriers reimburse poorly and as a consequence, hospitals often have inadequate resources for patients who urgently need this care. The situation is so dire that ERs are now being designed and configured to house psychiatric patients awaiting placement as inpatients. These patients deserve better." Read more on mental health.

Report Finds Positive, Negative News on U.S. Air Quality
Areas across the country have seen a mix in terms of improvement of air quality over the past decade, according to a new report from the American Lung Association (ALA). "The long-term trend is positive and headed to much cleaner air," said author Janice Nolen, ALA's assistant vice president of national policy and advocacy. "[However], there is an uptick in some areas that are a concern and some areas where the problem remains very, very serious." Approximately half of the 25 most polluted cities in 2000 saw improvements in air quality, with the others seeing declines. And some of the “improved” cities still were highly polluted, such as Los Angeles and Bakersfield, Calif. Houston, Dallas, Oklahoma City, Cincinnati, New York City and Washington, D.C. were the other cities with the highest levels of ozone. Overall, the report found that 132 million people were living in 254 counties with unhealthy levels of ozone or particle pollution. Read more on environment.

Supreme Court Lets FDA Move Forward with Graphic Cigarette Warnings and Other Tobacco Regulations
The Supreme Court yesterday announced that it will not hear the tobacco industry's appeal of a March 2012 ruling by the U.S. Court of Appeals for the Sixth Circuit on graphic cigarette warnings and several other tobacco regulations. That decision allows the U.S. Food and Drug Administration (FDA) to move forward in developing graphic cigarette warnings allowed by a 2009 law that gave the FDA sweeping new authority over tobacco, and other recent court rulings.

The 2009 law requires graphic warnings that cover the top half of the front and back of cigarette packs and 20 percent of cigarette ads. According to the Campaign for Tobacco-Free Kids (CTFK), a tobacco control advocacy group based in Washington, D.C., the graphic warnings are needed to better inform Americans about the deadly consequences of smoking. According to CTFK, the current, text-only warnings which are printed on the side of cigarette packs haven’t been updated since 1984 and often go unnoticed.

The appeals court ruling also upheld other key provisions of the law that:

• Tobacco companies are prohibited from making health claims about tobacco products without FDA review
• Several forms of tobacco marketing that appeal to children would be banned, including brand name sponsorships; tobacco-branded merchandise such as caps and t-shirts; and free samples of tobacco products
• Tobacco companies are prohibited from making statements implying that a tobacco product is safer because it is regulated by the FDA.

In a statement released yesterday, CTFK Executive Director Susan Liss said: “The FDA should move forward aggressively to reduce the death and disease caused by tobacco use, which is the nation's number one cause of preventable death.” Read more on tobacco.

Task Force Finds Insufficient Evidence for Universal Suicide Risk Screenings
While the U.S. Preventive Services Task Force’s latest draft guidelines stated that there is not enough evidence to support universal screening to identify people at risk of suicide, it’s still critical for health care professionals to be wary of certain signs, said David Grossman, MD, MPH, a member of the Task Force. "Although we did not find enough evidence to say ‘here are the right questions and tools to find the people who may be at risk for suicide,' doctors should be screening for depression and alcohol abuse disorders in their primary care population," he said. Top risk factors include depression and alcohol abuse. There are approximately 37,000 cases of suicide in the United States each year. Read more on mental health.

Poll: Nearly 1 in 4 High School Students Have Abused Prescription Meds
Approximately 24 percent of high school students have abused prescription drugs, according to a new poll from by Partnership at Drugfree.org. With about 5 million kids admitting to the medication abuse, the rate is up 33 percent since 2008. About 13 percent say they’ve experimented with Ritalin or Adderall, both of which are used to treat attention-deficit/hyperactivity disorder. At the heart of the problem is the misconception by both kids and parents that misusing prescription drugs is not as dangerous as taking other drugs. "The key here is that kids and often their parents are buying into the myth and misunderstanding that prescription drug abuse is a safer way to get high, a safer alternative to street drugs, and that they can control it," said said Steve Pasierb, president and CEO at the Partnership organization. "And it's very important to note that, on this, kids and parents are in the same place. Kids say that they don't think that their parents are going to be upset if they know about this, and parents are essentially saying the same thing." Read more on prescription drugs.

‘Clean Your Plate’ Order Can Lead to Negative Results
The seemingly reasonable parental edict of “clean your plate” may in fact be counterproductive toward maintaining a healthy weight, according to a new study in the journal Pediatrics. The same can be true with instruction to eat less. Researchers found that restrictive instructions were more common with kids who were overweight and obese, while kids who weren’t overweight were more often linked to encouragement to finish meals. "In the 1950s, cleaning your plate meant something different,” said author Katie Loth, a registered dietician, doctoral candidate and research assistant at the University of Minnesota in Minneapolis. “Portion sizes have gotten bigger over time, and if you encourage kids to rely on environmental indicators, like how much food is on their plates or the time of day, they'll lose the ability to rely on internal cues to know whether they're hungry or full." About 17 percent of U.S. youth and adolescents are obese, according to the U.S. Centers for Disease Control and Prevention. Read more on obesity.

Study: Lack of Insurance Leading Cause of Difficulty for Young Adults with Asthma
Leaving high school and a lack of adult supervision are both factors that may explain the general decline in asthma control for young adults once they’re over the age of 18. However, the main cause is a loss of health insurance, according to a new study in the journal Pediatrics. Researchers found that those under 18 were more likely to utilize primate care and medications. On the other hand, those over age 18 were more likely to turn to emergency care and have difficulty getting costly treatments. While young adults are generally healthier than older adults, people with chronic conditions such as asthma still need to be sure to seek out proper treatment. "Young people with asthma need to work with their care providers to create transition plans from pediatric to adult care that take into account their medical and social history," said study leader Kao-Ping Chua, a staff physician in the division of emergency medicine at Boston Children's Hospital. Read more on access to health care.

China’s Bird Flu Outbreak Keeps Growing; 20 Dead, 105 Infected
China’s outbreak of H7N9 virus—a new strain of bird flu—continues to spread, with 20 people dead and 105 overall infected, according to Reuters. The World Health Organization is conducting field investigations into the infections and the public health response to the outbreak. Ho Pak-leung, an associate professor in the Department of Microbiology at the University of Hong Kong, recently British Medical Journal that this outbreak has already caused twice as many Chinese infections as the H5N1 strain did in about a decade. "H7N9 is much more transmissible to humans, and it's much more difficult to track down," he said. "We don't understand why it's so difficult to find." Read more on infectious disease. Also, read more on what you need to know about H7N9 on APHA's Get Ready blog.

Hookahs Not a Safe Alternative to Cigarettes
Despite the belief of many, smoking tobacco using a hookah is not a safe alternative to cigarettes, according to a new study in the American Association for Cancer Research’s Cancer Epidemiology, Biomarkers & Prevention. Hookah use produces higher levels of carbon monoxide and benzene, linked with heart or respiratory conditions and increased risk of leukemia, respectively. “People want to know if it is a lesser health risk if they switch from cigarettes to smoking a water pipe on a daily basis,” said UC San Francisco research chemist Peyton Jacob III, PhD. “We found that water-pipe smoking is not a safe alternative to cigarette smoking, nor is it likely to be an effective harm-reduction strategy.” The mix of toxins produced by a hookah is due to the combination of the two difference materials smoked, according to researcher Neal Benowitz, MD, of the San Francisco General Hospital and Trauma Center. “You’re basically burning a charcoal briquette on top of the tobacco,” Benowitz said, “and most of what you’re smoking is a moist fruit preparation, which is mixed with the tobacco. It smells good and it tastes good.” Read more on tobacco.

CDC: Number of U.S. Foodborne Illness Cases at a Standstill
After dropping for many years, the number of foodborne illnesses in the United States has apparently leveled out, according to a new study in the Morbidity and Mortality Weekly Report. About 48 million people—or one in six—suffer from a foodborne illness each year. The most common cause is salmonella. "It is still the case now that numbers were lower than they were back in the 1990s," said Robert Tauxe, MD, deputy director of the division of foodborne, waterborne and environmental diseases at the U.S. Centers for Disease Control and Prevention (CDC). "But right now we're just about where we were in 2006 to 2008, and we may need to identify additional ways to reduce contamination, as well as heightening awareness among consumers about the importance of thoroughly cooking and safely handling ground beef in their own homes." Read more on food safety.

Exercise, Healthy Eating Helps Keep Sleep Apnea in Check
The combination of exercise and healthy eating is a simple way to ease the effects of mild sleep apnea, according to a new study in JAMA Internal Medicine. The key is weight loss. Researchers “found obese study participants who went through a one-year lifestyle intervention were about half as likely to see their sleep apnea progress to more severe disease,” according to Reuters. "It usually takes at least a few years to progress from mild disease to the more severe disease, and mostly it's due to weight gain," said Henri Tuomilehto, MD, who led the new study at the Oivauni Sleep Clinic in Kuopio, Finland. "With these results, we can say that if we change our lifestyle…we really can stop the progression of sleep apnea.” Read more on obesity.

Doctors’ Knowledge of Lab Test Costs Reduces Unnecessary Testing
Knowing the cost of a laboratory tests makes doctors less inclined to order them for hospitalized patients, according to a new study in JAMA Internal Medicine. About $226 billion was wasted on unnecessary tests in 2011, according to the study from researchers at The Johns Hopkins University School of Medicine in Baltimore. Unnecessary tests also increase the risk of patient harm and false positives. "The rational approach to ordering tests is something we should all be interested in, and something—if we did better—that would save the system money and save the patients the horror of causing harm," said Leonard Feldman, MD, of Johns Hopkins. Read more on access to health care.

Mass. Study Shows Importance of Simplifying Health Insurance Benefits Options
Just six months before open enrollment for the Affordable Care Act’s health insurance marketplaces begins, a new study in the journal Health Affairs shows that some Massachusetts families who enrolled in unsubsidized Commonwealth Health Insurance Connector Authority plans experienced higher financial burdens due to health care costs. The study found that 38 percent saw financial burdens and 45 percent saw higher-than-expected out-of-pocket costs—indicating that lower-income families with increased health care needs and multiple children are at particular risk for higher costs. “Given the complexity of health insurance choices and consumers’ limited understanding of health insurance benefits, policy makers need to reach out and simplify information to promote optimal plan choices for the people,” wrote the study’s authors. Read more on community health.

CSPI Classifies Ginkgo Biloba as ‘Avoid’
The Center for Science in the Public Interest (CSPI) is now recommending people avoid Ginkgo biloba after a National Toxicology Program study linked it to liver cancer in mice and thyroid cancer in rats. The substance can be found in many dietary supplements, herbal teas and energy drinks. "Ginkgo has been used in recent years to let companies pretend that supplements or energy drinks with it confer some sort of benefit for memory or concentration," said CSPI executive director Michael F. Jacobson. "The evidence for those claims has been dubious, at best. The pretend benefits are now outweighed by the real risk of harm." The U.S. Food and Drug Administration has previously sent warning to drink manufacturers stating that the ingredient is not generally considered safe for food. Read more on nutrition.

CDC: Cutting Smoking in Subsidized Housing Would Save $521M Annually
Eliminating the ability to smoke in U.S. subsidized housing would save approximately $521 million each year in health care, renovation and fire-related costs, according to the U.S. Centers for Disease Control and Prevention (CDC). This includes public housing and rental assistance programs. Secondhand smoke can be especially problematic in multi-unit buildings with at-risk populations and smoking in common rooms. "Many of the more than 7 million Americans living in subsidized housing in the United States are children, the elderly or disabled," said Tim McAfee, MD, MPH, director of the Office on Smoking and Health at CDC. "These are people who are most sensitive to being exposed to secondhand smoke. This report shows that there are substantial financial benefits to implementing smoke-free policies, in addition to the health benefits those policies bring." Read more on tobacco.

HHS Campaign to Promote Breastfeeding by African American Mothers
The new It’s Only Natural public education campaign from the U.S. Department of Health and Human Services will work to raise awareness of the importance of breastfeeding among African American women, according to Surgeon General Regina M. Benjamin, MD, MBA. “One of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed,” she said in a release. “By raising awareness, the success rate among mothers who want to breastfeed can be greatly improved through active support from their families, their friends and the community.” While overall 80 percent of U.S. women start out breastfeeding, that number is only 55 percent for African American women. The new campaign provides material specifically targeting African American women and giving them the information and encouragement they need to start and continue breastfeeding. Read more on maternal and health disparities.

U.S. Infant Mortality Rates Down; More Improvement Still Needed
Improvements in prenatal care and a reduction in elective deliveries helped cut the U.S. infant mortality rate by 12 percent from 2005 to 2011, according to a new study in the NCHS Data Brief. The National Center for Health Statistics (NCHS) said the rate was down to 6.05 deaths per 1,000 live births in 2011 from 6.87 in 2005. The rate of death from SIDS also dropped 20 percent over the period. Still, study author Marian MacDorman, PhD, an NCHS statistician, said more work is needed, noting that “preterm birth rates are much higher than in other countries, and the same is true with infant mortality" and that "[i]nfant mortality among blacks is about twice what it is for white women,” according to HealthDay. Jeffrey Biehler, MD, a pediatrician at Miami Children's Hospital, said that we "need to continue to advocate for prenatal care for every woman, and make sure they are educated so they know to seek care as early as possible and avoid smoking and alcohol and other things that put them and their babies at risk.” Read more on maternal and infant health.