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.

Past Decade's Poor Economy Drove Health Declines
More than a decade of research points to the negative impact of the austerity that accompanies a flagging economy on the population's health, according to Reuters. The studies will be detailed in a new book to be released by an interesting research pairing including a political economist from Oxford University and a professor of medicine and epidemiology at Standford University. the researchers say more than 10,000 suicides and up to a million cases of depression have been diagnosed during what they call the "Great Recession" and its accompanying austerity across Europe and North America. For example, more than five million Americans have lost access to health care during the latest recession. Researchers also tie cuts in governmental public health programs to excess disease rates. "In Greece, moves like cutting HIV prevention budgets have coincided with rates of the AIDS-causing virus rising by more than 200 percent since 2011—driven in part by increasing drug abuse in the context of a 50 percent youth unemployment rate," according to the Reuters article. Read more on poverty and health.

What Influences Kids to Smoke (or Not to) Changes Over Time
Peer pressure may have a bigger influence on middle school-aged kids in starting to smoke, but that influence may wane as they get older. On the other hand, researchers said parents seem to remain influential over their children's smoking behavior throughout high school, as reported by HealthDay. Researchers looked at data from  the Midwestern Prevention Project, the longest-running substance abuse prevention, randomized controlled trial in the United States, which includes 1,000 teens. Read more on tobacco use. 

Facebook Could Help Predict, Track and Map Obesity
The higher the percentage of people in a city, town or neighborhood with Facebook interests suggesting a healthy, active lifestyle, the lower that area's obesity rate, according to a new study. At the same time, areas with a large percentage of Facebook users with television-related interests tend to have higher rates of obesity. The study was conducted by Boston Children's Hospital researchers comparing geotagged Facebook user data with data from national and New York City-focused health surveys. 

"Online social networks like Facebook represent a new high-value, low-cost data stream for looking at health at a population level," said study author John Brownstein, PhD, from the Boston Children's Hospital Informatics Program. "The tight correlation between Facebook users' interests and obesity data suggest that this kind of social network analysis could help generate real-time estimates of obesity levels in an area, help target public health campaigns that would promote healthy behavior change, and assess the success of those campaigns." The study was published in PLOS ONE. Read more on obesity.

‘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.

Jill Birnbaum is an advocate for nutrition policy, tobacco control, and health care reform who has worked at the federal, state, and local levels. Her work began in Minnesota, and she now oversees state advocacy for the American Heart Association. Her grassroots experience, combined with her national role, gives her unique insights into public health policy at all levels of government. 

This is the first in a two-part interview conducted by Grassroots Change: Connecting for Better Health, a project of the Robert Wood Johnson Foundation Health Group. In part one, Jill shares her perspective on grassroots movements and the threat of preemption in the obesity prevention arena. Preemption can take away the ability of states and local communities to adopt innovative solutions to their own public health problems in a way that responds to each community’s unique needs.

>>View the original posting of this interview over at GrassrootsChange.net.
>>Read more on preemption and grassroots movement building.

Grassroots Change: What do you see as the impact of preemption in public health, especially in obesity prevention?

Jill Birnbaum: [Preemption] slows or even ends grassroots movements before they begin. It also drains our resources for future advocacy efforts. We leave it to the next generation of public health advocates to undo policy compromises that we make today. We’re still seeing that in a few states with tobacco, and anticipating the fights both at the federal and state levels that we might have to undo someday [in obesity prevention]. 

Preemption stifles innovation, and it also makes some assumptions that can be wrong. It assumes that we know everything today and that there’s nothing more that we have to learn tomorrow. That’s especially true in nutrition policy where science continues to evolve and policy needs to evolve along with the science. 

Preemption also has the effect of dividing the [public health] community when a small group of people, in some cases even a single individual or organization, negotiates away something that other people really want.

GC: Are the concerns about preemption in obesity prevention mostly about nutrition policy? There doesn’t seem to be a major effort to preempt local physical activity policies. 

Smoking in Youth-rated Movies Up Dramatically
Smoking scenes in youth-rated movies is back up to the same levels as about a decade ago, with approximately half of such movies in 2012 providing 14.8 billion “tobacco impressions,” according to a new study funded by Legacy. Tobacco impressions are calculated by multiplying incidents of tobacco use by the number of film tickets. From 2010 to 2012 alone the rate was up 169 percent; 2010 was an historic low for tobacco impressions. This trend is dangerous because of the way movies can influence youth behavior. "Increases in smoking imagery in the movies are discouraging," said Tom Frieden, MD, director of the U.S. Centers for Disease Control and Prevention. "Every day in the United States approximately 3,800 youth under 18 smoke their first cigarette, and approximately 1,000 become daily cigarette smokers. Reducing smoking and tobacco use in youth-oriented movies will help save lives, money, and years of suffering from completely preventable smoking-related chronic diseases." Read more on tobacco.

Online Tool Helps Family, Friends Determine Whether an Older Driver is Safe
A new free online tool can help family members and caregivers of drivers age 65 and older determine whether they’re safe to continue going out on the roads. The Fitness-to-Drive Screening Measure questionnaire, developed by researchers at the University of Florida (UF), provides a rating profile, recommendations on how to move forward and links to an array of resources. Sherrilene Classen, PhD, MPH, an associate professor of occupational therapy at the UF College of Public Health and Health Professions and the tool’s lead developer, said it’s designed to give a realistic assessment of the driving abilities without requiring an on-the-road evaluation. “We know from our research and others’ that drivers do not give valid self-reports,” said Classen, “Most everybody thinks they are driving better than they actually are. Because we don’t have the evaluators to assess the 36 million older adults who may potentially at some stage require a driving evaluation, we went to the next-best step, which is involving their caregivers or family members.” Read more on aging.

Study Links Breakfast Cereal, Healthier BMIs for Kids
Helping kids maintain a low BMI could be as simple as giving them cereal for breakfast, according to a new study in the Journal of the Academy of Nutrition and Dietetics. The study found that children who had cereal for breakfast four out of nine mornings were in the 95th percentile for BMI; kids who had cereal every day were in the 65th percentile. Researchers say the study shows the ability to combat childhood obesity by making breakfast cereal available to low-income kids; one in four U.S. kids live in a “food insecure household,” according to lead author Lana Frantzen, PhD. "(Cereal) is an excellent breakfast choice, it's simple, and gets those essential nutrients that children need, especially low income minority children," she said. Read more on obesity.

Hospital-based Quality Improvement Programs Cut Early Elective Deliveries
Elective early term deliveries are down significantly in part due to multistate, hospital-based quality improvement programs, according to a new study in the journal Obstetrics & Gynecology. Labor inductions and Cesarean sections without a medical reason were down 83 percent from 27.8 percent to only 4.8 percent over a one-year program at 25 hospitals. Early term babies are at increased risk of a host of medical problems and even death, according to the March of Dimes. “Reducing unnecessary early deliveries to less than five percent in these hospitals means that more babies stayed in the womb longer, which is so important for their growth and development,” said Edward R.B. McCabe, MD, medical director of the March of Dimes. Read more on maternal and infant health.

Study: School Lunch Standards Help Kids Maintain Healthy Weight
States with strict school lunch standards may be helping students maintain healthier weights, according to a new study in JAMA Pediatrics. The U.S. Department of Agriculture’s National School Lunch Program standards include maximums calories for lunches and the serving of only skim or reduced-fat milk. Depending on grade level, school lunches are between 550 and 850 calories. The preliminary findings help refute the concern that students would simply compensate with unhealthy snacks, according to Daniel Taber, MD, lead author from the Institute for Health Research and Policy at the University of Illinois at Chicago. Nutritionist Marion Nestle of New York University said that this “is important work and should stimulate government agencies to take a closer look at what they might do to make the food environment a lot healthier for children and adults.” Read more on obesity.

CDC: Many Skipping Medications to Save on High Health Care Costs
Lack of insurance and other factors are leading many Americans to request cheaper medications or even skip taking prescribed drugs, according to a new report from the U.S. Centers for Disease Control and Prevention. "Adults who do not take prescription medication as prescribed have been shown to have poorer health status and increased emergency room use, hospitalizations and cardiovascular events," said Robin Cohen of the NCHS's Division of Health Interview Statistics. About 20 percent of U.S. patients ages 18 to 64 requested cheaper medications from their health care providers; the uninsured in that group was also twice as likely—23 percent total—as those ages 65 and older to simply skip the medications entirely. Read more on prescription drugs.

Right-click to edit

Smaller, Frequent Meals Help Kids Keep Weight Off
Smaller, more frequent meals can help kids ward of overeating and obesity, according to several new studies in the journal Pediatrics. One study found that simply using smaller dishware—thus forcing smaller portions—meant kids ate less; they found that adult-sized dishware led first-graders to take 90 calories more of food. Researchers also found kids who ate more often were 22 less likely to be overweight. "The results are very interesting and confirm our expectations that the impact of plate size on adults in the laboratory also apply to children," said Thomas Robinson, MD, a childhood obesity researcher at Stanford University, according to Reuters. "This study provides very important preliminary evidence that using smaller dishware may help reduce children's energy intakes." Read more on obesity.

Low-calorie Drinks Increasingly Popular for Kids
While sugary drinks remain popular, low-calories drinks are also gaining more and more consumers, according to a new study in the journal Pediatric Obesity. Researchers at the University of North Caroline (UNC) found both that consumption of calories from sweetened drinks was down and consumer of low-calorie drinks was up over a 10-year period. The findings were especially significant for kids. "The food industry is trying many ways to reduce the caloric content of foods and beverages," said Barry M. Popkin, PhD, W.R. Kenan Jr. Distinguished Professor of Nutrition at UNC's Gillings School of Global Public Health. "We are increasingly seeing them replace caloric sweeteners with low-calorie sweeteners. This trend has particularly emerged in the last three to four years as U.S. concern about obesity, diabetes and other complications of consuming excessive sugary high-calorie beverages has increased." Read more on nutrition.

Missed, Delayed Mammograms Increase Death Risk for Older Women
Older women with misses or delayed mammograms are significantly more likely to die from breast cancer, according to new research to be presented at the annual meeting of the American Association for Cancer Research. Researchers found “that 23 percent of women who had their last mammogram five or more years before being diagnosed with breast cancer had advanced cancer, compared with 20 percent of those who had a mammogram six months to a year before their diagnosis,” according to HealthDay. Increased time between mammograms also significantly increased the risk of death from cancer for women age 75 and older. Researchers said more study is needed to examine the connection. "It is possible that the differences in the relationship between screening interval and [death] in older versus younger women may be related to the more aggressive nature of the tumors in younger women, which might obliterate the effects of more screening,” said Michael Simon, MD, leader of the breast multidisciplinary team at the Barbara Ann Karmanos Cancer Institute in Detroit. “Other reasons may include differences in cancer treatment, information that was not available for this [group] of women.” Read more on cancer.

Study: Most Intend to Comply With Mandatory Hurricane Evacuation
Most residents of areas most likely to be hit by hurricanes—no matter their income level—intend to comply with mandatory evacuation orders, according to a new study in the journal Disaster Medicine and Public Health Preparedness. Researchers at The University of Texas School of Public Health did find variations with other demographic differences, such as age, ethnicity and education level. The findings indicate that disaster preparedness should focus more on how to best evacuate the most vulnerable residents, which could include targeted messaging and education. Read more on preparedness.

Breath Test May Identify People Prone to Obesity
A breath test that measures bacterial overgrowth in the stomach could be used to determine whether a person will become overweight, according to a new study in the Journal of Clinical Endocrinology & Metabolism. Researchers found that higher levels of methane and hydrogen from the bacteria Methanobrevibacter smithii were associated with higher BMIs and more body fat. Overgrowth of “bad” bacteria can also lead to bloating, constipation and diarrhea. While noting that obesity is “not a one-size-fits-all disease," study author Ruchi Mathur, MD, director of the outpatient diabetes treatment center at Cedars-Sinai Medical Center in Los Angeles, said this could help identify people who would respond best to particular weight loss methods. Read more on obesity.

Study Finds Most Major Restaurants Post Accurate Nutrition Info
A new study from Consumer Reports found that most major chain restaurants post accurate nutritional information about their food. Shoppers purchased and tested 17 menu items from restaurants and fast-food chains, comparing the results for each item to the same items purchased at other restaurants in the chain. They determined that only two items had higher fat or calorie content than advertised: Olive Garden’s Lasagna Primavera with Grilled Chicken and Outback Steakhouse’s Chicken on the Barbie. “We found that you can usually trust the figures you see,” said editor Leslie Ware. “On average, most of them were telling the truth.” The U.S. Food and Drug Administration is slated to release new regulations regarding nutrition labeling later this year. Read more on nutrition.

Harvard Study: Public Supports Policy Interventions to Reduce Disease Burden
A survey by the Harvard School of Public Health finds that the public greatly supports government action with the goals of changing lifestyle choices that can lead to obesity, diabetes and other non-communicable diseases. However, the survey found that people are less likely to support actions that seem intrusive or coercive. The survey was published in Health Affairs. In a second poll from the Harvard School of Public Health, National Public Radio and the Robert Wood Johnson Foundation, researchers found a large gap between parents’ perceptions of their children’s weight and expert definitions. According to the parents, 15 percent of children are a little or very overweight; national data suggest more than twice as many, or 32 percent of all children, are overweight or obese. Read more on obesity.

Is Facebook Biased Against Older People?
Researchers at the Yale School of Public Health reviewed publicly available Facebook pages and found that many sites created by younger people often included negative age stereotypes. Some even suggested (possibly in jest) that older people should be killed. One Facebook group description, for example, stated that anyone “over the age of 69 should immediately face a firing squad.”

“Facebook has the potential to create new connections between the generations,” says Becca Levy, the lead author of the study. “Instead, it may have created new obstacles.” The study was published in The Gerontologist. Read more on aging.

Drug Use and Mental Health Issues Linked to Dropping Out of College
Marijuana and other illegal drug use, as well as mental health problems, are associated with an increased likelihood of dropping out of college, according to research from the University of Maryland School of Public Health. The research was part of the College Life Study, a longitudinal prospective study of health-risk behaviors among 1,253 college students between 17-19 years old, who were interviewed annually for four years, beginning with their first year of college. The study was published online in the Journal of Studies on Alcohol and Drugs. Read more on substance abuse.