Public Health Accreditation Board Awards National Accreditation to Five High-Performing Health Departments
The Public Health Accreditation Board (PHAB) this week awarded five-year national accreditation status to five more public health departments. The decisions bring the number of public health agencies now recognized by PHAB as high-performing health departments to 19. PHAB is the independent organization that administers the national public health accreditation program, which aims to improve and protect the health of the public by advancing the quality and performance of the nation’s Tribal, state, local and territorial health departments.

Accreditation status was awarded Aug. 20 to:

• Central Michigan District Health Department, Mount Pleasant, Mich.
• Chicago Department of Public Health, Chicago, Ill.
• El Paso County Public Health, Colorado Springs, Colo.
• Kansas City Missouri Health Department, Kansas City, Mo.
• Tulsa Health Department, Tulsa, Okla.

Read more on accreditation.

Needlestick, Sharps-related Injuries Cost Health Care Industry $1B Every Year
Improved safety-engineered devices, combined with better education and techniques, could save the health care industry more than $1 billion in preventable costs every year, according to a Safe in Common review of U.S. healthcare industry statistics. With approximately 1,000 skin puncture injuries per day in U.S. hospitals, needlestick and sharps-related injuries affect more than half a million health care personnel every year—both physically and emotionally. "The desperate need for attention to the risk of needlestick injuries and their dangerous implications for both patients and personnel are startling when you look directly at the impact to healthcare costs," said Safe in Common chairperson Mary Foley, PhD, RN. "Learning how to permanently prevent these types of injuries—with more education and the introduction of advanced safety devices—will ultimately reduce a significant cost burden and, most importantly, the pain and emotional trauma that the needlestick victims and their families are enduring." Read more on prevention.

Study: Volunteering Linked to Greater Happiness, Longer Lives
Volunteering is not only linked to greater happiness and improved mental health, but could also help people live longer, according to a new study in the journal BMC Public Health. The analysis of 40 published studies found that volunteers had a 20 percent lower risk of death, as well as lower levels depression and increased satisfaction with their lives. "It is still unclear whether biological and cultural factors and social resources that are often associated with better health and survival are also associated with a willingness to volunteer in the first place,” said leader Suzanne Richards, PhD, of the University of Exeter Medical School in England. "The challenge now is to encourage people from more diverse backgrounds to take up volunteering, and then to measure whether improvements arise for them," she explained. People often cite a desire to give back to their community as a reason for volunteering; gaining work experience and meeting new people are also popular reasons. Approximately 27 percent of U.S. adults and 23 percent of European adults actively volunteer. Read more on aging.

The United Nations Foundation believes that, for the biggest public health obstacles facing the world, it will take all nations and all sectors working toward solutions to succeed. So the Foundation works to make that a reality, bringing together partnerships, growing constituencies, mobilizing resources and advocating policies that can help everyone—in both the developing and developed world.

NewPublicHealth recently spoke with Kathy Calvin, President and Chief Executive Officer of the United Nations Foundation, about the organization’s many efforts to improve health both globally and locally—and how these two goals can support each other.

NewPublicHealth: What changes have you seen in global health during your time in the field?

Kathy Calvin: The number of nonprofits dedicated to health issues has quadrupled it seems, and real progress has been made, which is the most important point—that we’re actually seeing a reduction in maternal deaths and newborn deaths and preventable diseases such as measles and diarrhea and pneumonia. I mean, there’s just been enormous progress, with still much more to happen. But it’s been an exciting time after what I think has been a pretty discouraging period where no amounts of foreign aid seemed to be making a difference. I attribute that partly to some innovations in research and financing, but also to the fact that a lot of governments in Africa actually have prioritized women and prioritized health in some pretty significant ways. And I think we’ve had a very enlightened government in the last five years here, too, in terms of what we’re doing overseas.

So, it’s been exciting to see it. Health is not my background. I’ve really been privileged to see both how serious and significant the challenges are, but also how much good can be done with just a little bit of organized effort.

NPH: When you talk about enlightened government, what are some examples? What is making the difference now?

Calvin: Well ironically it isn’t all that political. In fact, some of the biggest shifts took place under President George W. Bush’s administration with his creation of the President’s Malaria Initiative—until then, there had been zero real depth of interest and progress on malaria—as well as PEPFAR, which some people criticized because it was so bilateral, but it had a huge impact in allowing the current administration to really set some ambitious goals for reducing and eliminating parent-to-child transmission and setting that audacious goal of an AIDS-free generation.

Who better to offer up advice on summer sun protection than the Los Angeles County Health Department? Recently the department warned its residents to “practice summer sun smarts” to protect themselves from skin cancer, which, at 1 million diagnoses per year according to the Environmental Protection Agency, is now the most common form of cancer among Americans.

July is recognized as "UV Safety Month" to encourage everyone—not just those in Los Angeles—to protect themselves from ultraviolet (UV) rays, a major risk factor for most skin cancers, by using sunscreen and avoiding prolonged sun exposure during peak hours. “Simple sun safeguards can go a long way in protecting the health of you and your family this summer,” says Jonathan E. Fielding, MD, MPH, the departments’ director of public health.

In other summer sun safety news, this week the National Highway Traffic Safety Administration (NHTSA) and SAFE KIDS Worldwide partnered up to promote National Heatstroke Prevention Day this past Wednesday, July 31. NHTSA and their partners used this opportunity to educate parents on the dangers of leaving children in unattended vehicles in the summer heat, as there have already been over 20 heat-related deaths of children in cars this summer. Children’s body temperatures can spike three to five times faster than an adult’s, and even cool temperatures in the 60s can cause the temperature in the car to rise well above 110 degrees Fahrenheit—so safety steps are critical at all times.

Task Force Calls for Regular Lung Cancer Screening for Older, High-risk Patients
New recommendations from the U.S. Preventive Services Task Force call for annual lung cancer screenings for people ages 55-79 who smoked at least a pack of cigarettes a day for 30 years, or the equivalent (e.g., two packs a day for 15 years). Low-dose computed tomography (CT) scans utilize an X-ray machine to take a series of detailed pictures that can help identify smaller tumors earlier, allowing for earlier treatment and improved health outcomes. “Lung cancer is the leading cause of cancer death in the United States and a devastating diagnosis for more than two hundred thousand people each year,” says Task Force chair Virginia Moyer, MD, MPH. “Sadly, nearly 90 percent of people who develop lung cancer die from the disease, in part because it often is not found until it is at an advanced stage. By screening those at high risk, we can find lung cancer at earlier stages when it is more likely to be treatable.” Lung cancer kills about 160,000 Americans each year. Read more on tobacco.

Study Links Breastfeeding, Higher Intelligence in Kids
Children who breastfeed score higher on intelligence tests later in life, according to a new study in JAMA Pediatrics. Researchers found that for each month spent breastfeeding there were slightly higher results on the intelligence tests at ages three and seven, though not on tests of motor skills or memory. Mandy Belfort, MD, who led the study at Boston Children's Hospital, said the study accounted for parental intelligence and other home factors and provides parents with one more piece of important information when making a decision on the complex question of whether to breastfeed. "Given the size of the benefit, I think this should be helpful for women who are trying to make decisions about how long to breastfeed… because there are many factors that go into that decision," said Belfort. "You have to weigh that against the time that it takes, maybe the time that it takes away from work and your other family duties." Previous studies have linked breastfeeding to lower risk of ear and stomach infections, as well as eczema. Read more on infant and maternal health.

NCI: ‘Cancer’ May Need to Be Redefined
The dramatic increase in cancer screenings over the past few decades has resulted in overdiagnosis and overtreatment, in part because of confusion—by both patients and physicians—over which types of cancer are actually lethal and require immediate treatment. As a result, a panel of experts commissioned by the U.S. National Cancer Institute has recommended that the word “cancer” may need to be redefined to differentiate between lethal and indolent cancers. The recommendations were published in the Journal of the American Medical Association. "We're still having trouble convincing people that the things that get found as a consequence of mammography and PSA testing and other screening devices are not always malignancies in the classical sense that will kill you," said Harold Varmus, MD, director of the National Cancer Institute, to The New York Times. "Just as the general public is catching up to this idea, there are scientists who are catching up, too." Over the past several years the U.S. Preventive Services Task Force has also called for an end to regular mammography screening for women under 50, as well as the widespread use of PSA tests to identify prostate cancer. Read more on cancer.

This week’s International Making Cities Livable Conference brings together city officials, practitioners and scholars in architecture, urban design, planning, urban affairs, health, social sciences and the arts from around the world to share experience and ideas. We spoke with some of those diverse attendees to find out: what do they want the public health community to know about working across sectors to make communities healthier and more livable?

Alain Miguelez, City of Ottawa, Program Manager for Zoning, Neighbourhoods and Intensification 

NewPublicHealth: What do you want public health to know about making communities more livable?

Miguelez: I want public health to know they’re at the heart of what we do. Usually urban planning is a pretty arcane thing. We’ve done a good job of making it tough for people to understand and relate to. They don’t have the patience. Public health brings it home. As we heard in a session this week, it’s not necessarily people who are disabled—it's the built environment that’s disabling. 

It comes down to how you see yourself functioning in your daily life. We've made it impossible to function any way other than with a car. For some people that’s okay, but for those who’ve had a taste of something different, there’s no going back. As planners people don't trust us anymore. We’ve done a lot of things in the name of progress. We’ve disconnected people from the built environment and forced them into places that make people fat and depressed and disconnected and not well-functioning. People coo about Portland and its trams and light rail and walkability. That’s how cities are supposed to be. Everywhere else has got to come up to that standard.

When you see statistics on obesity or depression, it becomes critical, especially with kids. I have two kids and I see very clearly how the environment we build around us impacts how they grow up. It gives kids the tools to function as independent human beings. The right type of city building and suburban repair [with an eye toward public health] can do that.

HHS Updates Guidelines to Prevention Disease Transmission from Organ Transplants
The U.S. Department of Health and Human Services (HHS) has updated its guidelines on reducing unexpected disease transmission through organ transplantation. The 2013 PHS Guideline for Reducing Human Immunodeficiency Virus, Hepatitis B Virus and Hepatitis C Virus Transmission through Organ Transplantation updates the 1994 U.S. Public Health Service guidelines designed to improve patient safety. The recommendations include additional screening, revised risk factors and more sensitive laboratory testing. “Transmission of infections through organ transplants is a critical concern for patients, their families and healthcare personnel involved in transplant procedures,” said HHS Assistant Secretary for Health Howard K. Koh, MD, MPH. “Putting these new recommendations into practice will allow doctors and patients to make better, more informed decisions when accepting organs for transplantation.” Read more on prevention.

HUD: $40M in Housing Counseling Grants to Improve Choices, Opportunities
The U.S. Department of Housing and Urban Development (HUD) is providing $40 million in housing counseling grants to help people find housing, to make more informed choices and to improve their ability to keep their existing homes. The grants will help more than 1.6 million households via 334 national, regional and local organizations. “Make no mistake: these grants will do a lot of good,” said HUD Secretary Shaun Donovan in a release. “The evidence is clear that housing counseling works. These grants are a smart investment to help families and individuals find and keep housing which helps promote neighborhood stability in the long term.” Read more on housing.

Majority of Adults Unaware of their Whooping Cough Vaccination Status
As the number of U.S. cases of pertussis—or whooping cough—rises, many adults are completely unaware of their need to remain up to date on their vaccinations. Only 20 percent say they’ve received the vaccine within the past decade and more than 60 percent do not even know their vaccination status. The lack of adult vaccinations can increase transmission rates to children; the majority of whooping cough deaths are children younger than 3 months. "Teens and adults who have received the [whooping cough] vaccine are less likely to get whooping cough themselves, and therefore less likely to spread whooping cough to other people, including infants who have not yet been protected by the recommended [whooping cough] vaccinations," said Matthew Davis, MD, director of the new University of Michigan National Poll on Children's Health. Read more on vaccines.

While the U.S. Departments of Health and Human Services, Labor and the Treasury jointly released rules about workplace wellness programs under the Affordable Care Act (ACA) last week, the financial and health improvement value of the programs has not yet been proven, according to several panelists at a briefing late last week co-sponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation.

How effectively these programs work is especially important now: beginning in 2014, employers will be allowed to charge their workers up to 30 percent more for health insurance premiums if they don't meet certain health goals. Currently, nearly half of large companies offer wellness programs, which can range from smoking cessation programs to penalties for employees who don’t meet employer-defined health targets in such areas such as cholesterol, blood pressure, and Body Mass Index.

Federal Agencies Issue Final Rules on Workplace Wellness Programs Under the Affordable Care Act
The U.S. Departments of Health and Human Services, Labor and the Treasury have issued final rules on employment-based wellness programs under the Affordable Care Act. Starting in 2014, the rules will allow companies to reward employees who participate in the programs by reducing their health insurance premiums up to 30 percent—up ten percent from current rules. Incentives for smoking cessation can be even higher. And employers can increase premiums for employees who don’t participate in workplace programs or don’t meet certain benchmarks. However, the rules require companies to provide "reasonable alternatives" to employees who can’t meet health benchmarks but still want the discounts. They also allow workers to involve their physicians to help tailor programs with their employers. "These rules will help ensure that wellness programs are designed to actually promote wellness, and that they are not just used as a back-door way to shift health-care costs to those struggling with health problems," said Ron Pollack, executive director of Families USA, a health advocacy group. Read more on prevention.

CDC: 20 Percent of U.S. Adults Visited ERs in a Year
Approximately one in five U.S. adults took at least one trip to an emergency department over the past year, according to a new comprehensive government report based on a survey conducted in 2011. Health, United States, 2012 compiled health data from federal health agencies, state health agencies and the private sector and includes a wide array of U.S. health data. Among the other findings are the fact that 7 percent of people reported at least two emergency department visits, cold symptoms were the most common reason for emergency visits by children and people up to age 64 with Medicaid coverage were the most likely to visit emergency department. The full U.S. Centers for Disease Control and Prevention report is available here. Read more on access to health care.

Study: ADHD Drugs Don’t Increase the Risk of Adulthood Addiction
Taking medication for attention-deficit/hyperactivity disorder (ADHD) during youth does not increase the risk of adulthood addiction to substances such as alcohol, cocaine, marijuana and nicotine, according to a new study in JAMA Psychiatry. There has been debate over the issue for years in the medical community, with studies reaching different conclusions. "Our study provides an important update to clinicians," said study author Kathryn Humphreys, a doctoral student in psychology at University of California, Los Angeles. "Particularly for those who are concerned that stimulant medication is a 'gateway' drug or increases the risk for later substance use, there is no evidence at the group level for this hypothesis." Stimulants such as Ritalin and Adderall are commonly used to treat ADHD. Read more on prescription drugs.

As we learn more about the long-term effects of traumatic brain injuries (TBI), the public health focus is increasingly on prevention in youth sports. A recent study funded by the Robert Wood Johnson Foundation and published in the American Journal of Public Health found that while 44 states and Washington, D.C., have enacted youth sport TBI laws, they all deal with identifying and responding to the injuries—not preventing them.

NewPublicHealth recently spoke with Robert Faherty, VP and Commissioner of the Babe Ruth League Inc., about what the baseball league in particular—and youth sports in general—are doing to improve the prevention of and response to traumatic brain injuries. The league includes about 1 million players across its Cal Ripken and Babe Ruth divisions.

>>Read more in a related Q&A with the author of the youth sports TBI law study.

NewPublicHealth: How is the Babe Ruth League working to prevent primary traumatic brain injuries in youth baseball?

Robert Faherty: One of the things that we really pride ourselves on— and, first of all, our organizations are entirely made up of volunteers, from the league administration level right down to the coach—is providing that league with the best insurance program we possibly can. Through Babe Ruth League, you have the opportunity to buy accident, or liability insurance. That's because we wanted to make sure that there would be no reason that a player wouldn’t go get checked out or a league wouldn’t send a player to a doctor or to an emergency room. We weren’t worried about the parents having insurance, we weren’t worried about somebody’s liability being in question—you can go to the doctor and have it covered.

The second part of that would be our ongoing attempt to educate and prevent injuries right down to the simplest practices. In our coaching certification and coaching education courses, which are mandated, not only are there safety issues that we include that in our score books that we provide to the teams, but it’s also the smallest things about how to run a practice. One of the most common injuries is being hit by a baseball, but it’s not the batter being hit by a baseball or a fielder being hit by a baseball—it’s an overthrow by kids warming up improperly, and not throwing all in the same direction.

IOM: Low Sodium Intake May Also Cause Adverse Health Effects
While multiple studies have shown that the average daily sodium intake for U.S. adults is far too high, lowering the intake too much could also lead to health problems, according to a new report from the Institute of Medicine. The average daily intake is 3,400 mg, or about 1.5 teaspoons. The Dietary Guidelines for Americans call for a maximum of 2,300 mg, and even 1,500 mg for certain demographics. However, there is also some evidence suggesting low sodium levels could be harmful to people such as those with mid- to late-stage heart failure. “These studies make clear that looking at sodium’s effects on blood pressure is not enough to determine dietary sodium’s ultimate impact on health,” said committee chair Brian Strom, George S. Pepper Professor of Public Health and Preventive Medicine at the University of Pennsylvania Perelman School of Medicine. “Changes in diet are more complex than simply changing a single mineral. More research is needed to understand these pathways.” Read more on heart health.

CDC Guidelines Help Cut Bloodstream Infections from Dialysis
Following the U.S. Centers for Disease Control and Prevention’s (CDC) prevention guidelines helped reduce overall bloodstream infection due to dialysis by 32 percent and vascular access-related bloodstream infections by 54 percent, according to a new study in the American Journal of Kidney Disease. There are approximately 37,000 bloodstream infections each year related to dialysis with central lines; in 2010 about 380,000 U.S. patients used hemodialysis for treatment of end-stage kidney disease, with 8 in 10 of utilizing central lines. "Dialysis patients often have multiple health concerns, and the last thing they need is a bloodstream infection from dialysis,” said CDC Director Tom Frieden, MD, MPH. “These infections are preventable. CDC has simple tools that dialysis facilities can use to help ensure patients have access to the safe healthcare they deserve.” Read more on prevention.

Study: Teen’s Use of Smokeless Tobacco Steady Over Past Decade
Despite a myriad of efforts to combat tobacco use by U.S. teens, their usage rate of “smokeless” tobacco products such as chew or snuff has remained steady since 2000, according to a new study in the Journal of the American Medical Association. The rate was 5.3 percent in 2000 and just barely lower in 2011, at 5.2 percent. While younger teens in the 9-14 age range have decreased their use, those in the 15-17 range have increased. The study suggests that the relatively low prices of smokeless tobacco products may be a contributor. About 9 million Americans used smokeless tobacco in 2012. Read more on tobacco.