Apr 10 2014
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PHLR Infographics: A Look at How Research is Improving Public Health Laws

Happy National Public Health Week! All week we've been sharing stories on the value of public health across all aspects of life, and all ages and stages.

Public Health Law Research (PHLR), a grantee of the Robert Wood Johnson Foundation, has also been participating in the week by contributing graphics and posts on the particular role of public health law—when backed by evidence and grounded in research—to save lives and make a difference. Below, we are highlighting some of the critical statistics PHLR has shared, along with some context on the research behind the numbers.

Child Seat Safety

Today, every state has a law requiring children to be restrained in federally-approved child safety seats while riding in motor-vehicles. These laws differ from state to state based on number of factors (e.g., age, height and weight of the children requiring safety seats). All current child safety seat laws allow for primary enforcement, meaning a police officer can stop a driver solely for a violation of such laws.

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Lead Laws

In 1990 approximately 20 percent of all U.S. children had elevated levels of lead in their blood. However, only a decade later that percentage was down to 1.6 percent, thanks to public health laws researched and crafted to look out for the wellbeing of children. One of the most significant pieces of legislation was The Lead Contamination Control Act of 1988, which was already on the path to improving public health in 1990.

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Watch this video on Philadelphia's lead court.

Sodium Laws

Eating too much sodium can cause high blood pressure, which raises the risk for heart disease and stroke—the first- and fourth-leading causes of death in this country. A variety of laws and legislatively enabled regulations attempt to reduce sodium in the food supply, including lowering the amount of salt in foods served in schools and child care facilities or purchased by state-regulated elder and health care facilities and prisons. Almost half of all U.S. states have laws to help reduce tghe sodium in processed foods.

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Sports-Related Traumatic Brain Injuries

As many as 300,000 kids suffer traumatic brain injuries (TBIs) from playing sports each year. TBIs can have serious short- and long-term health effects. Can public health law make a difference? The latest study finds that while all 50 states have laws in place to combat this problem, they haven't helped stop kids with concussions from playing. However, the research does help provide some context on how those laws have been implemented and how they might be revamped to work better.

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Apr 10 2014
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Future of Public Health: Q&A with Erin Yastrow, BSPH Candidate at Tulane University

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Future of Public Health is an ongoing series focused on the emerging faces in the world of public health. We spoke with Erin Yastrow, a Bachelor of Science in Public Health candidate at the Tulane University School of Public Health and Tropical Medicine, about what helped lead her to the field, her work as a leader in Tulane’s undergraduate student government and where she hopes to go from here.

NewPublicHealth: What encouraged you to pursue a degree and career in public health?

Erin Yastrow: I’ve always been interested in the field of health. I was actually thinking about going into nutrition when I first started looking at undergraduate schools and I had a family friend at one school who had worked in nutrition, but then ended up working at the School of Public Health. When I met with her, she encouraged me to pursue public health with an emphasis on nutrition because it would give me more opportunities. From there, I started my exploration into what public health was and I realized how interesting and fascinating it was and how it was applicable to so many more areas besides just nutrition.

In the meantime, I had also applied to Tulane. I wasn’t really considering it that much because I didn’t know that much about it. My mom was looking through their brochure and told me that they have a great public health program. So, I started looking and I realized how established the Bachelor’s and graduate programs were. They also had an option where you could pursue a combined degree and it was really appealing to me.

NPH: Are you pursuing a Master’s as well?

Yastrow: Not currently, but I’m actually attending Johns Hopkins next year for a Master’s in Public Health. Tulane does have a really great program where you can do a combined degree with your Bachelor’s and Master’s. Part of my undergraduate core, which has now changed, included taking five graduate classes, so I took some classes at that School of Public Health here.

NPH: Within the field of public health, what are your primary interests and why?

Yastrow: That has also sort of shifted as I’ve learned more about public health. As I mentioned, I started out really interested in nutrition and obesity prevention. As I took more electives and did some internships, I became more interested in the similar patterns of risk factors that exist in obesity and other epidemics that aren’t always considered to be health problems, such as violence. That has developed into an interest about addressing inequalities in health and the social determinants, such as socioeconomic status, education and race and how those, to me, are unjust reasons that people are more likely to develop further health conditions.

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Apr 10 2014
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National Public Health Week: Healthy Eating—There’s an App for That

Eat well. That’s today’s theme for National Public Health Week—and it’s good advice. After all, according to the American Public Health Association, Americans are now eating 31 percent more calories than we did 40 years ago, including 56 percent more fats and oils and 14 percent more sugars and sweeteners. The average American eats 15 more pounds of sugar a year today than in 1970. 

There are new food-oriented websites and smartphone apps (many free) that can help people keep track of what foods they’re eating and what’s in those foods.

At the Milk Street Café in Boston, for example, the restaurant’s ordering site lets you filter the full menu into just the categories you want. Click low “fat” and the tailored breakfast menu leaves off the breakfast pastries and zooms in on the yogurt parfaits.

Other recent apps include:

  • Locavore, which points to farmers’ markets and produce stands in your neighborhood.
  • Harvest, which offers tips for choosing ripe produce.
  • Fooducate, a food database on your smartphone that includes basic nutrient and calorie information, plus high points of each food such as the fiber quantify of crackers.
  • Substitutions, an app finds alternatives when you can’t use the ingredient in the original recipe because of an allergy or other dietary restriction. Popular tip: Swap in fat-free yogurt when the recipe calls for fat-free sour cream to save calories.
  • The U.S. Department of Agriculture hosts the Food Access Research Atlas, which presents a spatial overview of food access indicators for low-income and other census tracts using different measures of supermarket accessibility. The app is valuable for community planning and research.
Apr 10 2014
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Public Health News Roundup: April 10

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HHS Releases Data Giving Consumers Greater Transparency on Costs of Medical Procedures
The U.S. Department of Health and Human (HHS) services has released of new, privacy-protected data on services and procedures provided to Medicare beneficiaries by physicians and other health care professionals. The new data—which includes payment and submitted charges, or bills, for those services and procedures by provider—provides consumers with more information on how physicians and other health care professionals practice medicine, according to HHS Secretary Kathleen Sebelius. “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice,” she said. “The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns.” The release includes information for more than 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program. Read more on access to care.

HUD Grants $1.6B to Support 7,100 Local Homeless Housing and Service Programs
The U.S. Department of Housing and Urban Development (HUD) has announced approximately $1.6 billion in grants to continue support for 7,100 local homeless housing and service programs in all 50 states, as well as Puerto Rico, Guam and the U.S. Virgin Islands. The grants, which come through HUD’s Continuum of Care Program, support programs such as street outreach; client assessment; and direct housing assistance to individuals and families with children who are experiencing homelessness. "Whether it's helping to rapidly re-house families with young children or finding a permanent home for an individual with serious health conditions, HUD is working with our local partners to end homelessness as we know it," said HUD Secretary Shaun Donovan. Read more on housing.

Study: Concussion Symptoms May Be Worse For Girls than for Boys
Concussions may have a more severe and longer-lasting effect for girls than they do for boys, according to new research. Shayne Fehr, MD, a pediatrician at Children's Hospital of Wisconsin, tracked 549 patients who sought treatment at a pediatric concussion clinic, finding that girls on average reported more severe symptoms than boys and needed an additional 22 days to recover (56 days for girls, compared to 34 for boys). Approximately 76 percent of the injuries were sports related and the top five reported symptoms were headache, trouble concentrating, sensitivity to light, sensitivity to sound and dizziness. More research is needed to determine the cause of the disparity. Read more on injury prevention.

Apr 9 2014
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National Minority Health Awareness Month: Roundup of NewPublicHealth Coverage on Health Disparities

April is National Minority Health Awareness Month. A look back at NewPublicHealth’s coverage of health disparities so far this year shows significant steps being taken to both identify and rectify the public health problem. From understanding why certain demographics are at greater risk for cancer, to how income gaps and ethnicity can collide, to how racism can affect overall health, here’s a review of some of the key stories we’ve reported on health disparities in 2014.

Mistrust, Perceived Discrimination Affect Young Adult Latinos’ Satisfaction with Health Care
Mistrust of the medical community and perceived discrimination can affect how satisfied young adult Latinos are with their health care, which in turn can influence health outcomes, affect participation in health care programs under the Affordable Care Act and contribute to disparities in health care access.

Black, Latina Breast Cancer Patients More Likely to Struggle with Health Care-Related Debt
Black and Latina breast cancer patients are far more likely than their white counterparts to have medical debt as a result of treatment or to skip treatments due to costs

Faces of Public Health: Louis W. Sullivan, MD
Louis W. Sullivan, MD, former U.S. Secretary of Health and Human Services under President George H.W. Bush, recently wrote a memoir, Breaking Ground: My Life in Medicine, that offers a wide view of Sullivan’s experiences as a medical student in Boston, the founding dean of the Morehouse School of Medicine in Atlanta and as the country’s chief health officer. NewPublicHealth recently sat down with Sullivan to discuss the book and his thoughts on the history and future of improving the nation’s health.

Study: Many Chronically Ill Adults Forced to Decide Between Medicine, Food
Chronically ill adults who, due to financial instability, lack consistent access to food are far more likely to underuse or even skip their medications completely, according to a new study in The American Journal of Medicine. Researchers analyzed data of 9,696 adults with chronic illness who participated in the National Health Interview Survey, finding that 23.4 percent reported cost-related medication underuse, while 18.8% percent reported food insecurity and 11 percent reported both. Hispanic and non-Hispanic blacks were at the highest risk.

Free to Be You and Me @ 40
Free to Be You and Me, a blockbuster hit album of the 70s and beyond, is still widely available on most music platforms. The television special, filled with skits on gender neutrality, is still a popular kids’ birthday gift, in part because many of the issues it speaks to—especially advancement opportunities and equality—are still being grappled with today.

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Apr 9 2014
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FDA’s Role in Disaster Preparedness: Q&A with Brooke Courtney

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The U.S. Food and Drug Administration (FDA) was a partner agency for last week’s Preparedness Summit in Atlanta. NewPublicHealth spoke with Brooke Courtney, Senior Regulatory Counsel in the FDA Office of Counterterrorism and Emerging Threats, about how the agency plans for disasters it hopes never occur. Previously, Courtney was the Preparedness Director at the Baltimore City Health Department and in that role oversaw all of the public health preparedness and response activities for Baltimore City.

NewPublicHealth: What did you speak about at the Summit last week?

Brooke Courtney: FDA views the summit as an unparalleled opportunity each year to engage with stakeholders at the state, local and federal levels—to share with them updates from the federal side and also for us to get feedback from them about challenges and successes. We engage with stakeholders on a regular basis, but this is really the meeting where the largest number of people involved in preparedness come together, and it’s a great opportunity to see people face-to-face.

We feel really fortunate to have been able to take part in the summit for the past few years. For this year’s summit FDA served on the Planning Committee and also participated in the medical countermeasure policy town hall with federal colleagues from the Office of the Assistant Secretary for Preparedness and Response, the U.S. Department of Homeland Security and the national security staff, all of whom we work with closely.

Another thing that we like to do at the summit each year is to give a more in-depth update through a session with the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department for Health and Human Services (HHS) legal counsel on the authorities that we have that we use related to the emergency use of medical countermeasures during emergencies. This year’s session was especially exciting for us because it was an opportunity for us to discuss with stakeholders some new authorities that were established in 2013 to enhance preparedness and response flexibility.

For example, we can now clearly issue emergency use authorizations in advance of emergencies, which is really a critical medical countermeasure tool for preparedness purposes. Through these flexibilities, for example, we’ve issued three emergency use authorizations in the past year for three different in-vitro diagnostic tests to address the emerging threats of H7 and 9 influenza and MERS-CoV.

NPH: What are the key responsibilities the FDA has in helping to prepare the United States for possible disasters?

Courtney: As an agency of the U.S. Department of Health and Human Services, the FDA, at its core, is a public health agency. FDA’s mission is to protect and promote public health in a number of critical ways. We’re responsible for regulating more than $1 trillion in consumer goods annually, ranging from medical products such as drugs and vaccines to tobacco and food products.

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Apr 9 2014
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National Public Health Week: ‘Get Out Ahead’

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NewPublicHealth continues its coverage of National Public Health Week with today’s theme—“Get Out Ahead” on prevention.

According to the American Public Health Association (APHA), seven in 10 deaths in the United States are related to preventable diseases such as obesity, diabetes, high blood pressure, heart disease and cancer. And while 75 percent of U.S. health care dollars are spent treating such diseases, only 3 percent of health care dollars go toward prevention.

The APHA says there are now more options than ever when it comes to preventive health measures and that public health and clinical health professionals must work collaboratively to help individuals identify and pursue the best preventative health options.

A strong way to help prevent disease and premature death is to add health observance dates such as National Breast Cancer Awareness Month and National HIV Testing Day to personal and community calendars.

Healthfinder.gov, a website from the U.S. Department of Health and Human Services, lists health observance days, weeks and months which can steer people toward information and resources. Health observances often include community screenings such as blood pressure and cholesterol checks, making it easy to have those tests on a weekend in your neighborhood. Those checks include resources guiding people to community care if tests show a potential health problem.

A critical observance in April is Alcoholism Awareness Month. Decades of data shows that drinking too much alcohol increases people’s risk of health-related injuries, violence, drowning, liver disease and some types of cancer.

Actions communities are taking in observance of Alcoholism Awareness Month include:

  • Partnering with a local high school or youth organization to host an event about alcohol abuse prevention.
  • Alcohol-free community block parties.
  • Many local health clinics will offer free or low-cost screenings for alcohol abuse on National Alcohol Screening Day (April 11).

Many police stations are hosting Family Information Nights about the dangers of drinking and driving. Activities include special goggles that let kids and teens see how drinking can impact their vision behind the wheel.

Apr 9 2014
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Public Health News Roundup: April 9

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One in Four Teen Births Are Among Younger Teens Ages 15 to 17
While births to younger teens ages 15 to 17 years have declined, they still represent over a quarter of teen births and nearly 1,700 births a week, according to this month’s Vital Signs, the monthly health indicator report from the U.S. Centers for Disease Control and Prevention (CDC). “Although we have made significant progress reducing teen pregnancy, far too many teens are still having babies,” said CDC Director Tom Frieden, MD, MPH. “Births to younger teens pose the greatest risk of poor medical, social and economic outcomes. Efforts to prevent teen childbearing need to focus on evidence-based approaches to delaying sexual activity and increasing use of the most effective methods of contraception for those teens who are sexually active.” Read more on sexual health.

Study: Rural Girls Get More Daily Exercise than Those in Suburban, Urban Communities
While the level of urbanicty—whether they live in rural, suburban or urban communities—does not seem to affect boys’ levels of moderate-to-vigorous physical activity, there is a noticeable effect for girls, according to a new study in the American Journal of Preventive Medicine. Researchers determined that girls from rural areas are 4.6 times more likely than those in suburban areas and 2.8 times more likely than those in urban areas to exceed the national physical activity recommendation of 60 or more minutes of moderate-to-vigorous physical activity each day. The study tracked the daily activity of a random selection of 1,354 youth in 20 counties in North Carolina. Read more on physical activity.

Study: Mentions of Alcohol Brands in Popular Music Increase Youth Alcohol Use
The average young person in the United States hears approximately eight alcohol brand names each day while listening to music, increasing the risk they will use and abuse alcohol, according to a new study in the journal Alcoholism: Clinical & Experimental Research. Using information collected from more than 3,400 males and females ages 15 to 23, researchers determined that the average youth in that age group listens to 2.5 hours of music per day, with 3-4 brand mentions each hour. Lisa Henriksen, senior research scientist at the Stanford Prevention Research Center, called the findings “worrisome” in a release. "It would be foolish to think that the alcohol industry is unaware of and uninvolved with alcohol-brand mentions in music," said Henriksen. "The strategy of associating products with hip culture and celebrities who are attractive to youth comes straight from a playbook written by the tobacco industry." Approximately 39 percent of U.S. teens are current drinkers and about 22 percent are binge drinkers, according to the U.S. Centers for Disease Control and Prevention. Read more on alcohol.

Apr 8 2014
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Recommended Reading: FDA Approves Handheld Treatment for Prescription Drug Overdose

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In an effort to combat the growing epidemic of prescription drug abuse and overdose, the U.S. Food and Drug Administration (FDA) has approved a small, easy-to-use injector—similar to an EpiPen—that can be used to revive people who have stopped breathing or lost consciousness from an opioid drug overdose. The device, called Evzio, provides a single dose of naloxone, which is the standard treatment for opioid overdoses but up until now was mostly only available in hospitals and other medical settings.

The device, expected to be available starting this summer, will enable early intervention that increases the chances of survival. According to the National Center for Injury Prevention and Control , nationally, sales of prescription painkillers per capita have quadrupled since 1999—and the number of fatal poisonings due to prescription painkillers has also quadrupled.

The FDA’s approval comes at a critical time. In October of last year, Trust for America’s Health released a report that found that a very small number of states are implementing more than just a few promising strategies that have been identified to help combat the widespread drug abuse that continues to increase across the United States. The report, Prescription Drug Abuse: Strategies to Stop the Epidemic, which was funded by a grant from the Robert Wood Johnson Foundation, showed that only two states—New Mexico and Vermont—have implemented all ten strategies. TFAH also released an interactive tool with state-by-state prescription drug overdose death rates and state scores on the 10 key steps to curb abuse.

Carl R. Sullivan III, MD, director of the addictions program at West Virginia University, said the FDA’s approval of Evzio “is a big deal, and I hope [it] gets wide attention,” according to The New York Times. “It’s pretty simple: Having these things in the hands of people around drug addicts just makes sense because you’re going to prevent unnecessary mortality.”

Read the full story from The New York Times.

Apr 8 2014
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Preparedness Summit Partners: The American Red Cross

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At this year’s Preparedness Summit, which met last week in Atlanta, the American Red Cross was a first-time partner for the annual event which brings together more than 1,000 preparedness experts from around the country.

“It was important for us to partner with the American Red Cross because they have a major role and responsibility in disasters,” said Jack Herrmann, the Summit chair and Chief of Public Health Preparedness at the National Association of County and City Health Officials (NACCHO), the lead partner for the Summit. “We felt that it was important that the public health and health care communities understand the Red Cross’ role and authority during a disaster and look for ways to foster and build partnerships [among] local health departments, state health departments and American Red Cross chapters across the country.”

Just prior to the Summit, NewPublicHealth conducted an interview by email with Russ Paulsen, Executive Director, Community Preparedness and Resilience Services of the American Red Cross.

NewPublicHealth: What are the key issues that communities should focus on now to get themselves better prepared for a disaster should it occur?

Russ Paulsen: Everyone has a role to play in getting communities better prepared for disasters.

As a first step, individuals, organizations and communities should understand the problem: What hazards are in their area? How likely are any of these hazards to become actual disasters? What have people already put in place to deal with them? Local Red Cross chapters can help with this assessment.

Once people understand the problem, the next step is to make a plan. Plan what to do in case you are separated from your family or household members during an emergency, and plan what to do if you must evacuate your home. Coordinate your household plan with your household members’ schools, daycare facilities, workplaces and with your community’s emergency plans.

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