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Jul 16 2014
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Health Beyond Health Care: Expanding Physical Activity Opportunities in Every Neighborhood

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More than half of youths in the United States have access to parks or playground areas; recreation centers; boys’ and girls’ clubs; and walking paths or sidewalks in their neighborhoods, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC), State Indicator Report on Physical Activity, 2014.

While that information might conjure up images of newly built, dedicated playgrounds, the reality is different...and less expensive. Thousands of communities have created physical activity opportunities by developing shared use agreements with schools to allow the use of facilities after school hours and on weekends.

In 2011, for example, the nonprofit Partners for Active Living (PAL), in Spartanburg, S.C., met with the city’s Parks and Recreation Department and learned that while the city did have access to defunct school facilities, it had no shared use agreements that would let PAL use school facilities for exercise. With help from a board member (who was  also a member of the city council) and online resources for shared use agreements, PAL was able to move the concept forward by showing that:

  • Under South Carolina law, school districts and third parties would be protected under the recreational user statute.
  • The South Carolina Tort Claims Act imposes the same liabilities and protections both during and after the school day.
  • The school district may be liable for negligent supervision of a student only if a duty is executed in a grossly negligent manner.

After about a year of discussions with parents, activists, policymakers, school officials and others, agreements were worked out in 2012 for school soccer fields, basketball courts, trails, playgrounds and football fields to remain open to the community on weekends and from 9 a.m. to 6 p.m. on non-school days and after school until 6 p.m. on school days, with supervision by the Parks and Recreation Department to deal with damage, vandalism and other concerns. The agreement is automatically renewed every five years unless amended. To promote the continued usage of school playgrounds, the department will offer regularly scheduled programming at each site and PAL will be tracking usage.

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Jul 16 2014
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Public Health News Roundup: July 16

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Proposed Tobacco Merger Could Boost Smoking Rates
The proposed merger of the Reynolds American and Lorillard tobacco companies announced earlier this week could result in increased smoking rates, according to the Campaign for Tobacco-Free Kids. “This proposed merger is clearly driven by steep smoking declines in the U.S.,” said Matthew L. Myers, president of Tobacco-Free Kids. Myers said cigarette sales fell by 37.1 percent from 2000 to 2013, with the largest decline in 2009, when a 62 cent per-pack increase in the federal cigarette tax was implemented. “Reynolds and Lorillard no doubt hope the economic and political power of a merged company will help them slow or reverse these trends. Elected officials and regulators must be equally aggressive in working to accelerate progress in reducing smoking and other tobacco use.” Read more on tobacco.

Health Education Program Also Reduces Youth Dating Violence
A health education program designed to delay sexual behavior and promote healthy data relationships also significantly reduces dating violence behaviors among minority youth, according to a new study in the American Journal of Public Health. Researchers at the University of Texas Health Science Center at Houston (UTHealth) analyzed 766 students in 10 middle schools in a large, urban school district in southeast Texas, where 44 percent were African American and 42 percent were Hispanic. They looked at four areas—physical victimization, emotional victimization, physical perpetration and emotional perpetration—finding that the It’s Your Game...Keep it Real program reduced all but physical dating violence, which comprised the smallest portion of the program; a revised program with a heavier emphasis on this area is currently being tested in schools. The U.S. Centers for Disease Control and Prevention estimates that 10 percent of high school youth are victims of physical dating violence (with ethnic-minority students at increased risk), with other studies indicating that as many as 20 percent are victims of emotional dating violence. Read more on violence.

CDC Report Finds High Rates of Youth Fruit, Vegetable Consumption
Approximately 77.1 percent of U.S. youth ages 2-19 years consume fruit on any given day and 92 percent consume vegetables, according to a recent NCHS Data Brief from the U.S. Centers for Disease Control and Prevention. However, the rate drops as youth age, while at the same time the amount of fruits and vegetables they eat should be increasing. The report used data from the National Health and Nutrition Examination Survey, 2009–2010. The focused report looked only at whether the foods were consumed, and now how much was consumed. Read more on nutrition.

Jul 15 2014
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Wellness Rocks: National Prevention Council Releases its Third Annual Report

This week, the National Prevention, Health Promotion, and Public Health Council (National Prevention Council) submitted its annual status report  to the President and designated Congressional committees describing national progress in meeting specific prevention, health promotion and public health goals defined in the National Prevention Strategy first released three years ago. The National Prevention Strategy is required under the Patient Protection and Affordable Care Act and has the overarching goal of increasing the number of Americans who are healthy at every stage of life.

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The goal of the annual report is to show how cabinet-level agencies are working across the federal government to incorporate health in diverse sectors—such as housing, transportation and education—to advance the National Prevention Strategy and influence the health of individuals, families and communities. The status report also highlights how private- and public-sector partners across the country are advancing the National Prevention Strategy in organizations ranging from health care systems to national foundations.

Federal agency highlights for the past twelve months include:

The report also includes status updates from several partner organization promoting health and wellness, including the American Public Health Association; the Henry Ford Health System; the Delaware Department of Health and Social Services; and the Robert Wood Johnson Foundation. The health promotion efforts of these organizations over the last year includes the fifth annual release of the County Health Rankings, which shows how health is influenced by where we live, learn, work and play.

Read interviews and listen to podcasts with federal agency leaders about the National Prevention Strategy on NewPublicHealth.

Jul 15 2014
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Public Health News Roundup: July 15

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RWJF Analysis of ACA Effects Finds No Increase in New Patient Visits
A new report, ACAView, from the Robert Wood Johnson Foundation (RWJF) and athenahealth, finds that in the first five months of 2014 there was no increase in new patient visits, when compared to the same time last year. The ACAView initiative was created to measure the impact of the Affordable Care Act (ACA) on providers, patients and physicians from 2014 through 2016. The report focuses on the provider perspective, showcasing how the ACA affects the practice patterns and economics of physicians and other care team members around the country. Potential reasons for the lack of an increase in visits include the newly insured being unfamiliar with the health care system, or even the winter weather. Read more on the Affordable Care Act.

Study: Nickel in an iPad Linked to Boy’s Allergic Skin Reaction
An ever-increasing reliance on consumer electronics may also mean rarer allergies are becoming more common, according to researchers who linked an 11-year-old boy’s allergic skin reaction to the nickel found in a first-generation Apple iPad. The study was published in the journal Pediatrics. Previous studies have linked the nickel in computers, smartphones and other electronics to allergic reactions; other common sources of nickel include ear piercings, clothing fasteners and dental work. “With the increasing prevalence of nickel allergy in the pediatric population, it is important for clinicians to continue to consider metallic-appearing electronics and personal effects as potential sources of nickel exposure,” according to the study. Read more on pediatrics.

Study: Changing Generic Pill Color, Shape Can Decrease Prescription Adherence
In addition to known considerations such as side effects and cost, the change in the appearance of prescription medications may also lead some people to stop taking their prescriptions, according to a new study in the Annals of Internal Medicine. In a study of more than 11,000 patients, researchers determined that a change in pill color would increase the odds that a patient would stop taking their heart medication by 34 percent, while a change in pill shape would increase the chances by 66 percent. This adds another wrinkle to the series problem of medication adherence; the American Heart Association estimates that three out of four Americans do not take their medication as directed. Read more on prescription drugs.

Jul 14 2014
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Health Beyond Health Care: Greening the Blight - Cities and Towns Take on the Challenge

Earlier this year, when a federal task force convened to look at how to help Detroit pull out of bankruptcy and regain resident and business confidence, one of the first recommendations was to assess the many blighted areas of the city—typically created when residents leave an area in droves, or when a business moves out of a building and isn’t replaced by another—and begin restoring them for residential, business or green space use.

Blight matters. Beyond making a city ugly, abandoned areas become a haven for trash, toxic elements, drug sales and prostitution. In Dorchester, outside Boston, a space sold by the city for a parking lot was left vacant for years and became a trash dump with mounds of cigarettes, and cars and tires—all leaching toxins.

file A woman takes part in the Clean and Green program (Courtesy: Bon Secours Health System)

A growing number of communities are starting to clean up those lots. In Baltimore, flight from the city has left close to a million homes and apartment buildings vacant over the last few decades, leaving in their place empty, dirty spaces that invite crime and trash. Bon Secours Community Works—the foundation of the Bon Secours Health System with hospitals in Baltimore and other cities—supports initiatives aimed at creating stable housing, including a program called Clean and Green, which is a part of Bon Secours' Housing and Neighborhood Revitalization Department.

Clean and Green is a landscaping training program that has transformed more than 85 vacant lots into green spaces, and has also begun to initiate community arts projects such as large public murals and community gardens. The program is designed to teach green job development skills, as well as provide free cleanup and beautification services to Baltimore neighborhoods.

file A man works on landscaping as part of the Clean and Green program (Courtesy: Bon Secours Health System)

Each program team is hired for six months of on-the-job training in green landscaping, during which they learn how to use landscaping and gardening tools and then go out into the field to clean lots, plant trees, pick up trash and do weeding. As part of their training, each individual gives at least three presentations about some aspect of green landscaping that they’ve learned, further preparing them for job interviews and jobs in the field. Each summer, youth employees also join the Clean and Green team for six weeks, working alongside the adults to learn about green landscaping and giving back to a community.

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Jul 14 2014
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Recommended Reading: Health Affairs and RWJF Primer on E-Cigarettes

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The public comment period for rules regulating the sale and use of e-cigarettes proposed in April by the U.S. Food and Drug Administration (FDA) ends on August 8, after which the agency is expected to release final rules governing the products. Experts say the timing is critical because sales of the products—which weren’t even on the market a decade ago—are heating up, with revenues approaching $1 billion a year, according to Forbes Magazine.

Last week, Health Affairs and the Robert Wood Johnson Foundation (RWJF) released a health policy brief about e-cigarettes that sets out key issues concerning the products and provides important background, particularly for people poised to comment on the FDA’s proposed rules.

Among the issues the policy brief addresses are e-cigarette safety; whether the devices ought to be regulated as a medical (smoking cessation) device or as a cigarette; and whether e-cigarettes pose a risk as a “gateway” drug to tobacco products. It notes that the FDA is currently funding close to 40 studies on e-cigarettes.

The issue is especially critical because sales to kids and teens are increasing, and there is still insufficient information on whether the vapor emitted by the devices pose a cancer risk. A 2013 study of 40,000 middle and high school students around the country by researchers at UC San Francisco found that e-cigarette use in that group doubled between 2011 and 2012, from 3.1 percent to 6.5 percent.

Read the policy brief from Health Affairs and RWJF.

>>Bonus Link: Read a NewPublicHealth post on initiatives by major cities to regulate the sale and use of e-cigarettes. 

Jul 14 2014
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Public Health News Roundup: July 14

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CDC Closes Flu and Anthrax Labs After Serious Lapses
After two serious lapses with anthrax and avian flu virus, the U.S. Centers for Disease Control and Prevention (CDC) announced it was temporarily closing its anthrax and flu laboratories and stopping shipments of all infectious agents. Last month at least 63 CDC employees may have been exposed to live anthrax bacteria after samples were sent to laboratories that were not prepared to handle the infectious agents. Anyone possibly exposed has been offered a vaccine and antibiotics; the CDC says no one was in danger.

In the second incident, technicians in a CDC lab accidentally contaminated a largely benign flu virus with a much more dangerous H5N1 bird flu strain. A lab worker who received a shipment of the strain and realized it was more dangerous than the sample expected contacted the CDC. And, in a third incident, the CDC also announced on Friday that two of six vials of smallpox vaccine recently found stored at the National Institutes of Health since 1954 contained live virus that could have infected people.

CDC has convened an investigation with finding expected later this week, as well as:

  • Established a high-level working group, reporting to the CDC Director, to help accelerate improvements in laboratory safety; review and approve—on a laboratory-by-laboratory basis—resuming transfer of biological materials; and serve as the transition group for accountability on laboratory safety.
  • Established a review group, under the direction of CDC’s Associate Director for Science, to look at the systems, procedures and personnel issues that led to the events, as well as how to prevent similar events in the future.
  • Plans to take personnel action regarding individuals who contributed to or were in a position to prevent this incident.

Read more on infectious disease.

Military Servicemembers at Increased Risk of Financial Abuse
Members of the military are at increased risk of financial abuse, according to a new survey from the National Foundation for Credit Counseling (NFCC), and more must be done to help servicemembers protect themselves. An NFCC survey of active duty military personnel found that: 

  •  77 percent of respondents have financial worries
  •  55 percent feel not at all or only somewhat prepared to meet a financial emergency
  •  60 percent say they had to look outside of traditional institutions and utilized alternative, non-traditional lenders to meet their financial needs

In order to answer this need, the NFCC is working to give servicemembers a deeper understanding of personal finance through its Sharpen Your Financial Focus program, which includes materials that address their particular financial literacy challenges. The program presents 10 individual lesson topics, ranging from banking to planning for retirement. “No one should be victimized by financial abuse, particularly the military,” said Gail Cunningham, spokesperson for the National Foundation for Credit Counseling (NFCC). “One way to avoid financial abuse is through financial education, as an educated consumer is always a better consumer, one more equipped to identify fraud or deception and make wise financial decisions.” Read more on the military.

Study: Confusion Over Spoon Sizes Can Lead to Incorrect Medication Doses for Kids
Confusion over and differences in spoon sizes can lead to frequent medication dosing errors for children, according to a new study in the journal Pediatrics. Researchers observed 287 parents provide medicine to their children using teaspoons and tablespoons, finding that 39 percent incorrectly measured the dose they intended and 41 percent made an error in measuring what their doctor had prescribed. The findings indicate a growing need to change how doctors prescribe medicine for children. "A move to a milliliter preference for dosing instructions for liquid medications could reduce parent confusion and decrease medication errors, especially for groups at risk for making errors, such as those with low health literacy and non-English speakers," said the study's lead author Shonna Yin, MD, an assistant professor of pediatrics at NYU School of Medicine in New York City. Poison control centers receive approximately 10,000 calls each year related to incorrect dosages of oral liquid medications. Read more on pediatrics.

Jul 11 2014
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Recommended Reading: A Refurbished Bus Will Bring Showers to the Homeless in San Francisco

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There are an estimated 7,350 homeless people living in San Francisco, yet there are only eight facilities in the city at which the homeless can shower. At each of these facilities, there are at most two shower stalls—meaning that there is at most one shower for every 460 homeless people.

Lava Mae developed a mobile approach to target this public health issue.

The refurbished San Francisco MUNI bus outfitted with two full-service bathrooms successfully made its first rounds on June 28. The bus will travel around the city providing the homeless with mobile public utilities and giving them much-needed access to clean water and sanitation. Without the limitations of stationary locations, Lava Mae is able to aide people across the city while also staying free from high real estate prices, rising rent and potential eviction.

"For at least a decade, bathrooms have stood in for the city's anxieties about homelessness, public utilities, and the changing economy," wrote Rachel Swan in a piece on public bathrooms in SF Weekly. Lava Mae founder Doniece Sandoval hopes that the program will take big steps in improving the health of the homeless and public sanitation by increasing the number and scope of available public restrooms.

The relationship between the health and wellbeing of the homeless population correlates directly with the health of the community as a whole. As the homeless population strives for a better quality of life, so does the community—one shower at a time.

Read the full story, “A Refurbished Bus Will Bring Showers to the Homeless in San Francisco.”

Jul 11 2014
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Public Health News Roundup: July 11

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CDC: 60 Percent of Diners Will Use Menu Calorie Counts When Available
Approximately 6 in 10 U.S. adults will choose their restaurant meals in part because of menu label information when it’s available, according to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Report. Researchers analyzed the self-reported usage of 118,013 adults in 17 states in 2012 to determine that about 57 percent will look to the provided calorie information. New York had the highest rate, with 61.3 percent, while Montana had the lowest, at 48.7 percent. Federal law requires calorie information be provided by any restaurant with 20 or more locations; while the regulations are not yet final, many establishments already voluntarily provide menu labeling, according to the CDC. Read more on nutrition.

Depression, Stress, Hostility Tied to Higher Stroke Risk
Depression, stress and hostility may be linked to a higher risk for stroke, according to a new study in the journal Stroke. Using information provided by approximately 7,000 adults who did not have heart disease or a history of stroke at the beginning of the study, researchers followed up nearly nine years later and determined that depression was associated with an 86 percent increased chance of a stroke or a transient ischemic attack, stress was associated with a 59 percent increase and hostility doubled the risk. “[C]hronic stress and negative emotions are important psychological factors that affect one's health, and findings from this study link these factors to brain health in particular," said the study's lead author, Susan Everson-Rose, an associate professor of medicine at the University of Minnesota, according to HealthDay. "Patients and their health care providers should be aware that experiences of chronic stress and negative emotional states can increase risk for stroke.” Read more on heart health.

Washington State Sees Most Measles Cases Since 1996
A slight decline in Washington State’s mumps and rubella vaccination rate has coincided with the state’s highest number of measles case in 18 years, according to officials. Washington has reported 27 cases so far this year and is currently in the midst of its third outbreak. While homegrown measles was declared officially eliminated from the United States in 2000, infections from people who have travelled overseas remain a threat. There were 554 total cases of measles and 17 outbreaks reported in the United States between Jan. 1 and July 3 of this year. Read more on infectious diseases.

Jul 10 2014
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Health Beyond Health Care: Housing

Planners, public health experts, community development leaders, architects and many others have come together over the past decade to focus on housing as a framework for a healthy life. A report released earlier this year by the Robert Wood Johnson Foundation’s (RWJF) Commission to Build a Healthier America made the link between health and housing clear:

“Living in unhealthy homes and communities can severely limit choices and resources. Healthy environments—including safe, well-kept housing and neighborhoods with sidewalks, playgrounds and full-service supermarkets—encourage healthy behaviors and make it easier to adopt and maintain them.”

Housing also impacts health when people spend so much on their rent or mortgage that they don’t have enough left over to pay for critical expenses such as food and medicine. According to the MacArthur Foundation—which released its second annual “Housing Matters” survey last month—during the past three years more than half of all U.S. adults have had to make at least one sacrifice in order to cover their rent or mortgage, including:

  • Getting an additional job
  • Deferring saving for retirement
  • Cutting back on health care and healthy foods
  • Running up credit card debt
  • Moving to a less-safe neighborhood or one with worse schools

Ianna Kachoris, a MacArthur Foundation program officer who oversees its How Housing Matters to Families and Communities research initiative, said that the quality and safety of a home make a significant impact on a person’s overall quality of life. Among the housing specifics that can impact health are lead or mold; the need to move frequently; having to live with many other people to make housing affordable; and concern over being able to afford the rent, the mortgage or needed housing repairs. The survey also found that accessing affordable quality housing in their communities is difficult for many people, including families with average income, young people just getting started in the labor force and families who want to live in quality school districts.

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