A new Kaiser Health News (KHN) article describes the challenges of helping people who have never had health insurance sign up for coverage. The KHN profile looks at the Arab Community Center for Economic & Social Services (ACCESS) a nonprofit agency that is helping the large Arab-American population in Dearborn, Mich., sign up for coverage and access care.
The group has found that many of the people they are helping are immigrants who know little to nothing about health insurance concepts such as enrollment, copays and deductibles—an issue that also applies to millions of other people new to health insurance across the country. Immigrant and uninsured populations all over the country face cultural and language barriers to understanding and adopting U.S. insurance practices.
Ten million non-citizens living legally in the U.S. are expected to gain health insurance under the Affordable Care Act, according to KHN. The navigators at ACCESS are also trained to teach immigrants about free public health screenings for conditions such as breast cancer, which requires specialized training and conversations because of cultural stigmas associated with cancer.. At the ACCESS center in Dearborn, for example, women coming for free mammograms enter through an unmarked door.
Read the Kaiser Health News article.
- Kaiser Health News recently reported that, on average, premiums will decline in 16 major cities for the 2015 coverage year.
- Advertising for health insurance plans has already started across the country. Sign up for the 2015 coverage year begins October 15, 2014 and ends February 15, 2015, a period that is roughly three months shorter than last year’s enrollment period. Find information at healthcare.gov.
Mandatory Policies Increase Flu Shot Rates for Health Care Workers
Hospitals can improve their flu vaccination rate among health care workers by using a mandatory employee vaccination policy, according to a study by researchers at the Henry Ford Health System in Detroit. At Henry Ford, getting the flu shot is a condition of employment and the health system now has a 99 percent compliance rate. Nationally, only 63 percent of health care workers were immunized against the flu in the past two years, according to the Centers for Disease Control and Prevention, which poses a risk to patients. The study was presented this weekend at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Washington D.C.
Before making flu vaccination mandatory, the vaccination rate at Henry Ford was between 41 percent and 55 percent. An increasing number of health systems are making flu shots mandatory for employees. At Henry Ford, employees can opt out for religious or medical reasons so long as they have documentation from clergy or a physician and then must take other precautions against the flu, such as wearing a mask when caring for patients.
Many doctors’ offices, pharmacies and clinics already have the flu shot on hand for the upcoming flu season. The HealthMap flu shot locator has been updated for the 2014-2015 flu season.
Read more on the flu.
Study: Alcohol Ad Reminders to “Drink Responsibly” Promote Drinking
A new study by researchers at the Johns Hopkins School of Public Health finds that magazine ads from the alcohol industry that advise readers to “drink responsibly” or “enjoy in moderation” fail to convey important information about dangers associated with alcohol consumption.
The study, published in Drug and Alcohol Dependence, analyzed all alcohol ads that appeared in U.S. magazines from 2008 to 2010 to determine whether messages about responsibility define responsible drinking or provide clear warnings about the risks associated with alcohol consumption.
According to the study, 87 percent of the ads analyzed included a responsibility message, but none actually defined responsible drinking or promoted abstinence at particular times or in certain situations. When responsibility messages were accompanied by a product tagline or slogan, the messages were displayed in smaller font than the company’s tagline or slogan 95 percent of the time.
Responsibility statements are voluntary and are also frequently included in ads appearing in other media including radio and online ads. The researchers say more effective ads would have prominently placed tested warning messages that directly address behaviors and that do not reinforce marketing messages. “We know from experience with tobacco that warning messages on product containers and in advertising can affect consumption of potentially dangerous products,” say Katherine Clegg Smith, a professor at the Johns Hopkins Bloomberg School of Public Health and a lead author of the study. “We should apply that [tobacco ad] knowledge to alcohol ads and provide real warnings about the negative effects of excessive alcohol use.”
Read more on alcohol.
NYC Health Department Investigating Meningitis Outbreak among HIV Positive Men
The New York City Health Department is currently investigating a cluster of meningitis cases among HIV-positive men who have sex with men. Three cases of meningitis have occurred in Brooklyn and Queens since August 24, with the last two cases reported since early September.
Meningitis is a severe bacterial infection that has a high fatality rate. A previous outbreak of the disease among men who have sex with men ended in February 2013 after 22 cases were reported, including seven fatal cases.
The Health Department recommends meningitis vaccination for all HIV-positive men who have sex with men. Meningitis vaccinations are also recommended for men, regardless of HIV status, who regularly have intimate contact with other men met through a website, digital application (“app”), or at a bar or party.
People living with HIV are at a greater risk than the general population of acquiring meningitis and, if infected, dying from infection. This disease is spread by prolonged close contact with nose or throat discharges from an infected person.
Read more on sexual health.
Earlier this year, Durham County, N.C., was chosen by the Robert Wood Johnson Foundation (RWJF) as a Culture of Health Prize winner for its efforts to ensure that its most vulnerable residents have access to the county’s repository of world-class health resources, high-skilled jobs and places to exercise. As part of an ongoing series, Health Affairs blog has featured a piece by local Durham leader Erika Samoff on the community’s health successes.
While Durham is home to a wealth of health care resources—so much so that it’s been dubbed “The City of Medicine”—a 2004 health assessment found high rates of cardiovascular disease and other chronic conditions; HIV/AIDS and other sexually transmitted diseases; and infant mortality. In addition, a 2007 evaluation found that nearly one in three of Durham’s adults were obese, with the rate especially high in its African-American population, at 42 percent. Half of the adults surveyed pointed to a lack of opportunities for physical activity as a contributing factor to their condition.
County leaders responded to these findings by creating the Partnership for a Healthy Durham. It is an alliance of more than 150 nonprofits, hospitals, faith-based organizations and businesses. The partnership’s efforts include:
- Turning an empty, run-down junior high school into the Holton Career & Resource Center, which offers mentoring programs, internships and hands-on career training to high school students
- Creating new bike lanes, bike racks and sidewalks to encourage physical activity and help combat chronic obesity
- Creating Project Access of Durham County to provide access to specialty care for uninsured residents
- Passing smoke-free legislation
To learn more about Durham’s prize-winning efforts to improve health, read the Health Affairs blog post.
- Learn more about the 2014 RWJF Culture of Health Prize winners and read NewPublicHealth coverage of the prize announcement.
- Read Everyday Health’s post, “How Healthy Is Your Hometown?: What you can do to create a culture of health in your community – and win a prize for it.”
>>Bonus Content: Watch a NewPublicHealth video on Durham’s efforts to build a Culture of Health.
Last June, the Washington Post held a live event, Health Beyond Health Care, which brought together doctors, bankers, architects, teachers and others to focus on health beyond the doctor’s office. The goal of the Washington, D.C., event—which was co-sponsored by the Robert Wood Johnson Foundation others—was to showcase examples of communities working with partners to create cultures of health.
Healthy Detroit is a shining example. The project is a 501(c)(3) public health organization dedicated to building a culture of healthy, active living in the city of Detroit. It was formed less than a year ago in response to the U.S. Surgeon General’s National Prevention Strategy (NPS.) The NPS offers guidance on choosing the most effective and actionable methods of improving health and well-being, and envisions a prevention-oriented society where all sectors recognize the value of health.
NewPublicHealth recently spoke with Nicholas Mukhtar, founder and CEO of Healthy Detroit.
NewPublicHealth: How did Healthy Detroit get its start?
Nicholas Mukhtar: I was just about to the MPH part of a joint MPH/MD degree and had always wanted to be a surgeon. But as I started living in the city and getting more involved in the community, I really saw a different side of health care, and to me it just became more rewarding to focus on the systemic issues in the health care system, more so than treating people once they already got sick. I’ve now finished the MPH part of my degree, and am starting on my MD degree.
So I started sending out a number of emails to different people and reached out to Dr. Regina Benjamin, then the U.S. Surgeon General, as well as local individuals. And then we established our mission, which was really to build a culture of prevention in the city while implementing the National Prevention Strategy.
EBOLA UPDATE: Third U.S. Aid Workers Arrives for Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
A third U.S. medical missionary has arrived at the Nebraska Medical Center in Omaha for treatment for Ebola. Rick Sacra, MD, is a SIM USA missionary, as were Kent Brantly, MD, and Nancy Writebol, who were both treated successfully for Ebola at Emory Hospital. Approximately 1,900 people have died and 3,500 have been sickened in the ongoing outbreak. Approximately 400 deaths came in the past week alone. Read more on Ebola.
CDC Report Explores the Extent and Impact of Intimate Partner and Sexual Violence
The U.S. Centers for Disease Control and Prevention (CDC) has released a new report examining the extent and impact of intimate partner and sexual violence. According to the report, almost 20 people per minute are victims of physical violence by an intimate partner; almost 2 million women are raped each year; and more than 7 million women and men are victims of stalking each year. The report determined that since a “substantial portion” of this violence and stalking comes at a young age, primary prevention must also focus on people at young ages, accounting for the differences in victims, addressing risk factors and emphasizing health relationships. Read more on violence.
Study Links Breastfeeding, Lower Weight for Mothers
Mothers who were obese before pregnancy and who then go on to breastfeed may have an easier time losing their pregnancy weight and then keeping it off, according to a new study in journal Pediatrics. Researchers determined that previously obese mothers who breastfed weighed almost 18 pounds less than those who didn’t. "Breast-feeding not only burns extra calories but it also changes the metabolism through a series of hormonal effects required to lactate," said Lori Feldman-Winter, MD, a pediatrician and a professor of pediatrics at Children's Regional Hospital at Cooper University Health Care in Camden, N.J. "The full understanding of how breast-feeding leads to improvements in metabolism for both mother and her baby is incomplete, but there are multiple epidemiological studies showing the association." She also said that the healthier eating habits many mothers who breastfeed take up may also contribute to the lower weights. Read more on maternal and infant health.
Recently NewPublicHealth shared an interview from AlleyWatch, a Silicon Valley technology blog about SenseHealth, a new medical technology firm that has created a text message platform that health care providers can use to communicate with patients. In May, SenseHealth was picked to be part of the New York Digital Health Accelerator, which gives up to $100,000 in funding to companies developing digital health solutions for patients and providers. The accelerator is run by the Partnership Fund for New York City and the New York eHealth Collaborative. SenseHealth engaged in a clinical trial last year that used the technology to help providers engage with patients who are Medicaid beneficiaries.
Health conditions supported by the SenseHealth platform range from diabetes to mental health diagnoses, while the messaging options include more than 20 customizable care plans, such as medicine or blood pressure monitoring reminders. There are also more than 1,000 supportive messages, such as a congratulatory text when a patient lets the provider know they’ve filled a prescription or completed lab work. The platform couples the content with a built-in algorithm that can sense when a user has logged information or responded to a provider, and providers are able to set specific messages for specific patients. Early assessments show that the technology has helped patient manage their conditions, with data showing more SenseHealth patients adhered to treatment plans and showed up for appointments than patients who didn’t receive the text program.
We received strong feedback on the post, including a question from a reader about whether Medicaid beneficiaries lose contact with their providers if they disconnect their cell phones or change their numbers, a common occurrence among low-income individuals who often have to prioritize monthly bills. To learn more about SenseHealth and its texting platform, NewPublicHealth recently spoke with the company’s CEO and founder, Stan Berkow.
NewPublicHealth: How did SenseHealth get its start?
Stan Berkow: We got started about two to two-and-a-half years ago. I met one of the other founders while I was working at the Columbia University Medical Center in New York City. We were both clinical trial coordinators and were seeing—first hand—the difficulties in getting participants in our studies to actually follow through on all the exercise and nutritional changes they needed to make in order to complete the research project. That led us to step back and look at the bigger health care picture and recognize the challenges for providers to help patients manage chronic conditions, and recognizing that there’s a huge time limitation on the providers. That pushed us toward finding a way through technology to help those providers help the patients they work with more effectively to prevent and manage chronic conditions.
EBOLA UPDATE: WHO Says More than $600M Needed to Combat the Ebola Outbreak
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Approximately $600 million in supplies is needed to combat the ongoing Ebola outbreak in West Africa, according to the World Health Organization (WHO), while Canadian health officials continue to work on a way to transport an experimental treatment to the affected area. "We are now working with the WHO to address complex regulatory, logistical and ethical issues so that the vaccine can be safely and ethically deployed as rapidly as possible," said Health Canada spokesman Sean Upton, in a statement. "For example, the logistics surrounding the safe delivery of the vaccine are complicated." More than 1,900 people have died in the outbreak. Read more on Ebola.
RWJF, TFAH Report Finds State Obesity Rates Continue to Remain High
Adult obesity rates continue to be high across the country, with rates increasing in six states and decreasing in none over the past year, according to a new report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). The report, The State of Obesity: Better Policies for a Healthier America, found that rates climbed in Alaska, Delaware, Idaho, New Jersey, Tennessee and Wyoming. Mississippi and West Virginia have the highest rates, at 35.1 percent, and no state has a rate below 21 percent. “Obesity in America is at a critical juncture. Obesity rates are unacceptably high, and the disparities in rates are profoundly troubling,” said Jeffrey Levi, PhD, executive director of TFAH, in a release. “We need to intensify prevention efforts starting in early childhood, and do a better job of implementing effective policies and programs in all communities—so every American has the greatest opportunity to have a healthy weight and live a healthy life.” Read more on obesity.
Study: Women Are Underrepresented in Surgical Research
A review of more than 600 studies in five major surgical journals found that males are vastly overrepresented, calling into question how the findings will translate for female patients. The journals— Annals of Surgery, American Journal of Surgery, JAMA Surgery, Journal of Surgical Research and Surgery—responded by announcing they will now require study authors to report the sex of animals and cells in their research, or to explain why only one sex was analyzed. "Women make up half the population, but in surgical literature, 80 percent of the studies only use males," study senior author Melina Kibbe, MD, professor of surgical research at Northwestern University Feinberg School of Medicine, said in a release. "We need to do better and provide basic research on both sexes to ultimately improve treatments for male and female patients.” The study appeared in the journal Surgery. Read more on health disparities.
In the last few days, the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and the medical aid group Doctors Without Borders have sounded alarms on the growing needs of several countries in West Africa fighting the Ebola outbreak. The groups have called for increased funding, equipment and expert health personnel to help stem the rapidly increasing numbers of infections.
As of last week, there have been more than 3,000 cases and more than 1,500 deaths, making it by far the largest outbreak since Ebola was discovered during the 1970s, according to the WHO. CDC Director Tom Frieden, MD, MPH, who last week visited the main West African countries dealing with the Ebola outbreak, said the number of cases could spike to 20,000 if more isn’t done to stem spread of the disease in those countries.
In addition, a recent post on ForeignPolicy.com said that the epidemic must be controlled before it also poses a security threat. Liberia, which has seen the highest number of Ebola cases and deaths in the region so far, has been under the watch of an international United Nations (U.N.) peacekeeping force since a civil war ended in 2003. While the U.N. had planned to begin drawing down the force next year, U.N. Secretary General Ban Ki-moon said he’d like to delay any drawdown for at least three months because of the virus outbreak, which has needed troops to help secure order.
However, several countries want to pull out troops now in order to reduce the risk to their personnel and to citizens at home who they worry could be infected by returning soldiers. Ban has said that the nature of the illness poses little risk to the troops, who are unlikely to have contact with the bodily fluids of people who are ill—which is the way the virus spreads—and some of the countries involved are considering sending their own experts to assess the risks.
EBOLA UPDATE: HHS Partners with Mapp Biopharmaceutical on Development of Ebola Treatments
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Department of Health and Human Services has contracted with Mapp Biopharmaceutical Inc. for the development of an Ebola treatment. The funding will come through the Assistant Secretary for Preparedness and Response’s Biomedical Advanced Research and Development Authority. Under the 18-month, $24.9 million contract, Mapp will also continue the development and manufacture of its existing Ebola drug, ZMapp, which was used to successfully treat two Americans who were infected in the outbreak in West Africa. “While ZMapp has received a lot of attention, it is one of several treatments under development for Ebola, and we still have very limited data on its safety and efficacy,” said Nicole Lurie, MD, assistant secretary for preparedness and response, in a release. “Developing drugs and vaccines to protect against Ebola as a biological threat has been a long-term goal of the U.S. government, and today’s agreement represents an important step forward.” Read more on Ebola.
CVS Announces All Stores are Now Tobacco Free
Tobacco products are no longer sold at any of the approximately 7,700 CVS/pharmacy locations, the company announced today, almost a month ahead of its planned tobacco-free schedule. The company also announced that is has changed its corporate name to CVS Health. "Every day, all across the country, customers and patients place their trust in our 26,000 pharmacists and nurse practitioners to serve their health care needs," said Helena B. Foulkes, President of CVS/pharmacy, in a release. "The removal of cigarette and other tobacco products from our stores is an important step in helping Americans to quit smoking and get healthy." Read more on tobacco.
Study: Double Mastectomies and Lumpectomies Carry Similar Survival Rates
Double mastectomies for early stage breast cancer are no more effective than lumpectomies at improving survival rates, according to a new study in the Journal of the American Medical Association. Analyzing data on more than 189,000 patients in California, researchers found that while the percentage of women who opted for double mastectomies climbed from 2 percent in 1998 to 12.3 percent in 2011—and that in 2011 approximately one-third of patients younger than 40 chose to have a double mastectomy rather than the potentially breast-conserving lumpectomy—the death rates for the two treatments were similar. The researchers said their findings are especially significant for women at average risk. Read more on cancer.
NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to email@example.com.
The Federal Emergency Management Agency (FEMA) is starting off National Preparedness Month with a series of stark, dark and attention-getting public service advertisements (PSAs) developed in cooperation with the Ad Council. They are set in what looks to be a dark, crowded school auditorium and showcase an intact family sheltering from the storm, and another family unable to locate their son. The obvious focus is on making a plan to know where all family members are when disaster strikes, but the auditorium—with too few chairs, no apparent cots and little room to move or stretch—gives a rare glimpse into what a public shelter looks like during an emergency and adds to the urgency of making that plan.
“The first step to preparing for disasters is simple and it’s free—talk to your family and make a plan,” said Craig Fugate, FEMA administrator. “Do you know how you’ll reunite and communicate with your family during an emergency? Through our continued partnership with the Ad Council, this year’s campaign illustrates how making a plan can keep families together and safe during a disaster.”
According to a recently released FEMA survey, 50 percent of Americans have not discussed or developed an emergency plan for family members about where to go and what to do in the event of a local disaster.