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Sep 24 2014
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Public Health News Roundup: September 24

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EBOLA UPDATE: Number of Cases Could Reach 1.4M by January in Worst-Case Scenario
(NewPublicHealth is monitoring the public health crisis in West Africa.)
As many as 1.4 million people could be infected by the Ebola outbreak in Liberia and Sierra Leone by the end of January, according to the latest estimates from the U.S. Centers for Disease Control and Prevention. Earlier this week, a study in the New England Journal of Medicine also “warned that the epidemic might never be fully controlled and that the virus could become endemic,” according to The Washington Post. U.S. officials, however, noted that neither of these worst-case scenario estimates take into account public health efforts enacted since August and other planned efforts in the weeks and months ahead. Read more on Ebola.

Health Insurance Marketplace Will Include 77 New Issuers in 2015
Next year will see a 25 percent increase in the number of issuers offering coverage on the Health Insurance Marketplace, according to a new report from the U.S. Department of Health and Human Services. Among the preliminary report’s findings:

  • In the 44 states for which there is data, 77 issuers will be newly offering coverage in 2015
  • The Federal Marketplace states will have 57 more issuers in 2015, a 30 percent net increase over this year
  • The eight State-based Marketplaces where data is already available will have a total of six more issuers in 2015, a ten percent net increase over this year
  • Four of the 36 states in the Federal Marketplace will have at least double the number of issuers they had in 2014
  • In total, 36 states of the 44 will have at least one new issuer next year

Read more on the Affordable Care Act.

Study: The Younger a Person is When they First Drink, the More Likely they’ll Develop an Alcohol Problem
The younger a person is when they begin drinking, the more likely they are to develop an alcohol abuse problem, according to a new study in the journal Alcoholism: Clinical & Experimental Research. Researchers based their findings on a survey of 295 high school students—163 girls and 132 boys—which asked about when they first tried alcohol, when they first became drunk, how often they drank alcohol in the preceding month and how often they engaged in binge drinking. According to the researchers, their findings can help determine the best methods to stop alcohol abuse problems before they develop. "If age of any use is the primary risk factor, our efforts should be primarily focused on preventing initiation of any use. If, however, age of first intoxication—or delay from first use to first intoxication—is a unique risk factor above and beyond age of first use, prevention efforts should also target those who have already begun drinking in an effort to prevent the transition to heavy drinking,” said Meghan E. Morean, assistant professor of psychology at Oberlin College, Ohio and adjunct assistant professor of psychiatry at Yale School of Medicine, in a release. Read more on alcohol.

Sep 23 2014
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Recommended Reading: Culture of Health Prize Winner Taos Pueblo on Health Affairs

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Earlier this year, Taos Pueblo, N.M., was chosen by the Robert Wood Johnson Foundation (RWJF) as a Culture of Health Prize winner for its efforts to improve community health by declaring self-governance. As part of a new ongoing series, Health Affairs blog has featured a piece by local Taos Pueblo leader Ezra Bayles on the community’s health successes.

Taos Pueblo is a National Historic Landmark where Native Americans have continuously lived for more than 1,000 years. Approximately 1,350 people call it the sovereign nation home. Despite its concerted efforts to keep its ancient oral language, culture and traditions alive, the community faces serious public health issues that are rooted in high rates of poverty and unemployment. Approximately 47 percent of pueblo youth under age 20 are overweight or obese and 21 percent of its adults have diabetes.

As a means to address these troubling issues, in 2007 the Taos Pueblo Tribal Council took steps toward self-governance, which allowed them to reorganize and streamline community services.

“We’ve taken on even more responsibility and are taking on the programs, functions and services to serve our people,” said Shawn Duran, Tribal Programs Administrator for Taos Pueblo, to NewPublicHealth earlier this year. “We’re finding solutions that we’re familiar with and turning that into programs that work for our people.”

Taos Pueblo’s efforts include:

  • Forming the Red Willow Community Growers Cooperative and the Red Willow Farmers Market in order to revive and celebrate the tribe’s agricultural heritage while also providing healthier food options.
  • Serving children ages 1 to 5 with the Taos Pueblo Head Start and My First School, which incorporates healthy eating while also instilling a strong sense of community.
  • Creating the Public Health Nursing Department, which sends a Native American nurse and two trained Community Health Workers directly to people’s doors as a way to make accessing care easier.

To learn more about Taos Pueblo’s prize-winning efforts to improve health, read the Health Affairs blog post.

>>Bonus Links: Learn more about the 2014 RWJF Culture of Health Prize winners and read NewPublicHealth coverage of the prize announcement.

>>Bonus Content: Watch a NewPublicHealth video on Taos Pueblo’s efforts to build a Culture of Health. 

Sep 23 2014
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Public Health News Roundup: September 23

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EBOLA UPDATE: 20,000 Cases by December Unless Significant Measures are Taken
(NewPublicHealth is monitoring the public health crisis in West Africa.)
More than 20,000 people could have been infected by Ebola by early November unless public health officials quickly enhance their control measures in West Africa, according to a new study in the New England Journal of Medicine. Researchers from the World Health Organization (WHO) and Imperial College, London, reviewed data since the start of the outbreak, which they identified as December 2013. Between Dec. 30 and Sept. 14 a total of 4,507 cases were reported to the WHO. Read more on Ebola.

HHS: $99 Million to Improve Youth Mental Health Services
The U.S. Department of Health and Human Services (HHS) has announced approximately $99 million in grants to improve mental health services for young people across the country. The grants include:

  • Approximately $34 million to train more than 4,000 new mental health providers, as well as expand and support Minority Fellowship Programs
  • Approximately $48 million to help teachers, schools and communities recognize and respond to potential youth mental health issues
  • Approximately $16.7 million to support 17 new Healthy Transitions grants, which will improve access to treatment and support services for people ages 16 to 25 that have or are at high risk of developing a serious mental health condition

Read more on mental health.

FDA: New Challenge to Develop Innovative Ways to Identify Foodborne Pathogens
The U.S. Food and Drug Administration (FDA) has announced a $500,000 challenge to encourage the creation of “breakthrough” and innovative solutions on how to find disease-causing, microbial pathogens—including Salmonella—in fresh produce. The 2014 FDA Food Safety Challenge was developed under the America COMPETES Reauthorization Act of 2010. “We are thrilled to announce the FDA’s first incentive prize competition under the America COMPETES Act,” said Michael Taylor, the FDA’s deputy commissioner for foods and veterinary medicine, in a release. “This is an exciting opportunity for the federal government to collaborate with outside experts to bring forth breakthrough ideas and technologies that can help ensure quicker detection of problems in our food supply and help prevent foodborne illnesses.” According to the U.S. Centers for Disease Control and Prevention, approximately one in six Americans are sickened by foodborne illness each year, leading to approximately 3,000 deaths. Read more on food safety.

Sep 22 2014
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Following the Announcement of New Antibiotic Resistance Initiative, Advocates Call for Increased Emphasis on Prevention in Livestock

Despite growing awareness of the dangers, antibiotic resistance continues to sicken two million Americans and kill 23,000 each year, according to a 2013 report from the U.S. Centers for Disease Control and Prevention. Late last week the Obama administration announced a series of efforts targeting the public health issue. Among them:

  • A Cabinet-level task force to create a national action plan on  antibiotic resistance
  • Improved federal oversight of antibiotic use in the United States, including better tracking of outbreaks
  • Incentives for developing new generations of antibiotics aimed at treating currently resistant microbes
  • A $20-million prize for the development of a rapid diagnostic laboratory test that doctors can use to identify highly resistant bacterial infections

Many in the public health field are quick to note that more should be done to address a key source of antibiotic resistance—widespread use of antibiotics to prevent infection and promote growth in livestock. There have been concerns that, in addition to over-prescription by physicians overuse, of the antibiotics in farm animals has also contributed to the growing trend of antibiotic resistance. A recent study found that livestock workers can harbor resistant bacteria acquired on the job and introduce it into the community.

Ed Silverman, who writes the Pharmalot blog for the Wall Street Journal, said that an administration report calls for the U.S. Food and Drug Administration (FDA), the U.S. Department of Agriculture, the National Science Foundation and the U.S. Department of Homeland Security to work together to develop an analytic model to assess the relationship between antibiotic use in livestock and the development of antibiotic resistance. The FDA currently has voluntary guidelines for livestock producers on limiting antibiotic use that go into effect in 2016, but advocates had hoped for an actual ban.

APIC ABCs of Infections

>>Bonus Link: The Association for Professionals in Infection Control and Epidemiology (APIC) has released a useful infographic for public health professionals and physicians to share with consumers about their roles in preventing antibiotic resistance.

Sep 22 2014
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Public Health News Roundup: September 22

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UPDATE: Sierra Leone Ends Three-Day Lockdown, Reports 130 New Cases
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Officials in Sierra Leone have ended a three-day curfew designed to help contain the continuing spread of the Ebola virus, calling the effort a success. Authorities reported 130 new cases during the lockdown and are waiting for tests on 39 more people. The West African country has been one of the hardest hit by the outbreak—more than 550 of the nearly 2,800 total deaths have been in Sierra Leone. In addition more than 100 tons of health-related supplies are being flown to Sierra Leone and Liberia. They include gloves, masks, gowns, goggles, saline, antibiotics, oral rehydration solution and painkillers. "We must do all we can to reduce further the human tragedy caused by this deadly outbreak and help communities avoid an even deeper setback than has occurred already," said Chief Executive Thomas Tighe of Direct Relief, according to USA Today. Read more on Ebola.

Study: Medicare Patients Less Likely to Receive Post-Stroke Surgery
Despite the fact that it can significantly help recovery and reduce the risk of long-term disability or even death, a common post-stroke surgical treatment is far less likely to be referred by physicians of patients with Medicare, according to a new study in the journal PLOS One. Researchers at the University of Florida (UF) analyzed data on more than 21,000 adult patients discharged from 2003 to 2008 with a diagnosis of subarachnoid hemorrhage, finding that—when compared to patients with private insurance—Medicare patients were almost 45 percent less likely to receive surgery and were more than twice as likely to die in the hospital. Azra Bihorac, MD, the study’s senior author and an associate professor of anesthesiology, medicine and surgery at the UF College of Medicine, said the results could indicate a conscious or unconscious bias. “Not every hospital has skilled neurosurgeons who specialize in subarachnoid hemorrhage,” he said in a release. “If these hospitals don’t have the necessary expertise, then they may actually overestimate the risk of a bad prognosis. They may assume that the patient won’t do well anyway, so they won’t proceed with surgery.” Read more on access to care.

Study: Weekly Text Reminders about Calories Help People Make Healthier Choices
Something as simple as a weekly text reminder may help U.S. adults develop a better understanding of basic nutrition and make healthier food choices, according to a new study in Health Promotion Practice. Researchers from the Johns Hopkins Bloomberg School of Public Health sent either a weekly text message reminder, a weekly email reminder, or no weekly reminder about the U.S. Food and Drug Administration’s recommendation of a reasonable daily caloric intake—2,000 calories—to 246 participants dining in the Johns Hopkins Hospital cafeteria. They found that at the beginning of the study approximately 58 percent knew the recommended benchmark, but after four weeks the participants who received texts were twice as likely to know the benchmark. “While daily energy needs vary, the 2,000-calorie value provides a general frame of reference that can make menu and product nutrition labels more meaningful,” said study leader Lawrence J. Cheskin, MD, director of the Johns Hopkins Weight Management Center, in a release. “When people know their calorie ‘budget’ for the day, they have context for making healthier meal and snack choices.” Read more on nutrition.

Sep 19 2014
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Faces of Public Health: Q&A with Joshua Sharfstein, MD

Faces of Public Health Joshua Sharfstein

In the last few months, several prominent national and state public health leaders have announced plans to move on to new things, including David Fleming, MD, MPH, the former Public Health Director in Seattle & King County Washington, who NewPublicHealth spoke with last month. We also recently spoke with Joshua Sharfstein, MD, secretary of Maryland’s Department of Health and Mental Hygiene, who will leave his post at the end of the year to teach at the Bloomberg School of Public Health at Johns Hopkins University as part of the faculty of the School of Health Policy and Management.

Earlier this year, Sharfstein gave the commencement address at the graduation ceremony of the University of Maryland School of Public Health, and had this to say about the importance of ensuring the public’s health:

“The premise of public health is that the well­being of individuals, families and communities has fundamental moral value. When people are healthy, they are productive, creative and caring. They enjoy life and have fun with their friends and families. They strengthen their neighborhoods and they help others in need. In short, they get to live their lives.”

NewPublicHealth: What prompted you to move to academia at this point in your career?

Joshua Sharfstein: It's a chance to help train hundreds of new public health leaders as well as work in depth on issues that are important to me. I am especially looking forward to getting to work closely with so many talented faculty at the Johns Hopkins Bloomberg School.

NPH: How have your research and teaching skills benefitted from your time as deputy director of the U.S. Food and Drug Administration (FDA) and your position with the state of Maryland?

Sharfstein: I've seen a lot of public health in action at the local, state and federal level. My goal will be to show students how important, interesting, engaging and—at times—strange public health can be. I have a research interest in why certain policies are pursued and others are not—and how public health can be successful in a difficult political and economic climate.

Read more

Sep 19 2014
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Public Health News Roundup: September 19

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EBOLA UPDATE: Sierre Leone on Three-Day Lockdown
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Today the nation of Sierra Leone began a three-day lockdown in an effort to slow the spread of the Ebola virus. "Today, the life of everyone is at stake, but we will get over this difficulty if all do what we have been asked to do," said President Ernest Bai Koroma. "These are extraordinary times and extraordinary times require extraordinary measures." The ongoing outbreak has so far killed at least 2,630 people and infected a total of 5,357 people. Read more on Ebola.

FDA Revises Proposed Rules to Prevent Foodborne Illnesses
Taking into account the public comments stemming from its extensive outreach, the U.S. Food and Drug Administration (FDA) has issued revisions to four proposed rules designed to promote food safety and help prevent foodborne illness. The rules include produce safety, preventive controls for human food, preventive controls for animal food and the foreign supplier verification program. “Ensuring a safe and high-quality food supply is one of the FDA’s highest priorities, and we have worked very hard to gather and respond to comments from farmers and other stakeholders regarding the major proposed FSMA regulations,” said FDA Commissioner Margaret A. Hamburg, MD, in a release. “The FDA believes these updated proposed rules will lead to a modern, science-based food safety system that will better protect American consumers from potentially hazardous food. We look forward to public comment on these proposals.” Read more on food safety.

CDC: Too Many Americans Don’t Receive a Flu Vaccination
At a news conference this morning, U.S. Centers for Disease Control and Prevention (CDC) Director Thomas Frieden, MD, stressed the need for all people ages 6 months and older to be vaccinated for the upcoming flu season. According to the CDC, fewer than half of eligible Americans get vaccinations resulting in unnecessary lost work days, hospitalizations and even death. "It's really unfortunate that half of Americans are not getting the protection from flu they could get," said Frieden, according to HealthDay. More than 100 children died from the flu-relate complications last year, and approximately 90 percent of them were unvaccinated. Read more on influenza.

Sep 18 2014
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New Survey: Americans like Mass Transit

A new report on public transit, Who’s on Board: The 2014 Mobility Attitudes Survey, has good news for developers and planners. The review of transit across the United States by TransitCenter, a New York City-based non-profit aimed at increasing and improving mass transit, finds that Americans across the country think about and use public transit in remarkably similar ways. That can result in communities adopting good ideas from other regions—reducing cost and speeding up new and improved transit systems.

“We commissioned this survey to take a deeper look at the public attitudes which are propelling recent increases in transit ridership,” said Rosemary Scanlon, Chair of TransitCenter and Divisional Dean of New York University’s Schack Institute of Real Estate. “As Millennials begin to take center stage in American life and the Baby Boom generation confronts retirement, both the transit industry and the real estate industry will need to adjust.”

The survey—the largest of its kind, according to TransitCenter—reviewed online survey responses from nearly 12,000 people from 46 metropolitan areas across the country, including a mix of what the group refers to as “transit progressive” cities (such as Miami, Denver, Seattle and Minneapolis) and “transit deficient” cities (such as Tampa, Dallas, Fresno and Detroit.)

Among the findings:

  • When choosing whether or not to take public transportation, riders of all ages and in all regions place the greatest value on factors such as travel time, proximity, cost and reliability, putting them above safety, frequency and perks such as Wi-Fi.
  • There is a high demand for quality public transportation nationwide, but such infrastructure is often missing in the places where people currently live.
  • Fifty-eight percent of survey respondents said their ideal neighborhood contained “a mix of houses, shops and businesses,” but only 39 percent currently live in that type of neighborhood.
  • Mass transit attracts the wealthy as well as the poor. In New York City, Philadelphia, Washington, D.C., and Chicago, people with a salary of $150,000 or greater are just as likely to ride public transportation as people with a $30,000 salary.

“There is a desire for reliable, quality transportation in communities across all regions of the U.S., and among riders of all ages, backgrounds and financial status,” said David Bragdon, Executive Director of TransitCenter. “Unfortunately, this desire is largely going unmet, to the detriment of many local economies. To serve and attract residents and workforces today and in the future, cities need to unite land use and transit planning to form comprehensive, innovative infrastructures that can support this demand.”

The report is based on an online survey that TransitCenter plans to update regularly. Bragdon said that one innovation is the increased number of transit options in suburban areas for people who don’t plan to move to the city, but who still want some of the conveniences of city life. Daybreak, Utah, a suburb of Salt Lake City, for example, now has a buses, light rail stations, sidewalks and bike lanes. Planners say Daybreak took a “transit first” approach to new community development rail stations.

According to Bragdon, the survey will be updated and conducted regularly to track changes in transit rider attitudes and regional trends over time.

Sep 18 2014
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Public Health News Roundup: September 18

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EBOLA UPDATE: Death Toll to at Least 2,622
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The World Health Organization announced today that the Ebola outbreak in West Africa has now claimed at least 2,622 lives and infected at least 5,335 people. "The upward epidemic trend continues in the three countries that have widespread and intense transmission—Guinea, Liberia and Sierra Leone," the global health agency said in a statement, adding that the disease’s spread through Liberia is in large part due to an increasing number of cases in the capital of Monrovia. Read more on Ebola.

HHS to Sponsor the Development of a Portable Ventilator for Use in Public Health Emergencies
The U.S. Department of Health and Human Services (HHS) is sponsoring the development of a next-generation portable ventilator for use in pandemics and other public health emergencies. The low-cost, user-friendly device will be developed with Philips Respironics under a $13.8 million contract; the project will be overseen by the Biomedical Advanced Research and Development Authority (BARDA) within the HHS Office of the Assistant Secretary for Preparedness and Response. “In pandemics and other emergencies, doctors must have medicines, vaccines, diagnostics, and critical equipment such as mechanical ventilators at the ready in order to save lives,” said BARDA Director Robin Robinson, PhD, in a release. Read more on preparedness.

HUD Launches $1B National Disaster Resilience Competition
The U.S. Department of Housing and Urban Development (HUD) is launching a $1 billion National Disaster Resilience Competition to help state, local and tribal leaders prepare their communities for the impacts of climate change and other factors using federal funds. “The National Disaster Resilience Competition is going to help communities that have been devastated by natural disasters build back stronger and better prepared for the future,” said HUD Secretary Julián Castro, in a release. “This competition will help spur innovation, creatively distribute limited federal resources, and help communities across the country cope with the reality of severe weather that is being made worse by climate change.” Read more on disasters.

Sep 17 2014
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Can Idea Sharing Among CEOs Improve Health and Bring Down Health Care Costs?

The Bipartisan Policy Center (BPC) in Washington, D.C., and nine CEOs from leading U.S. companies issued a report yesterday that lays out their ideas for improving individual and community health while reducing health care costs. The report, Building Better Health: Innovative Strategies from America's Business Leaders, shares strategies from all the companies and makes several recommendations:

  • Implement and track the outcomes of corporate health and wellness programs
  • Collaborate on the implementation of community-based programs
  • Improve the health care system by supporting the movement toward transparency and payment and delivery models that are based on outcomes rather than on volume

The CEOs are members of the BPC’s CEO Council and collectively employ more than one million people and provide coverage for over 150 million people. Council participants include McKinsey & Company, Aetna, Johnson & Johnson, The Coca-Cola Company, Verizon Communications, Bank of America, Blue Cross Blue Shield Association and Walgreens Co.

In addition to the report, the council released an interactive website with examples of initiatives the companies have taken to improve individual and community health. Some examples also improve the corporations’ bottom lines, such as Verizon’s partnerships with university research centers to test wireless health monitors that individuals or companies can download and buy through the technology company. However, David Erickson, director of the Center for Community Development Investments at the Federal Reserve Bank of San Francisco, points out that no for-profit company can afford the investments required for improving public health without also being able to see an impact on their own bottom line. Examples include increased sales and greater efficiencies in delivering health care.

For example, Walgreens has increased its share of flu shots given from fewer than one million in 2009 to more than seven million in 2013. While that represents improved income for the company, Walgreens—which has stores within three miles of 63 percent of Americans, 75 percent of African-Americans and 78 percent of Latinos—has also worked with state and federal health officials to publicize and increase immunization initiatives. It has also worked with many third-party payers so that patients are often fully or largely covered for the vaccines, with little or no copayment required. Retail clinics such as those at many Walgreen stores also often improve on current health care delivery, such as being open 365 days a year, unlike most doctors’ offices.