Category Archives: Health and Human Services
Health and Human Services Secretary Kathleen Sebelius yesterday rejected an application to make Plan B, an emergency contraceptive pill, available without a prescription for girls younger than 17. The drug is already approved for sale without a prescription for girls and women over the age of 17. The Food and Drug Administration (FDA) had planned to approve the availability for younger girls. HHS Secretaries are permitted to overrule an FDA decision, though this is the first time a Secretary has done so, according to the FDA. Read more on sexual health.
Women may be able to reduce their risk for breast cancer by avoiding unnecessary medical radiation, avoiding use of use of combination estrogen-progestin menopausal hormone therapy, limiting alcohol, maintaining a healthy weight, exercising regularly and avoiding tobacco use, according to a new report on environmental risk factors for breast cancer released yesterday by the Institute of Medicine.
According to the new report, evidence also indicates a possible link to increased risk for breast cancer from exposure to benzene, 1,3-butadiene, and ethylene oxide, which are chemicals found in some workplace settings and in gasoline fumes, vehicle exhaust, and tobacco smoke. But avoiding personal use of hair dyes and non-ionizing radiation emitted by mobile devices and other technologies probably do not impact a woman’s risk for breast cancer, and there is insufficient data on the link between some other chemicals and an increased risk for breast cancer including bisphenol A (BPA), pesticides, ingredients in cosmetics and dietary supplements. Get more news on developments in cancer research and prevention.
The U.S. Department of Agriculture (USDA) has awarded 17 grants to universities in 13 states aimed at improving the safety of the U.S. food supply. USDA's National Institute of Food and Agriculture awarded the grants, which focus on areas including laboratory research and grower and consumer education. Read more on food safety.
What does a pair of running shoes have to do with healthy self-esteem and behavior change? Just ask Girls on the Run.
Girls on the Run is a national program for girls ages 8 to 13 that couples running and life lessons to help build self esteem and a healthy future for thousands of girls. The Washington, D.C. area chapters show off the program’s diversity with participating schools ranging from private academies with sky-high tuition to D.C. public school students whose families struggle to make ends meet.
The program concentrates on the 8 to 13 age group because studies show that girls between those ages are still receptive to adult influence, while beginning to feel peer pressure, says D.C. chapter head Elizabeth Hammond-Chambers. “Learning to value physical activity early in life increases the likelihood of participants staying physically healthy into adulthood,” says Hammond-Chambers.
National participation in the program is growing at about 20 percent a year, and while girls are proud of their physical feats, their emotional growth is just as significant. Hammond-Chambers says the girls have written testimonials saying they feel proud and able to stand up for themselves. “I love to watch the same look of pride on each girl’s face as they cross the finish line at our annual race.”
Non-competitiveness may be the ticket. Walking the 5K is as valued as running, and everyone gets a medal at the end. During training session girls are encouraged to cheer each other on. And they do. The point isn’t winning, it’s “moving with purpose” says Hammond-Chambers.
Although all chapters are modeled on the same national program, the D.C. chapter has some lofty neighbors cheerleading for the program. A special guest at the end of program run last year was Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services.
About 20 percent of Americans now smoke, down from about the half of American adults who smoked in the 1960s. Changes in advertising, physician advice, advocacy messages and social norms are behind the millions who have already quit—but what’s with the 20 percent still smoking?
Experts say current smokers, bombarded with no-smoking messages and obstacles to smoking such as higher cigarette prices and bans on smoking in many public places and workspaces likely have physiologic causes that keep them lighting up. That doesn’t mean they can’t quit, says Richard Hurt, MD, director of the Nicotine Dependence Center at the Mayo Clinic. It means they need combinations of specifically targeted strategies.
Hurt says that we’re all born with the same number of nicotine receptors in our brains but for some people, starting to smoke physiologically increases those receptors—and the dependence on nicotine. “It’s very difficult to give up tobacco when your brain is craving it that much,” says Hurt. Nicotine is always addictive, but the level of physical addiction can vary dramatically from one person to the next. Hurt adds that cigarette manufacturers have refined cigarettes over the years for the maximum delivery of nicotine—and dependence—to the brain.
“Smokers need to know that quitting is a process, most people need several quit attempts,” Hurt says. They also need to work with health professionals who can help adjust numbers of counseling sessions—often phone counseling is as effective as in person therapy—as well as continual adjusting of doses for nicotine replacement and types and amounts of drugs.
Where to start? Hurt suggests a health care professional or one of several gateway websites available 24/7 to help smokers quit. “Be part of a community... Sometimes just understanding what you’re up against, something more than just will power , is very powerful and enriching for smokers hoping to quit,” says Hurt.
- American Cancer Society's Great American Smokeout
- Centers for Disease Control and Prevention
- U.S. Department of Health and Human Services's SmokeFree.gov
- National Cancer Institute
- National Alliance for Tobacco Cessation
>>Read more tobacco news.
>>Weigh In: What have you found to be successful in helping smokers quit?
The White House issued an executive order yesterday to help remedy the current shortage of some prescription drugs, including some cancer medications. The order calls on the U.S. Food and Drug Administration to take a number of steps to intervene including adding staff, working with drug companies to alert the agency to impending drug shortages ahead of time and to investigate whether shortages are leading to price gouging. Prescription drug shortages tripled between 2005 and 2010.
The U.S. Department of Health and Human Services today released final standards to more consistently measure race, ethnicity, sex, primary language and disability status, thereby improving the ability to highlight health disparities and target interventions to reduce these disparities. Read up on health disparities here.
A new American Academy of Pediatrics policy statement recommends that pediatricians provide substance abuse education and screening to adolescents during routine clinical care, relying on protocols designed by the U.S. Substance Abuse and Mental Health Services Administration. Get more substance abuse news.
“The indicators help communicate high-priority health issues to the public and actions that can be taken to address them,” said Howard Koh, MD, Assistant Secretary of Health at HHS, at the briefing this morning. The indicators also give health professionals a chance to narrow their focus when it comes to the health of Americans. Healthy People 2020, which the leading indicators are linked to, contain 42 topic areas, nearly 600 objectives, and close to 1200 measures. “Through these… measures, communities can identify vital health issues and track how they are doing compared to other communities,” said Dr. Koh.
The new indicators include some of the usual, though critical, suspects including violence and injury prevention but also include two new measures that public health officials cheered at the announcement today—oral health and social determinants. The other indicators include access to health services, clinical preventive services, environmental quality, maternal, infant and child health, mental health, nutrition, physical activity and obesity, reproductive and sexual health, substance abuse and tobacco. According to HHS, preparedness was not selected because the topic is new and there’s a lack of historical data, however the agency will continue to monitor the issue to see if it should be included in the future.
The indicators were developed by HHS advisory groups and the Institute of Medicine, which released a report on leading health indicators several months ago.
Todd Park, HHS Chief Technology Officer, today announced a related app challenge at this morning’s briefing. “We’re launching a new application development challenge to bring technology innovators and public health mavens together to develop tools that can be used to help communities apply the power of the Leading Health Indicators to improve health,” said Park. The contest ends in March, and will be available at challenge.gov.
Weigh In: Do you have an idea for a leading health indicator app that would benefit communities?
>>Follow the rest of our APHA 2011 Annual Meeting Coverage here.
William Schaffner, MD, professor and chair of the preventive medicine department at Vanderbilt University, responded to an article on the effectiveness of the flu vaccine with a quote from Voltaire—“perfection is the enemy of the good." The article, published yesterday in Lancet Infectious Diseases, detailed an analysis of previous studies and found that the most commonly used vaccine in the U.S. is about 60 percent effective—somewhat less than had been thought—and that there are no trials on children ages two through 17 and on adults age 65 and older.
Schaffner, who is also a spokesman for the Infectious Diseases Society of America says that while the current flu vaccine isn’t fully effective for everyone who gets it, everyone eligible should get the shot because even in cases where it doesn’t prevent the flu, it can minimize serious flu effects including hospitalizations and deaths. “That’s crucial,” says Schaffner. “A healthy person with the flu can go from feeling fine to very ill in the hospital in just 48 hours.”
People have a tendency to disrespect the seriousness of the risk posed by the flu, but they make a mistake, says Paul Etkind, DrPH, senior director for infectious diseases at the National Association of County and City Health Offiicals. From 3,000 to 48,000 people die each year from the flu, depending on how active the season is, says Etkind, and about a quarter of a million people are hospitalized each year.
The U.S. sent some impressive firepower as part of its delegation to the United Nations High-level Meeting on non-communicable (also known as chronic) diseases that met this week in New York. The delegation included HHS Secretary Kathleen Sebelius, Surgeon General Regina Benjamin, M.D., M.P.H. and CDC Director Thomas Frieden, M.D., M.P.H. Additional delegation members included American Public Health Association Executive Director Georges Benjamin, M.D., and Risa Lavizzo-Mourrey, M.D., M.B.A., president and C.E.O. of the Robert Wood Johnson Foundation.
The U.N. meeting, the first high-level meeting on a health issue since a summit on AIDS ten years ago, was attended by more than 30 heads of state and at least 100 other senior ministers from around the world. The delegates adopted a declaration calling for a multi-pronged campaign by governments, industry and the public. The declaration calls for an international plan by 2013 to curb risk factors behind cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.
Chronic Disease Surpasses Infectious Disease in Global Deaths
Non-communicable diseases (NCDs) kill 35 million people each year and more people now die from these chronic diseases globally than from infectious diseases, according to the World Health Organization. The WHO also notes that the most prevalent diseases share common risk factors including tobacco use, unhealthy diets, physical inactivity, harmful use of alcohol, high blood pressure and high cholesterol.
“Our collaboration is more than a public health necessity. Non-communicable diseases are a threat to development. NCDs hit the poor and vulnerable particularly hard, and drive them deeper into poverty,” said U.N. Secretary General Ban Ki-moon in a speech to the summit. The Secretary General said families are often pushed into poverty when a member becomes too weak to work or when the costs of medicines and treatments overwhelm the family budget. According to the WHO, deaths from NCDs will increase by 17 percent in the next decade, and in Africa, that number will jump by 24 percent.
On the same day that a U.S. Department of Health and Human Services (HHS) task force released recommendations on health text messaging, HHS also announced some new text messaging smoking cessation resources:
- The National Cancer Institute launched the SmokeFreeTXT program, a mobile smoking cessation service designed for teens and young adults. Users enroll at the site to begin receiving the text messages.
- NCI is also launching QuitNowTXT, aimed at adults, which offers text messages that provide tips, motivation, encouragement and smoking and cessation facts based on information tailored to a user’s responses. The program offers a text message library for health departments, academic institutions and government agencies to pull from.
“Mobile device texting initiatives [like these] have the potential to be a powerful tool to support tobacco cessation globally,” says HHS Chief Technology Officer Todd Park. “Text messaging is widely available, inexpensive, and allows for immediate delivery of cessation information.”
>>For more on mobile initiatives in public health, take a look at the NewPublicHealth story, Public Health: There's an App for That.
The U.S. Department of Health and Human Services, including the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS), today announced the launch of Million Hearts, a public- private collaboration that aims to prevent 1 million heart attacks and strokes over the next five years.
"Too many people who need preventive care don’t get it," said HHS Secretary Kathleen Sebelius, who noted that heart attacks and strokes cost our nation $444 billion each year ($1.2 billion a day) in healthcare costs and lost productivity. "We’re paying much too high a price, and together we can and will do better," said Sebelius.
Sebelius said also this campaign represents a change in how the government and private sector will work to save lives from heart disease.
CDC Director Dr. Thomas Frieden said that the Million Hearts initiative won’t cost a lot because it harnesses what we know is effective – the "ABCS": aspirin for people at risk, blood pressure control, cholesterol management and smoking cessation. He also said the CDC will be working to prevent heart attacks and strokes in the community through community education, and working with industry to reduce sodium and artificial trans-fat content in foods. This step will "put control back into the consumers' hands on how much salt goes into their food."
Dr. Don Berwick, CMS Administrator, said CMS will be contributing to make sure evidence-based efforts like the ABCS are incorporated throughout care for Medicare and Medicaid recipients through incentive programs, quality measurement reporting systems, and adoption of meaningful use measures in health information technology.
- The American Heart Association will help monitor progress of the initiative’s goals and provide consumers with access to their heart health management tools, including Heart 360, My Life Check, and the Heart Attack Risk Calculator.
- The Y is aiming to expand coverage of the Y’s Diabetes Prevention Program as well as the successful National Diabetes Prevention Program and CDC’s Healthy Communities Program to better address risks for diabetes, heart attacks, and stroke. The Y is also working to bring together leaders to make changes at the community level to "make the healthy choice the easy choice," such as bringing farmer's markets to food deserts and creating smoke-free public spaces.
- Walgreens will engage its more than 26,000 health care providers to support the Million Hearts initiative’s prevention goal by providing blood pressure testing at no charge in consultation with a Walgreens pharmacist or nurse practitioner.
The first three years of a child's life are key, and problems then can lead to poor school achievement and poverty and crime later in life. Home visiting programs match at-risk families with trained professionals who offer support and resources during that critical time. A new report from the Pew Center on the States examines the extent to which all 50 states and the District of Columbia support evidence-based home visiting programs and tracks whether public expenditures are producing the expected outcomes.
Libby Doggett, Ph.D., director of the Pew Home Visiting Campaign, says many states are beginning to receive initial installments of a $1.5 billion, five-year federal funding stream to support home visiting programs but those public dollars must be tied to effective, efficient programs. NewPublicHealth spoke with Libby Doggett about the report and the effectiveness of home visiting programs.
NewPublicHealth: What advantages to the community does a home visiting program offer?
Libby Doggett: Home visiting programs match parents with trained professionals, often a nurse or a social worker, sometimes a well-trained paraprofessional, who provide information and support during pregnancy and throughout the child’s first few years, which is a critical developmental period. I think what’s most exciting about our visiting programs is the research behind them. We’ve found that infant mortality falls by about 60%, that the mother is half as likely to deliver a low birth weight baby, the children are less likely to end up in an emergency room or be treated for injuries and accidents, and they’re more likely to be ready for school and a have a more successful school career.
And for mothers, there are additional really good outcomes: an 83% increase in employment by the child’s fourth year, a 20% reduction in welfare use, and 46% increase in the father’s presence in the household. Those are the kind of outcomes that we want for children and for families. Most importantly, the programs reap good returns for taxpayers as well. For every dollar invested, you’re likely to get $5.70 back. That’s a pretty good rate of return. Some of that return is in cost savings because you don’t spend the money on children in ICU, for example, related to child neglect and abuse. So it’s both savings projected from the program as well as some actual savings in terms of welfare costs, food stamp costs and other expenses.
NPH: What were the key findings in the Pew report?