The U.S. Department of Health and Human Services released a set of twelve Leading Health Indicators at the annual meeting of the American Public Health Association this morning.

“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.

Private partners are wide-ranging, but the American Heart Association, the Y and Walgreens were all featured in this morning's live event to announce their efforts to support heart health:

• 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?

HHS Awards $700 Million to Help Expand Community Health Centers

The U.S. Department of Health and Human Services has announced $700 million in grants to help build, expand and improve community health centers across the country.

Listeria Outbreak in Three States Linked to Cantaloupe

Reuters is reporting that a listeria outbreak in Nebraska, Colorado and Texas has caused at least one death so far. The outbreak has been linked to cantaloupe, though officials have not yet tracked the source of the outbreak.

FDA Announces Public Meeting on Drug Shortages

The U.S. Food and Drug Administration held a stakeholder meeting last week on acute drug shortages across the country, including shortages of cancer and anesthesia drugs. Some of the shortage is the result of raw ingredient supply disruptions and the discontinuation of some drugs. The FDA will hold a public hearing on the issue on September 26.

Study Looks at Possible Link between DDT and Asthma, Autism

A new study by researchers at the Harvard School of Public Health and researchers from Denmark has found a link between exposure to the pesticide DDT and asthma as well as a possible link between DDT exposure and autism, using a new computer modeling system. The study was published in the journal Environmental Health Perspectives.

Judging by traffic in the last 36 hours on local and federal government social media sites, preparedness has the nation’s attention right now—no surprise given the 5.8 magnitude earthquake that hit the East coast Tuesday and the increasing intensity of Hurricane Irene.

So now might be the very best time to check your “Go Kit” or create one if it isn't already on a shelf in the basement.

The Federal Emergency Management Agency’s latest update on Hurricane Irene offers a strong reason for why those who can prepare a kit with necessities should: While the federal agency, private organizations and state and local agencies and health departments are all preparing resources, those will be most needed, if a hurricane strikes, by people who lack the financial resources to stock up on supplies on their own.

FEMA and the Centers for Disease Control and Prevention both have websites to help prepare individuals, families, schools, companies and health departments in case of an emergency. For consumers, preparing early increases the chance of finding discounts and a wider selection of products.

Even if you’ve packed a kit and checked it twice, some new and updated tips can help if a threat arrives:

• Several agencies including FEMA (m.fema.gov) and CDC (m.cdc.gov) have just launched mobile versions of their websites which take users directly to emergency information and are formatted for smart phones. Key the URL into a smart phone browser
• Cell phone circuits clogged up Tuesday across the East Coast from the vast increase in usage as people contacted friends and families in the wake of the earthquake, and that can happen during other emergencies as well. Text messages are more likely to get through than calls during busy periods, and just about all cell and smart phones can send and receive texts, even if the user is not signed up for a plan.
• People who have supplies and a go bag all ready should ask themselves what has changed since the items were collected. Are prescription drugs up-to-date? Do the spare clothes still fit? Is there a newly-diagnosed food allergy to prepare for?
• Check chain stores for battery-powered chargers for cell and smart phones to use in case the power goes out, and then stock up on batteries.
• CDC’s site has a link to a map of all state health departments that can come in handy for updated information if an emergency occurs. Virginia, for example, added information to its site on Wednesday about Hurricane Irene.
• Need more incentive than an impending hurricane to get prepared? CDC has announced a preparedness video contest. Submit entries from August 29 through September 30.
• The Department of Heath and Human Services just announced an app challenge. While it’s limited to software application developers, the idea behind it may get even laymen thinking about how Facebook might be used before and after an emergency. According to HHS, the ideal application includes a way for users to identify lifelines, to create and share a personal preparedness plan including health considerations with these lifelines, and to encourage others to use the application.

Weigh In: Has your community updated emergency recommendations?

HHS Awards State Grants to Help Sign Kids up for Public Health Insurance

The Department of Health and Human Services has announced $40 million in grants to help and enroll eligible children for Medicaid and the Children’s Health Insurance Program (CHIP). The two year grants were awarded to state agencies, community health centers, school-based organizations and non-profit groups in 23 states.

Vitamins Reduce Likelihood of Premature, Smaller Babies

A new study of close to 40,000 women in the American Journal of Clinical Nutrition found that pregnant women who take multivitamins regularly about the time they get pregnant seem to have a lower risk of going into labor prematurely or having a smaller-than-normal weight baby.

First Study of Window-Related Injuries in Children Finds Rate is High

Between 1990 and 2008, close to 100,000 children under r 18 were treated at hospitals for injuries they sustained after falling out of a window, according to a new study in Pediatrics. Toddlers accounted for two thirds of all cases and two in 1,000 cases resulted in deaths.

Ban on Using Food Stamps for Soda Rejected

New York City Mayor Michael Bloomberg last year proposed a two-year trial ban on using food stamps to purchase soda and other drinks with added sugar, but the Obama administration has turned down the request, the WSJ reports.

In the summer of 2011, nearly 800 public health and informatics professionals from across the country convened in Atlanta for the Public Health Informatics 2011 conference. 

Around the conference, NewPublicHealth spoke with Farzad Mostashari, M.D., S.c.M., Director of the Office of the National Coordinator for Health Information Technology in the U.S. Department of Health and Human Services, to get his perspective on how health information technology can impact public health, and how the public health informatics field is evolving.

NewPublicHealth: The Public Health Informatics Conference is coming up this month. For those who aren't familiar with the field, what exactly is public health informatics?

Dr. Mostashari: I think that I’m a little bit of a student of public health informatics myself, and an avid follower. In the early days it was about building better systems – disease surveillance and outbreak detection systems. The second phase was building the connection between those systems and clinical systems, and using clinical information systems as primary data sources for public health. The third stage is about how public health informatics systems can embed within them a public health consciousness. I think about having a Tom Frieden [Director of the Centers for Disease Control and Prevention (CDC)] on the left shoulder of every physician to help inform clinical decisions from a public health perspective, as enabled by health information technology.

NPH: What is the role of the Office of the National Coordinator (ONC) in advancing public health informatics?