Category Archives: Physical activity
U.S. Youth Exercise, Diet Improved Over Past Decade
Exercise and dietary habits of U.S. kids and teenagers seems to have improved over the past decade, according to a new study in the journal Pediatrics. The study found that from 2001-2002 to 2009-2010, the average number of days per week being physically active for at least 60 minutes for sixth through tenth graders climbed from 4.3 to 4.5; the days eating breakfast before school climbed from 3 to 3.3; and hours per day watching television dropped from 3.1 to 2.4. The findings suggest that it takes time for public health efforts to translate into behavioral changes. "I would like to believe that all the public health efforts focusing on increasing physical activity and increasing fruit and vegetable consumption are having an effect, because that seems to be a pattern," said Ronald Iannotti, study author from the University of Massachusetts Boston. "The fact that (obesity) is leveling off, that's a surprise and a major change from the steady increase that we've seen over time.” Read more on pediatrics.
Study: Kids of Same-sex Couples Less Likely to Have Private Health Insurance
Children of same-sex parents are less likely to have private health insurance, although the rates improve in states that recognize same-sex marriages or unions, according to a new study in the journal Pediatrics. Approximately two-thirds of U.S. youth with same-sex parents have private health insurance, compared to approximately 78 percent of U.S. youth with married heterosexual parents. When accounting for additional factors such as parental incomes and education level, researchers determined that youth living with same-sex parents were as much as 45 percent less likely to have private health insurance than were youth living with married heterosexual parents. The findings indicate yet another public health benefit of same-sex marriage, as access to health insurance directly affects a child’s health; previous studies have shown a connection between legal unions and improved mental health for gay and lesbian adults. A likely cause for the disparity is the fact that employers have not had to extend coverage to an employee’s same-sex partner or that employee’s children. "I think we are going to see more and more research like this that shows how marriage-equality laws have far-reaching health consequences," said Richard Wight, a researcher at the University of California, Los Angeles, who was not a part of the study. Read more on LGBT issues.
HHS: $67M for Expanded Preventive and Primary Care for 130,000 Americans
The U.S. Department of Health and Human Services (HHS) has awarded approximately $67 million for the creation of 32 new health service delivery sites to expand access to individuals, families and communities across the country. The sites will provide improved preventive and primary health care to more than 130,000 people. Another $48 million will go toward the approximately 1,200 existing centers. “Health centers have a proven track record of success in providing high quality health care to those who need it most,” said HHS Secretary Kathleen Sebelius. “New health center sites in some of the neediest communities in the country will provide access to health care for individuals and families who otherwise may have lacked access to high quality, affordable and comprehensive primary care services.” Read more on access to health care.
Higher Education Linked to Better Obesity Rates for Women in Poorer Areas
Higher education is a key factor that helps protect women in economically disadvantaged areas from obesity, according to a new study in the American Journal of Health Promotion. “It is possible that education is a marker of an individual’s access to health information, capacity to assimilate health-related messages, and ability to retain knowledge-related assets, such as nutrition knowledge,” wrote the study’s authors. Previous studies have shown that women living in area with fewer economic resources have higher body mass index (BMI) than other women. The results indicate that both low education and personal income should be addressed by obesity prevention initiatives. Read more on obesity.
Regular Exercise May Help Decrease Depression
Increases in exercise may be linked to decreases in depression, according to a new review of existing research by The Cochrane Library. The researchers found people with depression who also exercised saw a “moderate” reduction in their symptoms when compared to people who did instead used relaxation techniques or received no treatment. Antidepressant medications and psychotherapy are the most common treatments for depression, which affects about 10 percent of Americans, according to the U.S. Centers for Disease Control and Prevention. More research is needed to better understand the relationship between exercise and depression symptoms. Still, Madhukar Trivedi, MD, a professor of psychiatry at the UT Southwestern Medical Center in Dallas, who was not a part of the study, said one of the keys is making sure patients stick with the exercise regimen. "Once people are prescribed exercise or they choose exercise, the big challenge is to make the exercise real," he said. "If the recommendation from the treating clinician is that you should be exercising with some frequency and intensity…it's important that the patient follow that regimen week after week.” Read more on mental health.
Predominantly Black Nursing Homes Deliver Lower Levels of Care, Perform Worse Financially
Nursing homes that are predominantly populated by black residents deliver overall poorer care and are less successful financially than homes with few or not minority residents, according to a new study in Health Services Research. The study looked at issues such as the ratio of nursing staff to patients, success in preventing pressure ulcers, help with walking, help with getting out of bed, prevention of urinary tract infections, the incidence of medication errors and citations by governmental agencies. However, the study noted that black and white patients living in the same facilities received equal treatments, meaning the disparity is not due to any biases of health care workers. One factor leading to the disparity could be the fact that older black Americans are more likely to rely on Medicaid, which means lower reimbursement rates. Still, Latarsha Chisholm, assistant professor at the University of Central Florida and study author, believes something more must be at play. "It isn't only the financial performance [of nursing homes] that affects performance," she said. "There has to be something else affecting quality. I want to understand what management practices promote improved care in nursing homes with high proportions of minorities that don't have disparities in care.” Read more on health disparities.
Last week the Public Health Accreditation Board (PHAB) awarded five-year national accreditation status to five public health departments, bringing the number of health departments now accredited to 19 since the credential was launched two years ago. Hundreds more health departments are currently preparing to apply for accreditation, which includes a peer-reviewed assessment process to ensure it meets or exceeds a set of public health quality standards and measures. Among the newly accredited is the Chicago Department of Public Health.
"This is an important achievement and recognition that highlights the city of Chicago’s ongoing commitment to health and wellness on the part of all of our residents,” said Chicago Mayor Rahm Emanuel in a statement issued by PHAB. "We are focused on policies that will help all Chicagoans and their families enjoy the highest quality of life, [and w]e will continue to strive to make Chicago one of the healthiest cities in the world."
NewPublicHealth recently spoke with Bechara Choucair, MD, MS, Commissioner of the Chicago Department of Public Health, about the value of accreditation for improving the health of the community—and about how this effort supports Healthy Chicago, the city’s public health agenda.
>>Read more about Healthy Chicago in a previous NewPublicHealth Q&A with Choucair.
NewPublicHealth: You’re one of the first public health departments to be accredited. How did that happen so quickly?
Bechara Choucair: When we released Healthy Chicago in 2011, one of the strategies we identified was to obtain accreditation. We wanted to be the first big city to earn the credential. It took us 18 months and we are excited that we are the first big city to be accredited and the first in Illinois. And one of the added bonuses of accreditation is a sense of pride. It says a lot to our staff, residents and our mayor.
NPH: A community health assessment is required as part of the accreditation application. What did Chicago’s community health assessments entail?
CDC: U.S. School Districts Seeing Improvements in Multiple Health Policies
U.S. school districts are seeing continued improvements in measures related to nutritional policies, physical education and tobacco policies, according to the U.S. Centers for Disease Control and Prevention (CDC). The findings are part of the 2012 School Health Policies and Practices Study, a periodic national survey assessing school health policies and practices at the state, district, school, and classroom levels. "Schools play a critical role in the health and well-being of our youth," said CDC Director Tom Frieden, MD, MPH. "Good news for students and parents – more students have access to healthy food, better physical fitness activities through initiatives such as ‘Let’s Move,’ and campuses that are completely tobacco free."
Among the key findings:
- The percentage of school districts that allowed soft drink companies to advertise soft drinks on school grounds decreased from 46.6 percent in 2006 to 33.5 percent in 2012.
- Between 2006 and 2012, the percentage of districts that required schools to prohibit junk food in vending machines increased from 29.8 percent to 43.4 percent.
- The percentage of school districts that required elementary schools to teach physical education increased from 82.6 percent in 2000 to 93.6 percent in 2012.
- The percentage of districts with policies that prohibited all tobacco use during any school-related activity increased from 46.7 percent in 2000 to 67.5 percent in 2012.
Read more on school health.
Poor Oral Health Linked to Increased Risk for Oral HPV Infection
Poor oral health is associated with increased risk of the oral human papillomavirus (HPV) infection responsible for as many as 80 percent of oropharyngeal cancers, according to a new study in the journal Cancer Prevention Research. Researchers found that people who reported poor oral health had a 56 percent higher prevalence oral HPV, people with gum disease had a 51 percent higher prevalence and people with dental problems had a 28 percent higher prevalence. “The good news is, this risk factor is modifiable—by maintaining good oral hygiene and good oral health, one can prevent HPV infection and subsequent HPV-related cancers.” said Thanh Cong Bui, MD, postdoctoral research fellow at the University of Texas School of Public Health. Other factors also increased the risk, such as being male, smoking tobacco or using marijuana. Read more on cancer.
Study: Hospital Pediatric Readmission Rates Not an Effective Measure of Quality of Care
Hospital readmission rates for children are not necessarily an effective measurement of the quality of care, according to a new study in the journal Pediatrics. "As a national way of assessing and tracking hospital quality, pediatric readmissions and revisits, at least for specific diagnoses, are not useful to families trying to find a good hospital, nor to the hospitals trying to improve their pediatric care," study author Naomi Bardach, MD, an assistant professor of pediatrics at the University of California, San Francisco, Benioff Children's Hospital. "Measuring and reporting them publicly would waste limited hospital and health care resources." After analyzing 30- and 60-day readmission rates for seven common pediatric conditions, researchers found that at 30 days readmission for mood disorders was most common, at 7.6 percent, followed by 6.1 percent for epilepsy and 6 percent for dehydration. Readmission rates for asthma, pneumonia, appendicitis and skin infections were all below 5 percent. Bardach said the low rates leave “little space for a hospital to be identified as having better performance.” Further study could improve the way readmission rates are utilized to assess the quality of pediatric care. Read more on pediatrics.
In the last decade or so, leaders in the field of architecture have begun to look at not just the aesthetics of building and community design, but also their own impact on the health of communities. In New York City, for example, the local chapter of the American Institute of Architecture’s New York chapter partnered with several agencies in New York City, including the departments of Health and Mental Hygiene, Design and Construction, Transportation, City Planning, and Office of Management and Budget, as well as research architects and city planners to create the city’s Active Design Guidelines. These provide architects and urban designers with a manual of strategies for creating healthier buildings, streets, and urban spaces, based on the latest academic research and best practices in the field. The Guidelines include:
- Urban design strategies for creating neighborhoods, streets, and outdoor spaces that encourage walking, bicycling, and active transportation and recreation.
- Building design strategies for promoting active living where we work and live and play, through the placement and design of stairs, elevators, and indoor and outdoor spaces.
NewPublicHealth recently spoke with Rick Bell, policy director of AIA New York, who was instrumental in the creation of the guidelines, about the burgeoning intersection between design and healthier communities.
>>Read more on architecture and design for a fit nation.
NewPublicHealth: How did AIA New York become involved in healthy design with the city of New York?
TFAH: U.S. Adult Obesity Rates Relatively Level, But Still Extremely High
Though adult obesity rates are level in all states except Arkansas, the rates are still far too high, according to F as in Fat: How Obesity Threatens America's Future 2013, a new report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation. The plateau comes after mostly 30 years of rising rates. No state had higher than a 15 percent obesity rate in 1980; today every state is about 20 percent and 13 states have rates higher than 30 percent. “While stable rates of adult obesity may signal prevention efforts are starting to yield some results, the rates remain extremely high,” said Jeffrey Levi, PhD, executive director of TFAH. “Even if the nation holds steady at the current rates, Baby Boomers—who are aging into obesity-related illnesses—and the rapidly rising numbers of extremely obese Americans are already translating into a cost crisis for the healthcare system and Medicare. In order to decrease obesity and related costs, we must ensure that policies at every level support healthy choices, and we must focus investments on prevention.” Read more on obesity.
Soda Consumption Tied to Higher Aggressive Behavior in Kids
Soda consumption is tied to higher aggressive behavior in kids, according to a new study in The Journal of Pediatrics. Study authors cautioned that the increase may not be apparent in individuals and the study does not show causation. However, previous studies have demonstrated a link between soda consumption and violent behavior. The researchers analyzed data of mothers’ assessment of their children’s aggressiveness, including acts such as destroying their belongings or the belongings of others. On an aggression scale of 0-100, kids who drank no soda scored an average of 56, kids who drank one scored 57, who drank two scored 58, who drank three scored 59 and who drank at least four scored 62. Janet Fischel, director of developmental and behavioral pediatrics in the department of pediatrics at Stony Brook University School of Medicine in New York, who was not involved in the study, believes it represents a strong first step. "I think it's really important and a giant first step in gathering an evidence base for what's becoming a very widespread dietary habit. I think that's really important.” Read more on pediatrics.
People with Insomnia Need Regular Exercise, Not a Quick Trip to the Gym
It takes time for exercise to help cure insomnia, so people shouldn’t expect one trip to the gym to do the trick, according to a new study in the Journal of Clinical Sleep Medicine. "The message here is that exercise is not a quick fix, which I don't really think is discouraging at all," said study author Kelly Baron, director of the Behavioral Sleep Medicine Program with the Feinberg School of Medicine at Northwestern University in Chicago. "Our previous work found that exercise over a 16-week period is very effective in promoting sleep, on par with any kind of medication. But like with weight loss or any sort of behavioral change, it doesn't happen immediately. You have to measure progress over months, not day-to-day." Baron said it is important for people with insomnia to make exercise a part of their routine, planning ahead and being sure to make it a regular endeavor. She also noted that a poor night of sleep makes it less likely for someone to exercise the next day, further emphasizing the need for routine. Approximately 14 percent of the population experiences chronic insomnia. Read more on physical activity.
In the national conversation on the spreading epidemic of obesity and chronic diseases, and the ways in which public health initiatives can fight these issues, architecture and design are continuing to play a leading role in developing fit and healthy solutions. The way a community or a school or a store or a workplace is built can actually influence physical activity, access to healthier food and more to help create an overall fitter nation.
FitNation is an initiative that highlights innovative design strategies across the country to get people healthy and moving. These projects, which stretch across the realms of local and national policy and grassroots-driven action to urban improvements, are brought together in FitNation as inspired by New York City’s Active Design Guidelines and the annual Fit City Conference, which is a partnership between the American Institute of Architects New York and the New York City Department of Health and Mental Hygiene.
Here is a selection of some of the creative solutions featured in FitNation that were developed to help individuals and communities lead happier and healthier lives.
Red Swing Project
Design by Hatch Workshop and University of Texas at Austin Architecture Students
Starting in Austin, Texas, a group of architecture students seeking to make better use of public spaces started the Red Swing Project, an open source initiative to transform some unexpected places into playgrounds. The swings consist of a piece of scrap wood, painted red, and rock climbing rope and have popped up all over the world—transforming areas hit by natural disasters, lining a bicycle path from Paris to Barcelona, and below an interstate overpass. You can track the project online with a geo-tagged map or through #redswingproject on Instagram and Facebook.
Urban Farming Food Chain, Edible Wall
Design by Elmslie Osler, Architect
Los Angeles, CA
We all know that some of the healthiest foods grow on trees, but now in Los Angeles thanks to the Urban Farming Food Chain, they can grow on walls too. The Food Chain consists of “edible walls” that grow fresh fruits, vegetables, and herbs, intended to provide economically disadvantaged populations with healthier food options. The walls are installed on pre-existing structures and have storage for tools, seeds and soil. This project’s vertical angle on community gardens help provide social activities as well as the opportunity to share and develop skills and healthy habits.
Even Insured Low-income Immigrants Less Likely to Visit Doctors
About 47 percent of insured and uninsured low-income immigrant children saw a doctor in 2010, compared about 60 percent for U.S.-born children, according to a new study from the Migration Policy Institute (MPI). The report also found that immigrant adults are less likely (8 percent) than native-born adults (13 percent) to visit emergency rooms. As immigrants are generally not eligible for coverage under the Affordable Care Act, their care will in many cases fall to health departments. Read more on access to care.
Exercise Alone Won’t Lower Weight; Lifestyle Changes Also Required
Exercise alone is good for maintaining a healthy weight, but should be combined with other lifestyle changes if a person expects to lose weight and then keep it off. People also negate the positive effects of exercise by overindulging in their post-workout rewards. "There's a war between exercise and nutrition in our heads," said American Council on Exercise spokesperson Jonathan Ross. "People tend to overestimate the amount of physical activity they get. They work out a little bit and treat themselves a lot." Between 250 and 300 minutes of exercise each week is necessary for weight loss, according to Joseph E. Donnelly, MD, an exercise physiologist with the American College of Sports Medicine; the government’s recommendation of 150 minutes of moderate-intensity is for cardiovascular fitness. A single pound of fat is about 3,500 calories. Read more on physical activity.
Soda Company to Stop Adding, Promoting Antioxidants in Some 7UP Drinks
The Dr. Pepper Snapple Group has agreed to stop fortifying certain of its 7UP soft drinks with vitamins and will no longer claim the product has antioxidants. The agreement ends a class action lawsuit against the company. 7UP’s regular and diet Cherry Antioxidant, Mixed Berry Antioxidant and Pomegranate Antioxidant varieties had small amounts of vitamin E added at the time of the lawsuit. According to the complaint, the pictures of cherries, blackberries, cranberries, raspberries and pomegranates on various 7UP labels gave the impression that the antioxidants might have come from fruit, but there is no fruit juice of any kind in any variety of 7UP. And last week a federal magistrate ruled that a separate lawsuit against Coca-Cola, for what the Center for Science in the Public Interest says is deceptive marketing of its vitaminwater line of soft drinks, may proceed as a class action suit. Read more on nutrition.
NIH: Greater Physical Activity Linked to Lower Stroke Risk
People who exercise vigorously enough to work up a sweat are at reduced risk for stroke, according to a new study in the journal Stroke. Inactivity is one of the main risk factors for stroke, along with high blood pressure, diabetes and smoking. Researchers found that inactive people were 20 percent more likely to experience a stroke or transient ischemic attack (TIA) than subjects who exercised at least four times a week. Researches utilized data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a long-term study funded by the National Institutes of Health’s National Institute of Neurological Disorders and Stroke that looks at the reasons behind the higher rates of stroke mortality among African-Americans and others in the Southeastern United States. “Our results confirm other research findings but our study has the distinct advantage of including larger numbers, especially larger numbers of women as well as blacks, in a national population sample so these provide somewhat more generalizable results than other studies,” said Virginia Howard, PhD, senior author of the study from the School of Public Health, University of Alabama at Birmingham. Read more on stroke.
Study: Calorie Guidance on Menus Doesn’t Lead to Healthier Eating
Research had already shown that providing calorie counts on restaurant menus did little to improve food selection. New research now shows that offering general daily or per-meal calorie guidelines also does little to help people make healthier eating choices, according to a study in the American Journal of Public Health. "The general inability of calorie labeling to result in an overall reduction in the number of calories consumed has already been pretty widely shown," said study lead author Julie Downs, an associate research professor of social and decision sciences in the Dietrich College of Humanities and Social Sciences at Carnegie Mellon University. "So that's nothing new. But in the face of that, there has been the growing thought that perhaps the problem is that people don't know how to use the information without some framework, some guidance." Instead, the study found that people given calorie guidance not only didn’t make overall better use of calorie labeling or consume fewer calories, but they actually consumed slightly more calories. Lona Sandon, a registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, said the findings help illustrate that “[k]nowledge is just one piece of the puzzle. We must consider people's attitudes, beliefs and values surrounding healthier eating and body weight.” Read more on nutrition.
Sequester to Close all HUD Offices on July 22
Every office of the U.S. Department of Housing and Urban Development (HUD) will be closed on Monday, July 22 as part of the sequester which is being felt across all of government. The automatic spending cuts took effect March 1. HUD’s plan is to pair its seven required furlough days with holidays and weekends. HUD is encouraging people and businesses that work with the agency to plan around the schedule day of shutdown. Read more on budgets.
The final plenary session at this year’s NACCHO Annual included a talk by Christopher Murray, MD, DPhil, director of the Institute for Health Metrics and Evaluation at the University of Washington on how data is used to measure health, evaluate interventions and find ways to maximize health system impact. Dr. Murray was a lead author on three pivotal studies published last week that used data to assess the state of health in the United States compared with 34 other countries and county level data on diet and exercise. One of the key findings is that Americans are living longer, but not necessarily better—half of healthy life years are now lost to disability instead of mortality; and dietary risks are the leading cause of U.S. disease burden.
NewPublicHealth spoke with Dr. Murray about the study findings, their impact and upcoming research that can add to the data public health needs to improve the health of all Americans.
NewPublicHealth: Tell us about the three studies that were published this week using the Institute’s research.
Dr. Murray: The study in JAMA [Journal of the American Medical Association] is an analysis of a comprehensive look at the health of the United States in comparison to the 34 OECD [Organisation for Economic Co-operation and Development] countries. The study looks at both causes of death and premature mortality through over 290 different diseases and puts them all together in a comprehensive analysis of what the contributors are to lost healthy life. That study also looks at the contribution to patterns of health in the U.S., from major environmental, behavioral, and metabolic risk factors. In each of those categories, there are important findings:
- The U.S. spends the most on healthcare but has pretty mediocre outcomes and ranks about 27th for life expectancy among its peer countries.
- For many large, important causes of premature death, the U.S. does pretty poorly. And we also see a big shift towards more and more individuals having major disability—from mental disorders, substance abuse, and bone and joint disease.
- On the risk factor front, the big surprise is that diet is the leading risk factor in the U.S. It is bigger than tobacco, which is second and then followed by obesity, high blood pressure, high blood sugar, and physical inactivity. Diet in this study is made up of 14 subcomponents, each analyzed separately and then put together.