Category Archives: Prevention
Living Near Foreclosed Property is Linked to Higher Blood Pressure
Living near foreclosed property may increase the risk of higher blood pressure, according to new research published in the American Heart Association journal Circulation. Researchers reviewed data from 1,740 participants (mostly white, 53 percent women) in 1987-2008 in the Framingham (Massachusetts) Offspring Cohort, which is part of the Framingham Heart Study. The researchers distinguished between real-estate-owned foreclosures, which are owned by lenders and typically sit vacant, and foreclosures purchased by third-party buyers, which are generally put into housing use. The researchers found each additional foreclosed property within 100 meters (328 feet) of participants’ homes was associated with an average increase of 1.71 mm Hg in systolic blood pressure. The association only applied to properties that were real-estate owned and there was no effect from foreclosed properties more than 100 meters from participants’ homes.
“The increases in blood pressure observed could be due in part to unhealthy stress from residents’ perception that their own properties are less valuable, their streets less attractive or safe and their neighborhoods less stable,” said Mariana Arcaya, Sc.D., M.C.P., study lead author and a research fellow at the Harvard Center for Population and Development Studies in Cambridge, Mass. “Safety could also be a concern that affects their ability to exercise in these neighborhoods.”
Research on different populations in urban and rural settings is needed, says Arcaya. The study was funded by the Robert Wood Johnson Foundation, the Harvard School of Public Health and the National Institutes of Health and the Robert Wood Johnson Foundation funded the study. Read more on prevention.
Underage College Men Downplay Danger of Driving after Using Marijuana
Underage male college students who report using marijuana in the month before they were surveyed had a high prevalence of driving under the influence of marijuana and of riding with a marijuana-using driver, at a rate more than double that of driving or riding after alcohol use, according to a recent study by researchers from the University of Massachusetts Amherst School of Public Health and Health Sciences and University of Washington pediatrics department. The researchers also found that among marijuana-using students, 44 percent of males and 9 percent of females drove after using the drug, and 51 percent of males and 35 percent of females rode as a passenger with a marijuana-using driver. The researchers say the study results reflect the widespread belief that driving after using marijuana is safe and that strategies to dispute that belief are needed to help change social norms and encourage using a designated driver not only after alcohol use, but after a driver has used any risky substance. The study was published in JAMA Pediatrics. Read more on substance abuse.
Moderate Exercise Reduces Premature Death Risk in Older Men
Older men with hypertension can lower their risk of premature death with even moderate levels of exercise, according to a new study in Hypertension. The researchers say the needed level of fitness can be achieved by a brisk twenty to forty minute walk on most days. The researchers reviewed the fitness levels of 2,153 men, aged 70 years and older with high blood pressure by a standard treadmill exercise test, using a standard measure of fitness called metabolic equivalents (METs.) An MET is equal to the amount of oxygen the body uses per kilogram of body weight per minute. The peak MET level of a sedentary 50-year-old is about five to six METs; for a moderately fit individual it’s about seven to nine METS; and for a highly fit person it’s 10 to 12 METs. (Marathon runners, cyclists and other long distance athletes often have MET levels of 20 or higher.)
After an average follow-up of nine years, researchers found that the risk of death was 11 percent lower for every one-MET increase in exercise capacity:
- Those in the low-fit category (4.1 to 6 peak METs) had an 18 percent lower risk of death.
- Moderately-fit men (6.1 to 8 peak METs) had a 36 percent lower risk of death.
- High-fit men with peak METs of more than 8 reduced the risk of death by 48 percent.
Read more on heart health.
U.S. Cervical Cancer Rates Higher than Previously Reported
Cervical cancer rates in the United States are higher than previously reported, especially among women ages 65-69 and African-American women, according to a study published in the journal Cancer. Previous research showed about 12 cases of cervical cancer per 100,000 women in the United States, with the incidence reaching a peak at age 40-44 and then leveling off. However, those estimates included women who had hysterectomies in which the cervix had been removed and the authors of the new study say excluding these women—who are no longer at risk of developing this cancer—from their analysis, changes the rate to 18.6 cases of cervical cancer per 100,000 women. The new study also found that incidence increased steadily with age and peaked at a higher rate and at an older age—in women 65-69. Read more on cancer.
ADHD Treatment Linked to Lower Smoking Rates
Treating attention deficit hyperactivity disorder (ADHD) with stimulant medication may reduce smoking risk, especially when the medication is taken consistently, according to an analysis of 14 studies published in Pediatrics. The studies evaluated by the researchers were longitudinal studies of cigarette smoking and ADHD treatment which included 2,360 individuals with ADHD; this is the largest meta-analysis on the issue to date, according to the study authors. The researchers looked at data on nicotine dependence, smoking frequency and whether study participants smoked at the time of the study, and found a significant association between stimulant treatment and lower smoking rates. The effect was larger in those with more severe ADHD and when participants took stimulant medications continuously. The researchers say more studies are needed to determine the recommended timing and duration of stimulant treatment to help lower smoking risk. Read more on tobacco.
Number of Nurse Practitioners Working in Primary Care Increases
Almost half of recently licensed U.S. nurse practitioners (NPs) have become part of the U.S. primary care workforce, according to a report released today by the Health Resources and Services Administration. The National Sample Survey of Nurse Practitioners shows that in 1992 approximately 59 percent of graduating NPs worked in primary care, decreasing to 42 percent between 2003 and 2007. However, the new survey shows that 47 percent of NPs graduating since 2008 have entered primary care. According to the report, 76 percent of the NP workforce has certification in a primary care specialty, including family, adult, pediatric, or gerontology care, and nearly half have a family NP certification. More than half of the NP workforce works in ambulatory care settings, while nearly a third work in hospitals. Read more on prevention.
Study: Monday the Best Time to ‘Reset’ and Improve Personal Health Regimens
People are more likely to think about their health earlier in the week, which could help researchers and officials determine how to better improve public health strategies, according to a new study in the American Journal of Preventive Medicine. Researchers from San Diego State University (SDSU), the Santa Fe Institute, Johns Hopkins University and the Monday Campaigns analyzed Google searches that utilized the term “healthy” and were health-related in the United States from 2005 to 2012, finding searches for healthy topics were 30 percent more frequent at the beginning of the week than later in the week; Saturday saw the fewest searches. The findings correspond with previous research indicating Mondays offered the opportunity for a “heath reset”—a chance to get back into healthy habits. "Many illnesses have a weekly clock with spikes early in the week," said SDSU's John W. Ayers, lead author of the study. "This research indicates that a similar rhythm exists for positive health behaviors, motivating a new research agenda to understand why this pattern exists and how such a pattern can be utilized to improve the public's health.” Read more on prevention.
Despite Recommendations Against, Codeine Still Prescribed to Many Kids During ER Visits
Codeine is often prescribed by emergency room physicians to treat coughs and other pains for children, even though the powerful opioid is not recommended for use in children by groups such as the American Academy of Pediatrics (AAP) and American College of Chest Physicians (ACCP), according to a new study in the journal Pediatrics. For the new study, the researchers used data from 189 million ER visits by children and teens between the ages of three and 17 years old. The visits took place between 2001 and 2010. Researchers from the University of California, San Francisco analyzed data from 189 million ER visits for youth ages 3-17, finding that while emergency room prescriptions were down slightly from 2001 to 2010, as many as 877,000 children are still taking the drug each year. Codeine can slow breathing and breaks down differently in children of different ethnicities, increasing the chance of overdose. Read more on prescription drugs.
Rates of Childhood Obesity Keeps Rising, Especially Among the Most Obese
A recent study out of the University of North Carolina (UNC) finds that childhood obesity is up for all classes of obesity in U.S. children over the past 14 years, with more severe forms of obesity—a body mass index (BMI) 120 to 140 percent higher than the averages—seeing the greatest increase. The study appeared in JAMA Pediatrics. “An increase in more severe forms of obesity in children is particularly troubling,” said Asheley Cockrell Skinner, PhD, lead author of the study and assistant professor of pediatrics in the UNC School of Medicine, in a release. “Extreme obesity is more clearly associated with heart disease and diabetes risk in children and adolescents, and is more difficult to treat.” Researchers analyzed data on 26,690 children ages 2-19 years from 1999 to 2012 collected as part of the National Health and Nutrition Examination Survey (NHANES). Read more on obesity.
Study: Mean Devices Approved for Pediatric Use Never Tested on Kids
The majority of medical devices recently approved for pediatric use were never actually tested on kids, but rather only on people ages 18 and older, according to a new study in the journal Pediatrics. Researchers analyzed the clinical data used to get each device approved, finding that 11 of 25 examined devices were not tested on any patient age 21 and younger, and that only four had been tested on patients under the age of 18; three devices were specifically approved for patients under age 18, while the test were approved for people ages 18 to 21. "Children are not simply 'small adults,' and a device found to be safe and effective in adults may have a very different safety and effectiveness profile when used in a pediatric population," said Brigham and Women's Hospital and Harvard Medical School research fellow Thomas J. Hwang, one of the study’s authors, according to Reuters. "Without this data, it is difficult for clinicians and parents to make informed treatment decisions that weigh the risks and benefits of a particular treatment.” Read more on pediatrics.
Kaiser Report Examines Employer-Sponsored Retiree Health Benefits
A new report from the Kaiser Family Foundation on employer-sponsored retiree health benefits for pre-65 and Medicare-eligible retirees finds that the percentage of employers sponsoring retiree health coverage has declined, while employers that offer coverage are redesigning their plans almost annually in response to rising health care costs. The report, Retiree Health Benefits At the Crossroads, also examines the effect of recent legislation on retiree health coverage, such as the Medicare drug benefit and the Affordable Care Act. Read more on aging.
Study: Fewer Blood Transfusions Would Mean Fewer Infections
The increased use of blood transfusions in hospitals also leads to the increased risk of infection, according to a new study in the Journal of the American Medical Association. In a review of 21 randomized control trials, researchers from the University of Michigan School of Public Health determined that for every 38 patients considered for a red blood cell transfusion, the reduction of transfusions would mean one patient did not develop a serious infection, with the elderly undergoing hip and knee surgeries benefiting the most. “The fewer the red blood cell transfusions, the less likely hospitalized patients were to develop infections, “ says lead author Jeffrey M. Rohde, MD, assistant professor of internal medicine in the division of general medicine at the U-M Medical School, in a release. “This is most likely due to the patient’s immune system reacting to donor blood (known as transfusion-associated immunomodulation or TRIM). Transfusions may benefit patients with severe anemia or blood loss; however, for patients with higher red blood cell levels, the risks may outweigh the benefits.” Read more on prevention.
NewPublicHealth continues its coverage of National Public Health Week with today’s theme—“Get Out Ahead” on prevention.
According to the American Public Health Association (APHA), seven in 10 deaths in the United States are related to preventable diseases such as obesity, diabetes, high blood pressure, heart disease and cancer. And while 75 percent of U.S. health care dollars are spent treating such diseases, only 3 percent of health care dollars go toward prevention.
The APHA says there are now more options than ever when it comes to preventive health measures and that public health and clinical health professionals must work collaboratively to help individuals identify and pursue the best preventative health options.
A strong way to help prevent disease and premature death is to add health observance dates such as National Breast Cancer Awareness Month and National HIV Testing Day to personal and community calendars.
Healthfinder.gov, a website from the U.S. Department of Health and Human Services, lists health observance days, weeks and months which can steer people toward information and resources. Health observances often include community screenings such as blood pressure and cholesterol checks, making it easy to have those tests on a weekend in your neighborhood. Those checks include resources guiding people to community care if tests show a potential health problem.
A critical observance in April is Alcoholism Awareness Month. Decades of data shows that drinking too much alcohol increases people’s risk of health-related injuries, violence, drowning, liver disease and some types of cancer.
Actions communities are taking in observance of Alcoholism Awareness Month include:
- Partnering with a local high school or youth organization to host an event about alcohol abuse prevention.
- Alcohol-free community block parties.
- Many local health clinics will offer free or low-cost screenings for alcohol abuse on National Alcohol Screening Day (April 11).
Many police stations are hosting Family Information Nights about the dangers of drinking and driving. Activities include special goggles that let kids and teens see how drinking can impact their vision behind the wheel.
Poison Prevention Week 2014
March 16-24 is Poison Prevention Week this year, and an important opportunity to remind health officials and consumers about the resources provided by the National Poison Prevention Program and Hotline (1-800-222-1222). The National Poison Control Program is a program of the Health Resource Services Administration (HRSA). Programs include:
- Poison centers serving all states, Puerto Rico, the District of Columbia, Guam, the Federated States of Micronesia and American Samoa.
- A single, national toll-free number (1-800-222-1222) that connects callers with the poison center serving their area.
- A nationwide media campaign to educate the public and health care providers about poison prevention, poison center services and the 1-800 number.
- Programs to support the enhancement and improvement of poison education, prevention and treatment.
- Partnership development with other federal agencies and national organizations to advance poison prevention awareness.
- Development of uniform patient management guidelines so that poison centers can provide uniform treatment recommendations.
- Improvement of data collection systems and toxic exposure surveillance for enhanced capability to capture national poisoning data.
- Multilingual interpreter service in 161 languages to anyone who calls the 1-800 number.
Colon Cancer Incidence Rates Decreasing Steeply in Older Americans
Colon cancer incidence rates have dropped 30 percent in the United States in the last 10 years among adults 50 and older because of the widespread use of colonoscopies, according to a new study in CA: A Cancer Journal for Clinicians. The largest decrease has been in people over age 65. Colonoscopy use has almost tripled among adults ages 50-75, from 19 percent in 2000 to 55 percent in 2010. The study relied on data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the U.S. Centers for Disease Control and Prevention's National Program of Cancer Registries.
The "larger declines among Medicare-eligible seniors likely reflect higher rates of screening because of universal insurance coverage," according to the study authors. Mortality rates from colon cancer have also declined most rapidly within the past decade. From 2001 to 2010, death rates from colon cancer decreased by approximately 3 percent per year in both men and women, compared with declines of approximately 2 percent per year during the 1990s. The data is being released as the U.S. Department of Health and Human Services launches a nationwide effort to increase colorectal cancer screening rates to 80 percent by 2018. Read more on cancer.
DOT Proposed Rules on Electronic Log Books for Large and Bus Drivers to Help Reduce Fatalities and Injuries
The U.S. Department of Transportation (DOT) has announced a proposal to require interstate commercial truck and bus companies to use Electronic Logging Devices (ELDs) in their vehicles to improve compliance with the safety rules that govern the number of hours a driver can work. According to DOT, the proposed rule will ultimately reduce hours-of-service violations by making it more difficult for drivers to misrepresent their time on logbooks and—significantly—help reduce crashes by fatigued drivers and prevent approximately 20 fatalities and 434 injuries each year, for an annual safety benefit of $394.8 million. Impaired driving, including fatigue, was a factor in more than 12 percent of the 129,120 total crashes that involved large trucks or buses in 2012. Read more on injury prevention.
Robert Wood Johnson and CDC Foundations Launch New Project on Using Law and Policies to Help People Make Healthier Choices
The Robert Wood Johnson and CDC Foundations have announced the launch of a new project to advance discussion about how laws and policies can assist people in making healthier choices. Subject matter experts will work with federal partners to develop 10 to 15 evidence-based reports during the next three years to highlight laws and policies related to specific topic areas within the U.S. Department of Health and Human Services (HHS) Healthy People 2020 initiative. Healthy People 2020 is a set of goals and objectives with 10-year targets designed to guide national health promotion and disease prevention efforts aimed at improving the health of all people in the United States.
The new project, which will be led by the Office of Disease Prevention and Health Promotion (ODPHP) at HHS, will provide practical information to public health officials and associations; health-related industries; legal practitioners; non-profit organizations; policymakers; and individuals about the use of law and policy to address health factors:
- ODPHP will provide leadership and support for the development of the reports.
- CDC will provide technical guidance on the development of specific reports and collaborate with public health partners and communities to promote knowledge and understanding of the reports.
- RWJF will provide public health law and policy expertise.
- The CDC Foundation will manage administration and implementation of the project and amplify the results to stakeholders through communications efforts.
“The Robert Wood Johnson Foundation believes that law and policy are important levers for building a culture of health in our nation,” said Risa Lavizzo-Mourey, MD, president and CEO of the Robert Wood Johnson Foundation. “We’re pleased to collaborate with leaders in public health and government to focus attention on policies based on the best science to help achieve the national health goals set out in Healthy People 2020—strategies that all states and communities can use to help people live healthier lives.” Read more on prevention.
FDA Approves Marketing of First Migraine Prevention Device
The U.S. Food and Drug Administration (FDA) has authorized the marketing of the first device designed to stop migraine headaches before they happen. The preventative treatment is a small, portable prescription device that uses an electrical current to stimulate branches of the trigeminal nerve, which has been associated with migraine headaches. An estimated 10 percent of people suffer from migraines, which if untreated can last from four to 72 hours and lead to nausea, vomiting and sensitivity to light and sound. In a release, Christy Foreman, director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health, said Cefaly “may help patients who cannot tolerate current migraine medications for preventing migraines or treating attacks.” Read more on technology.
HHS: 4.2 Million Have Signed Up for Coverage Under the Affordable Care Act
Just a few weeks before the final deadline of March 31, the U.S. Department of Health and Human Services (HHS) has announced that more than 4.2 million people have enrolled in the Health Insurance Marketplace under the Affordable Care Act. Approximately 943,000 enrolled in February. Of the 4,242,300 who have enrolled:
- 55 percent are female and 45 percent are male;
- 31 percent are age 34 and under;
- 25 percent are between the ages of 18 and 34;
- 63 percent selected a Silver plan (up one percentage point over the prior reporting period), while 18 percent selected a Bronze plan (down one point)
- 83 percent selected a plan and are eligible to receive Financial Assistance (up one point)
Read more on the Affordable Care Act.
FDA Proposes New ‘Nutrition Facts’ Food Labels
The U.S. Food and Drug Administration (FDA) has put forth a new proposed Nutrition Facts label for packaged foods. The updated design would reflect scientific information not available when the current label was designed two decades ago. For example, it would replace out-of-date serving sizes and feature a design that highlights key parts of the label, such as calories and serving sizes. “For 20 years consumers have come to rely on the iconic nutrition label to help them make healthier food choices,” said FDA Commissioner Margaret A. Hamburg, MD. “To remain relevant, the FDA’s newly proposed Nutrition Facts label incorporates the latest in nutrition science as more has been learned about the connection between what we eat and the development of serious chronic diseases impacting millions of Americans.” Read more on nutrition.
Study: One in Five U.S. Health Facilities Don’t Provide Hand Sanitizer Everywhere Needed
One in five U.S. health facilities don’t make hand sanitizer available everywhere necessary, needlessly increasing the risk for health-care associated infections, according to a new study in the American Journal of Infection Control. In addition, approximately half of the hospitals, ambulatory care facilities and long-term care facilities included in their budgets funds for proper hand hygiene training. The study examine compliance with the World Health Organization’s hand hygiene guidelines at 168 facilities in 42 states and Puerto Rico. "When hospitals don't focus heavily on hand hygiene, that puts patients at unnecessary risk for preventable health care-associated infections," said by Laurie Conway, RN, MS, CIC, PhD student at Columbia Nursing, in a release. "The tone for compliance with infection control guidelines is set at the highest levels of management, and our study also found that executives aren't always doing all that they can to send a clear message that preventing infections is a priority." Read more on infectious disease.
CDC Foundation Expands Safe Injection Campaign
The CDC Foundation and Eli Lilly are partnering to expand the U.S. Centers for Disease Control and Prevention’s (CDC) Safe Injection Practices Coalition—a safety awareness campaign that provides information for health providers and patients. According to CDC data, more than 150,000 patients have been notified of potential exposure to hepatitis and HIV because of unsafe injection practices in U.S. health care settings since 2001, and CDC researchers have found that medical injections are an overlooked source of infections and outbreaks. Planned actives of the partnership include:
- Expand the One & Only Campaign to new audiences such as individual and group-owned physician practices
- Educate health care providers through new and enhanced training and communication materials to address emerging issues
- Improve the Safe Injection Practices Coalition website and social media platforms to share resources and toolkits with new audiences
- Engage new and existing Safe Injection Practices Coalition partners
Read more on prevention.
A new infographic from the Office of the U.S. Surgeon General highlights collaborations within the federal government and between the health and healthcare sectors to help improve prevention outreach. These efforts are part of the cross sector National Prevention Strategy launched by the office several years ago.
Current examples of collaboration include Million Hearts, an initiative of the U.S. Department of Health and Human Services to prevent one million heart attacks by 2017. The initiative includes a commitment by close to 150 large private medical practices in the United States to get hypertension control rates above 80 percent in their communities.
You can also view the fully interactive infographic here.
>>Bonus Link: Read interviews and listen to podcasts about the National Prevention Strategy conducted with former and current U.S. Cabinet Secretaries and agency heads.
IOM Report: More Evidence-Based Practices Needed to Help Treat and Prevent Psychological Disorders among Service Members and Families
Between 2000 and 2011, almost 1 million service members or former service members were diagnosed with at least one psychological disorder either during or after deployment, according to recent research by the Institute of Medicine (IOM). As a follow up, the U.S. Department of Defense (DOD) asked the IOM to evaluate the department’s efforts to prevent psychological disorders among active-duty service members and their families. That report was recently released.
The report includes recommendations on how the DOD can improve care.
Finding 1: DOD has implemented numerous resilience and prevention programs for service members and their families, but it faces a number of challenges, including an insufficient evidence base to support its interventions and a lack of systematic evaluation and performance measures.
Recommendation 1: By targeting resources to develop the evidence base and disseminate that evidence, DOD’s prevention efforts can be both more effective and cost effective.
Finding 2: There is a need for DOD to improve approaches for identifying and intervening with service members and their members who may already have or may be at risk for developing a psychological disorder.
Recommendation 2: DOD should dedicate funding, staffing and logistical support for data analysis and evaluation to support performance monitoring of programs for accountability and continuous improvement.
Finding 3: Screening, assessment and treatment approaches for psychological health problems are not always implemented between and within the DOD and the U.S. Department of Veterans Affairs (VA) in a consistent manner or aligned with the evidence base, which threatens the delivery of high-quality care and hampers evaluation efforts.
- There are opportunities to improve processes of training and evaluating clinicians, including the incorporation of continuing education and supervision; standardized periodic evaluation; and a greater emphasis on coordination and interdisciplinarity.
- The DOD and VA should invest in research to determine the efficacy of treatments that do not have a strong evidence base.
- Both departments should conduct systematic assessments to determine whether screening and treatment interventions are being implemented according to clinical guidelines and departmental policy.
- Accessible inter-department data systems should be developed to assess treatment outcomes, variations among treatment facilities and barriers to the use of evidence-based treatment.
- Read the complete report.
- Read a NewPublicHealth interview with Jonathan Woodson, MD, Assistant Secretary of Defense for Health Affairs about the National Prevention Strategy.
- Learn more about the state of mental health in the military from this infographic from the American Psychiatric Association embedded below.