Category Archives: Technology
Future of Public Health is an ongoing series focused on the emerging faces in the world of public health. We spoke with Margo Klar, MPH, a PhD candidate in the Department of Epidemiology at the University of Florida’s College of Public Health & Health Professions, about what helped lead her to the field, her Bill and Melinda Gates Foundation-funded work in maternal health, and where she hopes to go from here.
NewPublicHealth: What encouraged you to pursue a degree and career in public health?
Margo Klar: As an undergraduate at the University of California, Irvine (UCI) I majored in Chemical Engineering and worked in an environmental engineering lab. My undergraduate research focused on the effects of urban runoff on water quality, which we tracked from inland California to the ocean. During my last quarter at UCI, I took a biomedical engineering course. As a part of the class, we were asked to invent a new sleep apnea device. I really enjoyed that creative process and it opened my eyes to the fields of biomedical engineering and medicine.
After graduating, I began looking at applying to medical schools. I went back to school and took anatomy and biology prerequisites. My anatomy teacher once said, “In the United States we worry about problems with our feet, in other countries people don't have feet.” This really resonated with me. While researching medical school programs, I learned about Master of Public Health programs. I decided the MPH would be a great stepping-stone and improve my application to medical school. I was accepted into the Yale School of Public Health in the department of Environmental Health Science. Not only did I receive the training necessary to evaluate health and look for ways to improve global health, I was also able to direct my own thesis research project. I wrote my master’s thesis on an indoor cookstove improvement project for Proyecto Mirador, LLC in rural Honduras. I collected health data and examined indoor air quality improvement and reduction of firewood use as a result of cookstove replacement. This was a terrific learning experience.
NPH: You’ve received a Grand Challenges Explorations grant from the Bill and Melinda Gates Foundation to develop ceramic umbilical cord scissors. What drove you to pursue maternal and child health coming from an environmental background?
Klar: My mentor at Yale, Catherine Weikart Yeckel, PhD thought I should take a look at the Grand Challenges Explorations grant through the Gates Foundation. Essentially this funding mechanism releases a set of topics every six months to which they fund somewhere between 80 to 100 grants to the amount of $100,000 for two years of work. After the first proof of concept phase is complete, a second phase application can be submitted for up to $1 million.
Dr. Yeckel encouraged me to take a look at the maternal and child health topic. Essentially, I Googled top reasons for neonatal mortality in developing countries- neonatal tetanus and infection as a result of poor birthing hygiene and the way the umbilical cord is cut, was among the top causes. I really did not, at the time, have a strong interest in maternal and child health. I had an interest in problem solving, mainly because it’s been something, which has been a personal strength throughout my education. Thanks to my engineering background, I can look at a problem and come up with a solution to try to mitigate it. So, essentially I just applied my problem solving skills to the maternal and child health topic.
The American Red Cross recently announced the opening of its second Digital Operations Center—the first one outside of its national headquarters in Washington, D.C.—in the organization’s North Texas Region. Both centers are funded by the Dell Computer Corporation. The new center, along with others to be opened in the next few years, expands the ability of the American Red Cross to engage in social media, especially during regional disasters.
The Center will “allow us to build a center of expertise through our digital volunteers who help provide social data for regional responses,” said Laura Howe, vice president of public relations at the American Red Cross. NewPublicHealth recently spoke with Howe about the impact of using social media to respond during disasters.
NewPublicHealth: How did the Red Cross social listening program begin?
Laura Howe: We started a social listening program for emergencies and disaster in a fulsome way after the Haiti earthquake. I walked out of my office and I had a bunch of staff members who were in tears. They were getting Twitter and Facebook messages from members of the Haitian diaspora community here in the United States giving them the exact locations of where people were trapped under rubble and where people needed help in Port au Prince. We were able to move that information to the U.S. Department of State and the U.S. Department of Defense to hopefully get people help on the ground. But, it showed us two things. It showed us the power of individuals to provide information that can help responders, but it also showed that there was a tremendous gap in the response system for being able to take in information and respond specifically to people who had an urgent emergency rescue need, and there really is no infrastructure to be able to do that.
But I do want to make clear that the Red Cross as an organization and Red Cross disaster workers are not going to be able to take in information off of social media and then send one of our people to come get you out of the rubble or to come rescue you. We are not acting as a 911 dispatch here. We are using social media platforms to provide people with preparedness information, emotional support and information that they can take action on. We’re also listening for information that can help us in our disaster response generally and help us better hone where we’re putting our resources during a disaster.
NPH: What are the criteria for an optimal American Red Cross digital volunteer?
Laura Howe: We want someone who is comfortable in a social space; understands social media platforms and how social communities work; and is comfortable engaging with the public, having done that previously. Volunteers don’t necessarily have to have professional experience with social media, but do have to have a personal comfort level. Our training follows up on those prior skills about how to engage on behalf of the Red Cross. We train the digital volunteers about how we take in the information and then move it to our decision makers in order to make operational decisions.
If you’re planning on foreign travel then the U.S. Centers for Disease Control and Prevention (CDC) wants to help you find foods that won’t bite you back. Can I Eat This? is a free app from the agency that lets users search country-by-country for what’s safe to eat and drink. Once you choose the country you’ll be eating in—or where you already are, perhaps standing in line deciding what to order—simply tap the food or drink icon and wait for questions specific to that country.
For example, tapping “eating” in Argentina prompts the app to ask whether you’ll be buying from a street vendor or a store, and your answers prompt even more questions about the food ‘s storage and handling. In Bulgaria, tap “drinking” and you’ll be asked if there’s ice in the drink. Tap “yes” and a scary X will pop up with a warning of “probably not,” because the ice is likely made with tap water, which the CDC has identified as a poor safety choice in that country.
>>Bonus Link: Find more travel health information from the CDC here.
CDC: American Indians, Alaska Natives Have 50 Percent Higher Death Rates than Non-Hispanic Whites
American Indian and Alaska Native (AI/AN) death rates were approximately 50 percent higher than rates among non-Hispanic whites—for both men and women—from 1999 to 2009, according to a new study in the American Journal of Public Health. The study determined that patterns of mortality were strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking and health-harming social determinants. Among the findings:
- Among AI/AN people, cancer is the leading cause of death followed by heart disease. Among other races, it is the opposite.
- Death rates from lung cancer have shown little improvement in AI/AN populations and AI/AN people have the highest prevalence of tobacco use
- Suicide rates were nearly 50 percent higher for AI/AN people
- Death rates from motor vehicle crashes, poisoning and falls were two times higher among AI/AN people
- Death rates were higher among AI/AN infants
“The Indian Health Service is grateful for this important research and encouraged about its potential to help guide efforts to improve health and wellness among American Indians and Alaska Natives,” said Yvette Roubideaux, MD, MPH, acting IHS director, in a release from the U.S. Centers for Disease Control and Prevention. “Having more accurate data along with our understanding of the contributing social factors can lead to more aggressive public health interventions that we know can make a difference.” Read more on health disparities.
FDA Proposes New Program to Help Patients With Unmet Tech Needs
The U.S. Food and Drug Administration (FDA) has proposed a new program designed to help treat or diagnose people with serious conditions, but whose needs aren’t met by current technology. The proposed Expedited Access Premarket Approval Application for Unmet Medical Needs for Life Threatening or Irreversibly Debilitating Diseases or Conditions (“Expedited Access PMA” or “EAP”) program would include earlier and more interactive engagement with FDA staff, with the goal of providing patients with earlier access to safe and effective medical equipment. “The program allows manufacturers to engage early and often with the agency,” said Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health. “We expect most devices that enter this program will be in the pre-clinical trial phase.” Read more on technology.
Study Links Internet Use, Lower Depression Rates in Older Americans
Older Americans who spend more time online are also less likely to suffer from depression, according to a new study in The Journals of Gerontology: Series B. Using data on 3,075 retired men and women who didn’t live in nursing homes gathered by the U.S. Health and Retirement Survey, researchers determined that the 30 percent who were Internet users also had a 33 percent lower probability of depression. "The largest impacts on depression were actually for those people who lived alone, so it's really suggesting that it's about connecting with others, eliminating isolation and loneliness," lead study author Shelia Cotton, according to Reuters. Read more on aging.
Eat well. That’s today’s theme for National Public Health Week—and it’s good advice. After all, according to the American Public Health Association, Americans are now eating 31 percent more calories than we did 40 years ago, including 56 percent more fats and oils and 14 percent more sugars and sweeteners. The average American eats 15 more pounds of sugar a year today than in 1970.
There are new food-oriented websites and smartphone apps (many free) that can help people keep track of what foods they’re eating and what’s in those foods.
At the Milk Street Café in Boston, for example, the restaurant’s ordering site lets you filter the full menu into just the categories you want. Click low “fat” and the tailored breakfast menu leaves off the breakfast pastries and zooms in on the yogurt parfaits.
Other recent apps include:
- Locavore, which points to farmers’ markets and produce stands in your neighborhood.
- Harvest, which offers tips for choosing ripe produce.
- Fooducate, a food database on your smartphone that includes basic nutrient and calorie information, plus high points of each food such as the fiber quantify of crackers.
- Substitutions, an app finds alternatives when you can’t use the ingredient in the original recipe because of an allergy or other dietary restriction. Popular tip: Swap in fat-free yogurt when the recipe calls for fat-free sour cream to save calories.
- The U.S. Department of Agriculture hosts the Food Access Research Atlas, which presents a spatial overview of food access indicators for low-income and other census tracts using different measures of supermarket accessibility. The app is valuable for community planning and research.
CDC: Calls to Poison Centers for E-Cigarettes Has Jumped Dramatically Since 2010
Calls to poison centers involving e-cigarette liquids containing nicotine jumped from just one per month in September 2010 to 215 per month in February 2014, according to a new U.S. Centers for Disease Control and Prevention (CDC) study in the Morbidity and Mortality Weekly Report. There was no similar increase for conventional cigarettes. The study found that 51.1 percent of the e-cigarette calls involved children under age 5 and about 42 percent involved people ages 20 and older. “This report raises another red flag about e-cigarettes—the liquid nicotine used in e-cigarettes can be hazardous,” said CDC Director Tom Frieden, MD, MPH, in a release. “Use of these products is skyrocketing and these poisonings will continue. E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.” Read more on the FDA.
HHS Draft Report Would Strengthen Innovative Health IT, Help Patients
The U.S. Department of Health and Human Services (HHS) has released a draft report that includes a proposed strategy for a health information technology (health IT) framework to help promote product innovation while also ensuring patent protections and avoiding regulatory duplication. The congressionally mandated report was developed by the U.S. Food and Drug Administration in consultation with HHS’ Office of the National Coordinator for Health IT (ONC) and the Federal Communications Commission (FCC). “The diverse and rapidly developing industry of health information technology requires a thoughtful, flexible approach,” said HHS Secretary Kathleen Sebelius. “This proposed strategy is designed to promote innovation and provide technology to consumers and health care providers while maintaining patient safety.” Improved health IT could help lead to greater prevention of medical errors; reductions in unnecessary tests; increased patient engagement; and faster identifications of and response to public health threats and emergencies. Read more on technology.
Study: Fewer Cases of Smoking on TV Screens May Be Tied to Overall Drop in U.S. Smoking Rates
Fewer scenes of cigarette use in prime-time television shows may be linked to an overall reduction in the U.S. smoking rate, according to a new study in the journal Tobacco Control. Analyzing 1,800 hours of popular U.S. prime-time dramas broadcast between 1955 and 2010, researchers from the Annenberg Public Policy Center at the University of Pennsylvania in Philadelphia determined that scenes involving cigarette use on such shows fell from nearly five scenes per hour of programming (excluding commercials) in 1961 to about 0.3 scenes per hour in 2010. Based on this data they concluded that one less depiction of smoking per hour over two years of prime-time programming was associated with an overall drop of almost two packs of cigarettes, or 38.5 cigarettes, a year for every adult. The new findings support previous research showing that seeing other people smoke prompts cigarette cravings in adult smokers. Read more on tobacco.
“Two or three years ago we were urging you to ask your health directors for social media tools, and now we’re talking about how it’s making a difference,” said Tom Hipper, MSPH, MA, Public Health Planner at the Center for Public Health Readiness and Communication at Drexel University, who helped lead a session on social media and public health response at the Preparedness Summit on Tuesday. He was joined by Jim Garrow, MPH, Operations and Logistics Manager at the Philadelphia Department of Public Health.
While many in the audience of a couple of hundred attendees are still in the early days of using social media, the benefit of adding social media to communications channels for routine and emergency communication is clear said the presenters.
Examples included the use of Twitter by public health officials in Edmonton, Alberta last year after flooding covered the downtown area. So many users accessed the feed that it looked like spam and Twitter shut down the feed, forcing the health department to move to the police Twitter account and then to a private constable’s account when the second feed was also shut down. Despite the switches, a survey after the flooding showed that 98 percent of responders were satisfied with the health department’s responsiveness on social media.
There is also the Verification Handbook for digital content to help verify digital images on social media. One example of an altered report was a shark moving alongside a car in New Jersey just after Hurricane Sandy hit.
Hipper had strong advice for both novice and seasoned health department social media users:
- During disasters, retweet important information from credible agencies, such as street closings from the Office of Emergency Management
- Use Twitter message libraries when available. Drexel is creating one that includes messaging for all sorts of public health emergencies such, as an active shooting or a ricin attack. The value of the messages includes faster response in an emergency even if some tweaking is needed, and many of the preset messages are based on feedback to messaging used previously.
- Engage your audience before an emergency so they will turn to your social media platforms if an emergency strikes. Hipper gave the examples of Chicago, which held an immunization Twitter chat last fall and had 180,000 followers, as well as the Boston Police Department, which already had 40,000 followers before the Marathon bombing last year and saw that number rise to 300,000 as the search for the bombers unfolded.
Hipper and Garrow also advised repeating information during a disaster because people join the conversation at different points; to announce when to expect next updates and what hashtags are being use; to point to other credible agencies for information; and to ask users to send questions which can help improve the information they provide.
The U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) and the National Council on Disability (NCD) have established a virtual town hall conversation to examine the accessibility barriers of social media for individuals with disabilities. The town hall, which will continue through Friday, April 4, is the first in a series of three online events on the topic of social media accessibility that will take place over the next three months.
Social media is a critical tool for engaging customers, employees, jobseekers and stakeholders. When it is inaccessible to people with disabilities, a large portion of the population is excluded from important conversations. Advancing Accessibility and Inclusion in Social Media—The User Experience aims to identify the barriers to social media use and develop solutions to help ensure that all people can reap the benefits of social media and digital services.
Town hall participants are able to discuss personal social media experiences; submit comments and ideas; and vote on suggested solutions to accessibility barriers. Participants have shared feedback regarding a variety of social media platforms: Calling for captioning on government-produced Vine videos, seeking recommendations for using social media to find employment and suggesting increased accessibility training for social media developers. ODEP and NCD will use insights gleaned from the town halls to work with the social media industry to improve experiences for Americans with disabilities.
"We anticipate that this online discussion will present new and exciting opportunities for Americans with disabilities and people around the world,” said Janni Lehrer-Stein, chairperson of access and integration for NCD. “Social media opens up a new marketplace of ideas and access for everyone, including people with disabilities, adding value and providing new opportunities through inclusive engagement in the virtual world."
To participate, register at ODEP’s ePolicyWorks town hall and submit your feedback.
CDC: 1 in 68 U.S. Children on Autism Spectrum
The U.S. Centers for Disease Control and Prevention (CDC) has significantly increased its estimates of the number of U.S. children with an autism spectrum disorder (ASD). According to a new surveillance summary report, approximately 1 in 68 children—or 14.7 per 1,000 eight-year-olds—are on the spectrum. The new estimate is about 30 percent higher than previous CDC estimates. The report also found that ASD continue to be five times more common among boys than girls; more common among white children than Black of Hispanic children; and that most children are still not diagnosed until after age 4, despite the fact that ASD can be diagnosed as early as age 2. “The number of children identified with autism continues to increase and the characteristics of these children have changed over time,” said Coleen A. Boyle, PhD, MS, director of CDC’s National Center on Birth Defects and Developmental Disabilities, in a release. “While progress has been made, there is an urgent need to continue the search for answers and provide help now for people living with autism.” Read more on pediatrics.
New Cancer Cases Dropped Slightly from 2009 to 2010
Rates of new cancer cases dropped slightly for both men and women in the United States from 2009 to 2010, according to the new U.S. Centers for Disease Control and Prevention report, Invasive Cancer Incidence—United States, 2010. The report saw the incidence rate drop to 446 per 100,000 persons from 459 per 100,000 persons. Rates varied by state, from a high of 511 to a low of 380. The rate was higher for men than it was for women, with the highest rate of all among black Americans. Read more on cancer.
HHS Releases New Security Risk Assessment Tool for Small-to-Medium-Sized Health Care Organizations
The U.S. Department of Health and Human Services (HHS) has released a new security risk assessment (SRA) tool to help health care providers in small-to-medium sized offices conduct risk assessments of their organizations. A collaborative effort of the HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR), the tool enables the organizations to conduct and document a thorough risk assessment at their own pace by allowing them to assess the information security risks under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. The SRA tool’s website contains a User Guide and Tutorial video to help providers begin using the tool. Videos on risk analysis and contingency planning are available at the website to provide further context. The tool is available for both Windows and operating systems and iOS iPads. Read more on technology.
Study Finds Dramatic Increase in Opioid Prescriptions by Emergency Rooms
The past decade has seen a dramatic increase in opioid analgesic prescriptions by emergency rooms, despite only a modest increase in pain-related complaints, according to a new study in the journal Academic Emergency Medicine. Using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2001 and 2010, researchers found that there was a 49 percent increase in prescriptions for potentially addictive narcotic painkillers such as OxyContin, Percocet and Vicodin. Approximately 12 million Americans abused prescription painkillers in 2010 and approximately 15,000 die annually due to overdoses, according to the U.S. Centers for Disease Control and Prevention. Read more on prescription drugs.
Study: Many Chronically Ill Adults Forced to Decide Between Medicine, Food
Chronically ill adults who due to financial instability lack consistent access to food are far more likely to underuse or even skip their medications completely, according to a new study in The American Journal of Medicine. Researchers analyzed data of 9,696 adults with chronic illness who participated in the National Health Interview Survey (NHIS), finding that 23.4 percent reported cost-related medication underuse, while 18.8% percent reported food insecurity and 11 percent reported both. Hispanic and non-Hispanic blacks were at the highest risk. "The high overall prevalence of food insecurity and cost-related medication underuse highlights how difficult successful chronic disease management in the current social environment is," said lead investigator Seth A. Berkowitz, MD, Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, in a release. "These findings suggest residual unmet needs for food-insecure participants and thus have clear implications for health policy." Read more on health disparities.
FDA Approves Implantable Device for Adults with a Certain Type of Hearing Loss
The U.S. Food and Drug Administration (FDA) has approved the first implantable hearing device for adults with severe or profound sensorineural hearing loss of high-frequency sounds in both ears, but who can still hear low-frequency sounds with or without a hearing aid. Sensorineural hearing loss is the most common form of hearing loss and can be caused by aging, heredity, exposure to loud noise, drugs that are toxic to the inner ear and certain other illnesses. “Hearing loss greatly impacts the education, employment, and well-being of many Americans,” said Christy Foreman, director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health, in a release. “This device may provide improved speech recognition for people with this kind of hearing loss, who have limited treatment options.” Read more on technology.