Aug 12 2014
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Public Health News Roundup: August 12

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EBOLA UPDATE: Death Toll at 1,013 as Two More Doctors are Set to Receive an Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Two more Ebola-infected doctors are set to receive the experimental ZMapp drug that was given to two American health workers and a Spanish priest. The Americans continue to receive treatment in an Atlanta hospital, while the 75-year-old missionary died early this morning. The death toll of the West African outbreak—the largest Ebola outbreak in history—now stands at 1,013, according to the World Health Organization. Read more on Ebola.

FDA Approves New Colorectal Screening Test
The U.S. Food and Drug Administration (FDA) has approved the first stool-based colorectal screening test to identify cancers such as colon cancer or precursors to cancer. The test can detect red blood cells and DNA mutations that can indicate certain types of abnormal growths. Colorectal cancer is the third most common cancer among those that affect both men and women, and regular screening tests for all people ages 50 and older could reduce related deaths by at least 60 percent, according to the U.S. Centers for Disease Control and Prevention. “This approval offers patients and physicians another option to screen for colorectal cancer,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Health at the FDA’s Center for Devices and Radiological Health, in a release. “Fecal blood testing is a well-established screening tool and the clinical data showed that the test detected more cancers than a commonly used fecal occult test.” Read more on cancer.

Study: Women, Blacks Affected Most by Heart Disease and Stroke
Women and African-Americans are affected the most by chronic diseases linked to increased risk of heart attack or stroke, according to a new population-based study in the journal Circulation. Researchers analyzed the five major risk factors for heart disease—high cholesterol, smoking, high blood pressure, obesity and diabetes—in more than 13,500 Americans from 1987 to 1998, finding that while the combined risk for women dropped from 68 percent to 58 percent, it was still higher than the risk for men, which dropped from 51 percent to 48 percent. The study also found that diabetes more than doubled the risk of heart disease for African-Americans when compared to whites—28 percent versus 13 percent. Researchers said the difference could be because heart disease has been traditionally viewed as a disease of white men, affecting how it is treated. Read more on health disparities.

Aug 11 2014
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High-Quality Care in Low-Income Communities: Q&A with Steven Weingarten, Vital Healthcare Capital

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Vital Healthcare Capital (V-Cap) and the Robert Wood Johnson Foundation (RWJF) have announced a $10 million investment in Commonwealth Care Alliance (CCA), based in Boston, Mass., to help fund the organization as it rapidly expands its model of care for patients who are dually eligible for Medicare and Medicaid.

The non-profit care delivery system provides integrated health care and related social support services for people with complex health care needs covered under Medicaid and for those eligible for both Medicaid and Medicare. CCA’s expansion comes as Massachusetts continues to pioneer integrated, patient-centered care for people who are eligible for both Medicare and Medicaid though the newly created “One Care: MassHealth plus Medicare” program, one of several financial alignment initiatives for people with dual eligibility established by the Affordable Care Act (ACA) that are launching nationwide.

The loan—the first to be made by Vital Healthcare Capital, a new social impact fund based in Boston, through support from RWJF—provides funds needed by CCA for financial reserves required by the Commonwealth of Massachusetts as the agency expands the number of beneficiaries in its programs.

According to CCA Director Robert Master, the social impact goals are to:

  • Scale a person-centered integrated care model for high-needs populations.
  • Demonstrate what are known in public health as “triple aim” outcomes in health status, care metrics and cost effectiveness.
  • Train, develop and create frontline health care workforce jobs, including health aides, drivers and translators.
  • Create innovations in health care workforce engagement in coordinated care plans to better integrate into the care plan the staff members who most directly touch the lives of its members.

Over the next five years, Vital Healthcare Capital plans to establish a $100 million revolving loan fund, leveraging $500 million of total project capital for organizations working on health care reform for patients in low-income communities.

NewPublicHealth recently spoke with Steven Weingarten, CEO of Vital Healthcare Capital, about the inaugural loan and the firm’s expansion plans going forward.

NewPublicHealth: How did Vital Healthcare Capital get started and what are its overarching goals and investment criteria?

Steven Weingarten: Vital Healthcare Capital has been formed as a new non-profit financing organization to invest in quality health care and good health care jobs in low-income communities. The organization came about after a couple of years of research and development with funding from the Robert Wood Johnson Foundation, as well as from the Ford and Rockefeller Foundations and support from SEIU, the health care union. Healthcare reform is really part of a broader restructuring of health care that has enormous implications for low-income communities, and for the health care providers and plans that have been focused on these communities. Having financial capital to be able to transform health care to a better delivery model will be a critical challenge in upcoming years. So we are coming in to serve that need.

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Aug 11 2014
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Public Health News Roundup: August 11

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EBOLA UPDATE: Spanish Priest Receives Experimental U.S. Drug
(NewPublicHealth is monitoring the public health crisis in West Africa.)
As the World Health Organization (WHO) and other public health agencies continue to debate the ethics and intricacies of using experimental treatments in response to the ongoing Ebola outbreak in West Africa, Spain has imported the U.S.-made ZMapp drug to treat a 75-year-old Spanish missionary priest who was evacuated from Liberia last week. The experimental drug, produced by Mapp Biopharmaceutical Inc. of San Diego, Calif., was previously used on two American health workers who are now being treated at an Atlanta, Ga., hospital. More than 1,000 people have been killed so far in the outbreak which began last March. Read more on Ebola.

Study: Concussions Similar No Matter their Locations
One concussion should be treated just as seriously as any other concussion no matter where on the head it occurs, according to a new study in the journal Pediatrics. Researchers determined that no matter the location, the symptoms and time away from the field were similar for high-school football players who received a concussion. Approximately 44.7 percent of concussions from player-to-player collisions occurred from front-of-the-head impacts and 22.3 percent were from side-of-the-head impacts. The researchers recommended improved education on safer “head up” tackling techniques in order to reduce student athlete concussions. Read more on injury prevention.

Pregnant Women, Fetuses Exposed to Unnecessary Antibacterial Compounds
Children of pregnant women who are exposed to certain antibacterial compounds may experience developmental and reproductive issues, according to new data presented this weekend at the American Chemical Society annual meeting in San Francisco, Calif. Researchers looked at triclosan and triclocarbon levels in the urine of 184 pregnant women, finding that all tested positive for the former and 85 percent tested positive for the latter. Triclosan was also found in more than half of the samples of umbilical cord blood. The two chemicals are found in more than 2,000 everyday consumer products, including toothpastes, soaps, detergents, carpets, paints, school supplies and toys. Researchers also found butyl paraben in more than half of the urine and cord samples; the chemical has been linked to shorter length in newborns. All three can and should be removed from household goods, according to Andrea Gore, a spokeswoman for The Endocrine Society and a professor of pharmacology and toxicology at the University of Texas at Austin. "The efficacy of these products as being helpful to human health has not been proven, but companies are adding them to products anyway," she said, according to HealthDay. "There's no downside to removing chemicals that have no proven benefit." Read more on maternal and infant health.

Aug 8 2014
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New NHTSA Infographic on Safe Summer Driving

Summer is the deadliest time of year to be on the road. In fact, nearly twice as many people are killed in auto accidents during the summer months than are killed during the rest of the year’s months combined, according to the National Highway Traffic Safety Administration (NHTSA). This increase is linked directly to alcohol consumption. According to NHTSA:

  • There was a drunken-driving fatality every 51 minutes in 2012
  • 35 percent of all drivers in nighttime fatal crashes were alcohol-impaired
  • 24 percent of male drivers involved in fatal crashes in 2012 had a blood alcohol content of .08 or higher
  • A DUI can cost drivers up to $10,000—or more than three months-worth of income for the average working American

NHTSA has created a new infographic to illustrate the need for drivers to stay sober:

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>>Bonus Link: Find more information and resources about drunk driving here.

Aug 8 2014
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Public Health News Roundup: August 8

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EBOLA UPDATE: WHO Declares an International Health Emergency
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The West African Ebola outbreak, which has now killed 961 people, has been deemed an “extraordinary event” and an international health risk by the World Health Organization (WHO). "The outbreak is moving faster than we can control it," said WHO Director-General Margaret, according to Reuters. "The declaration...will galvanize the attention of leaders of all countries at the top level. It cannot be done by the ministries of health alone." Read more on Ebola.

NGA Picks Four States to Study Improving Outcomes in the Juvenile Justice System
The National Governors Association has selected Arkansas, Indiana, Michigan and Tennessee to examine new ways to improve outcomes for kids in the juvenile justice system. The four states will “explore strategic recommendations, focusing on improving information sharing across youth-servicing systems, limiting involvement of low-risk youth in the juvenile justice system and expanding community based-alternatives to incarceration,” according to a release. The goals are to lower recidivism rates, reduce costs and improve public safety. Read more on pediatrics.

Study: HIV Diagnosis Rate Down by One-Third Over the Past Decade
The rate of diagnosed HIV infections has dropped by approximately one-third over the past decade, according to a new study in The Journal of the American Medical Association. In 2011, approximately 16 of every 100,000 people in the United States ages 13 and older were diagnosed with HIV; in 2002 the rate was approximately 24 in every 100,000. The rate increased for young gay and bisexual men, but decreased among men, women, blacks, whites, Hispanics, heterosexuals and users of injected drugs. Read more on HIV/AIDS.

Aug 7 2014
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Columbia’s Public Health ‘Summer School’

Close to fifty college undergraduates got a bird’s-eye view of public health careers this summer during the Summer Public Health Scholars Program (SPHSP), a partnership with Columbia University’s College of Physicians and Surgeons, College of Dental Medicine, School of Nursing and Mailman School of Public Health.

“I’ve learned that public health isn’t just about medicine,” said 2014 participant Richmond Laryea, a junior at the University of Central Florida. “It’s about things like the security and safety of public parks, places for farming, transportation, and education—it really takes place in every sector."

>>Bonus Content: Watch participants in last year’s program talk about their public health internships. 

The program, which is funded by the U.S. Centers for Disease Control and Prevention’s Office of Minority Health and Health Equity, is designed to show students the range of public health practice. Students typically spend three days at an internship, one day in the classroom and one day on a field trip to places such as the Harlem Children’s Zone. Each student is also mentored by the Mailman School’s associate dean of Community and Minority Affairs.

Laryea said his career plan is to become a cardiothoracic surgeon, but with some time spent gaining a public health degree, as well.

“With my experience in public health, I’ve learned that I want to look into a community approach to help others as a whole, instead of just helping an individual person,” he said.

Public health agencies where students are performing fieldwork this summer include the Northern Manhattan Perinatal Partnership, BOOM!Health, the South Bronx Overall Economic Development Corporation and New York City’s Correctional Health Services

Aug 7 2014
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Public Health News Roundup: August 7

EBOLA UPDATE: CDC Increases Deployments to West Africa
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Centers for Disease Control and Prevention (CDC) has announced an increase in its deployments and efforts in West Africa in response to the ongoing Ebola outbreak, which is the largest in the history of the disease. The public health agency has activated its Emergency Operations Center to its highest response level and plans on adding 50 disease control experts to the region within the next month.

As of Monday, CDC deployments are:

  • Guinea: 6 currently deployed,
  • Liberia: 12 currently deployed
  • Nigeria: 4 currently deployed
  • Sierra Leone: 9 currently deployed

“The bottom line with Ebola is we know how to stop it: traditional public health. Find patients, isolate and care for them; find their contacts; educate people; and strictly follow infection control in hospitals. Do those things with meticulous care and Ebola goes away,” said CDC Director Tom Frieden, MD, MPH, in a release. “To keep America safe, health care workers should isolate and evaluate people who have returned from Guinea, Liberia, and Sierra Leone in the past 21 days and have fever or other symptoms suggestive of Ebola. We will save lives in West Africa and protect ourselves at home by stopping Ebola at the source.” Read more on Ebola.

Study: About Half of All Physicians Utilize EHRs
Electronic health records (EHRs) are increasingly being utilized by physicians and hospitals, according to two new studies in the journal Health Affairs. Researchers from the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology determined that in 2013 approximately 78 percent of  office-based physicians used some form of EHRs and about 48 percent of all physicians used an EHR system with advanced functionalities. They also found that 59 percent of hospitals in 2013 were using an EHR system with certain advanced functionalities. “Patients are seeing the benefits of health IT as a result of the significant strides that have been made in the adoption and meaningful use of electronic health records,” said Karen DeSalvo, MD, MPH, national coordinator for health information technology. “We look forward to working with our partners to ensure that people’s digital health information follows them across the care continuum so it will be there when it matters most.” Read more on technology.

Number of Suicide Attempts Using Prescription Drugs Up Dramatically
Suicide attempts involving prescription medications and other drugs climbed 51 percent among people ages 12 and older from 2005 to 2011, according to two new reports from the Substance Abuse and Mental Health Services Administration. The greatest increase was seen in people between the ages of 45 and 64, with a 104 percent increase, followed by adults younger than 30, with a 58 percent increase. "We probably are seeing an increase in overall suicide attempts, and along with that we are also seeing an increase in drug-related suicide attempts," said Peter Delany, director of the agency's Center for Behavioral Health Statistics and Quality, in a release. "People have access to medications, and they are using both prescription and over-the-counter meds. It is clear that there are more drugs out there." Read more on prescription drugs.

Aug 6 2014
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Alcohol Abuse Among Returning U.S. Veterans

The focus on military concerns in the last few weeks has understandably been on events in the Middle East, Ukraine and Afghanistan. But a new study from the Mailman School of Public Health at Columbia University is shining a light on the continuing problems faced by returning U.S. military personnel—in particular their increased risk of abusing alcohol.

The study found that regardless of whether they experienced traumatic events during deployment, returning National Guard soldiers were more likely to develop a drinking problem when faced with civilian life setbacks, including job loss, legal problems, divorce, and serious financial or legal problems. The study authors say these are all very common for military families. The study was published in the American Journal of Preventive Medicine.

Previous studies have shown that alcohol abuse is a major concern for reservists returning home. While almost 7 percent of Americans abuse or are dependent on alcohol, the rate of alcohol abuse among reserve soldiers returning from deployment is 14 percent, or almost double that of the civilian population, according to the Mailman researchers.

The study looked at 1,095 Ohio National Guard soldiers who had primarily served in either Iraq or Afghanistan in 2008 and 2009. The soldiers were interviewed three times over three years via telephone about their alcohol use, exposure to deployment-related traumatic events and stressors such as land mines, vehicle crashes, taking enemy fire and witnessing casualties. They were also questioned about any stress related to everyday life since returning from duty.

More than half (60 percent) of the soldiers who responded experienced combat-related trauma, 36 percent of soldiers experienced civilian stressors and 17 percent reported being sexually harassed during their most recent deployment. The researchers found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders; combat-related traumatic events were only marginally associated with alcohol problems.

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Aug 6 2014
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Public Health News Roundup: August 6

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EBOLA UPDATE: African Death Toll Hits 932 as Liberia Shuts Down a Major Hospital Over Continued Infections
(NewPublicHealth is monitoring the public health crisis in West Africa.)
St. Joseph's Catholic hospital in the Liberia capital of Monrovia has been shut down after the death of its hospital director from Ebola and the subsequent infections of six staff members, including two nuns and a priest. The World Health Organization reports that there were 45 deaths in the three days leading to August 4—bringing the death toll so far to 932—and is calling for an emergency meeting to determine whether the outbreak constitutes a "Public Health Emergency of International Concern" and to discuss what additional public health measures can be taken. Read more on infectious diseases.

‘Gluten-free’ Labels Must Now Fully Meet FDA Standards
What does a “gluten-free” food label actually mean? Exactly what it says, as of yesterday. August 5 was the deadline for all U.S. foods bearing a gluten-free label claim to meet the U.S. Food and Drug Administration’s (FDA) final rule covering the issue. The rule sets a gluten limit of less than 20 ppm (parts per million) in foods that carry the label, which is the lowest level that can be detected. The agency issued the rule last August, giving manufacturers one year to bring their product lines into compliance. “Gluten-free” labeling is critical to people with celiac disease, which has no cure and can only be treated through diet. "This standard ’gluten-free’ definition eliminates uncertainty about how food producers label their products. People with celiac disease can rest assured that foods labeled 'gluten-free' meet a clear standard established and enforced by FDA," said Felicia Billingslea, director of FDA's division of food labeling and standards, in a release. Read more on food safety.

Study: Daily Aspirin Linked to Reduction in Risk for Some Cancers
A daily dose of aspirin is linked to a reduction in the risk of developing and dying from colon, stomach and esophageal cancers, according to a new study in the Annals of Oncology. Researchers analyzed the results of available studies, determining “that most people between the ages of 50 and 65 would benefit from a daily aspirin," said lead researcher Jack Cuzick, head of the Center for Cancer Prevention at Queen Mary, University of London, adding, “It looks like if everyone took a daily aspirin, there would be less cancer, and that would far outweigh any side effects.” The most serious side effect associated with aspirin is gastrointestinal bleeding. According to HealthDay, Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society, said that while the study does not mean that everyone should be taking aspirin as a cancer-prevention measure, if does mean they should discuss the possibility with their doctors. Read more on cancer.

Aug 5 2014
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Ebola Update: NIH Testing of a Potential Ebola Vaccine Set to Begin this Fall

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The National Institute of Allergy and Infectious Diseases (NIAID), a division of the National Institutes of Health, is set to begin an early-stage clinical trial for a vaccine to protect against the Ebola virus. The trial should begin as early as September. The vaccine to be tested was developed by the NIAID’s Group Health Research Center in Seattle and does not contain infectious Ebola virus material. Instead, it’s what is known as an adenovirus vector vaccine containing an insert of two Ebola genes. The vaccine works by entering a cell and delivering the new genetic material, causing a protein expression that activates an immune response in the body. Researchers have seen success with studies in primates.

The vaccine being tested is not the experimental serum that was used on two Ebola-infected health workers recently evacuated from Liberia. In those cases, Samaritan’s Purse, the aid organization that sent the health workers to Africa, contacted officials from the U.S. Centers for Disease Control and Prevention (CDC) in Liberia to discuss the status of various experimental treatments they had identified through a medical literature search. CDC officials referred them to an NIH scientist in West Africa familiar with experimental treatment candidates who was then able to refer them to pharmaceutical companies working on experimental treatments. The serum being used is made by Mapp Biopharmaceutical of San Diego, Calif.

Read more on NIAID Ebola vaccine research.

>>Bonus Content: The CDC has released a new Ebola infographic.

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>>Bonus Links: