Study: U.S. Graphic Warning Labels Could Get 8.6M Smokers to Quit
A new study out of Canada indicates that the U.S. Food and Drug Administration may have underestimated the potential impact of graphic warning labels on tobacco products. From 2000 to 2009, the warning labels cut Canada's smoking rate somewhere between 12 and 20 percent, which would be the equivalent of between 5.3 million and 8.6 million U.S. smokers. That's also 33 to 53 times larger than the FDA's estimates when they pushed for the warning labels--and when the tobacco industry successfully challenged the measure, with the court pointing to the low impact as one of the reasons for the ruling. "Our analyses corrected for errors in the FDA's analysis, concluding that the effect of graphic warnings on smoking rates would be much stronger than the FDA found," said Jidong Huang, MD, the study's author. "Our results provide much stronger support for the FDA's revised proposal for graphic warnings, which we hope will be forthcoming in the near future." Read more on tobacco.
Expanding Nurse Practitioner Abilities Could Save Patients $472M by 2015
Expanding which health services nurse practitioners at retail health clinics can provide could save at least $34 per visit, or as much as $472 million in health costs by 2015, according to a new study in the journal Health Affairs. The estimated 6,000 retail health clinics, often found in chain pharmacies or "big box" stores, provide walk-in care for minor health problems. The rules for nurse practitioners vary from state to state, with some allowing them to prescribe medications and practice independently of a doctor's supervision. Researchers looked at insurance claims from 2004 through 2007, finding that the state's that grant wider latitude also tend to see lower costs for the patients:
- $704 -- Average cost of treatment in the 14 days after a traditional doctor's office visit
- $543 -- Average cost of care during and after a retail visit in states where nurse practitioners had no independence and could not prescribe medication
- $484 -- Average cost of care during and after a retail visit in states where nurse practitioners were allowed to practice without the supervision of a doctor
- $509 -- Average cost of care during and after a retail visit in states where nurse practitioners were allowed to practice without supervision and prescribe medication
Read more on access to health care.
New Estimate Puts 2009 Swine Flu Global Death Toll at More than 200K
The death toll from the 2009 swine flu epidemic was likely far higher than previously believed, according to a new study in the journal PLoS Medicine. Previously, the total stood at about 18,500 laboratory-confirmed deaths, though experts considered that to be a low estimate because it only factored in confirmed cases of H1N1. A new study, bringing together 60 researchers in 26 countries, now places the toll at as many as 203,000 global deaths--or 11 times higher than the previous estimate. "This study confirms that the H1N1 virus killed many more people globally than originally believed," study lead author Lone Simonsen, a research professor in the department of global health at the George Washington University School of Public Health and Health Services. "We also found that the mortality burden of this pandemic fell most heavily on younger people and those living in certain parts of the Americas." Read more on global health.
The normally hectic pre-Thanksgiving travel day could be more frenzied than usual this year because of predicted storms in the west that could move east—and storms are often a precursor to flight delays. So why not use the extra time to get a jump start on 2014 resolutions?
Mindful that air passengers are captive audiences, many airports have added fitness options ranging from trail markers to let you know how far you’ve walked on the airport’s walking trail (Baltimore Washington International) to a yoga room (San Francisco International and Dallas Fort Worth) and even a full fitness center with workout clothes for rent (Toronto Pearson).
Airport Hotel Gyms
While most airports don’t yet have a gym right on the premises, a growing number of airports have hotels with attached gyms in one of the terminals, including Chicago O’Hare and Orlando International. (The hotels are located outside of the security areas, so if you’re planning a workout, build in the time you need to shower, dress and clear security before boarding your flight.) Passes to the airport gyms are typically under $20 per person. Check your airport’s website for hotels onsite, and then check the hotel to find out rates and rules for short term use. And remember to wear your sneakers to the airport so you’re sure you have them for the workout.
Airport Walking Trails
In addition to the walking trail at Baltimore Washington International, a growing number of airports have marked walking trails. Keep that in mind when you pack your carryon, as there aren’t usually storage facilities for luggage once you pass security, though for $39-50 you can get a day pass at many airline clubs where you can find a quiet corner, snacks and a place to store you hand luggage while you walk the indoor trail. Ask at the airport information desk where the trail begins, or check the American Heart Association walking path website or phone app, and put in “airport” for the search engine section marked “type of path.”
Chicago Announces Trio of Anti-tobacco Initiatives to Curb Youth Smoking
The city of Chicago and Mayor Rahm Emanuel this morning announced a trio of anti-tobacco initiatives designed to reduce youth access to tobacco. The first would regulate e-cigarettes as tobacco products, while the second would restrict the sale of flavored tobacco products near schools and the third would work to educate the public on the dangers of menthol-flavored cigarettes. Further details:
- By defining “tobacco products” as products that are made of tobacco or include tobacco-derived nicotine, the city would be able to regulate e-cigarettes as they do any other tobacco product. This would mean that under the Chicago Clean Indoor Air Act, e-cigarette use would be restricted everywhere where smoking is restricted, including almost all public places and places of employment.
- Flavored tobacco products, including menthol products, could not be sold within 500 feet of schools, and existing stores would not be grandfathered in. This would be the first regulation of menthol-flavored cigarettes anywhere at the federal, state or local levels.
- Understanding that menthol-cigarettes are often—and wrongly—viewed as less unhealthy than other tobacco products, as well as that fact that the flavoring makes them more appealing to kids, the city is launching a public service advertising campaign on the realities of the products.
“E-cigarettes, as well as flavored products, are gateway tobacco products targeted at our kids,” said Emanuel. “The tobacco industry has spent years developing products that are aimed at hooking our youth on nicotine and getting them smoking for their entire life.” Read more on tobacco.
FDA to Investigate Reports on Weight-related Problems with the Morning-After-Pill
Following yesterday’s report that the European equivalent of the Plan B One-Step “morning after pill,” Norlevo, is less effective for women who weigh 165 pounds or more and ineffective for women who weigh 176 pounds or more, the U.S. Food and Drug Administration (FDA) has announced it will perform its own investigation into the product. The agency is "currently reviewing the available and related scientific information on this issue, including the publication upon which the Norlevo labeling change was based," said FDA spokeswoman Erica Jefferson said in a Monday statement. "The agency will then determine what, if any, labeling changes to approved emergency contraceptives are warranted." By law, the morning-after pill is available to all U.S. women of child-bearing age, over the county and with no point-of-sale restrictions. Read more on sexual health.
Concerns Over Cost, Sexual Activity Keep Many Parents From Having Kids Vaccinated Against HPV
Costs and parental concern over their kids’ sexual activity may be the reason that so view children—both girls and boys—are not being vaccinated against the human papillomavirus (HPV), according to a new review of 55 studies appearing in JAMA Pediatrics. HPV vaccines protect against the strains of genital warts that cause approximately 70 percent of cervical cancers, and they are recommended for girls aged 11 to 12. Boys are recommended to receive the vaccine as young as age 11, as it protects not just against genital warts, but also oral, penis and rectal cancers. However, the review found that many parents put off the vaccination either because they believe their child is not sexually active—so doesn’t “need” the vaccine—or because they fear it will encourage them to become sexually active. Researchers determined that a physician’s recommendation was one of the strongest motivators toward deciding to accept the vaccination, although this did not happen nearly enough. The researchers recommended improving these statistics by educating doctors and parents on the importance of the vaccine. Read more on cancer.
Today is Public Health Thank You Day 2013, when Research!America and other leading public health organizations recognize the public health professionals working to improve health where we all live, learn, work and play.
Among the biggest names in public health at the moment is Shiriki Kumanyika, PhD, MPH, a University of Pennsylvania professor who earlier this month became the president-elect of the American Public Health Association (APHA). In a recent Q&A on APHA’s Public Health Newswire blog, Kumanyika spoke about the overall landscape of public health and gave her thoughts on particular issues.
One of the big takeaways from the APHA annual meeting earlier this month—where she was named president-elect—was how APHA is shifting its focus to concentrate more on being an action- and goal-oriented organization, according to Kumanyika.
“We are going to be more convincing about the importance of a focus on prevention and wellness, while making better use of scientific evidence and creating a greater sense of urgency around health equity issues,” she said. “I think that, over time, this new positioning in the public arena will really enhance the sense of community among our thousands of diverse members, attract more members and align our combined efforts for greater overall impact.”
Kumanyika also has particular ideas on the greatest opportunities for improving health in African-American communities, especially when it comes to nutrition and obesity prevention. Not only are unhealthy foods too easily available in the average black community but, when compared to other communities, the situation is even more troubling, with black communities seeing more advertising for unhealthy food. The answer is targeted efforts to promote healthier alternatives.
However, she also noted how food and nutrition present their own particular public health obstacles.
“Food is a particularly complex area; we can’t treat it like tobacco and tell people to avoid it altogether. The changes we need are more complicated and will have huge implications across the spectrum from agriculture to environmental sustainability,” she said. “We have to make both a public health case and a business case for a healthier food supply and for marketing healthier foods and beverages. We have a tremendous opportunity to make progress that will change the food and health landscape for the population at large if we do our health diplomacy well.”
Read the full interview on Public Health Newswire here.
More than 145 million adults now include walking as part of a physically active lifestyle, according to a report released by the U.S. Centers for Disease Control and Prevention (CDC) earlier this year. More than 6 in 10 people walk for transportation or for fun, relaxation, or exercise, or for activities such as walking the dog. The percentage of people who report walking at least once for 10 minutes or more in the previous week rose from 56 percent in 2005 to 62 percent in 2010.
But creating communities amenable for walking takes much more than the proverbial “putting one foot ahead of the other.” Over the last decade, more and more communities have done local walkability assessments, added sidewalks, installed or improved crossing signs and signals, and vastly increased programs such as Walking School Bus, which encourages parents and kids who live a mile or less from school to join safe walking programs.
And behind most of these advances is a walkability advocate who knows the transportation chiefs, the local policymakers and the laws in other jurisdictions that promote or dissuade walking. In Boston, that person is Wendy Landman, executive director of WalkBoston, a non-profit membership organization dedicated to improving walking conditions in cities and towns across Massachusetts.
“Our goal is to make walking and pedestrian needs a basic part of the transportation discussion,” says Landman.
NewPublicHealth spoke with Landman at WalkBoston’s central Boston offices during our visit to the city for the recent American Public Health Association annual meeting.
NewPublicHealth: Why is walking advocacy so important?
Wendy Landman: At WalkBoston we sometimes describe walking as the club that everybody belongs to and nobody joins. Because it’s such a basic element of what every human being does, walking often gets forgotten, and it gets forgotten in many different ways. At the most basic level, walking is often left out of land-use planning and civil engineering. We forget to incorporate sidewalks and safe-street crossings. We forget to design and build our communities so that people can actually walk between places—whether it is kids walking to school or to a friend’s house, or adults walking to shops or church. That’s not to say that we should all live in a scale that’s just walkable, but many things that we do every day, day in and day out, would be better for human beings and for the planet if we could walk to some of them.
FDA Approves Vaccine for H5N1 Strain of Avian Flu
The U.S. Food and Drug Administration (FDA) has approved the first adjuvanted pandemic influenza vaccine for the prevention of the H5N1 strain of the avian flu, also known as bird flu. While most influenza A viruses do not infect people, H5N1 does and has demonstrated a 60 percent mortality rate when a person becomes infected. The U.S. Department of Health and Human Services has added the vaccine to the National Stockpile. “This vaccine could be used in the event that the H5N1 avian influenza virus develops the capability to spread efficiently from human to human, resulting in the rapid spread of disease across the globe,” said Karen Midthun, MD, director of the FDA’s Center for Biologics Evaluation and Research. “Vaccines are critical to protecting public health by helping to counter the transmission of influenza disease during a pandemic.” Read more on infectious diseases.
Study: Excessive Television Watching Equals Excess Weight in Kids
Children and teenagers who spend excessive amounts of time watching television or in front of other screens are also more inclined to be overweight or obese, according to a new study in the journal Pediatrics. Researchers analyzed data on nearly 8,000 boys and girls, ages 9-16, finding that each additional hour a day spent watching television was linked to a body mass index (BMI) scale increase of about 0.1 points, or about half a pound. Kids who watch television or play video/computer games are not only for the most part physically idle, but also more likely to snack. While many parents believe their kids spend a reasonable amount of time in front of screens, the reality is that most kids in the United States and Canada surpass the recommended daily limit of two hours. "We don't pay attention to the fact that it's half an hour here, half an hour there, an hour here, an hour there," said Mark Tremblay, director of Healthy Active Living and Obesity Research at the Children's Hospital of Eastern Ontario Research Institute in Ottawa, Canada, who was not a part of the study. Read more on obesity.
Study: One in 10 U.S. Kids has ADHD
About one in 10 U.S. children have attention-deficit/hyperactivity disorder (ADHD), according to a new study in the Journal of the American Academy of Child and Adolescent Psychiatry. A 2011 poll of more than 95,000 parents found 11 percent of kids ages 4-17 had ADHD, up from 9.5 percent in 2007. The number of kids on ADHD medication also climbed about 1 percent, with research showing that half the kids with ADHD are diagnosed before the age of 6. "This finding suggests that there are a large number of young children who could benefit from the early initiation of behavioral therapy, which is recommended as the first-line treatment for preschool children with ADHD," study author and U.S. Centers for Disease Control and Prevention (CDC) researcher Susanna Visser. The study also found that while the number of kids with ADHD is still climbing, it is no longer climbing as fast—the rate was increasing about 6 percent a year in the mid-2000s, but was only 4 percent a year from 2007 to 2011. Read more on pediatrics.
Earlier this year, fans of the National Football League’s Seattle Seahawks set a record for outdoor stadium noise with a volume of 136.6 decibels. That record stood for a mere four weeks—the Kansas City Chiefs hit 137.5.
The fans revel in it—both records were set in part through the encouragement of fan organizations—and this record-seeking behavior is encouraged by teams and the league.
“Fans know they are going to a football game and not searching for a book at a library,” said Brian McCarthy, an NFL spokesman.
However, according to a recent story in The New York Times, such loud revelry at sporting events comes with severe costs for people’s hearing health. Elliott Berger, an acoustical engineer at 3M, said the average volume during an NFL game hovers at around 90 decibels. Considering the fact that an average NFL game lasts about three hours—and the National Institute for Occupational Safety and Health recommends limiting exposure to levels that high to 60 minutes—by going to football games people are putting themselves at serious risk for partial deafness and ringing, or even hyperacusis, an intolerance to sound that sometimes can cause pain.
While this may be alright (although very unhealthy) for the casual fans who only attend a few games per year, people who already have auditory problems are at substantial risk. And it’s something that even a simple set of earplugs or earmuffs can prevent.
“People think it’s cool or funny or whatever, but there is increasing evidence that if your ears are ringing, damage is happening,” said M. Charles Liberman, a professor of otology at Harvard Medical School and the director of a hearing research lab at the Massachusetts Eye and Ear Infirmary. “There’s something irreversible going on. It’s only going to worsen as you get older.”
Read the full story at The New York Times.
CDC Report Finds Health Disparities, Inequalities Persist across the U.S. Population
The U.S. Centers for Disease Control and Prevention (CDC) has released a new report examining the disparities in mortality and disease risk as they relate to income, education level, sex, race, ethnicity, employment status and sexual orientation. CDC Health Disparities and Inequalities Report — United States, 2013 is the second CDC report to take this wide look at the U.S. population. Among its key findings:
- The overall birth rate for teens 15-19 years old dropped 18 percent from 2007 to 2010, although it varied widely from state to state
- People who are Hispanic, are low wage earners, were born outside of the United States, have no education beyond high school, or are male are more likely to work in an occupation in which workers are more likely than average to be injured or become ill
- Binge drinking is most common for people ages 18-34, men, non-Hispanic whites and people with higher household incomes
“It is clear that more needs to be done to address the gaps and to better assist Americans disproportionately impacted by the burden of poor health,” said Chesley Richards, MD, MPH., director of CDC’s Office of Public Health Scientific Services, which produced the report. “We hope that this report will lead to interventions that will allow all Americans, particularly those most harmed by health inequalities, to live healthier and more productive lives.” Read more on health disparities.
HUD Grants to Help Transform Distressed Communities into Thriving Communities
The U.S. Department of Housing and Urban Development (HUD) is granting approximately $4.37 million to help nine areas transform their public or other HUD-assisted housing and distressed neighborhoods into thriving communities. Fifty- two communities had applied for the Choice Neighborhoods Planning Grants. The agency’s Choice Neighborhoods Initiative supports locally-driven economic developments to create renewed, sustainable communities, with a focus on creating energy-efficient, mixed-income housing that has easy access to high-quality services, education programs, early learning programs, public assets and public transportation. Full details on each community can be found here. Read more on housing.
Study: Certain Health Behaviors Tied to Complication-free Pregnancies
Women who engage in certain healthy behaviors—and avoid certain unhealthy ones—are more likely to have complication-free pregnancies, according to a new study in the journal BMJ. An analysis of health data on more than 5,600 women found that eating fruit, having a healthy weight, having lower blood pressure, having a job, and stopping drug and alcohol abuse at 15-20 weeks of gestation "may increase the likelihood of normal pregnancy outcomes," according to Lucy Chappell, of the Women's Health Academic Center of King's College London. The most common pregnancy-related complications are babies who were too small for their gestational age, high blood pressure, preterm birth and preeclampsia. Read more on maternal and infant health.
A conference in St. Paul, Minn., earlier this month examined ideas and emerging examples for building a healthier Minnesota by promoting the integration of health-related programs and community development to address health where we live, learn, work and play. The conference was convened by the Federal Reserve Bank of Minnesota and Wilder Research, the research arm of the Amherst H. Wilder Foundation. The gathering, which was a follow-up to an initial conference on the intersection of health and community development held in Minnesota a year ago, highlighted current successful cross-sector efforts throughout the state.
Elaine Arkin, manager of the Robert Wood Johnson Foundation Commission to Build a Healthier America, was a keynote speaker at the conference. Her remarks included the announcement that the Commission’s recommendations on early childhood and supporting healthy communities will be released in early 2013.
The highlighted projects included a task force on increasing access to healthier foods, often an obstacle in poorer communities; locating needed services alongside senior housing; a stable housing concept for people at risk of homelessness following a hospital stay; and a project underway to give kids living in trailer parks a safe place to play.
“The strategy that we used this year in engaging people with actual examples...was very effective in really acknowledging that this work is messy, that it does take time and that in order to keep people enthusiastic about it sometimes it does require giving people a pat on the back even just for the small progress that they’ve made,” said Ela Rausch, community development project manager of the Federal Reserve of Minnesota.
Following the conference, NewPublicHealth spoke with Ela Rausch and Paul Mattessich, PhD, Executive Director of Wilder Research.
NewPublicHealth: What were the key goals of this year’s meeting?
Paul Mattessich: The overarching goal is at the national level to bring together public health with community development finance in order to better address health issues, social determinants of health and improved community health. But what we did the first time a year ago was to try to get the two sectors to understand what each other does, what their vocabulary was, how best to work together and to start some networking.
This year the goal was to take the next step and highlight some examples where this cross-sector collaboration occurred, and to use that to try to further that even more and to underscore the fact that the two sectors really do address the same end goal, even though they do it in different ways. And if they team up they can do it more effectively.
CDC Releases ‘Winnable Battles Progress Report 2010-2015’
The U.S. Centers for Disease Control and Prevention (CDC) has released its Winnable Battles Progress Report 2010-2015, which details the progress made in key areas where CDC has determined that progress is possible. The individual reports detail what’s been accomplished, and what still needs to be accomplished, to reach these goals by 2015. They include healthcare-associated infections; tobacco; nutrition, physical activity and obesity; food safety; motor vehicle safety; teen pregnancy; and HIV prevention. “By implementing the programs with the greatest potential impact, we are addressing Americans’ biggest health challenges while we try to get the most health bang for precious resources,” said CDC Director Tom Frieden, MD, MPH. Read more on the CDC.
Study: One-third of Kids’ Calories from Schools, Stores, Fast Food Restaurants are ‘Empty Calories’
In the battle to improve nutrition for kids, parents need to look beyond just fast food restaurants and take a closer look at food from grocery stores and at schools. A new study in the Journal of the Academy of Nutrition and Dietetics found that roughly a third of the calories consumed from each of these three sources constituted “empty calories” coming from added sugar or solid fat. The 2010 Dietary Guidelines for Americans recommends between 8 and 19 percent of calories should be “empty” for both kids and adults; excessive empty calories can lead to weight gain and obesity. While all three sources offered high counts of empty calories, they did so for different reasons, demonstrating the need to tailor health efforts to meet their particular obstacles. "Our study found that 20 percent of pizza and 22 percent of high-fat milk consumed by kids are provided by schools, and 72 percent of sugar-sweetened beverages like sodas, fruit drinks, sports drinks and energy drinks consumed by kids are obtained from grocery stores," said study author Jennifer M. Poti, a doctoral candidate in nutritional epidemiology at the University of North Carolina at Chapel Hill. Read more on nutrition.
American Headache Society: New Guidelines on Treating Migraines, Limiting Unnecessary Treatments
The American Headache Society has issued new guidelines on how physicians can better treat patients with migraines while limiting unnecessary or even risky treatments. For example, because of their serious long-term risks, opiod painkillers such as OxyContin and Vicodin, as well as the barbiturate butalbital, should not be the first treatments prescribed. Also, CT scans should only be limited to non-emergency situations when possible, as MRIs are both able to diagnose more conditions and do not expose patients to radiation. "Our aim is to encourage doctors and patients to think carefully about medical care that can be harmful or unnecessary," said Elizabeth Loder, MD, president of the American Headache Society. "We didn't approach this with cost uppermost in mind. The goal is to help address the problems of low-value care." Approximately 12 percent of Americans are estimated to suffer from migraines. Read more on migraines.