EBOLA UPDATE: Administration Asks Congress for $6.18 Billion in Emergency Funds
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The Obama administration has asked the U.S. Congress to approve $6.18 billion in new emergency funds to combat the ongoing Ebola outbreak in West Africa. More than 5,000 people have died so far from the outbreak. The new funds would include:
- $1.83 billion for the U.S. Centers for Disease Control and Prevention to prevent, detect and respond to the Ebola epidemic and other diseases and public health emergencies abroad and in the United States.
- $1.98 billion for the U.S. Agency for International Development for foreign assistance in the Ebola crisis.
- $127 million would go to the U.S. Department of State to expand its medical support and evacuation capacity.
- $112 million for the U.S. Department of Defense including funding to support efforts to develop technologies relevant to the Ebola crisis.
- $1.54 billion for a contingency fund, divided between the U.S. Department of Health and Human Services, USAID and State to ensure resources are available to adapt as the crisis evolves.
Read more on Ebola.
CDC: 8 Million Women Ages 21-65 Haven’t Been Screened for Cervical Cancer
Approximately eight million women ages 21-65 years have not been screened for cervical cancer in the past five years, according to the latest Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). More than half of the women who receive a diagnosis of cervical cancer have never been or are rarely screened. “Every visit to a provider can be an opportunity to prevent cervical cancer by making sure women are referred for screening appropriately,” said CDC Principal Deputy Director Ileana Arias, PhD, in a release. “We must increase our efforts to make sure that all women understand the importance of getting screened for cervical cancer. No woman should die from cervical cancer.” Read more on prevention.
U.S. Premature Birth Rate to 11.4 Percent; March of Dimes Gives the Country a ‘C’
The national preterm birth rate has fallen to the Health People 2020 goal of 11.4 percent seven years early. Despite this, the 7th annual March of Dimes Premature Birth Report Card gave the U.S. health care system a “C” for not reaching the organization’s lower target of 9.6 percent. More than 450,000 U.S. babies were born premature in 2013, which leads to increased risks to their health as well as billions of dollars in health care costs. "Achieving the Healthy People 2020 goal is reason for celebration, but the U.S. still has one of the highest rates of preterm birth of any high resource country and we must change that," said March of Dimes President Jennifer L. Howse, MD, in a release. "We are investing in a network of five prematurity research centers to find solutions to this still too-common, costly, and serious problem." Read more on maternal and infant health.
Several heart disease associations—including the American Heart Association and the American College of Cardiology—have released a report that calls on patients to take responsibility for following doctor’s orders when it comes to improving heart heath. The report authors say that while performance measures for improvements in heart disease have traditionally been doctor-focused, patient actions are also needed.
Those actions can include:
- Following treatment plans
- Taking medications as prescribed
- Going to follow-up appointments
- Maintaining lifestyle changes such as weight loss and regular exercise
The report calls on doctors to facilitate shared goal setting; shared decision making; and shared care planning and monitoring with their patients. It also pushes doctors to look at not just short-term measures, but long-term goals for patients and how they do on those goals.
One example from the report is tracking how well a patient adheres to a medication regimen—not just whether a drug was prescribed—and whether the prescribed treatment actually achieved its goal, such as lowering blood pressure or preventing a subsequent heart attack.
“The goal of performance measurement is to improve patient outcomes, including improving the patient’s health status, and reducing their morbidity and mortality. Therefore, it is important to engage everyone that can have an impact on these goals including patients, family members or caregivers, clinicians, and the healthcare system,” said Eric D. Peterson, MD, MPH, director at the Duke Clinical Research Institute and writing committee co-chair. “Shared-accountability performance measures explicitly acknowledge these interdependencies so that everyone can work together towards the improved health of the patient.”
Massachusetts Now Has the Nation’s Strongest Paid Sick Leave Requirements
Massachusetts now has the nation’s strongest requirement for providing paid sick leave. Under a ballot question passed yesterday, people who work for businesses with 11 or more employees are now entitled to up to 40 hours of paid sick time each year. Workers at smaller companies will receive 40 hours of annual unpaid sick time. NewPublicHealth has previously written on the benefits of paid sick leave, including about an American Journal of Public Health study which found that a lack of paid sick leave can be a significant factor in the spread of disease. Read more on business.
Study: Fast Food Marketing to Children Disproportionately Affects Certain Communities
Fast food marketing directed toward children disproportionately affects black, middle-income and rural communities, according to a new study out of Arizona State University (ASU). Researchers studied the marketing practices of 6,716 fast food restaurants, determining that “while most fast food restaurants sampled were located in non-Hispanic and majority white neighborhoods, those situated in middle-income neighborhoods, rural communities and majority black neighborhoods had higher odds of using child-directed marketing tactics.” “Marketing food to children is of great concern not only because it affects their current consumption patterns, but also because it may affect their taste and preferences,” said ASU researcher Punam Ohri-Vachaspati, an associate professor of nutrition in the School of Nutrition and Health Promotion. “We know that consumption of fast food in children may lead to obesity or poorer health, and that low income and minority children eat fast food more often.” Read more on nutrition.
Study: No Link Between Media Violence and Real-Life Violence
Despite the popular notion that media violence is a factor in real-life crime, homicide rates have actually fallen over the past several decades as media violence—in movies, on television and in video games—has increased, according to two new studies in the Journal of Communication. One of the studies examined the level of violence in 90 movies from 1920 to 2005, while the other looked for links between violence in video games and real-life violence among American young people from 1996 to 2011. "The idea that media has big effects on us or shapes our society is probably untenable," said author Christopher Ferguson, chair of the psychology department at Stetson University in Florida. "This doesn't mean media has no effect at all, of course, only that we need to try to move media research out of these culture wars if we're going to make any progress." Read more on technology.
WHO: Wider Use of Naloxone Could Prevent 20,000 U.S. Drug Overdose Deaths Each Year
More than 20,000 U.S. deaths from drug overdoses could be prevented each year if naloxone were more widely available, according to the World Health Organization (WHO). Approximately 69,000 people around the world die each year from overdoses of heroin or other opioids. Opioids are commonly prescribed for chronic non-cancer pain and are the most addictive substances in common use. Naloxone can be used to counter opioid overdoses. "If opioids are easily available in people's bathroom cabinets, it might make sense for naloxone to be equally available," said WHO expert Nicolas Clark. Read more on substance abuse.
Obesity During Pregnancy Linked to Higher Risk of Kidney, Urinary Tract Abnormalities in Infants
Children of women who are obese are more likely to be born with congenital abnormalities of the kidney and urinary tract, according to a new study to be presented at ASN Kidney Week 2014 in Philadelphia, Penn. While such abnormalities are diagnosed in only 1 percent of pregnancies, they account for 20-30 percent of all prenatal abnormalities. Researchers based their findings on linked birth-hospital discharge records from Washington State from 2003 to 2012. "Our findings add to the public health importance of obesity, particularly as a modifiable risk factor," said study author Ian Macumber, MD. "The data supplement the literature regarding obesity's association with congenital abnormalities and highlight the importance of future research needed to clarify the mechanisms of these associations." Read more on maternal and infant health.
Study: Increased in Autism Cases Due to Changes in How the Condition is Defined
The dramatic increasing in the number of autism cases among children since the mid-1990s is in larger part due to how the condition is reported and defined, with today’s classification system more broader than the one used in the past, according to a new study in JAMA Pediatrics. Danish researchers determined that 60 percent of the increase in cases “can be attributed to changes in diagnostic criteria and the inclusion of out-of-hospital diagnoses.” "That the increase until now has been left more or less unexplained has undoubtedly raised considerable concern among the public and might, in fact, have affected some parents' health decisions regarding their child," said lead researcher Stefan Hansen, from the section for biostatistics in the department of public health at Aarhus University, according to HealthDay. "As our study shows, much of the increase can be attributed to the redefinition of what autism is and which diagnoses are reported. The increase in the observed autism prevalence is not due alone to environmental factors that we have not yet discovered." Read more on pediatrics.
Deaths and injuries from falls in people older than age 65 have doubled in the last decade. Last year, 24,000 older people died after a fall and more than two million sustained severe injuries—which can often lead to permanent disability. To find ways to prevent those falls and the injuries, deaths and costs that come with them, earlier this year the National Institutes of Health (NIH) and the Patient-Centered Outcomes Research Institute (PCORI) joined forces on the Falls Injuries Prevention Partnership, which will fund clinical trials at ten U.S. centers over the next five years.
The trials include some implementation of proven fall prevention strategies at the ten research sites. NIH researchers say a key goal is to help change physician behavior about fall prevention, because recent education efforts through conventional medical education channels and other methods have not been very effective.
“With this trial, we will be able to evaluate interventions on a comprehensive and very large scale,” said Richard J. Hodes, MD, director of the National Institute on Aging, which is a division of NIH. “This study will focus on people at increased risk for injuries from falls, the specific care plans that should be implemented—including interventions tailored to individual patients—and how physicians and others in health care and in the community can be involved.”
Each person in the trial will be assessed for their risk of falling, and receive either the current standard of care—information about preventing falls—or individualized care plans first shared with the trial participant’s primary care physician for review, modification and approval. They will include proven fall risk reduction interventions that can be implemented by the research team, physicians and other health care providers, caregivers and community-based organizations.
The trial directors hope to enroll 6,000 adults age 75 and older who have one or more risk factors for falls. The first year of the study is a pilot phase; if the go-ahead is given by NIH and PCORI to proceed with the study after that, enrollment for the full trial will start in June 2015, with participants followed for up to three years. The main goals of the trial are reductions in serious injuries from falls.
“With active input from patients and other stakeholders from the very beginning of this study, we think we can have a major impact, changing practice to make a real difference in the lives of older people,” says PCORI Executive Director Joe Selby, MD, MPH.
The ten trial sites and regions they serve are:
- Essentia Health, Duluth, Minnesota (Midwest)
- HealthCare Partners, Torrance, California (Southern California)
- Johns Hopkins Medicine, Baltimore (Mid-Atlantic)
- Mount Sinai Health System, New York City (Northeast)
- Partners HealthCare, Waltham, Massachusetts (Northeast)
- Reliant Medical Group, Worcester, Massachusetts (Northeast)
- University of Iowa Health Alliance, Iowa City (Midwest)
- University of Pittsburgh Medical Center (Mid-Atlantic)
- University of Texas Medical Branch, Galveston Health (Southwest)
- University of Michigan, Ann Arbor (Midwest)
Data management and analysis will be coordinated by the Yale School of Public Health.
EBOLA UPDATE: UN’s Secretary-General Calls Travel Bans ‘Unnecessarily’ Strict
(NewPublicHealth is monitoring the public health crisis in West Africa.)
U.N. Secretary-General Ban Ki-moon again came out strongly against travels bans related to Ebola, calling them “unnecessarily” strict in a Monday news conference. Some U.S. state officials have imposed quarantines on health workers returning from West Africa, but there is no federal ban; Canada and Australia have barred citizens from Liberia, Sierra Leone and Guinea. "The best way to stop this virus is to stop the virus at its source rather than limiting, restricting the movement of people or trade," said Ban, according to Reuters. "Particularly when there are some unnecessarily extra restrictions and discriminations against health workers. They are extraordinary people who are giving of themselves, they are risking their own lives." Read more on Ebola.
HUD Accepting Cities’ Applications for Economic Revitalization Assistance
The U.S. Department of Housing and Urban Development (HUD) is now accepting applications for cities looking to spur economic revitalization through the National Resource Network, which brings together national experts to work with cities to improve economic competiveness while reversing population decline, job loss and high poverty rates. “Knowledge is fuel for progress and innovation,” said HUD Secretary Julián Castro, in a release. “The National Resource Network will be a valuable tool in helping local governments address their challenges and achieve their goals. It will provide on-the-ground technical assistance and human resources that cities can use to build for the future.” Eligibility is based on economic and demographic criteria, with approximately 275 cities eligible to apply. Read more on community development.
Study: High School Football Players Need More Education on Concussion
More needs to be done to educate high school football players on the dangers of concussions, according to a new study in the Journal of Athletic Training. Researchers surveyed 334 varsity players from 11 Florida schools. Based on a written questionnaire, while most know that headache, dizziness and confusion were potential concussion signs, they did not know the link to other signs such as nausea, neck pain and difficulty concentrating. In addition, 25 percent said they had no education about concussions at all. "Our results showed that high school football players did not have appropriate knowledge of concussion. Even with parents or guardians signing a consent form indicating they discussed concussion awareness with their child, nearly half of the athletes suggested they had not," study co-author Brady Tripp, from the University of Florida, said in a National Athletic Trainers' Association news release. Emergency rooms treat more than 300,000 people for brain injuries related to sports each year. Read more on injury prevention.
The U.S. Consumer Product Safety Commission (CPSC) awarded prizes this week for four new online applications to help consumers track product recalls. Earlier this year, the CPSC challenged developers to create apps to help consumers track recall announcements and safety incidents involving consumer products. Nine developers submitted proposals, using the CPSC’s SaferProducts.gov website.
The CPSC’s research finds that recalls impact both consumers who purchase new products and consumers who purchase products—such as cribs and high chairs, whose safety standards change over the years—at yard sales and thrift stores. The products’ bar codes can be used by some of the apps to determine whether there has been a recall. Others check user emails for information on products purchased online.
The four new apps:
- Safety Checker usually needs just three fields filled in or the bar code scanned to find recall data. The app works with iOS and Android devices.
- Recall Pro uses Google Chrome to help consumers find recall information before making an online purchase.
- The “Slice” app checks purchases via email inboxes against the CPSC’s recall list and is available for iOS and Android users.
- Total Recall 101 checks a user’s email inbox and archives for references to purchased products, including product receipts and conversations with friends (but emails remain private to the user). The app matches products against the CPSC’s recall list and alerts users to any problems.
>>Bonus Link: Injuries cause tens of thousands of deaths in the United States each year. Find more information on product safety advice from the CPSC.
EBOLA UPDATE: China to Dispatch PLA Squad to Build an Ebola Treatment Center in Liberia
(NewPublicHealth is monitoring the public health crisis in West Africa.)
In response to the United Nations’ call for a greater global effort to help combat the ongoing Ebola outbreak in West Africa, China has announced it will send an elite unit of the People’s Liberation Army (PLA) to Liberia. The squad will build and run a 100-bed treatment center, which should be open within a month. China will also send 480 PLA medical staff to treat patients. Read more on Ebola.
HUD: U.S. Homelessness Continues to Decline
U.S. homelessness continues to decline, according to the latest estimates from the U.S. Department of Housing and Urban Development (HUD). HUD’s 2014 Annual Homeless Assessment Report to Congress found that there were 578,424 persons experiencing homelessness on a single night in 2014, an overall 10 percent reduction and 25 percent drop in the unsheltered population since 2010. “As a nation, we are successfully reducing homelessness in this country, especially for those who have been living on our streets as a way of life,” said HUD Secretary Julián Castro. “There is still a tremendous amount of work ahead of us but it’s clear our strategy is working and we're going to push forward till we end homelessness as we’ve come to know it.” Read more on housing.
Study: Care in the 24 Hours after a Stroke is Critical to Health Outcomes
Care in the immediate 24 hours after a stroke is both complex and critical to patient outcomes, according to a new study in the journal MedLink Neurology. Most strokes are caused by blood clots that block blood flow to the brain, so keeping a patient lying flat or as flat as possible will help increase blood flow. At the same time, sitting upright can improve blood draining and reduce intracranial pressure. "The period immediately following an acute ischemic stroke is a time of significant risk," wrote researchers from the Loyola University Medical Center. "Meticulous attention to the care of the stroke patient during this time can prevent further neurologic injury and minimize common complications, optimizing the chance of functional recovery." Read more on heart and vascular health.
NewPublicHealth began its 2014 Ebola coverage several months ago as the number of cases—and deaths—in West Africa continued climbing and concern about diagnoses in the United States emerged. Our daily news roundups frequently link to critical announcements from the U.S. Department of Health and Human Services and the U.S. Centers for Disease Control and Prevention, as well as prevention and treatment research news, and provide perspectives we haven’t seen elsewhere such as this week’s interview on the legalities of quarantines.
We’ve also continued posting stories on other infectious diseases, some of which—although deadly—have taken a back seat to Ebola in the daily U.S. news cycle.
Our colleagues at Global Health NOW, the global health blog of the Bloomberg School of Public Health at Johns Hopkins University, recently wrote about the potential for Ebola news overload. In the newsletter, editor Brian Simpson shared a note from a reader who noted that “It’s vital to not let Ebola crowd out other equally and more impactful health issues.”
Simpson replied that the writer “raises an important issue. Ebola has not made heart disease, AIDS, traffic injuries, gun violence, maternal mortality, schistosomiasis—or any other threat to human health—go away. However, dipping into any media stream might make you think so.”
Simpson adds that GHN “have run a slew of news...on Ebola since March 20” and adds that the challenge is reporting on the most important news while still maintaining perspective.”
“It’s a difficult balance, and sometimes we’ll screw up,” he said. “But we’ll always strive to keep things in perspective and find the essential news for you.” We feel the same way at NewPublicHealth.
Flu season in the United States typically runs from November through March, with the peak coming in January and February. But people can catch the flu both earlier than the usual start time and after the usual end of the season. In addition, the severity of the flu season can vary with from 3,000 to 49,000 U.S. deaths in a given year, an average of more than 200,000 hospitalizations and millions of illnesses, according to the U.S. Centers for Disease Control and Prevention (CDC).
Flu shot season has a shorter time table, so many pharmacies and doctors’ office that are well stocked at the moment can run out before Christmas, making it difficult for people who put off their vaccinations to find a vaccine location and protect themselves.
And despite a yearly campaign to get people to roll their arms up, less fewer than half of adults and less than 60 percent of kids received a flu shot last year. NewPublicHealth recently spoke with Carolyn Bridges, MD, the CDC’s associate director for adult immunizations about what keeps people from getting the flu shot and how more people can be encouraged to get the vaccine.
NewPublicHealth: What is it that keeps people from getting the shot?
Carolyn Bridges: I think there are a number of things. Certainly, we have pretty good awareness about the recommendations for the influenza vaccine, although some people may just not realize that they are potentially at risk. The current recommendations call for all persons six months of age and older to get an annual flu vaccine, with rare exceptions. But the vaccine recommendations have changed over time and in the last few years have been broadened to include [just about] everyone. For some people the message hasn’t gotten to them that in fact they are now included in the group recommended for a yearly flu vaccine
NPH: What common misconceptions do people still have about the flu vaccine?
Bridges: In terms of the safety, some people question or are worried about getting the flu from the flu vaccine. That’s still a common comment that we receive. Sometimes people will certainly have body aches or some tenderness in the arm where they get their flu vaccine, but that’s certainly not the same as getting influenza, and those symptoms generally are very self-limited and go away within two to three days. But the flu vaccine cannot cause the flu.