Category Archives: Aging
“What aging is, is the greatest success of public health,” said Ruth Finkelstein, director of the Age-Friendly Initiative of the New York Academy of Medicine.
The City of New York has released a progress report on Age-friendly New York City, a cross-agency, public-private partnership created in 2009 to improve the lives of older New Yorkers. The report highlights progress in several areas including pedestrian safety, parks access and innovative senior centers among others initiatives. New York City is home to 1.3 million older New Yorkers, a number expected to increase by close to 50 percent by 2030. In 2007, the City Council provided funding to the New York Academy of Medicine to begin creating a blueprint to help New York City become a model of an age-friendly city.
The report’s release coincides with the city’s announcement of its recognition as the Best Existing Age-friendly Initiative in the World through a competition sponsored by the International Federation on Aging.
“It’s a fact of life that everyone gets older and we need to make sure our City is prepared to meet the needs of our aging population,” said Department for the Aging Commissioner Lilliam Barrios-Paoli. “Our success is due to the collaborative efforts of our sister City agencies, the New York City Council and the New York Academy of Medicine. Without this uniquely innovative partnership and the grassroots community efforts from local businesses and neighborhood organizations, we would not have been able to build the foundation for what makes New York City a better place to live for our seniors.”
The city’s age-friendly initiatives include:
Report: U.S. Poverty, Uninsured Rates Remain Stagnant
Despite an improving economy that included the creation of more than 2 million jobs last year, the U.S. poverty rate in 2012 remained relatively equal to the previous year, according to a new report from the U.S. Census Bureau, Income, Poverty, and Health Insurance Coverage in the United States: 2012. About 46.5 million people lived at or below the poverty line in 2012, or about 15 percent of the nation. That’s about 2.5 percentage points higher than 2007, right before the economic recession. About 48 million people were without health insurance in 2012, only slightly lower than the 48.6 million in 2011. While the recession seems to have leveled out, the fact that poverty rates have yet to truly rebound has many experts concerned. “We’re supposed to be in recovery,” said Austin Nichols, a researcher at the Urban Institute. “Poverty rates should be falling because long-term unemployment is falling. And they're not.” Read more on poverty.
Economic, Mental Toll of Economic Crisis Likely Responsible for Global Jump in Men’s Suicide Rates
The economic and mental toll of the 2008 global economic crisis was likely a major contributor to the surprising increase in the U.S. and global male suicide rates in 2009, according to a new study in the journal BMJ. There were about 5,000 more suicides than expected that year. The male suicide rate in the United States climbed almost 9 percent in the United States in 2009; the overall global rate climbed 3.3 percent, with the largest increases seen in the European Union and North and South American countries. Depression and stress can lead to increased alcohol and drug abuse, which are also suicide risk factors. The study concluded that immediate action, such as job-creation programs, may help prevent a continued increase in suicides. "Unemployment appears to lead to an increase in anxiety and depression -- two psychiatric symptoms that might be intermediate steps toward suicide," said Robert Dicker, MD, associate director of the division of child and adolescent psychiatry at North Shore-LIJ, in New Hyde Park, N.Y., who was not a part of the study. "More unemployment, more family distress, more losses [of status and friends] also most likely are involved." Read more on mental health.
Study: Two Simple Questions on Mobility Can Help Assess, Treat Older Adults’ Physical Declines
Two simple questions about mobility could help doctors more accurately assess and treat an older adult’s physical decline, according to a new study in the Journal of the American Medical Association:
- For health or physical reasons, do you have difficulty climbing up 10 steps or walking a quarter of a mile?
- Because of underlying health or physical reasons, have you modified the way you climb 10 steps or walk a quarter of a mile?
The answers could help determine whether physical therapy or mobility-assistance devices are needed. The findings emphasize the importance of increased physical activity and exercise in health aging, according to Cynthia Brown, MD, of the division of gerontology, geriatrics and palliative care at the University of Alabama at Birmingham. "With an increasing older population in the United States, it is incumbent on us to find ways to help older Americans continue to live well and independently,” she said. “The major barriers—lack of physical activity, obesity and smoking—are all risk factors that can be successfully overcome with appropriate treatment and assistance." Read more on aging.
Public Health Accreditation Board Awards National Accreditation to Five High-Performing Health Departments
The Public Health Accreditation Board (PHAB) this week awarded five-year national accreditation status to five more public health departments. The decisions bring the number of public health agencies now recognized by PHAB as high-performing health departments to 19. PHAB is the independent organization that administers the national public health accreditation program, which aims to improve and protect the health of the public by advancing the quality and performance of the nation’s Tribal, state, local and territorial health departments.
Accreditation status was awarded Aug. 20 to:
- Central Michigan District Health Department, Mount Pleasant, Mich.
- Chicago Department of Public Health, Chicago, Ill.
- El Paso County Public Health, Colorado Springs, Colo.
- Kansas City Missouri Health Department, Kansas City, Mo.
- Tulsa Health Department, Tulsa, Okla.
Read more on accreditation.
Needlestick, Sharps-related Injuries Cost Health Care Industry $1B Every Year
Improved safety-engineered devices, combined with better education and techniques, could save the health care industry more than $1 billion in preventable costs every year, according to a Safe in Common review of U.S. healthcare industry statistics. With approximately 1,000 skin puncture injuries per day in U.S. hospitals, needlestick and sharps-related injuries affect more than half a million health care personnel every year—both physically and emotionally. "The desperate need for attention to the risk of needlestick injuries and their dangerous implications for both patients and personnel are startling when you look directly at the impact to healthcare costs," said Safe in Common chairperson Mary Foley, PhD, RN. "Learning how to permanently prevent these types of injuries—with more education and the introduction of advanced safety devices—will ultimately reduce a significant cost burden and, most importantly, the pain and emotional trauma that the needlestick victims and their families are enduring." Read more on prevention.
Study: Volunteering Linked to Greater Happiness, Longer Lives
Volunteering is not only linked to greater happiness and improved mental health, but could also help people live longer, according to a new study in the journal BMC Public Health. The analysis of 40 published studies found that volunteers had a 20 percent lower risk of death, as well as lower levels depression and increased satisfaction with their lives. "It is still unclear whether biological and cultural factors and social resources that are often associated with better health and survival are also associated with a willingness to volunteer in the first place,” said leader Suzanne Richards, PhD, of the University of Exeter Medical School in England. "The challenge now is to encourage people from more diverse backgrounds to take up volunteering, and then to measure whether improvements arise for them," she explained. People often cite a desire to give back to their community as a reason for volunteering; gaining work experience and meeting new people are also popular reasons. Approximately 27 percent of U.S. adults and 23 percent of European adults actively volunteer. Read more on aging.
New Tools from DOT to Help Keep Pedestrians Safe
The U.S. Department of Transportation has released a new set of tools to help communities reverse a rise in pedestrian deaths in the last two years. As part of the campaign, the National Highway Traffic Safety Administration (NHTSA) is making $2 million in pedestrian safety grants available to cities with the highest rate of pedestrian deaths. States have until August 30 to apply for the grants. In addition, NHTSA and the Federal Highway Administration have launched a new website that includes pedestrian safety tips and resources for community officials, city planners and community residents. According to NHTSA data, 4,432 pedestrians were killed in traffic crashes in 2011. That’s an 8 percent increase since 2009. Three out of four pedestrian deaths occurred in urban areas and 70 percent of those killed were at non-intersections. The data also shows that 70 percent of deaths occurred at night and many involved alcohol. Read more on injury prevention.
National Farmers Market Week
In observance of National Farmers Market Week, the U.S. Department of Agriculture (USDA) has released data showing that that 8,144 farmers market are now listed in USDA's National Farmers Market Directory, up from about 5,000 in 2008. The agency has also announced that the Food and Nutrition Service has increased the number of farmers markets able to accept SNAP (Supplemental Nutrition Assistance Program) payments, which will improve access to fresh produce for SNAP recipients. Currently, more than 3,800 farmers markets are authorized to accept SNAP in FY 2012, and farmers markets generate more than $16 million in SNAP sales. Read more on nutrition.
Researchers Create Home Safety Self-Assessment Tool to Help Prevent Falls
One in three adults ages 65 and older suffer falls every year—many at home, since more seniors are continuing to live in their homes as they grow older. To help prevent falls, researchers and occupational therapists at the University at Buffalo SUNY School of Public Health and Health Professions have created the Home Safety Self-Assessment Tool which details ways to prevent falls. The tool includes safety tips and checklists for each room of a home, including common hazards such as area rugs, which account for many home falls when people catch a shoe heel at the edge. Read more on aging.
Much Like Television, Excessive Cell Phone Use Lowers Fitness Levels
Are you reading this on your smartphone? If so, it’s probably not doing your weight any good. A new study in the International Journal of Behavioral Nutrition and Physical Activity has linked cell phone use by college students to decreased physical activity and fitness levels. Much like watching television, cell phone use is a largely sedentary activity that is easy to get lost in. It can also lead to casual overeating. Researchers found the average student spent about five hours on the phone each day and sent hundreds of text messages. "We have to look at this similar to what happened in the industrial revolution and how it changed us," said Nancy Copperman, director of public health initiatives at North Shore-LIJ Health System, in Great Neck, N.Y. "A study like this raises the importance of how this technology affects how we move, eat and sleep. We have to look at the impact of technology on our health." Read more on technology.
Study Links Bipolar Disorder, Early Death
A new study showing that people with bipolar disorder are more likely to die early and from a variety of causes also illustrates the difficulty of treating the physical effects of the illness. "Whatever we're doing, these people are not dying (just) because of suicide. That's not the reason for increased mortality. That's a hard thing to get across," said David Kupfer, PhD, a professor of psychiatry at the University of Pittsburgh School of Medicine, who was not a part of the study. The study found that people with bipolar disorder—an estimated 1 to 5 percent of the global population—die about nine years earlier and are at higher risk for heart disease, diabetes, chronic obstructive pulmonary disorder, the flu and pneumonia. However, people who knew they were bipolar had the same death rates as those who were not, which suggests "that timely medical diagnosis and treatment may effectively reduce mortality among bipolar disorder patients to approach that of the general population," according to the study. Read more on mental health.
One Dose of ADHD Medication Improves Balance in Older Adults
A single dose of an attention deficit/hyperactivity disorder (ADHD) medication can improve the balance of older adults who have difficulty walking, according to a new study in The Journals of Gerontology. Methylphenidate (MPH) is also used to treat narcolepsy. Researchers at Ben-Gurion University of the Negev found that it can reduce the number and rate of step errors in both single and dual tasks. "Our results add to a growing body of evidence showing that MPH may have a role as a therapeutic option for improving gait and reducing fall risk in older adults," said Itshak Melzer of BGU's Schwartz Movement Analysis and Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences. "This is especially true in real-life situations, where the requirement to walk commonly occurs under more complicated, 'dual task' circumstances with cognitive attention focused elsewhere (e.g., watching traffic, talking) and not on performing a specific motor task." Read more on aging.
Study: The Longer People Are Obese, the Greater Their Risk for Heart Disease
At a time when obesity rates for both U.S. adults and children are rising, new research indicates that the longer someone is obese, the greater their risk for heart disease. The study appeared in the Journal of the American Medical Association. "Each year of obesity was associated with about a 2 to 4 percent higher risk of subclinical coronary heart disease," said study lead author Jared Reis, an epidemiologist with the U.S. National Heart, Lung, and Blood Institute. "Those with longest duration of both overall obesity and abdominal obesity tended to have the highest risk [for subclinical disease].” Subclinical heart disease includes arterial damage indicated by markers such as calcium buildup on arterial walls, but which “has not yet developed into symptomatic illness,” according to HealthDay. The study is yet more evidence of the need to focus on the prevention and treatment of childhood obesity, according to the researchers. Read more on heart health.
EHRs Would Help Doctors’ Offices Cut Costs Slightly
Doctors’ offices that utilize electronic health records (EHRs) will spend less per patient than offices that use traditional paper records, according to a new study in the journal Annals of Internal Medicine. While the savings is expected to be small—about $5 per patient per month—they will add up over time. With a government commitment of about $30 billion for the widespread adoption of EHRs, the hope is the decrease in inefficiencies, incorrect care and errors will lead to better, cheaper health care. Previous studies have shown conflicting results. Rainu Kaushal, MD, who wrote an editorial that accompanied the study, said that while she does not expected the EHRs to contribute significantly to cost savings, their adoption is still vital. "EHRs may or may not directly contribute to those savings… but without investing in them you cannot achieve new models of healthcare delivery," said Kaushal, director of the Center for Healthcare Informatics and Policy at Weill Cornell Medical College in New York. Read more on technology.
No Evidence of Benefits of Community-wide Dementia Screening
New research has found no proof that there are any clinical, economic or emotional benefits to programs that use community-wide screening to identify people with dementia. "We found no evidence that population screening would lead to better clinical or psychosocial outcomes, no evidence furthering our understanding of the risks it entails and no indication of its added value compared to current practice," said author Carol Brayne, a professor of public health medicine from Cambridge Institute of Public Health, in the United Kingdom. The debate over the strategy’s efficacy has been going on for quite some time, with one side noting that there isn’t even a cure for Alzheimer’s disease, and the other noting that as many as half of the people with dementia remain undiagnosed. The researchers, however, did emphasize that family and friends should be aware of the warning signs of dementia so they can help loved ones get treatment. Read more on community health.
The final plenary session at this year’s NACCHO Annual included a talk by Christopher Murray, MD, DPhil, director of the Institute for Health Metrics and Evaluation at the University of Washington on how data is used to measure health, evaluate interventions and find ways to maximize health system impact. Dr. Murray was a lead author on three pivotal studies published last week that used data to assess the state of health in the United States compared with 34 other countries and county level data on diet and exercise. One of the key findings is that Americans are living longer, but not necessarily better—half of healthy life years are now lost to disability instead of mortality; and dietary risks are the leading cause of U.S. disease burden.
NewPublicHealth spoke with Dr. Murray about the study findings, their impact and upcoming research that can add to the data public health needs to improve the health of all Americans.
NewPublicHealth: Tell us about the three studies that were published this week using the Institute’s research.
Dr. Murray: The study in JAMA [Journal of the American Medical Association] is an analysis of a comprehensive look at the health of the United States in comparison to the 34 OECD [Organisation for Economic Co-operation and Development] countries. The study looks at both causes of death and premature mortality through over 290 different diseases and puts them all together in a comprehensive analysis of what the contributors are to lost healthy life. That study also looks at the contribution to patterns of health in the U.S., from major environmental, behavioral, and metabolic risk factors. In each of those categories, there are important findings:
- The U.S. spends the most on healthcare but has pretty mediocre outcomes and ranks about 27th for life expectancy among its peer countries.
- For many large, important causes of premature death, the U.S. does pretty poorly. And we also see a big shift towards more and more individuals having major disability—from mental disorders, substance abuse, and bone and joint disease.
- On the risk factor front, the big surprise is that diet is the leading risk factor in the U.S. It is bigger than tobacco, which is second and then followed by obesity, high blood pressure, high blood sugar, and physical inactivity. Diet in this study is made up of 14 subcomponents, each analyzed separately and then put together.
Gulf States Partner with East, Midwest States to Share Health Records After Disasters
Four Gulf Coast states have partnered with six East and Midwest states to help ensure that patients and providers have access to health records in the event of hurricanes or other major disasters, according to the U.S. Department of Health and Human Services. In concert with the Department of Health and Human Services Office of the National Coordinator for Health IT, health information exchange (HIE) programs in Alabama, Georgia, Louisiana, Florida, South Carolina, North Carolina, Virginia, Michigan, Wisconsin and West Virginia will share information on residents forced to move from their homes because of a disaster. “Through disasters like Hurricane Katrina and Hurricane Sandy and large tornadoes in Alabama and Joplin, Missouri, in 2011 and more recently in Moore, Oklahoma, we have learned the importance of protecting patients’ health records through electronic tools like health information exchanges,” said Farzad Mostashari, MD, national coordinator for health IT. “Patients are better off when states and health information exchange organizations work together to ensure that health information can follow patients when they need it the most.” Read more on preparedness.
Physical Punishment of Kids Tied to Obesity, Other Adult Health Problems
Obesity and other health problems are more likely in children who are punished through violence such as pushing, shoving and slapping, according to a study in the journal Pediatrics. Previous studies have also connected violent discipline with negative mental health outcomes. Researchers found that people who were punished physically “sometimes”—without more extreme physical or emotional abuse—were 25 percent more likely to have arthritis and 28 percent more likely to suffer from cardiovascular disease. About 31 percent of those punished physically were obese; about 26 who were not punished physically were obese. "Changes in sleep, risk-taking behaviors, immune functioning and regulation of stress hormones that result from chronic or intense stress may be important factors," said Michele Knox, a psychiatrist who studies family and youth violence at the University of Toledo College of Medicine, who was not involved in the study. "If we want what's best for our children, we need to choose discipline that does not come with these risks.” Read more on violence.
Putting Off Retirement May Also Help Put Off Alzheimer’s
Staying longer in the workforce may help decrease the risk of Alzheimer’s disease, according to new research looking at more than 429,000 workers in France. It found a 3 percent reduction in risk for each extra year at the age of retirement. The study is to be presented today at an Alzheimer's Association conference in Boston. About 5.2 million U.S. adults live with Alzheimer’s and it is the country’s sixth-leading cause of death. "There's increasing evidence that lifestyle factors such as exercise, mental activities, social engagement, positive outlook and a heart-healthy diet may reduce the risk of developing Alzheimer's disease and other forms of dementia," said James Galvin, MD, director of the Pearl Barlow Center for Memory Evaluation and Treatment at the NYU Langone School of Medicine, who was not involved with the research. "Now we can add staying in the workforce to this list of potential protective factors." About one-third of U.S. adults earning less than $100,000 annually said they would need to work until the age of 80 to retire comfortably, according to a 2012 Wells Fargo survey of 1,000 Americans. Read more on aging.
Study: Americans Living Longer…But Not Necessarily Healthier
A new study in the Journal of the American Medical Association paints a broad, sweeping picture of life expectancy and health in the United States, finding that while people are living long in general, they’re also spending more of their lives in poor health as illnesses that used to lead to early deaths have been replaced with chronic conditions. The overall average U.S. life expectancy in 2010 was 78.2 years. The new findings are part of the Global Burden of Disease Study, which is a collaboration of 488 researchers in 50 countries. "It's rare these days that you get information or studies that give you the big picture," said study author Christopher Murray, MD, director of the Institute for Health Metrics and Evaluation at the University of Washington, in Seattle. "It's pretty uncommon to step back and say, 'What does all the evidence tell us about the most important health problems, and where does the U.S. fit in that landscape?'" While the United States has been making improvements, they’ve not been coming as quickly as they have in other countries. The main causes of earlier death in the country are heart disease, lung cancer, stroke, chronic obstructive pulmonary disease and road injuries, and the top causes of disability are lower back pain, depression and other musculoskeletal disorders. Read more on global health.
Five Daily Servings of Fruits, Vegetables Tied to Longer Lives
Eating plenty of fruits and vegetables is directly tied to living a longer life, according to a new study in the American Journal of Clinical Nutrition. Researchers found that consuming fewer than five servings a day—the recommended amount by many public health organizations—was tied to a higher chance of early death. They did not find that people who consumed more than the recommended level saw greater returns. They also found that while people who ate fewer fruits and vegetables were more likely to smoke, to eat more red meat, to eat high-fat dairy products and to be undereducated, the overall study results did not change even after accounting for gender, smoking, exercise, alcohol consumption and body weight. Read more on nutrition.
Red Cross: Emergency Call for Blood, Platelet Donations
A recent drop in blood donations has led the American Red Cross to issue an emergency request for more donors of all blood types. Donations were down about 10 percent in June and more is needed to ensure enough blood and platelets for the summer months. "We're asking for the public's help now to prevent a more serious shortage," said spokesperson Stephanie Millian in a release. "Each day donations come up short, less blood is available for patients in need. It's the blood products on the shelves today that help save lives in an emergency." To see if you are eligible to make a donation or to make an appointment either call 1-800-RED CROSS (1-800-733-2767) or go to RedCrossBlood.org. Read more on preparedness.
Just a few metro stops can mean the difference between an extra five to ten years added to your lifespan. Using new city maps, the Commission to Build a Healthier America, which reconvened recently after a four year hiatus, is illustrating the dramatic disparity between the life expectancies of communities mere miles away from each other. Where we live, learn, work and play can have a greater impact on our health than we realize.
For too many people, making healthy choices can be difficult because the barriers in their communities are too high—poor access to affordable healthy foods and limited opportunities for exercise, for example. The focus for the Commission’s 2013 deliberations will be on how to increase opportunities for low-income populations to make healthier choices.
The two maps of the Washington, D.C. area and New Orleans help to quantify the differences between living in certain parts of the region versus others.
Living in Northern Virginia’s Fairfax and Arlington Counties instead of the nearby District of Columbia, a distance of no more than 14 miles, can mean about six or seven more years in life expectancy. The same disparity exists between babies born at the end of the Washington Metropolitan Transit Authority’s (known as the Metro) Red Line in Montgomery County—ranked second out of 24 counties in the County Health Rankings, metrics developed by the Robert Wood Johnson Foundation and the University of Wisconsin to show the health of different counties—and those born and living at the end of the Metro’s Blue Line in Prince George’s County, which ranked 17th in the County Health Rankings.