Category Archives: Cancer
Poison Prevention Week 2014
March 16-24 is Poison Prevention Week this year, and an important opportunity to remind health officials and consumers about the resources provided by the National Poison Prevention Program and Hotline (1-800-222-1222). The National Poison Control Program is a program of the Health Resource Services Administration (HRSA). Programs include:
- Poison centers serving all states, Puerto Rico, the District of Columbia, Guam, the Federated States of Micronesia and American Samoa.
- A single, national toll-free number (1-800-222-1222) that connects callers with the poison center serving their area.
- A nationwide media campaign to educate the public and health care providers about poison prevention, poison center services and the 1-800 number.
- Programs to support the enhancement and improvement of poison education, prevention and treatment.
- Partnership development with other federal agencies and national organizations to advance poison prevention awareness.
- Development of uniform patient management guidelines so that poison centers can provide uniform treatment recommendations.
- Improvement of data collection systems and toxic exposure surveillance for enhanced capability to capture national poisoning data.
- Multilingual interpreter service in 161 languages to anyone who calls the 1-800 number.
Colon Cancer Incidence Rates Decreasing Steeply in Older Americans
Colon cancer incidence rates have dropped 30 percent in the United States in the last 10 years among adults 50 and older because of the widespread use of colonoscopies, according to a new study in CA: A Cancer Journal for Clinicians. The largest decrease has been in people over age 65. Colonoscopy use has almost tripled among adults ages 50-75, from 19 percent in 2000 to 55 percent in 2010. The study relied on data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the U.S. Centers for Disease Control and Prevention's National Program of Cancer Registries.
The "larger declines among Medicare-eligible seniors likely reflect higher rates of screening because of universal insurance coverage," according to the study authors. Mortality rates from colon cancer have also declined most rapidly within the past decade. From 2001 to 2010, death rates from colon cancer decreased by approximately 3 percent per year in both men and women, compared with declines of approximately 2 percent per year during the 1990s. The data is being released as the U.S. Department of Health and Human Services launches a nationwide effort to increase colorectal cancer screening rates to 80 percent by 2018. Read more on cancer.
DOT Proposed Rules on Electronic Log Books for Large and Bus Drivers to Help Reduce Fatalities and Injuries
The U.S. Department of Transportation (DOT) has announced a proposal to require interstate commercial truck and bus companies to use Electronic Logging Devices (ELDs) in their vehicles to improve compliance with the safety rules that govern the number of hours a driver can work. According to DOT, the proposed rule will ultimately reduce hours-of-service violations by making it more difficult for drivers to misrepresent their time on logbooks and—significantly—help reduce crashes by fatigued drivers and prevent approximately 20 fatalities and 434 injuries each year, for an annual safety benefit of $394.8 million. Impaired driving, including fatigue, was a factor in more than 12 percent of the 129,120 total crashes that involved large trucks or buses in 2012. Read more on injury prevention.
New Report on US Cancer Care Finds Significant Cost and Quality Challenges
A new report from the American Association of Clinical Oncology (ASCO) finds that several factors including an aging population and poor lifestyle habits in the United States have resulted in an increase in annual cancer cases at the same time many smaller oncology practices are closing because of financial pressures. "We're facing a collection of challenges, each one of which could keep cancer treatment advances out of reach for some individuals," said ASCO President Clifford A. Hudis, MD.
ASCO’s recommendations include:
- Support for novel cancer care delivery efforts.
- Development of new healthcare delivery and payment models to help ensure the viability of small community practices while encouraging high-quality care.
- Support for quality initiatives that will speed up dissemination of cancer treatment breakthroughs and changes.
Read more on cancer.
Spring Break Highlights Dangers of Binge Drinking
The average male Spring Breaker reports drinking 18 alcoholic drinks per day during the week-long festivity, while the average female reports up to 10 drinks, according to the American College of Health. Five or more drinks within two hours qualify as “binge drinking” for men and four or more qualifies for women. Each year 1,825 college students ages 18-24 die from alcohol-related unintentional injuries, with alcohol poisoning among the biggest causes. Signs of alcohol poisoning include irregular breathing, vomiting, confusion and unconsciousness, and should be met with an immediate trip to the emergency room.
Among the other unintentional injuries:
- Assault — More than 690,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking.
- Sexual Abuse — More than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape.
- Injury — 599,000 students between the ages of 18 and 24 receive unintentional injuries while under the influence of alcohol.
Read more on alcohol.
Mass Analysis Confirms Link Between Bullying, Suicidal Thoughts
A new review of 43 previous studies seems to confirm the link between bullying and an increase in suicidal thoughts, with cyber bullying linked the most strongly. The study appears in JAMA Pediatrics and included data on approximately 350,000 youths. Approximately half of students in grades 4-12 report being bullied within the previous month, with one-third saying they were bullies themselves. While the new analysis does not demonstrate causation, it does indicate a more complex connection, perhaps even showing that kids with suicidal thoughts in the first place are more likely to be bullied. Read more on violence.
CDC: Reducing High-risk Antibiotic Prescriptions Could Also Reduce Deadly Infections
The most recent Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC) finds that if prescriptions of high-risk antibiotics in hospitals were reduced by just 30 percent, then there could be as many as 26 fewer cases of deadly diarrhea infections with Clostridium difficile. “Improving antibiotic prescribing can save today’s patients from deadly infections and protect lifesaving antibiotics for tomorrow’s patients,” said CDC Director Tom Frieden, MD, MPH. “Health care facilities are an important part of the solution to drug resistance and every hospital in the country should have a strong antibiotic stewardship program.” As part of its ongoing efforts to improve antibiotic prescribing, the CDC has release a checklist of seven core elements for hospitals:
- Leadership commitment: Dedicate the necessary human, financial, and IT resources.
- Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
- Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
- Act: Take at least one prescribing improvement action, such as requiring reassessment of prescriptions within 48 hours to check drug choice, dose, and duration.
- Track: Monitor prescribing and antibiotic resistance patterns.
- Report: Regularly report prescribing and resistance information to clinicians.
- Educate: Offer education about antibiotic resistance and improving prescribing practices.
Read more on infectious diseases.
Poorer Women Most Likely to Be Caught in ‘Vicious’ Caregiving, Financial Well-being Cycle
Low-income women are at increased risk of finding themselves caught in a “vicious cycle” of parental caregiving and financial well-being, according to a new study in The Journals of Gerontology. While women of better financial means can afford additional caregiver assistance and better health care for aging parents, poorer women lack those options. "People who had less household income and less financial resources were more likely to take care of their parents so there is this cycle that they cannot get out of—they are poor, then taking care of parents, then being poor and taking care of their parents—there's this kind of cycle," said lead author Yeonjung Lee, a researcher and professor at the Faculty of Social Work at the University of Calgary in Alberta, Canada, according to Reuters. Read more on aging.
Young Skin Cancer Survivors at Heightened Risk for Other Cancers
Younger skin cancer survivors are at increased risk for additional cancer types later in life, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention. A review of data of more than 500,000 people with a history of nonmelanoma skin cancer found that while all age groups were at heightened risk for melanoma and other types of cancers, the increase was especially significant for people under the age of 25, who were 23 times more likely to develop cancer than people who had never had nonmelanoma cancer. The risk was 3.5 times higher for nonmelanoma survivors ages 25-44, 1.74 times higher for those ages 45-59 and 1.32 times higher for those older than 60. The types of cancer they are at risk for include melanoma skin cancer, and cancers of the breast, colon, bladder, liver, lung, brain, prostate, stomach and pancreas. Read more on cancer.
Several leading cancer organizations recently formed a think tank to address health disparities in cancer research with the goal of improving treatment access and outcomes for underserved populations. “Closing the inequality gap will not happen easily, and won’t get done if any of us goes it alone," said Otis W. Brawley, MD, chief medical officer of the American Cancer Society (ACS), one of four groups involved, in addition to the American Association for Cancer Research (AACR); the American Society of Clinical Oncology (ASCO); and the National Cancer Institute (NCI), a branch of the National Institutes of Health (NIH).
“Cancer mortality rates are decreasing for most minorities, but absolute death rates continue to be higher," said NCI Deputy Director Doug Lowy, MD. Lowy adds that it’s important to understand the sources of the disparities in order to reduce them.
The goal of the collaboration is to address the fact that that some racial and ethnic minorities in the United States are more likely to develop cancer, less likely to access high-quality cancer care and more likely to die from cancer when compared to others and to whites. For example, the death rate for cancer among African-American males is 33 percent higher than among white males, and the rate for African-American females is 16 percent higher than it is for white females.
“We must move from describing the problems to more quickly identifying and implementing solutions to address the racial and economic-based disparities that continue to affect many cancer patients and families in the United States,” said ASCO president Clifford A. Hudis, MD.
NewPublicHealth recently spoke with Hudis about the new collaboration.
NewPublicHealth: What key issues help explain—and then overcome—differences in cancer incidence and severity among different populations?
Clifford A. Hudis: We can’t completely disentangle environmental factors, which include nutrition, access to care, general health behaviors, exercise and education, which relates to behaviors such as tobacco use. And of course underlying that is the socioeconomic status. But there also is a burgeoning understanding of the role of genetic variations that may be clustered in various populations and may influence things such as drug metabolism and diseases.
Study: Increasing Young Men’s Knowledge of Emergency Contraception Could Increase Access, Use
Increasing young men’s knowledge of emergency contraception could increase access to the drug and help prevent unwanted pregnancies, according to a new study in Journal of Family Planning and Reproductive Health Care. Emergency contraception, commonly known as "the morning after pill," prevents pregnancy after unprotected sex or when other methods of contraception fail. Nine U.S. states allow pharmacists to dispense emergency contraception without a prescription under certain conditions. The study gauged the knowledge of 101 males and 97 females ages 18 to in 2008 and 2009. "About half of the women understood basic facts about emergency contraception, how you get it, how you use it, and the fact that male partners were also able to buy it over-the-counter for their female partners," said Sheree Schrager, a member of the study team and a researcher at Children's Hospital Los Angeles, California. “But young men had significantly lower knowledge then the young women did, and this is an opportunity for providers to reach out to young men in the hopes of reaching more young women to use emergency contraception.” According to the researchers, unplanned pregnancies are more common in poor communities, where there are also greater health and economic consequences. Read more on sexual health.
U.S., Global Partners to Joint in Prevention, Detection and Response to Infectious Disease
The United States has joined with 26 countries and other global partners to, over the next five years, work to prevent, detect and effectively respond to naturally occurring, accidental and intentional infectious disease threats. Additional partners in the Global Health Security Agenda include the World Health Organization (WHO), the Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE). “While we have made great progress in fighting and treating diseases, biological threats can emerge anywhere, travel quickly, and take lives,” said Lisa Monaco, Assistant to the President for Homeland Security and Counterterrorism. “The recent outbreaks of H7N9 influenza and Middle East Respiratory Syndrome are reminders of the need to step up our efforts as a global community. The Global Health Security Agenda is about accelerating progress toward a world safe and secure from infectious disease threats.” The U.S. Centers for Disease Control and Prevention (CDC) has pledged $40 million in FY 2014 to advancing Global Health Security Agenda objectives, and its FY 2015 budget will include an additional $45 million to prevent avoidable catastrophes, detect threats early and mobilize effective responses to contain outbreaks. Read more on global health.
CDC: States with Indoor Tanning Laws See Far Less Use by Female High School Students
States with indoor tanning laws—especially those requiring parental permission or setting age restrictions—see lower rates of indoor tanning by female high school students, according to a new study in the American Journal of Public Health. The study was conducted by the U.S. Centers for Disease Control and Prevention. Studies have connected the increased exposure to ultraviolet radiation from indoor tanning to increased risk of melanoma; each year the United States sees 60,000 new melanoma diagnoses and approximately 3.5 million treatments for nonmelanoma skin cancer. The study determined that the odds of female students engaging in indoor tanning in states with any indoor tanning laws were 30 percent less than those in states without such laws, and that the odds in states with systems access, parental permission and age restriction laws were 42 percent less than those in states without any laws. “State indoor tanning laws, especially age restrictions, may be effective in reducing indoor tanning among our nation’s youth,” said Gery Guy, PhD, health economist and the study’s lead author. “We need to address the harms of indoor tanning, especially among children. Indoor tanning laws can be part of a comprehensive effort to prevent skin cancers and change social norms around tanned skin.” Read more on cancer.
Looking for powerful ways to save I love you?
- Send ecards reminding those you love to get a flu shot, make a preparedness plan and wash their hands, courtesy of the American Public Health Association.
- Learn about your own—and loved one’s—risk of heart disease and stroke.
- One in ten teens reports being physically hurt by a boyfriend or girlfriend. Find out how to help prevent teen dating violence.
- Learn the signs of heart attack, stroke and cardiac arrest.
Read more on heart health.
American Society of Clinical Oncology Weighs in on Mammography
In response to a study published this week in the British Medical Journal which called into question the benefit of mammography, the American Society of Clinical Oncology (ASCO) issued a statement today saying that because mammography is similar to many other tests that can detect a condition that may never cause harm, the benefits of screening are likely to be greater for women who are at increased risk of developing breast cancer based on factors such as age and family history, than for women at average risk. It also stated no single study should be used to change screening policy and that all women should be encouraged to speak with their doctors about their personal risk for breast cancer, as well as the potential benefits and harms of mammography screening. ASCO and other cancer advocacy and women’s health groups have announced that they will be monitoring additional mammography studies now being conducted, and the American Cancer Society is expected to release new mammography recommendations later this year. Read more on cancer.
NHTSA Announces New Mandatory Label to Help Owners Instantly Identify Recall Mailings
The U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) today announced that starting February 18, all manufacturers must use a distinctive label on the agency’s required mailings that notify owners of recalled vehicles or equipment.
The requirement was introduced to help owners instantly distinguish important recall notices arriving in their mailboxes from other mail and hopefully avoid mistakenly discarding the safety notices. NHTSA has also just launched the SaferCar app for Android devices that will provide information for car owners and shoppers, including recalls and safety performance. There is already a SaferCar app for iPhone, iPad and iPod Touch users. Other safety notification options from NHTSA include:
- Register Your Cars, Tires and Car Seats: Receive NHTSA email notifications when there is a recall by the federal government. There is no way to locate or notify individual owners of car seats or tires if the product is not registered with the manufacturer or NHTSA.
Check for Open Recalls on Used Cars: Verify with the previous owner or dealer whether a used car has been fixed by using www.safercar.gov, which provides a general search tool to help consumers identify recalls that may affect their vehicle.
Read more on transportation.
Minimum Alcohol Prices Could Help Low-income, High-risk Drinkers
Setting a minimum price for alcohol would have a positive impact on low-income, high-risk drinkers, but little effect on low-income, moderate drinkers, according to a new study in The Lancet. British researchers at the University of Sheffield utilized a computer model to assess the impact of a 73 cents per unit of alcohol minimum on different demographics, finding it would have the greatest positive impact—reducing the amount of alcohol consumption—on the 5 percent of the population defined as high-risk drinkers. "Our study finds no evidence to support the concerns highlighted by government and the alcohol industry that minimum unit pricing would penalize responsible drinkers on low incomes,” said study co-author Petra Meier, director of the Sheffield Alcohol Research Group. “Instead, minimum unit pricing is a policy that is targeted at those who consume large quantities of cheap alcohol. By significantly lowering rates of ill health and premature deaths in this group, it is likely to contribute to the reduction of health inequalities." Read more on alcohol.
Smoking Linked to Most Common Type of Breast Cancer
Adding yet another health risk to the use of tobacco, smoking is linked to an increased risk for the most common type of breast cancer, according to a new study in the journal Cancer. Researchers at the Fred Hutchinson Cancer Research Center in Seattle conducted a population-based study of 778 patients, ages 20-44, with estrogen receptor positive breast cancer (the most common type) and 182 patients with triple-negative breast cancer; there were 938 cancer-free controls. They found that women who were current or recent smokers and had been smoking a pack a day for at least 10 years had a 60 percent increased risk of estrogen receptor positive breast cancer. "The health hazards associated with smoking are numerous and well known. This study adds to our knowledge in suggesting that with respect to breast cancer, smoking may increase the risk of the most common molecular subtype of breast cancer but not influence risk of one of the rarer, more aggressive subtypes," said Christopher Li, MD, PhD. Read more on cancer.
Low Testosterone Drugs Can Double Heart Attack Risk in Some Men
Ads asking men about their “low T”—or low testosterone levels—have become so common of late that in 2013 sales of the testosterone gel Androgel exceeded those of Viagra. However, a recent study indicates that men under the age of 65 with a history of heart disease see their heart attack risk double shortly after beginning testosterone therapy. The joint study from the UCLA Fielding School of Public Health, the National Institutes of Health and Consolidated Research Inc. appears in the journal PLOS ONE. Researchers decided to perform this larger study after three smaller studies raised concerns about the connection. "We decided to investigate cardiovascular risks of this therapy in a large health care database since these previous studies were modest in size and only focused on men 65 and older," said the study's senior author, Sander Greenland, MD, a professor of epidemiology at the UCLA Fielding School of Public Health and a professor of statistics in the UCLA College of Letters and Science. "Our study allowed us to examine cardiovascular risk in men under the age of 65 and to replicate the findings in men over 65." Read more on heart health.
CDC Report Details Support of State, Local Health Responses
The U.S. Centers for Disease Control and Prevention (CDC) has released a new report detailing its support of state and local public health responses from 2012 to 2013, as well as assessments of all state and select local public health preparedness. The 2013-2014 National Snapshot of Public Health Preparedness is the sixth annual report from CDC’s Office of Public Health Preparedness and Response. “The lives protected by the public health response to Hurricane Sandy, the fungal meningitis outbreak, and the tornadoes in Joplin are just a few examples of how communities and CDC can work together to protect the public's health when its needed most,” said CDC Director Tom Frieden, MD, MPH.
Among the report’s highlights:
- During outbreaks and emergencies, response time is essential. In 2012, lead state responders reported for immediate duty within 27 minutes of receiving notification of a potential public health emergency—9 minutes faster than the 2011 national average.
- In 2012, across the 62 Public Health Emergency Preparedness (PHEP) cooperative agreement awardees, Emergence Management Program (EMP) activities included 185 engagements and 204 exercises. Internationally, EMP activities across 35 countries included 15 activations, 19 engagements, and 12 exercises.
- The percentage of E. coli-positive tests analyzed and entered into the PulseNet database within four working days increased from 90 percent to 94 percent and timely testing and reporting of Listeria-positive results increased from 88 percent to 92 percent.
“The ability of our local and state health departments to be innovative and maintain a steady level of preparedness despite extensive budget cuts is reassuring,” said Ali Khan, M.D., M. P. H., director CDC’s Office of Public Health Preparedness and Response. “However, preventing an erosion of our nation’s health security will be difficult in the current fiscal environment.” Read more on preparedness.
Study: Overweight Kindergarteners Four Times as Likely to Be Overweight Teens
Children who are overweight at the age of five are four times as likely to be obese by the age of 14 than are children who start their school years at an average weight, according to a new study in the New England Journal of Medicine. Approximately 27 percent of the five-year-olds in the study were overweight. Using data on almost 8,000 children gathered by the Early Childhood Longitudinal Study conducted by the U.S. National Center for Education Statistics, researchers determined that:
- Approximately 32 percent of kids who were overweight when they entered kindergarten had become obese by age 14, compared to 8 percent of normal-weight kindergarteners.
- The obesity rate rose most rapidly between first and third grades—from 13 percent to almost 19 percent—but not significantly between fifth and eighth grades.
- Between kindergarten and eighth grade, the prevalence of obesity rose by 65 percent among white children, 50 percent among Hispanic children and more than doubled among black children.
"If we're just focused on improving weight when kids are adolescents, it may not have as much of an impact as focusing on the preschool-age years," said lead researcher Solveig Cunningham of Emory University, adding that the study "doesn't tell us what to do about it, but it helps tell us when we need to think creatively about what to do." Read more on obesity.
Study: One-third of Americans, Two-Thirds of University Students Have Used Indoor Tanning
Despite clear and widespread data on their link to skin cancer risk, more than a third of Americans and nearly two-thirds of U.S. university students have used indoor tanning, according to a new study in the journal JAMA Dermatology. Approximately 19 percent of teens had also used the machines. Researchers at the University of California, San Francisco based their conclusions on an analysis of 88 surveys covering more than 406,000 people in the United States, Europe and Australia. "It is appalling how often exposure to indoor tanning takes place in presumably educated populations and particularly worrisome that we allow adolescents to be exposed to this carcinogen," said Mark Lebwohl, MD, chairman of the department of dermatology at Mount Sinai Hospital in New York City. "We must do a much better job at educating people of all ages about the risks of indoor tanning.” Read more on cancer.
Survey: Latinos See Diabetes as Greatest Family Health Concern
A new NPR/Robert Wood Johnson Foundation/Harvard School of Public Health poll found that Latinos see diabetes as the biggest health concern for their families. Almost 19 percent of Latinos surveyed cited diabetes as the top worry, including across both immigrant (19 percent) and non-immigrant (22 percent) populations. Cancer, at 5 percent, was the second-biggest concern. In addition to health and health care, the poll also asked about communities, financial situation and discrimination. According to the U.S. Centers for Disease Control and Prevention, Hispanic adults are 1.7 percent more likely than non-Hispanic whites to be diagnosed with diabetes, and 1.5 percent more likely to die from it. Read more on health disparities.
Heart Attack Patients in ER Off-Hours Seeing Higher Mortality Rates
Heart attack patients who present during off-hours—at night and on weekends—are more likely to die, according to a new study from the journal BMJ. Their emergency care is also more likely to take longer than it would during normal hospital hours, including inflation of the coronary artery, which can take an additional 15 minutes. After analyzed records on 1,896,859 patients, researchers at the Mayo Clinic determined that heart attack patients who present during off-hours had a 5 percent relative increase in mortality—or an additional 6,000 U.S. deaths. The study’s authors concluded that emergency departments "should focus on improving their off-hour care, with the goal of providing consistently high quality care 24 hours a day and seven days a week." Read more on heart health.
Study: HPV Vaccination Rate Remains Low, More Physician Recommendations Needed
Only 14.5 percent of girls ages 11 and 12 have received at least one does of the human papillomavirus (HPV) vaccination, with only 3 percent having completed a three-dose series, according to a new study in the American Journal of Preventive Medicine. The study from the Moffitt Cancer Center indicates that increasing the rate of physician recommendations, which so far remains low, could do much to up the vaccination rate and cut the risk of cancer. The vaccination protects against the two types of HPV that cause 70 percent of cervical cancer cases. “This study demonstrates that the change in consistent HPV vaccine recommendations to early adolescent females was modest, and for older adolescent females was virtually nonexistent, from three to five years after the vaccine became available,” explained Susan T. Vadaparampil, PhD, MPH, associate member of the Health Outcomes and Behavior Program at Moffitt. “Physician recommendation is central to increasing HPV vaccination rates because it is one of the most important predictors of whether a patient gets the HPV vaccine.” Read more on cancer.
U.S. Lung Cancer Rates Dropping for Both Men and Women
The rate of new lung cancer cases decreased among men and women in the United States from 2005 to 2009, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC), with the fastest drop among adults aged 35-44 years. The rate of decrease has been 6.5 percent per year among men and 5.8 percent per year among women. Lung cancer incidence rates decreased more rapidly among men than among women in all age groups. “These dramatic declines in the number of young adults with lung cancer show that tobacco prevention and control programs work—when they are applied,” said CDC Director Tom Frieden, MD, MPH. Lung cancer is the leading cause of cancer death and the second most commonly diagnosed cancer among both men and women in the United States, with most lung cancers attributable to cigarette smoking and secondhand smoke. Because smoking behaviors among women are now similar to those among men, women are now experiencing the same risk of lung cancer as men, according to the CDC. Read more on tobacco.
DOT to Fund New Low or No Emission Buses
The U.S. Department of Transportation (DOT) has announced funding of close to $25 million to help fund non-polluting buses in communities across the country. The funds will be awarded competitively to transit agencies and state transportation departments working either independently or jointly with bus manufacturers already making low- and zero-emission buses. According to the DOT, in addition to the environmental benefits, the new buses will also save money for transportation agencies because they can more than double the fuel economy of buses that run on diesel and other fuels. Read more on transportation.
Assistance for Paying Heat Costs
The polar vortex deep freeze much of the country experienced this past week is ending, but there are still many more weeks left of winter. People having trouble paying for heating costs can contact the National Energy Assistance Referral project at: 1-866-674-6327, e-mail firstname.lastname@example.org or access the LIHEAP website to find out where to apply for help to pay for heating costs. Read more on community health.