Category Archives: Injury Prevention

Apr 23 2014
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NewPublicHealth Q&A: Kathleen Hoke, Network for Public Health Law

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Earlier this month U.S. Department of Transportation Secretary Anthony Foxx kicked off April’s National Distracted Driving Awareness Month by announcing the department’s first-ever national advertising campaign and law enforcement crackdown in states with distracted driving bans. That effort ended last week, but through individual interactions with drivers by law enforcement and through ads on television, radio and online, the effort raised attention to the dangers—and penalties—of distracted driving, according to the National Highway Traffic Safety Administration (NHTSA.) According to NHTSA 3,328 people were killed and an estimated 421,000 were injured in distraction-related crashes in 2012, the latest year for which data is available.

"This campaign puts distracted driving on par with our efforts to fight drunk driving or to encourage seatbelt use," said Foxx.

According to NHTSA, the national campaign built upon the success of federally funded distracted driving state demonstration programs in California and Delaware, “Phone in One Hand, Ticket in the Other.” Over three enforcement waves, California police issued more than 10,700 tickets for violations involving drivers talking or texting on cell phones, and Delaware police issued more than 6,200 tickets. Observed hand-held cell phone use dropped by approximately a third at each program site, from 4.1 percent to 2.7 percent in California, and from 4.5 percent to 3.0 percent in Delaware.

Currently 43 states, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands ban text messaging for drivers of all ages; 12 states, Washington, D.C., Puerto Rico, Guam and the U.S. Virgin Islands prohibit drivers of all ages from using hand-held cell phones while driving; and 37 states and D.C. ban cell phone use by new drivers.

More state campaigns are expected to be launched, according to NHTSA. To find out more about the ability of public health laws such as laws aimed at reducing distracted driving to improve health and save lives, NewPublicHealth recently spoke with Kathleen Hoke, director of the Network for Public Health Law, Eastern Region. The Network is a program of the Robert Wood Johnson Foundation.

NewPublicHealth: In his announcement of the campaign, Secretary Foxx said that the national distracted driving reduction efforts show how public health laws can be transformative. What public health does this build on? Could this have been done if there hadn’t been a history of using laws to help improve the public’s health?

Kathleen Hoke: I think there is kind of a cycle that we see in public health using law to effectuate improvements in public health, particularly injury prevention. I know we can’t think today that there was a time that children weren’t in car seats, but there was. And what happened was there was an education campaign much like the Department of Transportation’s current campaign that was all about encouraging folks to put their children in safety seats. The law took it to a certain level, so we went from roughly 20 percent of people putting their kids in car seats to maybe 60 percent of people putting their kids in car seats.

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Apr 17 2014
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Public Health News Roundup: April 17

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Study: Banning Chocolate Milk in Elementary Schools Also Decreases Overall Sales, Increases Waste
Banning chocolate milk in 11 Oregon elementary schools and replacing it with healthier fat-free white milk had the unintended consequence of reducing milk consumption overall, according to a recent study in the journal PLOS One. The study determined that the chocolate milk ban led to a 10 percent overall drop in milk sales; a 29 percent increase in the amount of wasted milk; drops in calcium and protein intake; and a 7 percent decrease in the number of students taking part in the Eugene School District's lunch program. "Given that the role of the federal school meal program is to provide nutritious meals to students who may otherwise have no access to healthy foods, I wouldn't recommend banning flavored milk unless you have a comprehensive plan in place to compensate for the lost nutrients when kids stop drinking milk altogether,” said Nicole Zammit, former assistant director of nutrition services at the Eugene School District in Oregon, in a Cornell University news release. The study was conducted by the Cornell Food and Brand Lab. Read more on nutrition.

CDC: Significant Drops in Five Major Diabetes-related Complications
The last two decades has seen declines in five major diabetes-related complications, according to a new study in the New England Journal of Medicine. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found declining rates of lower-limb amputation (about 50 percent), end-stage kidney failure (about 30 percent, heart attack (more than 60 percent) , stroke (about 50 percent) and deaths due to high blood sugar (more than 60 percent). “These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes,” said Edward Gregg, Ph.D., a senior epidemiologist in CDC’s Division of Diabetes Translation and lead author of the study. “While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes.” A recent study determined that approximately one in 10 U.S. adults have either type 1 or type 2 diabetes. Read more on diabetes.

FDA Sees Rising Number of Cases of Injuries Linked to E-cigarettes
The rising use of e-cigarettes has been accompanied by a rising number of injury complaints linked to e-cigarettes, including burns, nicotine toxicity, respiratory problems and cardiovascular problems, according to new data. From March 2013 to March 2014 there were more than 50 such complaints filed with the U.S. Food and Drug Administration (FDA), roughly the total reported over the previous five years. The findings come as the FDA prepares to regulate e-cigarettes and other "vaping" devices for the first time. Read more on injury prevention.

Apr 10 2014
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Public Health News Roundup: April 10

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HHS Releases Data Giving Consumers Greater Transparency on Costs of Medical Procedures
The U.S. Department of Health and Human (HHS) services has released of new, privacy-protected data on services and procedures provided to Medicare beneficiaries by physicians and other health care professionals. The new data—which includes payment and submitted charges, or bills, for those services and procedures by provider—provides consumers with more information on how physicians and other health care professionals practice medicine, according to HHS Secretary Kathleen Sebelius. “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice,” she said. “The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns.” The release includes information for more than 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program. Read more on access to care.

HUD Grants $1.6B to Support 7,100 Local Homeless Housing and Service Programs
The U.S. Department of Housing and Urban Development (HUD) has announced approximately $1.6 billion in grants to continue support for 7,100 local homeless housing and service programs in all 50 states, as well as Puerto Rico, Guam and the U.S. Virgin Islands. The grants, which come through HUD’s Continuum of Care Program, support programs such as street outreach; client assessment; and direct housing assistance to individuals and families with children who are experiencing homelessness. "Whether it's helping to rapidly re-house families with young children or finding a permanent home for an individual with serious health conditions, HUD is working with our local partners to end homelessness as we know it," said HUD Secretary Shaun Donovan. Read more on housing.

Study: Concussion Symptoms May Be Worse For Girls than for Boys
Concussions may have a more severe and longer-lasting effect for girls than they do for boys, according to new research. Shayne Fehr, MD, a pediatrician at Children's Hospital of Wisconsin, tracked 549 patients who sought treatment at a pediatric concussion clinic, finding that girls on average reported more severe symptoms than boys and needed an additional 22 days to recover (56 days for girls, compared to 34 for boys). Approximately 76 percent of the injuries were sports related and the top five reported symptoms were headache, trouble concentrating, sensitivity to light, sensitivity to sound and dizziness. More research is needed to determine the cause of the disparity. Read more on injury prevention.

Apr 1 2014
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Public Health News Roundup: April 1

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NHTSA: Rear Cameras for All New Cars by May 2018
All new vehicles under 10,000 pounds will be required to have rear visibility technology—or rear cameras—by May 2018, according to a new rule issued by the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA). According to NHTSA, the technology significantly reduces injuries and fatalities due to backover incidents; there are an average of 210 deaths and 15,000 injuries each year caused by such incidents, with children under age 5 accounting for 31 percent and adults ages 70 and older accounting for 26 percent. "Safety is our highest priority, and we are committed to protecting the most vulnerable victims of backover accidents — our children and seniors," said U.S. Transportation Secretary Anthony Foxx. "As a father, I can only imagine how heart wrenching these types of accidents can be for families, but we hope that today's rule will serve as a significant step toward reducing these tragic accidents." Read more on injury prevention.

Study: Diet of Fruit, Vegetables Linked to Reduced Risk of Death
Diets heavy on fruits and vegetables can reduce the risk of death at any age by as much as 42 percent, according to a new study in the Journal of Epidemiology and Community Health. Using data on the eating habits of more than 65,000 people in England from 2011 to 2013, researchers determined that the risk of death was reduced by 36 percent with five to seven portions, 29 percent with three to five portions and 14 percent with one to three portions. More specifically, they also determined that eating seven or more portions of fruits and vegetables reduced the risk of death from heart disease by 31 percent and the risk of death from cancer by 25 percent. "We all know that eating fruit and vegetables is healthy, but the size of the effect is staggering," study author Oyinlola Oyebode, at the department of epidemiology and public health of University College London, in a release. "Vegetables have a larger effect than fruit, but fruit still makes a real difference. If you're happy to snack on carrots or other vegetables, then that is a great choice but if you fancy something sweeter, a banana or any fruit will also do you good.” Read more on nutrition.

Affordable Care Act Expected to Hit Goal of Coverage for 7 Million
Despite a glitch-filled rollout of HealthCare.gov that allowed few people to enroll over the first month, the Affordable Care Act and its online portals appear to be on track to meet the original goal of enrolling 7 million people by its deadline of yesterday, March 31, according to Obama administration officials. More than 6 million had signed up for health care coverage as of last week and the run up to the deadline saw a surge that should put the total over 7 million. The administration also recently announced an extension of the enrollment deadline for Americans who had attempted to sign up for coverage but were impeded by technological problems. Read more on the Affordable Care Act.

Mar 19 2014
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Public Health News Roundup: March 19

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HHS: Common Sports Injuries Mean High Costs for People Without Insurance
The ASPE Office of Health Policy, part of the U.S. Department of Health and Human Services (HHS), has released a new issue brief analyzing the incidence and average health care charges associated with common sports injuries. The injuries range from minor sprains and strains to more serious injuries such as broken bones and concussions, where direct medical bills can be significant, placing an especially heavy burden on people without health insurance. Such individuals could be made to pay not just out-of-pocket costs, but also providers’ full stated charges. Breaking down health care costs by age and sometimes gender, the brief found, for example, that the average cost to fix a leg fracture for a person 10-19 years old was $4,689 and for those ages 25-40 was $3,403. Read more on injury prevention.

CDC: Drexel Meningitis Death Linked to Princeton Outbreak
Researchers at the U.S. Centers for Disease Control and Prevention have confirmed through “genetic fingerprinting” that a Drexel University student who died March 10 from meningitis died from the same serogroup B meningococcal strain that previously caused an outbreak at Princeton University. Health department officials confirmed that the Drexel student had been in close contact with Princeton students a week before becoming ill, indicating that the strain may still be present in the Princeton University community. Health officials have already administered antibiotic prophylaxis to prevent additional cases of meningococcal disease in people who had been close to the Drexel student. No new cases have since been reported. Read more on infectious diseases.

Study: ICU Survivors Face Heightened Risk for Mental Health Problems
Critically ill people who survive a stay in a hospital intensive care unit (ICU) are at heightened risk for mental health problems such as depression and anxiety in the following months, according to a new study in the Journal of the American Medical Association. Examining the records of more than 24,000 Danish ICU patients, researchers found that in the three months post-discharge that about 0.5 percent had a new diagnosis—which was 22 times higher than the rate in the general population. Approximately 13 percent received a new prescription for a psychiatric medication, including antidepressants and drugs for anxiety and insomnia, during that period. Researchers said the findings indicate that as doctors become better at saving the lives of critically ill patients, more people will also be at risk for problems beyond their physical health. Read more on mental health.

Mar 17 2014
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Public Health News Roundup: March 17

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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. 

Read an FAQ on assistance available from the Poison Prevention Program for consumers and health providers. Read more on prevention.

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.

Mar 13 2014
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Public Health News Roundup: March 13

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Hypertension Often Untreated in U.S. Hispanic Community
A new study in the American Journal of Hypertension finds that there is too little recognition and control of hypertension among the Hispanic population of the United States.

The new data comes from the Hispanic Community Health Study/Study of Latino, a longitudinal study of 16,415 Hispanics/Latinos, ages 18 to 74 years from four communities in the U.S. (Bronx, Chicago, Miami, and San Diego). Measures including hypertension levels and whether patients were on hypertension medications were collected between 2008 and 2011 and then followed up last year.

The study also found that the prevalence of hypertension in the Hispanic community increased with age, and was highest among those with Cuban, Puerto Rican, and Dominican backgrounds.

Read more on heart health.

USDA Funds News Childhood Obesity Prevention Programs at Three Universities
The National Institute of Food and Agriculture of the U.S. Department of Agriculture has given grants to childhood obesity prevention projects at three U.S. universities:

  • University of Tennessee, Knoxville, Tenn. for "Get Fruved:" A peer-led, train-the-trainer social marketing intervention to increase fruit and vegetable intake and prevent childhood obesity
  • Tufts University, Boston, Mass., for a “kids-only" retail coupon study to promote healthy snack options among adolescents in convenience stores.
  • Winston-Salem State University, Winston-Salem, N.C., for a program works with 10-12 year-old children from low income families.

Read more on obesity.

Almost Half of U.S. Population Lives in Jurisdictions that Strengthened Gun Laws in 2013
Fifteen states and the District of Columbia strengthened their gun laws in the year following the Newtown school shooting, according to a new review from the Johns Hopkins University press, Updated Evidence and Policy Developments on Reducing Gun Violence in America.

Among the changes in the last year was legislation at the state level to reduce intimate partner violence offenders’ access to firearms.

Read more on injury prevention.

Mar 6 2014
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Concussion Urgent Care Centers for Young Athletes: NewPublicHealth Q&A Robert Graw, MD

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A recent report from the Institute of Medicine found that young athletes in the United States face a "culture of resistance" to reporting when they might have a concussion and to complying with treatment decisions. That culture can result in students heading back to school too quickly—when they should be resting their brains to prevent short- and long-term complications.

"The findings of our report justify the concerns about sports concussions in young people," said Robert Graham, chair of the committee and director of the national program office for Aligning Forces for Quality, at George Washington University, Washington, D.C. (Aligning Forces is a program of the Robert Wood Johnson Foundation.) "However,” says Graham, “there are numerous areas in which we need more and better data. Until we have that information, we urge parents, schools, athletic departments, and the public to examine carefully what we do know, as with any decision regarding risk, so they can make more informed decisions about young athletes playing sports."

Recently, Righttime Medical Care, a chain of urgent care centers in Maryland, opened a number of HeadFirst sports injury and concussion centers in the state, staffed with health professionals who can assess injuries for concussions as well as evaluate students for return to play—in consolation with a team of experts who work with HeadFirst staff. HeadFirst will this year be presenting and publishing data on the more than 10,000 youth it has examined and treated for concussion in just the past two years.

NewPublicHealth recently spoke with Robert Graw, MD, head of Righttime and HeadFirst, about the need for better prevention, evaluation and treatment of concussions to prevent long-term health problems and disability.

NewPublicHealth: Why did Righttime add concussion care to the services provided?

Robert Graw: My son is an orthopedic surgeon and talked to me about the number of injuries he was seeing. We decided a few years ago that we’d learn as much as we could about preventing head injury and the consequences of head injury, and then promote that information through Righttime’s call center and through the visits that people made to our sites.

In the process of learning as much as we could we realized that the knowledge base of how people evaluate and manage concussions had changed drastically in the last five years as people have done more research. So, we then gathered together a group of consultant physicians and neuropsychologists to determine best practices. We met with them frequently, and then had them train our provider staff so that all of them became much more informed about what a concussion really is, the best way to evaluate them and the guidelines for management going forward.

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Feb 7 2014
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Public Health News Roundup: February 7

Decrease in Pediatric Antibiotic Leveling Off 
The number of children taking antibiotics has decreased over the past decade, but that decrease has stalled in recent years in certain age groups and geographic locations, according to a study in Pediatrics. Researchers reviewed pharmacy and outpatient claims over a 10-year period (2000 to 2010) in three health plans located in three different geographic locations to determine the number of antibiotics dispensed each year for children ages 3 months to 18 years. Although the overall antibiotic-dispensing rate in each age group and health plan was lower in 2009-2010 than in 2000-2001, the rate of decline in antibiotic use has slowed. The highest rate of antibiotic use was in children age 3 months to less than 24 months of age in all years of the study.

The study authors say the previous downward trend in antibiotic use in children may have reached a plateau, and continued improvements in judicious antibiotic dispensing are needed. Read more on pediatrics.

NHTSA Gives Okay for Vehicle to Vehicle Communication to Help Prevent Crashes
The National Highway Traffic Safety Administration has announced that it will begin taking steps to allow vehicle-to-vehicle (V2V) communication technology for light vehicles, which will allow vehicles to "talk" to each other and ultimately avoid many crashes by exchanging basic safety data, such as speed and position, ten times per second.

The safety applications currently being developed provide warnings to drivers so that they can prevent imminent collisions, but do not automatically operate any vehicle systems, such as braking or steering, although NHTSA is also considering future actions on active safety technologies that rely on on-board sensors.

V2V communications can provide the vehicle and driver with 360-degree situational awareness to address additional crash situations — including those, for example, in which a driver needs to decide if it is safe to pass on a two-lane road (potential head-on collision), make a left turn across the path of oncoming traffic, or in which a vehicle approaching at an intersection appears to be on a collision course. In those situations, V2V communications can detect threats hundreds of yards from other vehicles that cannot be seen, often in situations in which on-board sensors alone cannot detect the threat. Read more on transportation.

Many Hospital ICUs Don't Follow Infection Prevention Rules
While most hospitals have evidence-based guidelines in place to prevent health care-associated infections in intensive care units (ICUs), clinicians often fail to follow them according to new research from the Columbia University School of Nursing published in the American Journal of Infection Control. The study, on over 1600 ICUs, found lax compliance in intensive care units where patients are more likely to be treated with devices linked to preventable infections – such as central lines, urinary catheters and ventilators.

The study focused on three of the most common preventable infections — central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections and determined that despite decades of research, establishing best practices for prevention of these infections, approximately one in 10 hospitals lack checklists to prevent bloodstream infections, and one in four lack checklists to help avoid pneumonia in ventilator patients, and that in hospitals with checklists, they are followed only about half of the time.

Health care-associated infections kill an estimated 100,000 Americans a year and result in over $30 billion in excess medical costs, according to the Centers for Disease Control and Prevention. Read more on injury prevention.

Feb 5 2014
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Public Health News Roundup: February 5

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NIH, Industry and Non-profits Form Partnership to Speed Drug Development
The National Institutes of Health (NIH), 10 biopharmaceutical companies and several non-profit organizations have launched the Accelerating Medicines Partnership (AMP) to identify and validate the most promising biological for several diseases. The first set of disease targets will be Alzheimer’s disease, type 2 diabetes, rheumatoid arthritis and lupus. Through the foundation for the NIH, AMP partners will invest more than $230 million over five years in the first drug projects. Read more on partnerships.

CDC: Child passenger Deaths Decrease 43 Percent from 2002-2011
While car crash deaths among children age 12 and younger dropped by 43 percent from 2002 to 2011, more than 9,000 children died in crashes during that time period, according to a new Vital Signs report from the U.S. Centers for Disease Control and Prevention. The report found that 45 percent of black children and 46 percent of Hispanic children who died in crashes were not buckled up, compared to 26 percent of white children. Read more on injury prevention.

New Survey Finds Skepticism about Health Law Continues for Many Adults
Analysis of a new Health Reform Monitoring Survey, funded in part by the Robert Wood Johnson Foundation, finds that more and better outreach is needed to educate uninsured people about free or low-cost health insurance through expanded Medicaid programs or subsidies to help them purchase health insurance in the new marketplaces. Among the survey findings:

  • On seven measures of health care quality, access, and cost, the majority of adults expect to be neither better-off nor worse-off in 2014 than in 2013, but of those expecting a change in 2014; more expect to be worse-off than better-off.
  • Adults are more pessimistic about health-related costs in 2014 than about health care quality and access.
  • Compared with insured adults, a higher share of the uninsured—expects to be better-off in 2014.
  • Younger adults tend to be more optimistic than older adults about overall health care quality, access, and cost.

In an effort to help more people seek out health insurance coverage, Enroll America in partnership with the Ad Council, just launched “Take Care, People,” a national multimedia public service advertising (PSA) campaign to raise awareness, educate and motivate uninsured Americans to get health insurance for themselves and their families under the Affordable Care Act (ACA).

The campaign uses pets to tell people it’s time to take care of themselves, with a particular focus on women ages 18 to 34. Research by Enroll America finds that that women are more likely than men to do investigate health insurance options, enroll and encourage others to seek out information. Enroll America research also shows that 81 percent of people who are uninsured are unaware of the March 31 deadline to enroll in coverage for 2014 and 69 percent don’t know that financial assistance is available to help pay for their coverage. The PSAs were produced in both English and Spanish. Read more on the Affordable Care Act.