Category Archives: Maternal and Infant Health
Health Insurance Marketplaces Under the Affordable Care Act Open Today in Every State
Health insurance marketplaces, also known as health insurance exchanges, open today in every state under the Patient Protection and Affordable Care Act, which was signed into law three years ago. Coverage obtained through the exchanges gives purchasers guaranteed access to health care and a range of preventive services, including cancer screenings; vaccinations; care for managing chronic diseases; and mental health and substance use services. “Most importantly…coverage will translate into more opportunities to live longer, healthier and fuller lives,” saidRisa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, which has launched a comprehensive resource site to help individuals, families and small businesses learn about coverage options available to them, and enroll. Read more on the Affordable Care Act.
2010 California Pertussis Outbreak Linked to ‘Personal Belief Exemptions’ to Vaccines
Researchers have linked the 2010 California pertussis—or “whopping cough”—outbreak to parents who refused to have their children vaccinated for other than medical reasons. During the outbreak, 9,120 people became sick and 10 infants died. The study, which was published in the journal Pediatrics, looked at both outbreaks and filed personal belief exemptions, finding that people who lived in areas with high rates of such exemptions were about 2.5 times more likely to live in an area with many cases of pertussis. Approximately 95 percent of a population must be vaccinated in order for it to maintain herd immunity. Read more on vaccines.
Study: Against Medical Advice, 14 Percent of Infants Sleep in the Same Bed as Parents, Caregivers
Despite the associated risks, many infants still sleep in the same bed as parents, other adults and or children, according to a new study in the journal JAMA Pediatrics. The rate has more than doubled since the early 1990s and now stands at about 14 percent. Such sleeping arrangements increase the risk of sudden infant death syndrome (SIDS) or death from other sleep-related causes. Study co-author Marian Willinger, special assistant for SIDS at the U.S. National Institute of Child Health and Human Development, said it is important for doctors to discuss proper sleep-time habits with new parents; the study found that parents who receive advice against sleeping in the same bed as infants are 34 percent less likely to do so. Read more on maternal and infant health.
CDC: ‘Tips From Former Smokers’ Campaign Created Spikes in Quitline Calls, Website Visits
An additional 150,000 U.S. smokers called the tobacco cessation helpline 1-800-QUIT NOW as a direct result of the U.S. Centers for Disease Control and Prevention's (CDC) 2013 “Tips From Former Smokers” campaign, which ran for 16 weeks, according to CDC’s latest Morbidity and Mortality Weekly Report. That’s an increase of about 75 percent. It also generated approximately 2.8 million visits to the campaign website, or a nearly 38-fold increase. "The TIPS campaign continues to be a huge success, saving tens of thousands of lives and millions of dollars; I wish we had the resources to run it all year long," said CDC Director Tom Frieden, MD, MPH. "Most Americans who have ever smoked have already quit, and most people who still smoke want to quit. If you smoke, quitting is the single most important thing you can do for your health – and you can succeed!" A recent study in The Lancet concluded that the campaign helped as many as 100,000 people quit smoking permanently. Read more on tobacco.
FDA, NIH Award as Much as $53M for 14 Tobacco Regulation Research Centers
The U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH) have joined together to award as much as $53 million in funding to create 14 Tobacco Centers of Regulatory Science (TCORS). The first-of-its-kind program will bring together a diverse array of scientists, public health experts, communications veterans and marketing experts to generate research to inform the regulation of tobacco products to protect public health. “While we’ve made tremendous strides in reducing the use of tobacco products in the U.S., smoking still accounts for one in five deaths each year, which is far too many,” said NIH Director Francis S. Collins, MD, PhD. “FDA/NIH partnerships like the Tobacco Centers of Regulatory Science keep us focused on reducing the burden and devastation of preventable disease caused by tobacco use.” Read more on research.
Overweight, Underweight Pregnant Women See More Complications and Longer Hospital Stays
Pregnant women who are either too thing or too heavy as measured by body-mass index (BMI) are at increased risk for complications and additional hospitalization, according to a new study in BJOG: An International Journal of Obstetrics and Gynaecology. Women with higher BMIs saw increased complications; severely obese women were three times as likely as normal weight women to have high blood pressure and gestational diabetes, as well as longer overall hospitalizations. Lower-weight women also had higher rates of additional hospitalization (8 percent) compared to normal-weight women, though not as high as the rates for overweight and obese women. The findings indicate the need to fine and implement new approaches to combating obesity. "Longer-term benefits of reducing maternal obesity will show improvements, not only in the health outcomes of mothers and their babies, but the workload and cost to current maternity services," said study co-author Fiona Denison, MD, of Queens's Medical Research Institute in Edinburgh. Read more on maternal and infant health.
Every baby should have a chance to celebrate a healthy, happy first birthday. Unfortunately, that is not always the case. And that risk disproportionately affects people with lower income and people of color. This Infant Mortality Awareness Month, we can celebrate some progress in helping more babies reach that first milestone, according to health officials who shared successes at the Association of State and Territorial Health Officials (ASTHO) Annual Meeting in Orlando, Fla., this week.
>>Follow our ASTHO Annual Meeting coverage throughout the week.
“We are collectively moving forward in improving birth outcomes across the nation,” said David Lakey, MD, Commissioner of the Texas Department of State Health Services and former ASTHO president, who took on healthier babies as his President’s Challenge during his tenure. Lakey set out a goal of an 8 percent reduction in premature births by 2014.
“There is a high human cost of prematurity,” said Lakey, and that cost includes low birth weight, increased morbidity and mortality, and an impact on standardized test scores and other outcomes later in life for those who do survive. “Those who are born early have a much lower chance of having a healthy, happy first birthday.”
There is also an economic and societal cost of premature birth, the cost of which is largely paid for by Medicaid. Lakey said that 57 percent of all Texas births are paid for by Medicaid. Extreme preterm birth costs an average of $71,000—while a full-term birth costs an average of $420.
Despite decades of outreach around car seat safety, car crashes remain the number one cause of death for children under the age of 12, according to the U.S. National Highway and Traffic Safety Administration (NHTSA). The numbers from the U.S. Centers for Disease Control and Prevention (CDC) are also stark and troubling: more than 1,200 U.S. children ages 14 years and younger died in motor vehicle crashes in 2010, and approximately 171,000 were injured.
What makes these statistics even more tragic is the fact that many of these deaths and injuries are preventable by following these simple edicts—put kids in the right seat and use it the right way. In fact, NHTSA has identified child seat safety restraints as the most effective way to protect young children in motor vehicle crashes.
Child safety seats reduce the risk of death in passenger cars by 71 percent for infants and by 54 percent for kids ages 1 to 4, according to the CDC. For children ages 4 to 8, booster seats cut the risk of serious injury by 45 percent.
This week is Child Passenger Safety Week. It also marks the launch of the new BuckleUpForLife.org, Cincinnati Children’s and Toyota’s community-based safety program designed to educate families on critical safety behaviors and provide child car seats to families in need.
The website features the “Making Safety a Snap” online tool—a series of quick questions and videos that demonstrate exactly how parents and caregivers can make sure their child has the right safety seat and is using it properly.
You can follow a live Buckle Up for Life Twitter Q&A starting at 2 p.m. today. Use the hashtag #BuckleUpforLife to join the discussion and have your child car seats questions answered by their experts.
Study: E-cigarettes May Be as Effective as Nicotine Patches at Aiding Tobacco Cessation
E-cigarettes may be as effective as nicotine replacement therapy patches at helping people to reduce or quit smoking, according to a new study in the journal The Lancet. E-cigarettes are a hotly contested subject, with some seeing them as a “gateway” to nicotine use, and others seeing them as a way to actually help smoking cessation efforts. Researchers put participants who wanted to quit smoking on e-cigarettes, nicotine patches or placebo e-cigarettes for 13 weeks. After the time period they found that 7.3 percent of the e-cigarette users had successfully quit smoking, followed by 5.8 percent for the nicotine patch users and 4.1 percent for participants on the placebo e-cigarettes. "While our results don't show any clear-cut differences... in terms of quit success after six months, it certainly seems that e-cigarettes were more effective in helping smokers who didn't quit to cut down," said study leader Chris Bullen of New Zealand's University of Auckland. "It's also interesting that the people who took part in our study seemed to be much more enthusiastic about e-cigarettes than patches, as evidenced by the far greater proportion of people...who said they'd recommend them to family or friends." For more information on e-cigarettes, read the recent NewPublicHealth post, "Recommended Reading: A Closer Look at E-Cigarettes." Read more on tobacco.
HHS: $69.7M to Bolster Maternal, Infant, Early Childhood Services in 13 States
The U.S. Department of Health and Human Services (HHS) is providing approximately $69.7 million in grants to 13 states under the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. The funds will expand on each state’s efforts under the program, which helps deliver critical health, development, early learning and family support services to children and families. The program began in 2010 and has since served approximately 15,000 families in all 50 states, the District of Columbia and five territories. “This program plays a crucial role in the national effort to build comprehensive statewide early childhood systems for pregnant women, parents and caregivers, and children from birth to 8 years of age – and, ultimately, to improve health and development outcomes,” said Mary Wakefield, PhD, RN, Administrator, Health Resources and Services Administration. Read more on maternal and infant health.
Most Breast Cancer Deaths in Younger Women, Calling into Question Screening Guidelines
While in 2009 the U.S. Preventive Services Task Force revised its recommendations to say that women ages 50 to 74 should receive screening mammograms once every two years and women under 50 should decide on a schedule only after talking over all the details with their doctors, the American Cancer Society and other organizations continued to recommend screening beginning at age 40. A new study in the journal Cancer seems to support the need to start earlier for women of even average risk. Researchers found that half of all breast cancer deaths occur in women under the age of 50, and 71 percent of all deaths are among unscreened women. About 40,000 U.S. women die of breast cancer each year. One factor in the earlier deaths is that young women tend to have faster-growing, more aggressive tumors. "[The study] presents a very compelling argument in favor of screening beginning at age 40 on an annual basis. It corroborates what we have known for a long time," said Barbara Monsees, MD, chairwoman of the American College of Radiology Breast Imaging Commission, who was not involved in the study, adding “Screening doesn't reduce the risk of getting breast cancer, but it does reduce the risk of dying from it." Read more on cancer.
E-cigarette Use Doubled for Middle, High School Students from 2011 to 2012
The use of e-cigarettes by U.S. middle and high school students more than doubled from 2011 to 2012, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC). All told about 10 percent of the students used an e-cigarette in 2012; about 2.8 percent of students reported using one within the past 30 days; and a total of 1.78 million middle and high school students tried e-cigarettes in 2012. Curbing tobacco use early is critical because its addictive qualities can lead to a life time of use, which in turn can lead to a lifetime—and a shortened lifetime, at that—of severe health problems. “About 90 percent of all smokers begin smoking as teenagers,” said Tim McAfee, MD, MPH, director of the CDC Office on Smoking and Health. “We must keep our youth from experimenting or using any tobacco product. These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e-cigarettes among youth is critical.” Read more on tobacco.
U.S. Preterm Birth Rate at Lowest Point in 15 Years in 2012
The U.S. preterm birth rate was down to just 11.54 percent in 2012, its lowest point in 15 years and the sixth consecutive year the rate has fallen, according to a new preliminary date from the U.S. Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics. The pre-term rate reached a high of 12.8 percent in 2006. Jennifer L. Howse, MD, president of the March of Dimes, attributed the impressive drop to the efforts of the many state and local health departments; hospital partners; and physicians and nurses. “This sustained improvement over these past six consecutive years shows that when infant health becomes a priority, babies benefit,” she said, adding “We will continue to implement proven interventions and accelerate our investment in new research to prevent preterm birth so one day every baby will get a healthy start in life.” Infants who are born preterm (defined as 3 of more weeks before their due date) are at increased risk for health problems such as intellectual disabilities, cerebral palsy, respiratory problems, visual problems, hearing loss and digestive problems, according to the CDC. Read more on maternal and infant health.
Water Sanitation-based Outbreaks Still a Problem for Many Americans
Despite overall improvements, U.S. water sanitation is still a problem in some areas, with bacteria-laden drinking water leading to 1,040 illnesses, 85 hospitalizations and nine deaths in 17 states from 2009 to 2010, according to the U.S. Centers for Disease Control and Prevention. Legionella-tainted plumbing systems, untreated groundwater and problems with distribution systems were the leading causes of the 33 identified outbreaks. California, Florida, Georgia, Idaho, Illinois, Maine, Maryland, Minnesota, Missouri, Montana, Nevada, New York, Ohio, Pennsylvania, South Carolina, Utah and Vermont all reported drinking water-related outbreaks during that period. According to the CDC report, more research is needed into controlling Legionella, and more must be done to improve early detection and correction of problems with water-distribution systems. Read more on water and air quality.
Women with Midwives Less Likely to Have Complicated, Premature Births
Pregnant women cared for by midwives are less likely to have complicated or premature births, according to a new review of 13 studies by The Cochrane Library. The analysis found that women with midwives were 23 percent less likely have premature births and 19 percent less likely to lose the fetus before 24 weeks. Such pregnancies are also linked to fewer epidurals, episiotomies and the use of instruments such as forceps or vacuums during delivery. Lead author Jane Sandall, professor of social science and women's health in the Division of Women's Health of King's College London, said the next step is to determine exactly why this is the case. "For example, whether it is the model of care itself where midwives are in a position to pick up problems and get the right specialist input as early as possible, or whether a relationship where a women knows and trusts her midwife leads to a better outcome," said Sandall, according to Reuters. Read more on maternal and infant health.
Survey: Large U.S. Employers to Pay 7 Percent More on Health Benefits in 2014
Large U.S. employers estimated the cost of providing health care benefits to their employees will rise 7 percent in 2014, according to a new survey from the National Business Group on Health. The organization is a non-profit association of more than 265 large employers. The survey also found that some employers are interested in the possibility of health insurance exchanges for certain populations, as well as that more companies intend to offer consumer-directed health plans as their only options. This would be the third consecutive year that employers have budgeted for an increase of 7 percent. While this means rates have been kept “stable,” employers are still looking at ways to engage workers in health management and healthy lifestyles that would also help lower costs. “Rising health care costs remain a serious concern for U.S. employers,” said Helen Darling, President and CEO of the National Business Group on Health. Read more on access to health care.
More than 8.5 Million U.S. Adults Use Prescription Sleep Aids
More than 8.5 million U.S. adults took a prescription sleep aid in the past month, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC). As many as 70 million U.S. adults suffer from a sleeping disorder. The report found that the rates of use increases with age, that about 5 percent of women over the age of 20 utilized the medications, that about 3.1 percent of men over the age of 20 utilized the medications and that the higher a person’s level of education, the less likely they were to take the drugs. Report coauthor Yinong Chong, an epidemiologist at the CDC's National Center for Health Statistics, said the rate of usage climbed only about 1 percent from 1999 to 2010. Jordan Josephson, MD, a nasal and endoscopic sinus surgeon at Lenox Hill Hospital in New York City, said the report findings were not surprising. "More accurate diagnosis and better education has led more people to seek treatment for these disorders, which affect them in every aspect of their lives," he said. "For those people who suffer from fatigue and/or daytime somnolence—being tired and feeling sleepy—it is important for them to seek treatment from a board-certified sleep specialist.” However, the U.S. Food and Drug Administration has also lately been taking a closer look at the effects of sleep aids—which recent evidence shows can last into the following day—and plans to have manufacturers perform more extensive tests on the drugs. Read more on prescription drugs.
Preschoolers’ Stuttering Does Not Hurt Social, Emotional Development
Stuttering is a common issue and does not negatively impact the social and emotional development of preschoolers, according to a new study in the journal Pediatrics. Sheena Reilly, associate director of clinical and public health research at Murdoch Children’s Research Institute in Australia and the study's lead author, called the study’s conclusion that stuttering or stammering did not serve to make kids more withdrawn a “very positive finding” and said that parents "can be reassured that developmental stuttering is not associated with a range of poorer outcomes in the preschool years." Researchers found that the rate of kids stuttering by age four was 11 percent and the recovery rate from stuttering after 12 months was 6.3 percent. The former was higher than previous studies have indicated and the latter was lower than the researchers expected; Reilly said further research into recovery is needed. The study also found that children who stutter had higher verbal and non-verbal scores. Read more on pediatrics.
NIH: Parents Fully Informed on Blood Transfusion Trial on Premature Infants
The U.S. National Institutes of Health (NIH) late last week responded to an advocacy group’s call for the end of a government study of blood transfusion levels in premature infants with firm insistence that parents are given complete and accurate information about the risks. The organization, Public Citizen, contends that the study exposes the infants to risks without giving parents full information and should be stopped. Under the study, half of the children will receive transfusions at a high hemoglobin level and half at a low level; according to Public Citizen, a restrictive approach risks serious complications such as neurological injury. As reported by Reuters, "The NIH said it is committed to ensuring that prospective research participants — and the people who speak for and love them — are given clear complete, and accurate information about the risks and benefits of participating in research." Public Citizen earlier called for a closer look at a previous NIH study on the effectiveness of different levels of oxygen in the treatment of premature infants. Read more on research.
Report: Most Medications Safe to Take While Breastfeeding
Most medications taken by breastfeeding moms will have no harmful impact on nursing infants, according to a new report from the American Academy of Pediatrics in consultation with the U.S. Food and Drug Administration (FDA). The study appears in the journal Pediatrics. "Because we know that breast-feeding has both developmental and health benefits for the mom and the baby, we are encouraging research in this area so physicians can make informed decisions about how best to treat their patients," said study author Hari Cheryl Sachs, MD, a pediatrician and leader of the pediatric and maternal health team within the FDA's Center for Drug Evaluation and Research. FDA is proposing new regulations that would replace “Nursing Mothers” sections on drug labels with a “Lactation” section that would provide more detailed information about potential effects on a nursing infant. Most drugs currently carry a blank legal statement warning against any use by breastfeeding mothers. "The general takeaway message—that most drugs are compatible with breast-feeding, that mothers don't have to wean to take drugs and that the labels should accurately reflect the science—is really great news and progress for breast-feeding mothers," said Diana West, a lactation consultant and spokesperson for La Leche League International. Read more on maternal and infant health.
U.S. Circumcision Rate Down 10 Percent over Past Three Decades
The circumcision rate of U.S. newborns dropped approximately 10 percent from 1979 to 2010, according to new date from the National Center for Health Statistics. In 2010 about 58.3 percent of boys born in U.S. hospitals were circumcised; the rate was 64.5 percent in 1979. While beginning as a religious ritual, the use of circumcision expanded due to potential health benefits such as reduced risk of urinary tract infections in infants and reduced risk of sexually transmitted diseases. Last August the American Academy of Pediatrics said that these benefits outweigh any risks. However, the procedure also has many opponents. While the report did not go much into the reasons for the decline, possible explanations include the fact that Medicaid has stopped paying for circumcisions in 18 U.S. states, some insurers are not covering procedures without strong medical justifications and shorter hospital stays for new mothers means some circumcisions are performed later as outpatient procedures. Read more on maternal and infant health.
Eating Fruit Helps Prevent Certain Aneurysms
An apple—or any other fruit—a day may lower a person’s risk of an abdominal aneurysm, according to a new study in the journal Circulation. The thirteen year study of 80,000 people ages 48 to 64 in Swede found that people who reported eating more than two servings of fruit daily had a 25 to 31 percent lower risk of abdominal aortic aneurysm than those who ate little or no fruit. High levels of antioxidants in fruits might protect against abdominal aortic aneurysm by preventing oxidative stress that can promote inflammation, according to the researchers, who found no similar association for vegetables, which are also rich in antioxidants, but may lack some of the components in fruits. However, vegetables remain important to a person’s diet, say the study authors. Combined with fruit they may help decrease the risk of cardiovascular diseases, type 2 diabetes, high blood pressure and several cancers. The American Heart Association advises the average adult to eat four to five servings each of fruits and vegetables daily, based on a 2,000 calorie diet. Read more on nutrition.
Study: CTE Victims First Present with Impaired Mood or Thinking
People suffering from chronic traumatic encephalopathy (CTE)—a neurodegenerative disease that can only be diagnosed after death—will likely first begin exhibiting either impaired behavior and mood or impaired memory and thinking abilities, according to a new study in the journal Neurology. CTE is characterized by impulsivity, depression and erratic behavior. "The study itself is relatively preliminary, [but] we found two relatively distinct presentations of the disease," said study co-author Daniel Daneshvar, a postdoctoral researcher at the university's Center for the Study of Traumatic Encephalopathy. "So little is known about the clinical presentation of CTE that anything we found is not necessarily surprising, simply because there's a dearth of information about CTE." Researchers emphasized that far more study is needed. CTE and other head trauma have become increasingly prominent issues over the last several years, with cases linked to both sports injuries and battlefield injuries. There is currently a lawsuit by almost 4,000 former NFL players claiming the league did not properly inform them of the dangers of concussions or adequately protect their health. Read more on injury prevention.
Kaiser Family Foundation Finds Modest Increase for Family’s Share of Employer-Sponsored Health Insurance
Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 toward the cost of their coverage, according to a new Kaiser Family Foundation survey of more than 2,000 employers. That rise is moderate by historical standards according to the survey; since 2003, premiums have increased 80 percent, nearly three times as fast as wages (31 percent) and inflation (27 percent).
The survey also found that large deductibles of at least $1,000 are common in employer-sponsored plans, especially for employees at smaller firms. This year, 38 percent of all covered workers face such a deductible. At small firms, 58 percent of covered workers now face deductibles of at least $1,000, including nearly a third (31 percent) who face deductibles of at least $2,000, up from 12 percent in 2008.
Additional findings of the survey:
- Nearly all large employers (at least 200 workers) offer at least one wellness program and more than a third (36 percent) of large employers who offer them also provide some kind of financial incentive for workers to participate, such as lower premiums or a lower deductible, receiving a larger contribution to a tax-preferred savings account, or gift cards, cash or other direct financial incentives.
- Among large firms offering health benefits, more than half (55 percent) offer some kind of biometric screenings to measure workers' health risks. Of these, 11 percent reward or penalize workers financially based on whether they achieve specific biometric outcomes.
"This will be an important issue to watch next year, as employers [under the Affordable Care Act can] ask workers to pay more because of their lifestyles and health conditions," said Kaiser Vice President Gary Claxton, the study's lead investigator and director of the Foundation's Health Care Marketplace Project.
Read more on access to health care.
CDC: $75.8M to Help Health Departments Prepare for, Respond to Infectious Diseases
The U.S. Centers for Disease Control and Prevention (CDC) has awarded approximately $75.8 million in grants to help state, territorial and certain local health departments prepare for—and respond quickly to—an array of infectious diseases. The grants are through the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement. They will go to such critical areas as surveillance, detection, and outbreak response efforts in infectious disease areas such as foodborne diseases, influenza and healthcare-associated infections. “With many infectious diseases first identified at the local level, this funding ensures that state health departments are able to effectively prevent, detect and respond to such public health threats,” said Beth P. Bell, MD, MPH, director of CDC’s National Center for Emerging and Zoonotic Infectious Diseases.” Read more on infectious diseases.
Study: Quitting Smoking Even After Becoming Pregnant Reduces Risk, Complications of Low Birth Weight
While women who quit smoking right before or right after becoming pregnant will on average gain more pregnancy-related weight, and are also less likely to have babies who are born small, according to a new study in the journal Obstetrics and Gynecology. Low birth weight increases the risk for infections; breathing and respiratory disorders; delayed growth and social development; and learning disabilities. Other studies have also linked smoking during pregnancy to premature birth, birth defects and stillbirth. "The big thing to get out of this study is that quitting early in pregnancy is as helpful in respect to the birth weight of your baby as never having smoked while you were pregnant," said Amber Samuel, MD, a maternal-fetal medicine expert at Emory University School of Medicine in Atlanta. "I think that can be an inspiration to moms who are looking to make a change in their lives." Read more on maternal and infant health.