Category Archives: Maternal and Infant Health
One-third of U.S. Teens, Young Adults Victims of Dating Violence
About one-third of U.S. teens and young adults have been the victims of dating violence and about one-third have been the perpetrators, according to a new study from the Center for Innovative Public Health Research in San Clemente, Calif. Approximately one in four report being both. Overall, the public health issue is not improving, according to Emily Rothman, an associate professor at Boston University School of Public Health. "It is sorely disappointing that we have not seen improvements in the prevalence of dating violence in the past 12 years, but there is a clear reason for it," she said. "We spend virtually no money on dating violence prevention or education in schools and communities. Problems don't change unless you try to fix them." Dating violence is a serious issue that must be addressed, according to Yolanda Evans, MD, an assistant professor at Seattle Children's Hospital. "Intimate partner violence is associated with poor school performance, poor self-esteem, depression and thoughts of suicide. We should communicate with our teens that it is never OK to act violently against a partner or to force them to do something they do not feel comfortable doing. We also need to teach our teens that it is unacceptable for someone to act violently towards us in a relationship." Read more on violence.
CDC: Breastfeeding Rates Up Over Past Decade
In part due to longer hospital stays that work to keep moms and newborns together, breastfeeding rates have climbed significantly over the past decade, according to the U.S. Centers for Disease Control and Prevention (CDC). In 2010 about 49 percent of babies were breastfeeding at six months, up from 35 percent in 2000. And about 27 percent were breastfeeding at 12 months in 2010, up from 16 percent in 2000. At the same time, “room-in” and “skin-to-skin” maternity ward procedures that keep mother and child close and emphasize physical contact have also increased, which helps to start and continue the breastfeeding process, according to Janet L. Collins, PhD, director of CDC’s Division of Nutrition, Physical Activity, and Obesity. “This is great news for the health of our nation because babies who are breastfed have lower risks of ear and gastrointestinal infections, diabetes and obesity, and mothers who breastfeed have lower risks of breast and ovarian cancers,” said CDC Director, Tom Frieden, MD, MPH. “Also, breastfeeding lowers health care costs. Researchers have calculated that $2.2 billion in yearly medical costs could be saved if breastfeeding recommendations were met.” Read more on maternal and infant health.
HUD: $52M in Grants to Improve Housing, Services for American’s Homeless
As part of its “Continuum of Care Program,” the U.S. Department of Housing and Urban Development (HUD) has announced $52 million in funding to go toward 200 homeless housing/service programs and about 200 grants to assist with local strategic planning activities. The round of grants follows $1.5 billion in two rounds of funding earlier this year. The Continuum of Care grants fund programs such as street outreach and assessment, as well as transitional and permanent housing for homeless persons and families. “As we continue to see a decline in homelessness, investing in programs that are moving homeless families and individuals to permanent housing is as critical as ever because it’s not only the right thing to do, but it’s smart government and fiscally prudent,” said HUD Secretary Shaun Donovan. There were approximately 633,782 homeless persons on a single night in January of 2012, according to “point in time” estimates. Read more on housing.
Task Force Calls for Regular Lung Cancer Screening for Older, High-risk Patients
New recommendations from the U.S. Preventive Services Task Force call for annual lung cancer screenings for people ages 55-79 who smoked at least a pack of cigarettes a day for 30 years, or the equivalent (e.g., two packs a day for 15 years). Low-dose computed tomography (CT) scans utilize an X-ray machine to take a series of detailed pictures that can help identify smaller tumors earlier, allowing for earlier treatment and improved health outcomes. “Lung cancer is the leading cause of cancer death in the United States and a devastating diagnosis for more than two hundred thousand people each year,” says Task Force chair Virginia Moyer, MD, MPH. “Sadly, nearly 90 percent of people who develop lung cancer die from the disease, in part because it often is not found until it is at an advanced stage. By screening those at high risk, we can find lung cancer at earlier stages when it is more likely to be treatable.” Lung cancer kills about 160,000 Americans each year. Read more on tobacco.
Study Links Breastfeeding, Higher Intelligence in Kids
Children who breastfeed score higher on intelligence tests later in life, according to a new study in JAMA Pediatrics. Researchers found that for each month spent breastfeeding there were slightly higher results on the intelligence tests at ages three and seven, though not on tests of motor skills or memory. Mandy Belfort, MD, who led the study at Boston Children's Hospital, said the study accounted for parental intelligence and other home factors and provides parents with one more piece of important information when making a decision on the complex question of whether to breastfeed. "Given the size of the benefit, I think this should be helpful for women who are trying to make decisions about how long to breastfeed… because there are many factors that go into that decision," said Belfort. "You have to weigh that against the time that it takes, maybe the time that it takes away from work and your other family duties." Previous studies have linked breastfeeding to lower risk of ear and stomach infections, as well as eczema. Read more on infant and maternal health.
NCI: ‘Cancer’ May Need to Be Redefined
The dramatic increase in cancer screenings over the past few decades has resulted in overdiagnosis and overtreatment, in part because of confusion—by both patients and physicians—over which types of cancer are actually lethal and require immediate treatment. As a result, a panel of experts commissioned by the U.S. National Cancer Institute has recommended that the word “cancer” may need to be redefined to differentiate between lethal and indolent cancers. The recommendations were published in the Journal of the American Medical Association. "We're still having trouble convincing people that the things that get found as a consequence of mammography and PSA testing and other screening devices are not always malignancies in the classical sense that will kill you," said Harold Varmus, MD, director of the National Cancer Institute, to The New York Times. "Just as the general public is catching up to this idea, there are scientists who are catching up, too." Over the past several years the U.S. Preventive Services Task Force has also called for an end to regular mammography screening for women under 50, as well as the widespread use of PSA tests to identify prostate cancer. Read more on cancer.
Smoking During Pregnancy, Kids Behavioral Problems Linked
Women who smoked during pregnancy are more likely to have children with behavioral disorders, according to a new study in the journal JAMA Psychiatry. Researchers analyzed data from three separate studies, findings that the kids of smokers exhibited a noticeable increase in negative behaviors such as getting in fights or having difficulty paying attention. Possible explanations include being born smaller or experiencing impaired brain development. "It's illuminating the prenatal period as having an ongoing influence on outcomes," said Gordon Harold, the study's senior author from the University of Leicester in the U.K. "We're not saying life after birth is no longer relevant… Rather, both influences are clearly important." Read more on tobacco.
Study: Family History of One Cancer Type Can Also Raise the Risk of Other Tumor Types
Health care professionals already knew that people are at increased risk for developing the same type of cancer as a close relative. A new study in the journal Annals of Oncology shows that they are also at increased risk for developing cancer in general, including types of tumors dramatically different than those developed by relatives, which could provide physicians with new ways to identify cancers earlier. Previous genetic studies have shown that certain gene mutations can increase the risk of multiple types of cancer. The new findings include:
- A 1.5-fold increased risk of breast cancer in women with a history of colorectal cancer in the family.
- A 3.3-fold increased risk of oral and pharyngeal cancer among people who had a first-degree relative with cancer of the larynx.
- A four-fold increased risk of cancer of the esophagus among people with a first-degree relative who had oral or pharyngeal cancer.
- A 2.3-fold increased risk of ovarian cancer among those with a first-degree relative who had breast cancer.
- A 3.4-fold increased risk of prostate cancer if a first-degree relative had bladder cancer.
"These findings may help researchers and clinicians to focus on the identification of additional genetic causes of selected cancers and on optimizing screening and diagnosis, particularly in people with a family history of cancer at a young age," said study co-author Eva Negri, MD, head of the laboratory of epidemiologic methods at the Mario Negri Institute for Pharmacological Research in Milan, Italy. Read more on cancer.
Weight Discrimination Increases the Likelihood of Obesity
People who face discrimination for being overweight may be as much as two and a half times more likely to become or stay obese, according to a new study in the journal PLoS One. "Discrimination is hurtful and demeaning, and has real implications for physical health," said lead researcher Angelina Sutin, an assistant professor of psychology at Florida State University. "In the case of weight discrimination, people often rationalize that it is OK to do because it will motivate the victim to lose weight. Our findings suggest the opposite." The experience of “weightism” damages self-esteem and undermines efforts to maintain a healthy weight. Researchers said the observed increase in the likelihood of obesity was independent of factors such as age, sex, ethnicity and education. Experts say that approaches to improving the treatment of obesity could include working with patients to develop adaptive ways to cope with discrimination, public messaging campaigns to raise awareness of the negative effects of “weightism” and even working with health care professionals to ensure they are not exhibiting discriminatory behaviors which could actually damage their patients’ health. Read more on obesity.
Each year, the March of Dimes National Communications Advisory Council, which includes journalists from many websites and magazines that cover pregnancy and early childhood, holds a reporters’ luncheon to share information that can lead to healthier births, babies and mothers. This year’s luncheon, being held tomorrow, focuses on treating mental health conditions in mothers during and after pregnancy. The issue is important for many reasons, in particular because many women have been taking prescription medications for depression, anxiety, panic attacks, ADHD, and other mental health issues since adolescence and may need to change or stop the medicines in order to have a healthy baby, yet run the risk of a relapse or worsening of their health condition.
NewPublicHealth recently spoke with, Siobhan Dolan, MD, a consultant to the March of Dimes and an obstetrician gynecologist and clinical geneticist at Montefiore Medical Center/Albert Einstein College of Medicine about communicating information about treating mental health during pregnancy to both mothers and health care professionals.
NPH: For the upcoming luncheon, the March of Dimes has singled out mental health medications. Why that area of health?
Dr. Dolan: There is a huge overlap between women of reproductive age who are dealing with becoming pregnant and having families and caring for families and women who have mental health issues and may be entering their reproductive years already on medication.
And we know that bonding and creating a family and getting your family life off to a good start in the early postpartum period is much, much better when a woman is in a balanced mental health state. So if there’s either a preexisting depression or a postpartum depression, we need to pay attention to that.
FDA Releases Safety Checklist for ‘Hurricane Preparedness Week’
The U.S. Food and Drug Administration (FDA) has made available a Hurricane Safety Checklist for Hurricane Preparedness Week, which runs from May 26 to June 1. The list includes tips and steps to ensure water, food and medical supplies are safe not only during hurricanes, but also during flooding and lengthy power outages that may follow. Emergency medication and supplies are especially critical for those with serious health concerns or at particular risk, such as people with chronic conditions or the elderly. The checklist is also available in Spanish. Hurricane season in the Atlantic runs from June to November and in the Eastern Pacific from May 15 to November 30, according to Ready.gov. Read more on preparedness.
Study: Mother’s Obesity Surgery Decreases Child’s Risk of Obesity
A woman’s obesity surgery can reduce the risk of having an overweight or obese child later in life, according to a new study. Researchers from Laval University in Quebec, Canada looked at 20 mothers who had children before and after gastrointestinal bypass or a biliopancreatic bypass weight-loss surgeries, finding an actual genetic effect on the later offspring. They are at decreased risk of not only obesity, but also diabetes and cardiovascular disease. While the study is small, the researchers say this is the first step toward better identifying and even blocking “obese” genes. Read more on obesity.
Task Force: Screen All Pregnant Women for Gestational Diabetes after 24 Weeks
A new draft recommendation statement from the U.S. Preventive Services Task Force (USPSTF) says that all pregnant women should be screened for gestational diabetes after 24 weeks. The screening should be performed even for those women who haven’t shown symptoms. Gestational diabetes increases the risk of various labor and birth complications; the babies are also at increased risk of increased birth weight, birth injuries, glucose intolerance and childhood obesity. "It's always better to prevent a disease than to be diagnosed with one," said task force member Wanda Nicholson, MD, in a release. "Women should have a conversation with their doctor before getting pregnant or in the early stages of pregnancy about steps they can take—such as improving their diet, being physically active or other strategies—to reduce their risk of developing gestational diabetes." Read more on maternal and infant health.
March of Dimes Establishes Research Collaborative on Causes of Preterm Births
Three universities and four hospitals in Ohio have joined with the March of Dimes Foundation to establish a collaborative research program aimed at finding the unknown causes of premature birth. According to the March of Dimes, preterm birth is the most common and costly newborn health problem in the United States, affecting nearly half a million babies each year. It is also the leading cause of newborn death, and babies who survive an early birth often face the risk of lifelong health issues, including vision and breathing problems. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants. “The transdisciplinary approach will increase dramatically the rate of progress in understanding why some babies are born too soon. Ultimately our goal is to use this knowledge to develop effective therapies to prevent preterm birth and enable all pregnancies to proceed to full term,” said ” said Sam Mesiano, PhD, Site Director for the Case Western Reserve University, University Hospitals, and MetroHealth component of the collaborative. One of the focus aims of the research includes the sociobiology of racial disparities in preterm birth. African-American and Hispanic mothers have higher rates of preterm births than do whites. Read more on maternal and infant health.
House, Senate Consider Cuts to SNAP in Farm Bill Reauthorization
The U.S. House and Senate are each considering versions of the five-year Farm Bill reauthorization that would save money in part by cutting the budget for the supplemental Nutrition Assistance Program (SNAP), which helps nearly 48 million Americans purchase food each year. The House version would cut $2 billion and the Senate version would cut $400 million, according to The Washington Post. The House version would also stop certain forms of automatic SNAP benefits. James S. Marks, Senior Vice President of the Robert Wood Johnson Foundation Health Group, said cutting SNAP benefits would violate the fundamental tenet of medicine to “first, do no harm.” “Cutting SNAP is precisely the wrong prescription for our children and the nation's economic recovery. The notion that SNAP benefits are an overly generous handout could not be further from the truth,” he wrote in The Huffington Post, adding “SNAP has the potential to be a public health tool that can help address the complex problems of hunger and obesity.” Read more on nutrition.
CDC: High Rates of Unhealthy Behavior Persist
A new report from the U.S. Centers for Disease Control and Prevention finds that, overall, Americans aren’t making much improvement in their health. About 60 percent are overweight or obese, about 60 percent drink, about 20 percent smoke and about 80 percent don’t meet federal guidelines for exercise. "Changes have not been enormous," said report author Charlotte Schoenborn, a health statistician at the CDC's National Center for Health Statistics. "It's been a very, very slow process of changing awareness of personal choices for healthier ways of life.” Added Rich Hamburg, deputy director of Trust for America's Health: "I think we're in a situation now where we're at a crossroads. We have two paths to go. We're hopeful that if we continue to invest in community-based prevention, if we promote healthy eating and active living, these rates will begin to decrease." Read more on CDC.
FDA’s New Food Defense Tool Helps Stop Intentional Contamination
The U.S. Food and Drug Administration (FDA) has developed a new Food Defense Plan Builder tool to help owners and operators of food facilities create plans to minimize intentional contamination. While rare, intentional contamination, intentional contamination can be a serious public health problem. For example more than 40 people in Kansas became sick in 2009 when an employee put pesticide in salsa. Based on FDA’s food defense guidance documents, the tool uses a series of pointed questions to develop a customized food defense plan, including a vulnerability assessment; broad and focused mitigation strategies; and an action plan. Read more on food safety.
Text4baby Programs Gives Pregnant Women, Mothers Critical Information
The 2013 Text4baby State Enrollment Content will promote the mobile health tool while providing pregnant women with important information on their pregnancy and their child’s first year of life. By texting “BABY” (or “BEBE” for Spanish) to 511411, they will receive three free weekly text messages addressing issues such as labor signs and symptoms; prenatal care; developmental milestones; immunizations; nutrition; birth defect prevention; and safe sleep. The program is supported by more than 950 health departments, academic institutions, health plans, businesses and the U.S. Department of Health and Human Services. Under the contest, the states with the highest enrollment percentages will be recognized at the American Public Health Association Annual Meeting in Boston, Mass. in early November. Read more on maternal and infant health.
Citing High Cancer Risk, Angelina Jolie Undergoes Preventive Double Mastectomy
A mutated BRCA1 or BRCA2 gene makes a woman five times more likely to develop breast cancer in her life. On Tuesday in an op-ed in The New York Times, Angelina Jolie — who carries a “faulty” BRCA1 — announced she has undergone a double mastectomy to reduce her risk of developing the cancer. Her physicians had estimated an 87 percent risk of breast cancer and 50 percent risk of ovarian cancer. "I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer,” she wrote. “It is my hope that they, too, will be able to get gene tested." A woman with one of the faulty genes is at an average 60 percent risk of developing breast cancer; a woman without a mutated gene is at an average 12 percent risk. Today CNN anchor Zoraida Sambolin also announced she is getting a double mastectomy. Read more on cancer.
RWJF Obesity Report Details Tactics that Could Save Billions in Health Care Costs
The medical costs of the ongoing U.S. obesity epidemic could be as high as $210 billion annually, according to James S. Marks, Senior Vice President for the Robert Wood Johnson Foundation Health Group. The loss of economic productivity likely adds even more billions to the toll. However, increasing the Congressional Budget Office’s time frame for estimating the cost of legislation from 10 years to 75 years would greatly improve the battle against obesity by enabling us to better estimate the true costs—and savings—of health care and public health efforts. The Campaign to End Obesity estimates that over 75 years, obesity screening by physicians would save $44 billion, the S-CHIP childhood obesity demonstration project would save $41 billion, the U.S. Centers for Disease Control and Prevention’s diabetes prevention program would save $18.4 billion and Medicare part D weight-loss drug coverage would save $11.4 billion. Read the full report.
Citing Cancer Risk, FDA Proposes New Rules for Youth and Indoor Tanning
The U.S. Food and Drug Administration (FDA) is proposing that sunlamp products used for tanning be reclassified as a moderate risk device—up from a low risk device—and made to carry recommendations warning against their use by young people. The ultraviolet radiation from indoor tanning increases the risk of melanoma by 75 percent, according to the American Academy of Dermatology. “Using indoor tanning beds can damage your skin and increase your risk of developing skin cancer,” said FDA Commissioner Margaret A. Hamburg, MD. “The FDA’s proposed changes will help address some of the risks associated with sunlamp products and provide consumers with clear and consistent information.” Read more on cancer.
FDA Warns Pregnant Women of Migraine Drug Ingredient’s Risk to Children
Noting the link between the migraine medicine ingredient valproate and lower IQ scores in children, the U.S. Food and Drug Administration (FDA) is warning all pregnant women not to take medication containing the ingredient. "Valproate medications should never be used in pregnant women for the prevention of migraine headaches because we have even more data now that show the risks to the children outweigh any treatment benefits for this use," said Russell Katz, MD, director of the division of neurology products in the FDA's Center for Drug Evaluation and Research. FDA is also warning women who may become pregnant not to use valproate unless it is medically “essential” and that they make sure they are on effective birth control. Read more on maternal and infant health.
CDC: Cutting Smoking in Subsidized Housing Would Save $521M Annually
Eliminating the ability to smoke in U.S. subsidized housing would save approximately $521 million each year in health care, renovation and fire-related costs, according to the U.S. Centers for Disease Control and Prevention (CDC). This includes public housing and rental assistance programs. Secondhand smoke can be especially problematic in multi-unit buildings with at-risk populations and smoking in common rooms. "Many of the more than 7 million Americans living in subsidized housing in the United States are children, the elderly or disabled," said Tim McAfee, MD, MPH, director of the Office on Smoking and Health at CDC. "These are people who are most sensitive to being exposed to secondhand smoke. This report shows that there are substantial financial benefits to implementing smoke-free policies, in addition to the health benefits those policies bring." Read more on tobacco.
HHS Campaign to Promote Breastfeeding by African American Mothers
The new It’s Only Natural public education campaign from the U.S. Department of Health and Human Services will work to raise awareness of the importance of breastfeeding among African American women, according to Surgeon General Regina M. Benjamin, MD, MBA. “One of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed,” she said in a release. “By raising awareness, the success rate among mothers who want to breastfeed can be greatly improved through active support from their families, their friends and the community.” While overall 80 percent of U.S. women start out breastfeeding, that number is only 55 percent for African American women. The new campaign provides material specifically targeting African American women and giving them the information and encouragement they need to start and continue breastfeeding. Read more on maternal and health disparities.
U.S. Infant Mortality Rates Down; More Improvement Still Needed
Improvements in prenatal care and a reduction in elective deliveries helped cut the U.S. infant mortality rate by 12 percent from 2005 to 2011, according to a new study in the NCHS Data Brief. The National Center for Health Statistics (NCHS) said the rate was down to 6.05 deaths per 1,000 live births in 2011 from 6.87 in 2005. The rate of death from SIDS also dropped 20 percent over the period. Still, study author Marian MacDorman, PhD, an NCHS statistician, said more work is needed, noting that “preterm birth rates are much higher than in other countries, and the same is true with infant mortality" and that "[i]nfant mortality among blacks is about twice what it is for white women,” according to HealthDay. Jeffrey Biehler, MD, a pediatrician at Miami Children's Hospital, said that we "need to continue to advocate for prenatal care for every woman, and make sure they are educated so they know to seek care as early as possible and avoid smoking and alcohol and other things that put them and their babies at risk.” Read more on maternal and infant health.
Hospital-based Quality Improvement Programs Cut Early Elective Deliveries
Elective early term deliveries are down significantly in part due to multistate, hospital-based quality improvement programs, according to a new study in the journal Obstetrics & Gynecology. Labor inductions and Cesarean sections without a medical reason were down 83 percent from 27.8 percent to only 4.8 percent over a one-year program at 25 hospitals. Early term babies are at increased risk of a host of medical problems and even death, according to the March of Dimes. “Reducing unnecessary early deliveries to less than five percent in these hospitals means that more babies stayed in the womb longer, which is so important for their growth and development,” said Edward R.B. McCabe, MD, medical director of the March of Dimes. Read more on maternal and infant health.
Study: School Lunch Standards Help Kids Maintain Healthy Weight
States with strict school lunch standards may be helping students maintain healthier weights, according to a new study in JAMA Pediatrics. The U.S. Department of Agriculture’s National School Lunch Program standards include maximums calories for lunches and the serving of only skim or reduced-fat milk. Depending on grade level, school lunches are between 550 and 850 calories. The preliminary findings help refute the concern that students would simply compensate with unhealthy snacks, according to Daniel Taber, MD, lead author from the Institute for Health Research and Policy at the University of Illinois at Chicago. Nutritionist Marion Nestle of New York University said that this “is important work and should stimulate government agencies to take a closer look at what they might do to make the food environment a lot healthier for children and adults.” Read more on obesity.
CDC: Many Skipping Medications to Save on High Health Care Costs
Lack of insurance and other factors are leading many Americans to request cheaper medications or even skip taking prescribed drugs, according to a new report from the U.S. Centers for Disease Control and Prevention. "Adults who do not take prescription medication as prescribed have been shown to have poorer health status and increased emergency room use, hospitalizations and cardiovascular events," said Robin Cohen of the NCHS's Division of Health Interview Statistics. About 20 percent of U.S. patients ages 18 to 64 requested cheaper medications from their health care providers; the uninsured in that group was also twice as likely—23 percent total—as those ages 65 and older to simply skip the medications entirely. Read more on prescription drugs.