Category Archives: Physical activity
GAO Recommends FDA Set Schedules for Decisions on New Tobacco Products
The General Accounting Office issued a report yesterday recommending that the U.S. Food and Drug Administration (FDA) establish performance measures for the Center for Tobacco Products that include time frames for making decisions on the approval of new tobacco product submissions. The FDA has had authority over tobacco for more than four years, but a backlog remains on new tobacco products the agency must approve. New tobacco products applications submitted to the agency include devices that may deliver less nicotine to people who smoke. In a response to a draft of the GAO report, the FDA noted that the GAO report recognized that “the length of time from the end of jurisdiction review to the end of completeness review decreased from 8 months in FY2011 to 2 months in FY2012. This constitutes considerable progress and is a reflection of CTP’s ongoing commitment to shortening review times.” Read more on tobacco.
American Heart Association: Unlock School Gates
A new policy statement from the American Heart Association (AHA), published in the American Journal of Public Health, says school districts can increase physical activity among children and young adults by opening playgrounds, gyms and playing fields to the community outside of school hours, especially in low-income areas. AHA recommends that school districts enter shared-use agreements with community organizations to allow supervised activities such as sports leagues and unsupervised playing on school grounds. When previously locked schoolyards in two lower-income communities in New Orleans were opened and activities supervised, children’s outdoor physical activity was 84 percent higher than in a community with closed schoolyards, according to research cited in the statement. A U.S. Centers for Disease Control and Prevention survey finds that 61.6 percent of 800 school districts surveyed have a formal agreement for use of their facilities. Increasing shared use agreements is a key goal of Voices for Healthy Kids, a collaboration of the American Heart Association and the Robert Wood Johnson Foundation to reverse the current levels of childhood obesity by 2015. Read more on physical activity.
DOT Announces Funding to Improve Transit Safety and Preparedness
The U.S. Department of Transportation has announced the availability of $29 million in research funds for innovative projects to help transit agencies strengthen operational safety; better withstand natural disasters and other emergencies; and improve emergency response capabilities. “For the first time in FTA’s history, we’re calling on the transit industry, the private sector, universities and others to work with us to develop and implement innovative solutions…bringing transit facilities into a state of good repair,” said Federal Transit Administration (FTA) head Peter Rogoff. “This will translate into real-world improvements…ranging from reducing transit-related injuries to making transit systems less vulnerable to flooding and severe weather.” Funding proposals will be considered in three areas: operational safety; resiliency; and all-hazards emergency response and recovery. Read more on transportation.
American Heart Association: Doctors Should Routinely Ask About Physical Activity
A new scientific statement from the American Heart Association says that doctors should evaluate their patients’ physical activity habits as routinely as checking blood pressure and other risk factors for cardiovascular diseases. The statement was published in the journal Circulation.
The statement says that an exercise checkup should cover types, frequency, duration and intensity of physical activity at work, home and during leisure time.
The American Heart Association recommends at least 30 minutes of moderate-intensity aerobic activity five days a week or more, or at least 20 minutes of vigorous aerobic activity three days a week or more and moderate- to high-intensity muscle strengthening at least two days a week. Read more on heart health.
People with Mental Health Problems More Likely to be Uninsured
A new University of Minnesota study published in Health Affairs finds that people with mental health problems are more likely to be uninsured and rely on public insurance than people without mental health problems. The study reviewed national insurance coverage rates from 1999 to 2010. The study authors say the implementation of the Affordable Care Act will give many more people with mental health problems access to health insurance – particularly in states such as Minnesota that have that have opted to expand their Medicaid programs. The researchers also say that people with mental health problems on public insurance have better access to care and lower cost barriers than the uninsured or those with private health insurance coverage.
Kathleen Rowan, the lead author of the study and a doctoral student in health services research, policy, and administration at the University of Minnesota School of Public, says, “unfortunately, most persons with mental illness do not receive needed care due in part to a lack of health insurance coverage and the cost of treatment.” Read more on mental health.
Study: Research to Delay Aging is a Better Investment Than Cancer, Heart Disease Research
A new study in current issue of Health Affairs finds that research to delay aging and the infirmities of old age would produce better health and economic returns than advances in some fatal diseases such as cancer or heart disease.
The study found that even modest gains in the scientific understanding of how to slow the aging process would result in an additional 5 percent of adults over the age of 65 remaining healthy rather than disabled every year from 2030 to 2060, or 11.7 million more healthy adults over age 65 remaining healthy by 2060.
The analysis was conducted by scientists from a consortium of research centers. “Even a marginal success in slowing aging is going to have a huge impact on health and quality of life. This is a fundamentally new approach to public health that would attack the underlying risk factors for all fatal and disabling diseases,” said S. Jay Olshansky, professor of epidemiology at the UIC School of Public Health and one of the study’s authors. “We need to begin the research now. We don’t know which mechanisms are going to work to actually delay aging, and there are probably a variety of ways this could be accomplished, but we need to decide now that this is worth pursuing.” Read more on aging.
A recent article in The Atlantic on the history of competitive sports among American kids led The New York Times to write a wide-ranging debate on the pros and cons of competitive sports for kids and teenagers. The pivotal question: Do competitive sports overwhelm childhood or enhance it?
It’s an important debate. Sports can represent a gateway to a life of enjoyable exercise, good for both the heart and mind. But they also pose, as currently played, some significant risks. These include the risk of injury or even death and unhealthy competitive traits, all of which can be a turn-off for physical activity of all kinds for kids made to play and practice against their will.
Those weighing in on the Times’ debate pages include the head of Little League International, who says sports teach kids valuable lessons; a sociologist who says that since so few kids ever make their living in professional sports, we need a greater emphasis on education than athletics; and the head of the American Orthopaedic Society for Sports Medicine, who says that most children's bodies are not capable of playing one sport day after day, for years on end, and because of this many kids have bone and joint injuries.
>>Bonus Links: Read NewPublicHealth interviews on preventing concussions in youth sports with MacArthur fellow Kevin Guskiewicz, and Robert Faherty, VP and Commissioner of the Babe Ruth youth baseball league.
Four U.S. Regions on Alert for Severe Weather this Weekend
Severe weather is expected to impact at least four regions of the United States this weekend. That includes a tropical storm—downgraded from a hurricane for now—in the Gulf Coast; a tornado threat in the Midwest; early snow in the West that, in part because trees still have leaves that can be weighed down by wet snow, could lead to power outages; and spreading fires in California fueled by dry weather. The Federal Emergency Management Agency (FEMA) has already recalled some furloughed staff to prepare for the storms expected on the Gulf Coast. Read more on preparedness.
Study: Unnecessary Antibiotic Prescriptions Remain High, Endanger Public Health
Despite ongoing efforts by the U.S. Centers for Disease Control and Prevention (CDC) and other public health organizations, doctors continue to overprescribe antibiotics for sore throats, increasing the risk of the development of antibiotic-resistant bacteria, according to a new study in JAMA Internal Medicine. “Our research shows that while only 10 percent of adults with sore throat have strep, the only common cause of sore throat requiring antibiotics, the national antibiotic prescribing rate for adults with sore throat has remained at 60 percent,” said senior author Jeffrey A. Linder, MD, MPH, a physician and researcher in the Division of General Medicine and Primary Care at Brigham and Women’s Hospital. “For acute bronchitis, the right antibiotic prescribing rate should be near zero percent and the national antibiotic prescribing rate was 73 percent.” The researchers said the findings demonstrate the need to study and implement new interventions to reduce unnecessary antibiotic prescriptions. Read more on infectious disease.
Daily Walks Can Reduce Breast Cancer Risk for Older Women
Post-menopausal women can reduce their risk of developing breast cancer through physical activity as simple as a daily walk, according to a new study in Cancer Epidemiology, Biomarkers & Prevention. More intense exercise may have an even more profound impact. "The nice message here is, you don't have to go out and run a marathon to lower your breast cancer risk," said study researcher Alpa Patel, senior epidemiologist at the American Cancer Society, which funded the study. "Go for a nice, leisurely walk an hour a day to lower risk.” However, the study authors noted that they found only a correlation, not a causation, so further study is needed. Experts believe the reason exercise reduces breast cancer risk is related to hormones; they also recommend maintaining a healthy body weight and minimizing the consumption of alcohol as ways to reduce the risk of breast cancer. Read more on cancer.
Study: Improved Layperson CPR Education Increases Bystander Intervention, Saves Lives
As many as 80 percent of cardiac arrests occur outside of a hospital, meaning that improving the layperson’s knowledge of cardiopulmonary resuscitation (CPR) could improve the odds of effective bystander intervention—and along with it the chances of survival, according to a new study in the Journal of the American Medical Association. "In many cases, time from recognition of cardiac arrest to the arrival of emergency medical services is long, leaving bystanders in a critical position to potentially influence patient prognosis through intervention before EMS arrival," according to the study. "However, only a minority of cardiac arrests receive bystander CPR." The study authors looked at a 10-year period of about 19,400 out-of-hospital cardiac arrests in Denmark, finding that as the percentage who received bystander CPR rose from about 21 percent to 45 percent, the rate of people who arrived alive to the hospital also rose from about 8 percent to 22 percent. Read more on heart health.
Post-menopausal Hormone Therapy Ineffective at Long-term Disease Prevention
Post-menopausal hormone therapy is not effective at the long-term prevention of heart disease and other chronic conditions, according to a new study in the Journal of the American Medical Association. The study a review of the Women's Health Initiative (WHI), which is a collection of U.S. trials established to assess the role of hormone therapy in preventing chronic diseases in more than 27,000 healthy, older women. They found that the benefits were minimal and were offset by concerns over complications such as elevated rates of blood clots and strokes. However, the findings do support the continued use of hormone therapy for the short-term treatment of hot flashes, as well as for “relatively younger women who use it for a finite time,” according to HealthDay. Read more on prevention.
Study: Exercise as Effective as Drugs at Treating Heart Disease
When it comes to treating heart disease, exercise may be just as effective as medication, according to a new study in the British Medical Journal. The researchers from Britain's London School of Economics and Harvard and Stanford universities said this means physical activity should also be included as a comparison during the development and testing of new medications, as the lack of its inclusion "prevents prescribers and their patients from understanding the clinical circumstances where drugs might provide only modest improvement but exercise could yield more profound or sustainable gains." Cardiovascular disease accounts for 17 million global deaths each year. Another recent study also reinforced the ability of exercise to help prevent high blood pressure. Read more on physical activity.
U.S. Youth Exercise, Diet Improved Over Past Decade
Exercise and dietary habits of U.S. kids and teenagers seems to have improved over the past decade, according to a new study in the journal Pediatrics. The study found that from 2001-2002 to 2009-2010, the average number of days per week being physically active for at least 60 minutes for sixth through tenth graders climbed from 4.3 to 4.5; the days eating breakfast before school climbed from 3 to 3.3; and hours per day watching television dropped from 3.1 to 2.4. The findings suggest that it takes time for public health efforts to translate into behavioral changes. "I would like to believe that all the public health efforts focusing on increasing physical activity and increasing fruit and vegetable consumption are having an effect, because that seems to be a pattern," said Ronald Iannotti, study author from the University of Massachusetts Boston. "The fact that (obesity) is leveling off, that's a surprise and a major change from the steady increase that we've seen over time.” Read more on pediatrics.
Study: Kids of Same-sex Couples Less Likely to Have Private Health Insurance
Children of same-sex parents are less likely to have private health insurance, although the rates improve in states that recognize same-sex marriages or unions, according to a new study in the journal Pediatrics. Approximately two-thirds of U.S. youth with same-sex parents have private health insurance, compared to approximately 78 percent of U.S. youth with married heterosexual parents. When accounting for additional factors such as parental incomes and education level, researchers determined that youth living with same-sex parents were as much as 45 percent less likely to have private health insurance than were youth living with married heterosexual parents. The findings indicate yet another public health benefit of same-sex marriage, as access to health insurance directly affects a child’s health; previous studies have shown a connection between legal unions and improved mental health for gay and lesbian adults. A likely cause for the disparity is the fact that employers have not had to extend coverage to an employee’s same-sex partner or that employee’s children. "I think we are going to see more and more research like this that shows how marriage-equality laws have far-reaching health consequences," said Richard Wight, a researcher at the University of California, Los Angeles, who was not a part of the study. Read more on LGBT issues.
HHS: $67M for Expanded Preventive and Primary Care for 130,000 Americans
The U.S. Department of Health and Human Services (HHS) has awarded approximately $67 million for the creation of 32 new health service delivery sites to expand access to individuals, families and communities across the country. The sites will provide improved preventive and primary health care to more than 130,000 people. Another $48 million will go toward the approximately 1,200 existing centers. “Health centers have a proven track record of success in providing high quality health care to those who need it most,” said HHS Secretary Kathleen Sebelius. “New health center sites in some of the neediest communities in the country will provide access to health care for individuals and families who otherwise may have lacked access to high quality, affordable and comprehensive primary care services.” Read more on access to health care.
Higher Education Linked to Better Obesity Rates for Women in Poorer Areas
Higher education is a key factor that helps protect women in economically disadvantaged areas from obesity, according to a new study in the American Journal of Health Promotion. “It is possible that education is a marker of an individual’s access to health information, capacity to assimilate health-related messages, and ability to retain knowledge-related assets, such as nutrition knowledge,” wrote the study’s authors. Previous studies have shown that women living in area with fewer economic resources have higher body mass index (BMI) than other women. The results indicate that both low education and personal income should be addressed by obesity prevention initiatives. Read more on obesity.
Regular Exercise May Help Decrease Depression
Increases in exercise may be linked to decreases in depression, according to a new review of existing research by The Cochrane Library. The researchers found people with depression who also exercised saw a “moderate” reduction in their symptoms when compared to people who did instead used relaxation techniques or received no treatment. Antidepressant medications and psychotherapy are the most common treatments for depression, which affects about 10 percent of Americans, according to the U.S. Centers for Disease Control and Prevention. More research is needed to better understand the relationship between exercise and depression symptoms. Still, Madhukar Trivedi, MD, a professor of psychiatry at the UT Southwestern Medical Center in Dallas, who was not a part of the study, said one of the keys is making sure patients stick with the exercise regimen. "Once people are prescribed exercise or they choose exercise, the big challenge is to make the exercise real," he said. "If the recommendation from the treating clinician is that you should be exercising with some frequency and intensity…it's important that the patient follow that regimen week after week.” Read more on mental health.
Predominantly Black Nursing Homes Deliver Lower Levels of Care, Perform Worse Financially
Nursing homes that are predominantly populated by black residents deliver overall poorer care and are less successful financially than homes with few or not minority residents, according to a new study in Health Services Research. The study looked at issues such as the ratio of nursing staff to patients, success in preventing pressure ulcers, help with walking, help with getting out of bed, prevention of urinary tract infections, the incidence of medication errors and citations by governmental agencies. However, the study noted that black and white patients living in the same facilities received equal treatments, meaning the disparity is not due to any biases of health care workers. One factor leading to the disparity could be the fact that older black Americans are more likely to rely on Medicaid, which means lower reimbursement rates. Still, Latarsha Chisholm, assistant professor at the University of Central Florida and study author, believes something more must be at play. "It isn't only the financial performance [of nursing homes] that affects performance," she said. "There has to be something else affecting quality. I want to understand what management practices promote improved care in nursing homes with high proportions of minorities that don't have disparities in care.” Read more on health disparities.
Last week the Public Health Accreditation Board (PHAB) awarded five-year national accreditation status to five public health departments, bringing the number of health departments now accredited to 19 since the credential was launched two years ago. Hundreds more health departments are currently preparing to apply for accreditation, which includes a peer-reviewed assessment process to ensure it meets or exceeds a set of public health quality standards and measures. Among the newly accredited is the Chicago Department of Public Health.
"This is an important achievement and recognition that highlights the city of Chicago’s ongoing commitment to health and wellness on the part of all of our residents,” said Chicago Mayor Rahm Emanuel in a statement issued by PHAB. "We are focused on policies that will help all Chicagoans and their families enjoy the highest quality of life, [and w]e will continue to strive to make Chicago one of the healthiest cities in the world."
NewPublicHealth recently spoke with Bechara Choucair, MD, MS, Commissioner of the Chicago Department of Public Health, about the value of accreditation for improving the health of the community—and about how this effort supports Healthy Chicago, the city’s public health agenda.
>>Read more about Healthy Chicago in a previous NewPublicHealth Q&A with Choucair.
NewPublicHealth: You’re one of the first public health departments to be accredited. How did that happen so quickly?
Bechara Choucair: When we released Healthy Chicago in 2011, one of the strategies we identified was to obtain accreditation. We wanted to be the first big city to earn the credential. It took us 18 months and we are excited that we are the first big city to be accredited and the first in Illinois. And one of the added bonuses of accreditation is a sense of pride. It says a lot to our staff, residents and our mayor.
NPH: A community health assessment is required as part of the accreditation application. What did Chicago’s community health assessments entail?
CDC: U.S. School Districts Seeing Improvements in Multiple Health Policies
U.S. school districts are seeing continued improvements in measures related to nutritional policies, physical education and tobacco policies, according to the U.S. Centers for Disease Control and Prevention (CDC). The findings are part of the 2012 School Health Policies and Practices Study, a periodic national survey assessing school health policies and practices at the state, district, school, and classroom levels. "Schools play a critical role in the health and well-being of our youth," said CDC Director Tom Frieden, MD, MPH. "Good news for students and parents – more students have access to healthy food, better physical fitness activities through initiatives such as ‘Let’s Move,’ and campuses that are completely tobacco free."
Among the key findings:
- The percentage of school districts that allowed soft drink companies to advertise soft drinks on school grounds decreased from 46.6 percent in 2006 to 33.5 percent in 2012.
- Between 2006 and 2012, the percentage of districts that required schools to prohibit junk food in vending machines increased from 29.8 percent to 43.4 percent.
- The percentage of school districts that required elementary schools to teach physical education increased from 82.6 percent in 2000 to 93.6 percent in 2012.
- The percentage of districts with policies that prohibited all tobacco use during any school-related activity increased from 46.7 percent in 2000 to 67.5 percent in 2012.
Read more on school health.
Poor Oral Health Linked to Increased Risk for Oral HPV Infection
Poor oral health is associated with increased risk of the oral human papillomavirus (HPV) infection responsible for as many as 80 percent of oropharyngeal cancers, according to a new study in the journal Cancer Prevention Research. Researchers found that people who reported poor oral health had a 56 percent higher prevalence oral HPV, people with gum disease had a 51 percent higher prevalence and people with dental problems had a 28 percent higher prevalence. “The good news is, this risk factor is modifiable—by maintaining good oral hygiene and good oral health, one can prevent HPV infection and subsequent HPV-related cancers.” said Thanh Cong Bui, MD, postdoctoral research fellow at the University of Texas School of Public Health. Other factors also increased the risk, such as being male, smoking tobacco or using marijuana. Read more on cancer.
Study: Hospital Pediatric Readmission Rates Not an Effective Measure of Quality of Care
Hospital readmission rates for children are not necessarily an effective measurement of the quality of care, according to a new study in the journal Pediatrics. "As a national way of assessing and tracking hospital quality, pediatric readmissions and revisits, at least for specific diagnoses, are not useful to families trying to find a good hospital, nor to the hospitals trying to improve their pediatric care," study author Naomi Bardach, MD, an assistant professor of pediatrics at the University of California, San Francisco, Benioff Children's Hospital. "Measuring and reporting them publicly would waste limited hospital and health care resources." After analyzing 30- and 60-day readmission rates for seven common pediatric conditions, researchers found that at 30 days readmission for mood disorders was most common, at 7.6 percent, followed by 6.1 percent for epilepsy and 6 percent for dehydration. Readmission rates for asthma, pneumonia, appendicitis and skin infections were all below 5 percent. Bardach said the low rates leave “little space for a hospital to be identified as having better performance.” Further study could improve the way readmission rates are utilized to assess the quality of pediatric care. Read more on pediatrics.