Category Archives: Physical activity
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.
In the last decade or so, leaders in the field of architecture have begun to look at not just the aesthetics of building and community design, but also their own impact on the health of communities. In New York City, for example, the local chapter of the American Institute of Architecture’s New York chapter partnered with several agencies in New York City, including the departments of Health and Mental Hygiene, Design and Construction, Transportation, City Planning, and Office of Management and Budget, as well as research architects and city planners to create the city’s Active Design Guidelines. These provide architects and urban designers with a manual of strategies for creating healthier buildings, streets, and urban spaces, based on the latest academic research and best practices in the field. The Guidelines include:
- Urban design strategies for creating neighborhoods, streets, and outdoor spaces that encourage walking, bicycling, and active transportation and recreation.
- Building design strategies for promoting active living where we work and live and play, through the placement and design of stairs, elevators, and indoor and outdoor spaces.
NewPublicHealth recently spoke with Rick Bell, policy director of AIA New York, who was instrumental in the creation of the guidelines, about the burgeoning intersection between design and healthier communities.
>>Read more on architecture and design for a fit nation.
NewPublicHealth: How did AIA New York become involved in healthy design with the city of New York?
TFAH: U.S. Adult Obesity Rates Relatively Level, But Still Extremely High
Though adult obesity rates are level in all states except Arkansas, the rates are still far too high, according to F as in Fat: How Obesity Threatens America's Future 2013, a new report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation. The plateau comes after mostly 30 years of rising rates. No state had higher than a 15 percent obesity rate in 1980; today every state is about 20 percent and 13 states have rates higher than 30 percent. “While stable rates of adult obesity may signal prevention efforts are starting to yield some results, the rates remain extremely high,” said Jeffrey Levi, PhD, executive director of TFAH. “Even if the nation holds steady at the current rates, Baby Boomers—who are aging into obesity-related illnesses—and the rapidly rising numbers of extremely obese Americans are already translating into a cost crisis for the healthcare system and Medicare. In order to decrease obesity and related costs, we must ensure that policies at every level support healthy choices, and we must focus investments on prevention.” Read more on obesity.
Soda Consumption Tied to Higher Aggressive Behavior in Kids
Soda consumption is tied to higher aggressive behavior in kids, according to a new study in The Journal of Pediatrics. Study authors cautioned that the increase may not be apparent in individuals and the study does not show causation. However, previous studies have demonstrated a link between soda consumption and violent behavior. The researchers analyzed data of mothers’ assessment of their children’s aggressiveness, including acts such as destroying their belongings or the belongings of others. On an aggression scale of 0-100, kids who drank no soda scored an average of 56, kids who drank one scored 57, who drank two scored 58, who drank three scored 59 and who drank at least four scored 62. Janet Fischel, director of developmental and behavioral pediatrics in the department of pediatrics at Stony Brook University School of Medicine in New York, who was not involved in the study, believes it represents a strong first step. "I think it's really important and a giant first step in gathering an evidence base for what's becoming a very widespread dietary habit. I think that's really important.” Read more on pediatrics.
People with Insomnia Need Regular Exercise, Not a Quick Trip to the Gym
It takes time for exercise to help cure insomnia, so people shouldn’t expect one trip to the gym to do the trick, according to a new study in the Journal of Clinical Sleep Medicine. "The message here is that exercise is not a quick fix, which I don't really think is discouraging at all," said study author Kelly Baron, director of the Behavioral Sleep Medicine Program with the Feinberg School of Medicine at Northwestern University in Chicago. "Our previous work found that exercise over a 16-week period is very effective in promoting sleep, on par with any kind of medication. But like with weight loss or any sort of behavioral change, it doesn't happen immediately. You have to measure progress over months, not day-to-day." Baron said it is important for people with insomnia to make exercise a part of their routine, planning ahead and being sure to make it a regular endeavor. She also noted that a poor night of sleep makes it less likely for someone to exercise the next day, further emphasizing the need for routine. Approximately 14 percent of the population experiences chronic insomnia. Read more on physical activity.
In the national conversation on the spreading epidemic of obesity and chronic diseases, and the ways in which public health initiatives can fight these issues, architecture and design are continuing to play a leading role in developing fit and healthy solutions. The way a community or a school or a store or a workplace is built can actually influence physical activity, access to healthier food and more to help create an overall fitter nation.
FitNation is an initiative that highlights innovative design strategies across the country to get people healthy and moving. These projects, which stretch across the realms of local and national policy and grassroots-driven action to urban improvements, are brought together in FitNation as inspired by New York City’s Active Design Guidelines and the annual Fit City Conference, which is a partnership between the American Institute of Architects New York and the New York City Department of Health and Mental Hygiene.
Here is a selection of some of the creative solutions featured in FitNation that were developed to help individuals and communities lead happier and healthier lives.
Red Swing Project
Design by Hatch Workshop and University of Texas at Austin Architecture Students
Starting in Austin, Texas, a group of architecture students seeking to make better use of public spaces started the Red Swing Project, an open source initiative to transform some unexpected places into playgrounds. The swings consist of a piece of scrap wood, painted red, and rock climbing rope and have popped up all over the world—transforming areas hit by natural disasters, lining a bicycle path from Paris to Barcelona, and below an interstate overpass. You can track the project online with a geo-tagged map or through #redswingproject on Instagram and Facebook.
Urban Farming Food Chain, Edible Wall
Design by Elmslie Osler, Architect
Los Angeles, CA
We all know that some of the healthiest foods grow on trees, but now in Los Angeles thanks to the Urban Farming Food Chain, they can grow on walls too. The Food Chain consists of “edible walls” that grow fresh fruits, vegetables, and herbs, intended to provide economically disadvantaged populations with healthier food options. The walls are installed on pre-existing structures and have storage for tools, seeds and soil. This project’s vertical angle on community gardens help provide social activities as well as the opportunity to share and develop skills and healthy habits.
Even Insured Low-income Immigrants Less Likely to Visit Doctors
About 47 percent of insured and uninsured low-income immigrant children saw a doctor in 2010, compared about 60 percent for U.S.-born children, according to a new study from the Migration Policy Institute (MPI). The report also found that immigrant adults are less likely (8 percent) than native-born adults (13 percent) to visit emergency rooms. As immigrants are generally not eligible for coverage under the Affordable Care Act, their care will in many cases fall to health departments. Read more on access to care.
Exercise Alone Won’t Lower Weight; Lifestyle Changes Also Required
Exercise alone is good for maintaining a healthy weight, but should be combined with other lifestyle changes if a person expects to lose weight and then keep it off. People also negate the positive effects of exercise by overindulging in their post-workout rewards. "There's a war between exercise and nutrition in our heads," said American Council on Exercise spokesperson Jonathan Ross. "People tend to overestimate the amount of physical activity they get. They work out a little bit and treat themselves a lot." Between 250 and 300 minutes of exercise each week is necessary for weight loss, according to Joseph E. Donnelly, MD, an exercise physiologist with the American College of Sports Medicine; the government’s recommendation of 150 minutes of moderate-intensity is for cardiovascular fitness. A single pound of fat is about 3,500 calories. Read more on physical activity.
Soda Company to Stop Adding, Promoting Antioxidants in Some 7UP Drinks
The Dr. Pepper Snapple Group has agreed to stop fortifying certain of its 7UP soft drinks with vitamins and will no longer claim the product has antioxidants. The agreement ends a class action lawsuit against the company. 7UP’s regular and diet Cherry Antioxidant, Mixed Berry Antioxidant and Pomegranate Antioxidant varieties had small amounts of vitamin E added at the time of the lawsuit. According to the complaint, the pictures of cherries, blackberries, cranberries, raspberries and pomegranates on various 7UP labels gave the impression that the antioxidants might have come from fruit, but there is no fruit juice of any kind in any variety of 7UP. And last week a federal magistrate ruled that a separate lawsuit against Coca-Cola, for what the Center for Science in the Public Interest says is deceptive marketing of its vitaminwater line of soft drinks, may proceed as a class action suit. Read more on nutrition.
NIH: Greater Physical Activity Linked to Lower Stroke Risk
People who exercise vigorously enough to work up a sweat are at reduced risk for stroke, according to a new study in the journal Stroke. Inactivity is one of the main risk factors for stroke, along with high blood pressure, diabetes and smoking. Researchers found that inactive people were 20 percent more likely to experience a stroke or transient ischemic attack (TIA) than subjects who exercised at least four times a week. Researches utilized data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a long-term study funded by the National Institutes of Health’s National Institute of Neurological Disorders and Stroke that looks at the reasons behind the higher rates of stroke mortality among African-Americans and others in the Southeastern United States. “Our results confirm other research findings but our study has the distinct advantage of including larger numbers, especially larger numbers of women as well as blacks, in a national population sample so these provide somewhat more generalizable results than other studies,” said Virginia Howard, PhD, senior author of the study from the School of Public Health, University of Alabama at Birmingham. Read more on stroke.
Study: Calorie Guidance on Menus Doesn’t Lead to Healthier Eating
Research had already shown that providing calorie counts on restaurant menus did little to improve food selection. New research now shows that offering general daily or per-meal calorie guidelines also does little to help people make healthier eating choices, according to a study in the American Journal of Public Health. "The general inability of calorie labeling to result in an overall reduction in the number of calories consumed has already been pretty widely shown," said study lead author Julie Downs, an associate research professor of social and decision sciences in the Dietrich College of Humanities and Social Sciences at Carnegie Mellon University. "So that's nothing new. But in the face of that, there has been the growing thought that perhaps the problem is that people don't know how to use the information without some framework, some guidance." Instead, the study found that people given calorie guidance not only didn’t make overall better use of calorie labeling or consume fewer calories, but they actually consumed slightly more calories. Lona Sandon, a registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, said the findings help illustrate that “[k]nowledge is just one piece of the puzzle. We must consider people's attitudes, beliefs and values surrounding healthier eating and body weight.” Read more on nutrition.
Sequester to Close all HUD Offices on July 22
Every office of the U.S. Department of Housing and Urban Development (HUD) will be closed on Monday, July 22 as part of the sequester which is being felt across all of government. The automatic spending cuts took effect March 1. HUD’s plan is to pair its seven required furlough days with holidays and weekends. HUD is encouraging people and businesses that work with the agency to plan around the schedule day of shutdown. Read more on budgets.
The final plenary session at this year’s NACCHO Annual included a talk by Christopher Murray, MD, DPhil, director of the Institute for Health Metrics and Evaluation at the University of Washington on how data is used to measure health, evaluate interventions and find ways to maximize health system impact. Dr. Murray was a lead author on three pivotal studies published last week that used data to assess the state of health in the United States compared with 34 other countries and county level data on diet and exercise. One of the key findings is that Americans are living longer, but not necessarily better—half of healthy life years are now lost to disability instead of mortality; and dietary risks are the leading cause of U.S. disease burden.
NewPublicHealth spoke with Dr. Murray about the study findings, their impact and upcoming research that can add to the data public health needs to improve the health of all Americans.
NewPublicHealth: Tell us about the three studies that were published this week using the Institute’s research.
Dr. Murray: The study in JAMA [Journal of the American Medical Association] is an analysis of a comprehensive look at the health of the United States in comparison to the 34 OECD [Organisation for Economic Co-operation and Development] countries. The study looks at both causes of death and premature mortality through over 290 different diseases and puts them all together in a comprehensive analysis of what the contributors are to lost healthy life. That study also looks at the contribution to patterns of health in the U.S., from major environmental, behavioral, and metabolic risk factors. In each of those categories, there are important findings:
- The U.S. spends the most on healthcare but has pretty mediocre outcomes and ranks about 27th for life expectancy among its peer countries.
- For many large, important causes of premature death, the U.S. does pretty poorly. And we also see a big shift towards more and more individuals having major disability—from mental disorders, substance abuse, and bone and joint disease.
- On the risk factor front, the big surprise is that diet is the leading risk factor in the U.S. It is bigger than tobacco, which is second and then followed by obesity, high blood pressure, high blood sugar, and physical inactivity. Diet in this study is made up of 14 subcomponents, each analyzed separately and then put together.
International Making Cities Livable Conference: UCLA’s Richard Jackson on Shaping Healthy Suburban Communities
"We have medicalized what is in fact an environmental-driven set of diseases," said Richard Jackson, MD, MPH, professor and chair of environmental health science at the UCLA School of Public Health, in a keynote presentation that energized and galvanized discussion among the diverse audience of city planners, architects and public officials at this week’s International Making Cities Livable Conference. This year’s conference focuses on bringing together a vision— across sectors—of how to shape healthy suburban communities.
Jackson, a prominent pediatrician and host of the “Designing Healthy Communities” series that aired on PBS, told an all-too-familiar story of a child who comes into a doctor’s office overweight and with alarming cholesterol and blood pressure results even at a young age. So the doctor prescribes behavior change: No soft drinks in the house. No screens in the bedroom. Exercise, do more, and come back in two months. In two months, what’s changed? Nothing. The food at school is still unhealthy, the neighborhood is still unsafe to play in and the family still uses the car to get absolutely everywhere because there is no other choice. The likely outcome for that child and so many others, said Jackson, is to end up on costly cholesterol medication just two months later when the child’s vital statistics continue to spiral out of control.
"It’s a 20th century idea that our minds are separated from our bodies, and our communities are separated from ourselves,” he Jackson, who reminded the crowd that the most critical health advancements in the last century took place because of changes in infrastructure, not medicine—primarily new sanitary standards to curb out-of-control infectious disease.
Now, said Jackson, “We’ve built America around the car” and we need a whole new set of infrastructure changes to re-build communities that offer better opportunities for health as part of everyday life. “The built environment is social policy in concrete.”
Jane Brody is the Personal Health columnist for The New York Times. She joined the newspaper in 1965 as a specialist in medicine and biology after receiving degrees in biochemistry and writing for multiple college newspapers, as well as for the Minneapolis Tribune. With her column she has seen and reported on almost 50 years in the evolution of personal and community health.
NewPublicHealth recently spoke with Brody about her take on the state of community health—and what we can all do to improve it.
NewPublicHealth: Over the years, what efforts have you seen that you think have been most effective at improving community health?
Jane Brody: Well, I think one of the most exciting things that’s happened in New York City, and possibly in other cities as well, is getting better food to people who live in food deserts. For example, collecting food that would otherwise be wasted and bringing it to communities where people get free food that is healthy, fresh, and they even have demonstrations of recipes. In fact, I got one of my favorite recipes—it’s a green bean frittata—from one of their demonstrations that I attended just to see how it all worked out.
We’ve also, as you’ve no doubt heard, been putting in all of these bike lanes and we now have introduced the Bike Share Program, which is not inexpensive, but it does at least give more people an opportunity to get off their butts and get out of their cars and maybe even not even use public transportation in some cases, but to get some exercise to and from work, which is wonderful. I remember during one of the transit strikes that we had in New York City, I rode my bicycle from Brooklyn to Times Square where I work, over the bridges and stuff, and it was just wonderful because I got my exercise in at the same time as I got to work and I didn’t have to spend an extra hour exercising. There have been improvements. We have, of course, public pools that are only open in the summer, but in summer is better than no public pools and nobody has to pay anything for a public pool, which is really great.
A community needs assessment of a Chinese-American community in New York City several years ago found multiple barriers to physical activity for children and teens including parents unable to supervise kids at play because of long work hours, unsafe neighborhoods, limited knowledge or access to existing programs, financial hardship, inadequate support for physical activity in schools, limited time due to competing priorities such as academics, and too much time in front of video games, computer screens and television. To increase exercise time and options and help to reduce obesity rates among Chinese-American youth, public health professionals from the Charles B. Wang Community Health Center sought out funding from the New York State Department of Health and Mental Hygiene to create the Chinatown JUMP (Joining Urban Partners for More Physical Activity) program.
>>Read more on New York's Health Improvement Plan, which sets out a plan for similar community health assessments and cross-sectoral collaborations in response to these findings.
Chinatown JUMP currently works with eight afterschool programs to incorporate daily physical activity into the curriculum of these academic programs, blending activity with learning. Program goals include:
- Promote healthier and fit children by educating them and their families about the correlation between exercise and staying healthy.
- Increase staff capacity to support students’ healthier lifestyle through training and technical assistance.
- Establish an afterschool culture that supports physical activity as well as academic achievement.
The program works hard to incorporate parents’ support and involvement as well. Participating students in iMove receive a community resource guide with information about free and low-cost recreational centers and public spaces in the neighborhood to share with their parents. Parents are also invited to workshops on the importance of physical activity and healthy eating habits.
NewPublicHealth recently spoke with Susan Yee, Associate Director of Programs at the Charles B. Wang Community Health Center, about Chinatown JUMP.
NewPublicHealth: What is the Chinatown JUMP program and what do you think sets it apart from other programs with similar goals?
Susan Yee: Chinatown JUMP’s goal is to try to improve opportunities for more physical activity in the Manhattan Chinatown area in order to create sustainable changes within the community.