Category Archives: Preparedness
CDC Report Details Support of State, Local Health Responses
The U.S. Centers for Disease Control and Prevention (CDC) has released a new report detailing its support of state and local public health responses from 2012 to 2013, as well as assessments of all state and select local public health preparedness. The 2013-2014 National Snapshot of Public Health Preparedness is the sixth annual report from CDC’s Office of Public Health Preparedness and Response. “The lives protected by the public health response to Hurricane Sandy, the fungal meningitis outbreak, and the tornadoes in Joplin are just a few examples of how communities and CDC can work together to protect the public's health when its needed most,” said CDC Director Tom Frieden, MD, MPH.
Among the report’s highlights:
- During outbreaks and emergencies, response time is essential. In 2012, lead state responders reported for immediate duty within 27 minutes of receiving notification of a potential public health emergency—9 minutes faster than the 2011 national average.
- In 2012, across the 62 Public Health Emergency Preparedness (PHEP) cooperative agreement awardees, Emergence Management Program (EMP) activities included 185 engagements and 204 exercises. Internationally, EMP activities across 35 countries included 15 activations, 19 engagements, and 12 exercises.
- The percentage of E. coli-positive tests analyzed and entered into the PulseNet database within four working days increased from 90 percent to 94 percent and timely testing and reporting of Listeria-positive results increased from 88 percent to 92 percent.
“The ability of our local and state health departments to be innovative and maintain a steady level of preparedness despite extensive budget cuts is reassuring,” said Ali Khan, M.D., M. P. H., director CDC’s Office of Public Health Preparedness and Response. “However, preventing an erosion of our nation’s health security will be difficult in the current fiscal environment.” Read more on preparedness.
Study: Overweight Kindergarteners Four Times as Likely to Be Overweight Teens
Children who are overweight at the age of five are four times as likely to be obese by the age of 14 than are children who start their school years at an average weight, according to a new study in the New England Journal of Medicine. Approximately 27 percent of the five-year-olds in the study were overweight. Using data on almost 8,000 children gathered by the Early Childhood Longitudinal Study conducted by the U.S. National Center for Education Statistics, researchers determined that:
- Approximately 32 percent of kids who were overweight when they entered kindergarten had become obese by age 14, compared to 8 percent of normal-weight kindergarteners.
- The obesity rate rose most rapidly between first and third grades—from 13 percent to almost 19 percent—but not significantly between fifth and eighth grades.
- Between kindergarten and eighth grade, the prevalence of obesity rose by 65 percent among white children, 50 percent among Hispanic children and more than doubled among black children.
"If we're just focused on improving weight when kids are adolescents, it may not have as much of an impact as focusing on the preschool-age years," said lead researcher Solveig Cunningham of Emory University, adding that the study "doesn't tell us what to do about it, but it helps tell us when we need to think creatively about what to do." Read more on obesity.
Study: One-third of Americans, Two-Thirds of University Students Have Used Indoor Tanning
Despite clear and widespread data on their link to skin cancer risk, more than a third of Americans and nearly two-thirds of U.S. university students have used indoor tanning, according to a new study in the journal JAMA Dermatology. Approximately 19 percent of teens had also used the machines. Researchers at the University of California, San Francisco based their conclusions on an analysis of 88 surveys covering more than 406,000 people in the United States, Europe and Australia. "It is appalling how often exposure to indoor tanning takes place in presumably educated populations and particularly worrisome that we allow adolescents to be exposed to this carcinogen," said Mark Lebwohl, MD, chairman of the department of dermatology at Mount Sinai Hospital in New York City. "We must do a much better job at educating people of all ages about the risks of indoor tanning.” Read more on cancer.
Tips on Staying Warm During the ‘Polar Vortex’
As much of the country faces record lows due to a polar vortex, with many areas suffering through below-zero temperatures, experts are offering advice on how to stay warm and healthy. The first tip is staying indoors. "It's best to limit your outdoor activity as much as possible, since prolonged exposure can lead to frostbite and hypothermia," said John Marshall, MD, chair of emergency medicine at Maimonides Medical Center in New York City. "Both of these conditions can become serious, and even life-threatening if untreated." However, when you must go outside, follow these tips:
- Dress warmly — Layer clothing to retain body heat, and a non-permeable outer layer will help against strong winds.
- Protect your extremities — Wear extra socks. Also go with mittens over gloves, since fingers stay warmer when they’re next to each other.
- Wear a hat — And cover the ears and nose if possible.
- Wear properly fitted winter boots — If they’re too tight they can cut off circulation. Also go for a pair that’s insulated with treads.
- Stay hydrated — Drink fluids to replenish the energy your body spends to stay warm.
- Stay dry — Get out of wet clothing as soon as possible.
Read more on preparedness.
Study: Health Care Spending Remained Low as Economy Struggled
Health care spending has now stayed relatively steady—and low—for four consecutive years, rising by 3.7 percent in 2012 to $2.8 trillion. according to a new analysis from the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS). The study, published in Health Affairs, found that faster growth in hospital, physician and clinical services was somewhat offset by slower growth in prescription drug and nursing home services prices. Spending growth and growth in private health insurance for Medicaid were also near historic lows. "The low rates of national health spending growth and relative stability since 2009 primarily reflect the lagged impacts of the recent severe economic recession," said Anne B. Martin, an economist in the Office of the Actuary at CMS and the study’s lead author. "Additionally, 2012 was impacted by the mostly one-time effects of a large number of blockbuster prescription drugs losing patent protection and a Medicare payment reduction to skilled nursing facilities." Read more on budgets.
Study: Newer Antidepressant Drugs All Carry About Equal Risk of Suicidal Thoughts
New antidepressants all come with about the same level of risk for suicidal thoughts and behaviors in children, according to a new study in the journal Pediatrics. Previous studies identified the increased risk, especially within the first few weeks of treatment, but there were still questions of whether some drugs came with higher risks. The study analyzed the medical histories of almost 37,000 children, average age 14, enrolled in Tennessee's Medicaid program between 1995 and 2006. Each child was a new user of one of six antidepressants: Prozac, Zoloft, Paxil, Celexa, Lexapro or Effexor. The study found little difference in the rate of suicidal thoughts and attempts before and after they began the medications. However, they did note that children on multiple medications were at higher risk, though that could also be a result of more severe depression. Read more on mental health.
Study: State Car Seat, Seatbelt Laws Leave Children Vulnerable to Injury, Death
Many state laws on car seats and seatbelts are not current with regards to modern research or are inconsistent from state to state, leaving children vulnerable to injuries or even death, according to a new study in the journal Social Science and Medicine. Researchers look at child passenger safety laws from 1978-2010 across all 50 states [Editor’s note: Go here for an interactive map]. “These laws do not keep up with the published evidence, and even when they do, there are some cases where the laws are unclear,” said Jin Yung Bae, JD, MPH, the study’s lead author, and associate research scientist at the Steinhardt School of Culture, Education and Human Development at New York University. Approximately 250,000 children are injured and 2,000 are killed each year in the United States because of vehicle crashes, which many of these preventable, according to the study authors. The study was conducted by a team from New York University in collaboration with Temple University, and supported by the Robert Wood Johnson Foundation through its Public Health Law Research. The National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism also funded the study. Read more on injury prevention.
USDA Announces Grants to Improve Rural Housing
The U.S. Department of Agriculture (USDA) has announced that organizations in 45 states, the Western Pacific and the Commonwealth of Puerto Rico will receive grants to make housing repairs and improve housing conditions for limited-income rural residents. The funding is through the USDA Rural Development's Housing Preservation Grant program and will be provided to intermediaries such as local governments; public agencies; federally-recognized Indian Tribes; and non-profit, faith-based and community organizations. The organizations distribute the grants to homeowners and owners of multi-family rental properties or cooperative dwellings who rent to low- and very-low-income residents. Grants may be used to make general repairs, such as installing or improving plumbing, providing or enhancing access to people with disabilities and making homes more energy efficient. Read more on housing.
CDC’s Emergency Management Program Receives Full EMAP Accreditation
The U.S. Centers for Disease Control and Prevention (CDC) has become the first federal agency to achieve full accreditation of its emergency management program from the Emergency Management Accreditation Program (EMAP). “Accreditation is a serious accomplishment for CDC and the emergency management community we support,” said Ali S. Khan, MD, MPH, director of the Office of Public Health Preparedness and Response. “Preparing for and responding to emergencies of any kind—natural disasters, bioterrorism events, chemical terrorism or pandemics—is a core function of public health. Everyone at CDC has a hand, at one point in time, in emergency management and execution.” EMAP’s six steps to accreditation are subscription, self assessment, application, on-site assessment, committee review and accreditation decision. Thirty one states; the District of Columbia; and 14 U.S. cities and counties are accredited. Read more on preparedness and accreditation.
Severe weather is expected to impact at least four regions of the U.S. this weekend including a tropical storm in the Gulf Coast, a tornado threat in the Midwest, snow in the West 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.
Because there is an exception during the shutdown for agencies that help protect against loss of life and property, the National Hurricane Center and the National Weather Service (NWS) are regularly updating their websites, and the NWS site has an option to search by state at the bottom of the map on the Service’s home page at weather.gov.
Other federal sites, including ready.gov, the federal disaster preparedness site, and the Centers for Disease Control and Prevention (CDC), currently say they are not adding new information, though government sites already have excellent general disaster preparedness information consumers and health departments can access. The U.S. government has a web page explaining what’s up and running and what is not, during the shutdown. If any of the weather threats become disaster situations, some of the sites may be permitted to update with specific information for individual disasters. The Weather Channel, a commercial site, is updating its information regularly.
Many agency social media feeds, including CDC’s, are not updating during the shutdown, however FEMA is updating its Twitter feed for the severe weather in the Gulf. Yesterday FEMA tweeted:
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.
“I’ll pack the dead batteries.”
“I’ll only put what I don’t need into a duffle bag.”
“I’ll try to get the generator going without any gas.”
Not exactly smart moves in the event of a natural disaster or other emergency…but maybe not far from reality for many families. Six out of 10 Americans don't have a disaster plan and only 19 percent said they were very prepared for a disaster. A new PSA campaign from the U.S. Department of Homeland Security’s Federal Emergency Management Agency (FEMA) and the Ad Council hopes to change that.
The campaign is designed to educate and empower families with children in the household to take steps to get everyone prepared for emergencies. That means giving everyone a role and ensuring everyone knows the plan. Unfortunately, because the subject matter is difficult and weighty, some parents hesitate to even bring it up.
By showing exactly how not to approach the discussion of preparedness—the above quotes are from family members sitting around a table—the new campaign encourages parents to have honest conversations with their kids about disaster preparedness, which can inspire a sense of confidence, control and calm when an actual emergency strikes.
“Humor is important because people get their guard down when they’re engaged in message,” said Priscilla Natkins, Ad Council’s executive vice president and director of client services. “They’re laughing, they’re smiling—yet they’re listening to the content. They’re listening to what these people are saying.”
>>Read More: Go to CNN.com to read the full story and watch a video on the new PSA campaign.
>>Bonus Link: Learn more about how families can prepare for disasters at Ready.gov/kids.
CDC’s Ali Khan: “By Every Measure Our Nation Is Dramatically Better Prepared for Public Health Threats”
Today is the eighth anniversary of Hurricane Katrina, one of the deadliest and most expensive natural disasters in U.S. history. Close to 2,000 people died during the worst of the storm and in the flooding that followed.
Since then, local, state, national and private disaster preparedness efforts have been increasingly improved. States reeling from the impact of last year’s Super Storm Sandy on the East Coast, for example, were able to rely on some of those improvements. They included more and better trained disaster management assistance teams from other states, as well as both commercial and government social media tools that helped professionals communicate among themselves and with the public to share safety and recovery instructions.
“By every measure our nation is dramatically better prepared for public health threats than they were,” said Ali Khan, MD, MPH, Director, Office of Public Health Preparedness and Response at the U.S. Centers for Disease Control and Prevention (CDC), at a Congressional briefing last week on the topic. It was hosted by the Alliance for Health Reform and the Robert Wood Johnson Foundation. In a conversation with NewPublicHealth this week, Khan ticked off some recent advances in disaster preparedness:
Congressionally appropriated funds for the U.S. Department of Health and Human Services to allow all states to improve their public health and health care preparedness and response capabilities.
- Response activities now coordinated through state-of-the-art emergency operations center at CDC and centers at almost all state public health departments.
- Health departments use the National Incident Management System, allowing for structured collaboration across responding agencies.
- More than 150 laboratories in the United States now belong to CDC’s Laboratory Response Network and can test for biological agents with the addition of regional chemical laboratories.
- The National Disaster Medical System now includes 49 Disaster Medical Assistance Teams, ten Disaster Mortuary Response Teams and five National Veterinary Response Teams, as well as other specialized units to provide medical-response surge during disasters and emergencies through on-scene medical care, patient transport and definitive care in participating hospitals.
- The Strategic National Stockpile was authorized and expanded, ensuring the availability of key medical supplies. All states have plans to receive, distribute and dispense these assets. Development of new medical countermeasures under the Biomedical Advanced Research and Development Authority (BARDA) includes new drugs and diagnostics. BARDA has delivered nine new medical countermeasures to the Strategic National Stockpile (SNS) in the last six years.
As part of an effort to help make sure their residents’ health information is available after a hurricane or other wide-spread disaster, four Gulf states have partnered with six states in the East and Midwest to help relocated patients and their temporary health care providers access critical health information.
State health information exchange (HIE) programs in Alabama, Georgia, Louisiana, Florida, South Carolina, North Carolina, Virginia, Michigan, Wisconsin, and West Virginia worked with the Department of Health and Human Services Office of the National Coordinator for Health IT to create the new system. All of the state HIE programs participating in the initiative have established at least one operational interstate connection and are working with other states including Arkansas and Mississippi. The initiative uses a tool called Direct, created through a collaboration that allows for the secure exchange of health information over the Internet.
The Agency for Healthcare Research and Quality recently published a guide to help primary care clinicians connect their patients’ electronic health records to a local HIE hub and regional health information organizations.
Zachary Thompson, director of Dallas County Department of Health and Human Services, greeted the 1,000-plus attendees at last week’s annual conference of the National Association of County and City Health Officials (NACCHO) and expressed how honored he was to meet so many local health department leaders from across the country.
NewPublicHealth spoke with Thompson about Dallas’ particular health challenges and innovations the department has developed to help improve health in the community.
>>Read more NewPublicHealth coverage of the NACCHO Annual Meeting.
NewPublicHealth: Dallas ranks 67 out of 232 Texas counties in the County Health Rankings. What efforts are underway to help improve population health in the county?
Zachary Thompson: Dallas County is looking at various things, including adding more bike lanes and more parks where people can exercise. There’s a health assessment going on now to look at how all of the major stakeholders can come together to improve our health rankings. We have a great public health improvement work group that is working on ways to improve overall health in Dallas County.
NPH: West Nile virus was a major issue in Dallas last year. What are you doing this year to help keep the city safe?
Thompson: We had no deaths from West Nile virus in 2010 and 2011, then 20 deaths in 2012, which may have been a once-in-fifty-years event. Last year’s outbreak got everyone’s attention that West Nile virus is endemic in our community, and so we took the lessons learned and increased our resources.
We know what we improved on. We began to do year-round mosquito testing in 25 municipalities, and began meeting regularly with all the municipalities to assess their needs. Everyone has been on board with the overall integrated mosquito plan. So far this year we’ve had no human cases of West Nile virus. We definitely focused on preventive education—we started that earlier. We’ve also added additional ground-based truck spraying capabilities in the event that we needed to increase our spraying activity if we have a similar outbreak as last year. We have made insect repellent available for all senior citizens. Hopefully last year’s outbreak will have been a rare occurrence, but we’re prepared in any case.
Gulf States Partner with East, Midwest States to Share Health Records After Disasters
Four Gulf Coast states have partnered with six East and Midwest states to help ensure that patients and providers have access to health records in the event of hurricanes or other major disasters, according to the U.S. Department of Health and Human Services. In concert with the Department of Health and Human Services Office of the National Coordinator for Health IT, health information exchange (HIE) programs in Alabama, Georgia, Louisiana, Florida, South Carolina, North Carolina, Virginia, Michigan, Wisconsin and West Virginia will share information on residents forced to move from their homes because of a disaster. “Through disasters like Hurricane Katrina and Hurricane Sandy and large tornadoes in Alabama and Joplin, Missouri, in 2011 and more recently in Moore, Oklahoma, we have learned the importance of protecting patients’ health records through electronic tools like health information exchanges,” said Farzad Mostashari, MD, national coordinator for health IT. “Patients are better off when states and health information exchange organizations work together to ensure that health information can follow patients when they need it the most.” Read more on preparedness.
Physical Punishment of Kids Tied to Obesity, Other Adult Health Problems
Obesity and other health problems are more likely in children who are punished through violence such as pushing, shoving and slapping, according to a study in the journal Pediatrics. Previous studies have also connected violent discipline with negative mental health outcomes. Researchers found that people who were punished physically “sometimes”—without more extreme physical or emotional abuse—were 25 percent more likely to have arthritis and 28 percent more likely to suffer from cardiovascular disease. About 31 percent of those punished physically were obese; about 26 who were not punished physically were obese. "Changes in sleep, risk-taking behaviors, immune functioning and regulation of stress hormones that result from chronic or intense stress may be important factors," said Michele Knox, a psychiatrist who studies family and youth violence at the University of Toledo College of Medicine, who was not involved in the study. "If we want what's best for our children, we need to choose discipline that does not come with these risks.” Read more on violence.
Putting Off Retirement May Also Help Put Off Alzheimer’s
Staying longer in the workforce may help decrease the risk of Alzheimer’s disease, according to new research looking at more than 429,000 workers in France. It found a 3 percent reduction in risk for each extra year at the age of retirement. The study is to be presented today at an Alzheimer's Association conference in Boston. About 5.2 million U.S. adults live with Alzheimer’s and it is the country’s sixth-leading cause of death. "There's increasing evidence that lifestyle factors such as exercise, mental activities, social engagement, positive outlook and a heart-healthy diet may reduce the risk of developing Alzheimer's disease and other forms of dementia," said James Galvin, MD, director of the Pearl Barlow Center for Memory Evaluation and Treatment at the NYU Langone School of Medicine, who was not involved with the research. "Now we can add staying in the workforce to this list of potential protective factors." About one-third of U.S. adults earning less than $100,000 annually said they would need to work until the age of 80 to retire comfortably, according to a 2012 Wells Fargo survey of 1,000 Americans. Read more on aging.