Study: Fertility Drugs Not Tied to Increased Risk of Breast Cancer
Fertility drugs are not linked to an increased risk of breast cancer, according to a new long-term study in the journal Cancer Epidemiology, Biomarkers & Prevention. Researchers analyzed records for 9,892 U.S. women who were followed for 30 years after having been evaluated for infertility between 1965 and 1988, finding that about 38 percent of them were exposed to the fertility drug clomiphene and about 10 percent were exposed to drugs known as gonadotropins. There were 749 breast cancers diagnosed during the three decades, but women who were exposed to either drug were just as likely as the women who hadn’t been exposed to fertility drugs to develop breast cancer. The study did note an increased risk of breast cancer for the small group of women exposed to the highest doses of clomiphene. "It's reassuring that if women desire pregnancy and unfortunately have infertility that they can undergo treatment without modification of their overall risk for cancer later," said Kurt Barnhart, MD, president of the Society for Reproductive Endocrinology and Infertility, to Reuters Health. He was not involved in the study. Read more on cancer.
Study: CDC’s Salt Recommendations Are Too Low
The U.S. Centers for Disease Control and Prevention’s (CDC) salt guidelines are too low, according to a new study in the American Journal of Hypertension. Researchers reviewed 25 previous studies, concluding that both too much and too little salt can be harmful. They concluded that the safest intake range was between 2,645 and 4,945 mg of salt a day, although the CDC recommends less than 2,300 mg of salt per day for healthy people under age 50, and less than 1,500 mg per day for most people over age 50. "For most people, there is no reason to change their dietary habits concerning salt, as most people eat what appears to be the safest amount," said review author Niels Graudal, MD, a senior consultant at Copenhagen University Hospital in Denmark, according to HealthDay. Read more on nutrition.
HUD to Provide Disaster Assistance to Washington State Mudslide Victims
Having officially been given a major disaster declaration yesterday, Snohomish County and the Sauk-Suiattle, Stillaguamish and Tulalip Indian Reservations in Washington state will now received federal disaster assistance from the U.S. Department of Housing and Urban Development (HUD) to help recover from the flooding and mudslides that began on March 22. Among the assistance:
- Offering the State of Washington and other entitlement communities the ability to re-allocate existing federal resources toward disaster relief
- Granting immediate foreclosure relief
- Making mortgage insurance available
- Making insurance available for both mortgages and home rehabilitation
- Offering Section 108 loan guarantee assistance
- Information on housing providers and HUD programs
"Families who may have been forced from their homes need to know that help is available to begin the rebuilding process,” said HUD Secretary Shaun Donovan in a release. "Whether it's foreclosure relief for FHA-insured families or helping these counties to recover, HUD stands ready to help in any way we can." Read more on disasters.
Why walk? Well, today’s a good day to walk because it’s National Walking Day, an event hosted by the American Heart Association (AHA). And also every day is a good day to walk because research from the AHA finds that thirty minutes of walking each day had health benefits that include:
- Weight loss
- Lower blood pressure
- Reduced risk of heart disease and diabetes
- Increased well being
Walking, like other forms of exercise, releases endorphins linked to reduced depression and increased happiness—which certainly seems to be the case for the folks in the video PSA, Just Walk!, from the American Heart Association.
- National Walking Day
- 2013 Vital Signs report on the benefits of walking from the Centers for Disease Control and Prevention
“Two or three years ago we were urging you to ask your health directors for social media tools, and now we’re talking about how it’s making a difference,” said Tom Hipper, MSPH, MA, Public Health Planner at the Center for Public Health Readiness and Communication at Drexel University, who helped lead a session on social media and public health response at the Preparedness Summit on Tuesday. He was joined by Jim Garrow, MPH, Operations and Logistics Manager at the Philadelphia Department of Public Health.
While many in the audience of a couple of hundred attendees are still in the early days of using social media, the benefit of adding social media to communications channels for routine and emergency communication is clear said the presenters.
Examples included the use of Twitter by public health officials in Edmonton, Alberta last year after flooding covered the downtown area. So many users accessed the feed that it looked like spam and Twitter shut down the feed, forcing the health department to move to the police Twitter account and then to a private constable’s account when the second feed was also shut down. Despite the switches, a survey after the flooding showed that 98 percent of responders were satisfied with the health department’s responsiveness on social media.
There is also the Verification Handbook for digital content to help verify digital images on social media. One example of an altered report was a shark moving alongside a car in New Jersey just after Hurricane Sandy hit.
Hipper had strong advice for both novice and seasoned health department social media users:
- During disasters, retweet important information from credible agencies, such as street closings from the Office of Emergency Management
- Use Twitter message libraries when available. Drexel is creating one that includes messaging for all sorts of public health emergencies such, as an active shooting or a ricin attack. The value of the messages includes faster response in an emergency even if some tweaking is needed, and many of the preset messages are based on feedback to messaging used previously.
- Engage your audience before an emergency so they will turn to your social media platforms if an emergency strikes. Hipper gave the examples of Chicago, which held an immunization Twitter chat last fall and had 180,000 followers, as well as the Boston Police Department, which already had 40,000 followers before the Marathon bombing last year and saw that number rise to 300,000 as the search for the bombers unfolded.
Hipper and Garrow also advised repeating information during a disaster because people join the conversation at different points; to announce when to expect next updates and what hashtags are being use; to point to other credible agencies for information; and to ask users to send questions which can help improve the information they provide.
Last week the Robert Wood Johnson Foundation (RWJF) released its 2014 County Health Rankings, an annual assessment of how where we live, learn, work and play impacts our health. This coming Friday, April 4 from 12:00-1:00 p.m. ET, RWJF will be hosting a First Friday Google+ Hangout focused on the how the County Health Rankings can be used to help spur business, government, public health, education and other sectors to work together to create healthier communities.
>>Go here to register for Friday’s event.
Susan Dentzer, senior policy adviser to the Foundation, will lead the discussion exploring the Rankings’ key findings and how they have inspired communities to take meaningful action to improve health.
Panelists will include:
Katie Loovis, Director of U.S. Community Partnerships and Stakeholder Engagement, GlaxoSmithKline, will discuss how good health is good for business. When more people in a community are healthy, there are lower health costs, fewer sick days and increased productivity, according to Loovis. And when communities are healthier, everyone in the community benefits.
Mary Lou Goeke, Executive Director, United Way of Santa Cruz County, will discuss how the United Way uses the County Health Rankings’ framework to mobilize people and organizations to use good data and evidence to identify joint priorities; develop and implement collaborative solution; build public will; and engage in advocacy to improve education, financial stability and health. Santa Cruz County won an inaugural RWJF Roadmaps to Health Prize, which honors outstanding community partnerships helping people to live healthier lives.
Brian Smedley, Vice President and Director, Health Policy Institute, Joint Center for Political and Economic Studies, will discuss how where you live plays a significant factor in how healthy you are. The Joint Center runs a national initiative called PLACE MATTERS to build the capacity of local leaders around the country to improve social, economic, and environmental conditions that shape health. The learning community consists of 19 teams working in 27 jurisdictions.
Marjorie Paloma, Senior Policy Adviser, the Robert Wood Johnson Foundation (RWJF), who will discuss the foundation’s partnership with the University of Wisconsin Population Health Institute in producing the County Health Rankings, as well as the many online tools that can help communities compare rankings, delve more deeply into the data and learn more about particular interventions that can address community health issues.
>>Bonus Links: Read up on some of the panelists:
- United Way of Santa Cruz County won the RWJF Roadmaps to Health Prize for their efforts
- Brian Smedley shared why place matters to health in a recent interview with NewPublicHealth.
- Marjorie Paloma previously spoke with NewPublicHealth about the critical role of housing in better health. Housing is one of the new measures in the 2014 County Health Rankings and a national trend report found that almost 1 in 5 households are overcrowded, pose a severe cost burden, or lack adequate facilities to cook, clean, or bathe.
- Katie Loovis wrote about why living a healthy life is like a game of Shoots and Ladders, on the RWJF Culture of Health Blog. One of Katie Loovis' colleagues at GlaxoSmithKline, Robert Carr, also talked with NewPublicHealth about why businesses should care about community health.
“Disasters pose questions of who [is helped] first and who...last,” said Sheri Fink, MD, PhD, a correspondent for The New York Times and Pulitzer Prize-winning author, to more than 1,000 attendees of the 2014 Preparedness Summit in Atlanta this week. Fink is the author of Five Days at Memorial: Life and Death in a Storm Ravaged Hospital, about the response by health providers, first responders, volunteers, patients and family members who rode out the storm in a hospital that lost power in the early hours of the hurricane. Fink was the headline speaker for the first plenary session of the Summit.
Fink’s book—which Umair Shah, deputy director of Harris County Public Health and Environmental Health Services in Texas and a panelist for the plenary discussion, urged the audience to read even if they only had time to skim—takes a close up look at the response from what may have been mercy killings to heroics by family members who commandeered boats to help evacuate patients.
Questions posed during the emergency in New Orleans, said Fink, included whether the hospital should be taking in new patients during the storm at a time when it was trying to evacuate the patients there, and whether criteria for first evacuees should be maximizing numbers of lives saved or maximum number of years of life saved.
“And because there is no right answer, we need to develop better evidence to [rely on] when difficult decision are needed,” said Fink, who had been a disaster and conflict first responder.
In response to the deaths and delays of Katrina, Fink and other panelists including Shah, Paul Biddinger, MD, FACEP, director, emergency preparedness and response exercise program at the Harvard School of Public Health, and Nicole Lurie, MD, MSPH, Assistant Secretary for Preparedness and Response in the U.S. Department of Health and Human Services, ticked off disaster response improvements including the creation of Lurie’s office, and the development of new partnerships—in particular public and private ones such as with hospitals and health departments. One key change—mapped data from the Centers for Medicare and Medicaid Services—helps responders identify people in the community whose medical conditions require them to shelter in place.
Fink shared some recommendations for additional preparedness needs:
- A need to update infrastructure that is vulnerable to collapse or breakdown across the country
- Engage the public so that they will show their support for preparedness funding
- Face the fact that all power can be lost and respond in that way
- Promote research
- Maintain flexibility and creativity
Fink shared some examples of creativity at Memorial Hospital in New Orleans, including hospital workers who used a truck to transport patients to another side of the building and then carried them up rickety stairs to the helipad since it could not be reached by elevator; workers who hotwired boats to aid in evacuation; and workers who found that neonatal incubators would not fit on some of the evacuation helicopters and so kept babies warm by tucking their heads under their own clothing and continued to ventilate them manually.
>>Bonus Content: Read a NewPublicHealth interview with Paul Biddinger.
Mistrust, Perceived Discrimination Affect Young Adult Latinos’ Satisfaction with Health Care
Mistrust of the medical community and perceived discrimination can affect how satisfied young adult Latinos are with their health care, which in turn can influence health outcomes, affect participation in health care programs under the Affordable Care Act and contribute to disparities in health care access, according to a new study in The Journal of Rural Health. Researchers surveyed 387 young adult Latinos, ages 18-25, finding that approximately 73 percent were moderately or very satisfied with their health care, but among those who were not, medical mistrust and perceived discrimination were found to be factors. The researchers recommend improving “cultural competency” among health care providers—from the doctors to the receptionists to the lab technicians—to help ensure Latinos are treated with respect and dignity, and also that a bilingual/bicultural workforce may be more effective at building trust. “Trust is huge; it allows patients to disclose concerns and be honest,” said study co-author S. Marie Harvey, associate dean and professor of public health at Oregon State University in a release. Read more on health disparities.
FDA Approves First Sublingual Home Treatment for Hay Fever
The U.S. Food and Drug Administration (FDA) has approved the first sublingual—or under the tongue—allergen extract for use in the United States. Designed to treat hay fever with or without conjunctivitis that results from exposure to certain grass pollens in people ages 10-65, the first dose is administered in a health care providers office so that the patient can be observed for any adverse reactions, but can then be taken at home. Approximately 30 million Americans and 500 million people worldwide are affected by hay fever, also known as allergic rhinitis, which can cause repetitive sneezing; nasal itching; runny nose; nasal congestion; and itchy and watery eyes. “While there is no cure for grass pollen allergies, they can be managed through treatment and avoiding exposure to the pollen,” said Karen Midthun, MD, director of the FDA’s Center for Biologics Evaluation and Research, in a release. “The approval of Oralair provides an alternative to allergy shots that must be given in a health care provider’s office.” Read more on the FDA.
New Report Analyzes Link Between Metro Areas and Overall Health
People who live in compact, connected metropolitan regions are more likely to see their incomes rise, have lower household costs, have more transportation options and live longer, safer and healthier lives, according to Measuring Sprawl 2014, a new report from Smart Growth America and the University of Utah’s Metropolitan Research Center. The report looks at 221 major U.S. metropolitan areas, ranking them based on how sprawling or compact they are as well as examining how sprawl relates to factors such as economic mobility; the cost of housing and transportation; life expectancy; obesity; chronic disease and safety. “Smart growth strategies are about making life better for everyone in a community,” said Geoff Anderson, President and CEO of Smart Growth America. “If policymakers are looking for ways to lower costs for their constituents, improve public health and support their broader economy, they need to be thinking about how to improve their development.” Read more on community health.
Paul Biddinger, MD, FACEP, director of the Emergency Preparedness and Response Exercise Program at the Harvard School of Public Health, was a member of this morning’s opening panel on disaster preparedness at the 2014 Preparedness Summit. NewPublicHealth spoke with Biddinger ahead of the conference on what students and communities need to know and do to be best prepared for a disaster.
NewPublicHealth: Is it a requirement for students in graduate school for public health degrees to take at least one class in disaster preparedness?
Paul Biddinger: It is not. They have the option, but it is not a required element of what they have to take.
NPH: How do you think recent disasters have informed what students and public health staff members need to know about response?
Paul Biddinger: I think some of what students need to know has always been the case—but maybe has been underscored by recent events—which is that no matter what you do in public health you may be needed as part of the response, and whether you're working in maternal and child health or smoking cessation or HIV/AIDS, when a disaster happens it’s all hands on deck. And I think the hurricanes, the pandemic and other events have showed that often we need to reach well outside the traditional emergency response or preparedness work staff in public health, and so everyone has to be flexible, has to be able to participate in the response. I think in order to participate in the response you have to know that there is an emergency operations plan, what your role in it would be, how you would get information, to whom you would be responsible or to whom you would report. And those are things that you should know ahead of time.
I think the other thing we see when we see these wide-area disasters like we saw in Sandy, like we saw in Katrina, is the central role that public health can play in coordinating the health response—that multiple hospitals, long-term care facilities, out-patient facilities such as dialysis centers all need to be coordinated in their response to achieve the best possible health outcomes for the community. And public health is in a particularly strong place in the community to be able to help make sure that each of those individual participants is pointed in the same direction and is leveraging the community resources as best they can.
NHTSA: Rear Cameras for All New Cars by May 2018
All new vehicles under 10,000 pounds will be required to have rear visibility technology—or rear cameras—by May 2018, according to a new rule issued by the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA). According to NHTSA, the technology significantly reduces injuries and fatalities due to backover incidents; there are an average of 210 deaths and 15,000 injuries each year caused by such incidents, with children under age 5 accounting for 31 percent and adults ages 70 and older accounting for 26 percent. "Safety is our highest priority, and we are committed to protecting the most vulnerable victims of backover accidents — our children and seniors," said U.S. Transportation Secretary Anthony Foxx. "As a father, I can only imagine how heart wrenching these types of accidents can be for families, but we hope that today's rule will serve as a significant step toward reducing these tragic accidents." Read more on injury prevention.
Study: Diet of Fruit, Vegetables Linked to Reduced Risk of Death
Diets heavy on fruits and vegetables can reduce the risk of death at any age by as much as 42 percent, according to a new study in the Journal of Epidemiology and Community Health. Using data on the eating habits of more than 65,000 people in England from 2011 to 2013, researchers determined that the risk of death was reduced by 36 percent with five to seven portions, 29 percent with three to five portions and 14 percent with one to three portions. More specifically, they also determined that eating seven or more portions of fruits and vegetables reduced the risk of death from heart disease by 31 percent and the risk of death from cancer by 25 percent. "We all know that eating fruit and vegetables is healthy, but the size of the effect is staggering," study author Oyinlola Oyebode, at the department of epidemiology and public health of University College London, in a release. "Vegetables have a larger effect than fruit, but fruit still makes a real difference. If you're happy to snack on carrots or other vegetables, then that is a great choice but if you fancy something sweeter, a banana or any fruit will also do you good.” Read more on nutrition.
Affordable Care Act Expected to Hit Goal of Coverage for 7 Million
Despite a glitch-filled rollout of HealthCare.gov that allowed few people to enroll over the first month, the Affordable Care Act and its online portals appear to be on track to meet the original goal of enrolling 7 million people by its deadline of yesterday, March 31, according to Obama administration officials. More than 6 million had signed up for health care coverage as of last week and the run up to the deadline saw a surge that should put the total over 7 million. The administration also recently announced an extension of the enrollment deadline for Americans who had attempted to sign up for coverage but were impeded by technological problems. Read more on the Affordable Care Act.
The U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) and the National Council on Disability (NCD) have established a virtual town hall conversation to examine the accessibility barriers of social media for individuals with disabilities. The town hall, which will continue through Friday, April 4, is the first in a series of three online events on the topic of social media accessibility that will take place over the next three months.
Social media is a critical tool for engaging customers, employees, jobseekers and stakeholders. When it is inaccessible to people with disabilities, a large portion of the population is excluded from important conversations. Advancing Accessibility and Inclusion in Social Media—The User Experience aims to identify the barriers to social media use and develop solutions to help ensure that all people can reap the benefits of social media and digital services.
Town hall participants are able to discuss personal social media experiences; submit comments and ideas; and vote on suggested solutions to accessibility barriers. Participants have shared feedback regarding a variety of social media platforms: Calling for captioning on government-produced Vine videos, seeking recommendations for using social media to find employment and suggesting increased accessibility training for social media developers. ODEP and NCD will use insights gleaned from the town halls to work with the social media industry to improve experiences for Americans with disabilities.
"We anticipate that this online discussion will present new and exciting opportunities for Americans with disabilities and people around the world,” said Janni Lehrer-Stein, chairperson of access and integration for NCD. “Social media opens up a new marketplace of ideas and access for everyone, including people with disabilities, adding value and providing new opportunities through inclusive engagement in the virtual world."
To participate, register at ODEP’s ePolicyWorks town hall and submit your feedback.
Rockingham County, N.C., is one of several counties profiled in videos produced for the 2014 report of the County Health Rankings, a joint project of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, and released yesterday. The Rankings shows how communities across the country are doing and how they can improve on their health.
Rockingham evolved from a wealthy county to a poor one very quickly after losing two major industries only a couple of decades ago. The community suffers from high general smoking rates, high obesity rates and high rates of smoking during pregnancy. When the 2010 County Health Rankings were released, Rockingham was ranked at 71 out of 100 counties on health measures. The community's poor standing served as a wake-up call.
One new program set to begin this spring is the Nurse-Family Partnership, a decades-old, evidence-based community health program that serves low-income women pregnant with their first child.
Nurse-Family Partnership is based on the work of David Olds, MD, a professor of pediatrics, psychiatry and preventive medicine at the University of Colorado Denver. While working in an inner-city day care center in the early 1970s, Olds was struck by the risks and difficulties in the lives of low-income children and over the next decades tested nurse home visitation for low income families in randomized controlled trials in Elmira, New York, Memphis, Tennessee and Denver. Results have shown that the program improved pregnancy outcomes; improved the health and development of children; and helped parents create a positive life course for themselves. There are now Nurse-Family Partnership programs in 43 states, the U.S. Virgin Islands and six Indian tribal communities.
In the Nurse-Family Partnership programs, the mothers receive ongoing visits from the nurses in their homes from the first trimester until the baby is two years old. Program goals include:
- Improve pregnancy outcomes by helping the new mothers engage in good preventive health practices, including comprehensive prenatal care from their healthcare providers, improving their diets and reducing their use of cigarettes, alcohol and illegal substances.
- Improve child health and development by helping parents provide responsible and competent care.
- Improve the economic self-sufficiency of the family by helping parents develop a vision for their own future, plan future pregnancies, continue their education and find work.
According to Heather Adams, executive director of the Rockingham County Partnership for Children, there are about 5,000 children under the age of five in Rockingham County. Over half live in poverty and are born to mothers under the age of 20 and many of the children are in single parent households.
“The County Health Rankings really gave us some concrete data to show us what we knew anecdotally was really true,” said Adams. “Nurse-Family Partnership really rose to the top as a really strong program that could help meet some of our needs.”
As part of its County Health Rankings coverage, NewPublicHealth recently spoke with Elly Yost, MSN, PNP, director of nursing practice at the Nurse-Family Partnership national office in Denver, Co. Yost is a pediatric nurse practitioner who previously worked in hospitals and community practice settings.