Category Archives: Pediatrics
Administration: Half a Million Have Applied for Health Insurance Under Affordable Care Act
Despite problems with the Healthcare.gov online portal, approximately half a million people have applied for health insurance under the Affordable Care Act. Enrollment for all 50 states and the District of Columbia opened on October 1. As many as 7 million uninsured Americans are ultimately expected to receive coverage through the program. However, as soon as the site launched users began to experience error messages and other technological glitches; the administration pointed to the unexpectedly high volume of visitors as the reason for the problems. "The website is unacceptable, and we are improving it, but the product is good and across the country people are getting access to affordable care starting January 1," said an administration spokesperson, according to Reuters. On the other hand, an article in Politico points out that the numbers being reported are only a piece of the puzzle because the number of people who applied does not equate to the number of people who "actually completed the process of choosing and enrolling in a health plan." And, according to Politico, "Extensive 'glitches'...with the online marketplaces known as exchanges have made it impossible for most people to get all the way through the signup process, even after filling out the initial online application."Read more on the Affordable Care Act.
Study: Friendships Formed on Social Networking Sites Can Help Smokers Quit
The strong supportive bonds formed on social networking sites can help people in their efforts to quit smoking, according to a new study in the Journal of Communication. "I found that people who join health-based social networking sites are able to quit smoking and abstain for longer periods of time because of the sense of community they build with other members," said study author Joe Phua, an assistant professor in the department of advertising and public relations at the University of Georgia's Grady College of Journalism and Mass Communication. Researchers surveyed 252 members of six health-centric websites, finding that the friendships formed online “seemed to boost users' sense of empowerment with respect to their ability to stop smoking for good,” according to HealthDay. Phua said the online support sites are effective because they are cheap and easy to access, while also providing a connection to “a larger and credible community” of people working to quit tobacco. Read more on tobacco.
Study: Spankings Tied to More Behavior Problems in Elementary School
Spankings of five-year-old children are tied to increased behavior problems in elementary school, according to a new study in the journal Pediatrics. Led by Michael MacKenzie, from Columbia University in New York, the researchers analyzed long-term data on approximately 1,900 children, finding that spankings by moms at least twice a week were tied to a two-point increase on a 70-point scale of problem behavior. They also found that regular spankings by fathers were tied to lower scores on vocabulary tests. Elizabeth Gershoff of the University of Texas at Austin, who was not a part of the study, said that while the findings are difficult to interpret, "There's just no evidence that spanking is good for kids. Spanking models aggression as a way of solving problems, that you can hit people and get what you want,” she said. “When (children) want another kid's toy, the parents haven't taught them how to use their words or how to negotiate." Read more on violence.
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.
Study: Erratic Bedtimes Linked to Kids’ Behavior Problems
Children with erratic bedtimes also exhibit more behavior problems at home and at school, according to a new study in the journal Pediatrics. Researchers analyzed date on more than 10,000 children who were part of long-term sleep studies, finding that kids without a regular bedtime scored worse on a measure of behavior problems including acting unhappy, getting into fights and being inconsiderate. "If you are constantly changing the amounts of sleep you get or the different times you go to bed, it's likely to mess up your body clock," said study leader Yvonne Kelly, from University College London. "That has all sorts of impacts on how your body is able to work the following day," Kelly, from University College London.” However, the researchers also found that when a child went from no set bedtime to a scheduled bedtime, their behavior improved. Read more on pediatrics.
Overweight Teens at Increased Risk of Later Esophageal Cancer
People who are overweight or obese as teens have nearly twice the risk of developing esophageal cancer later in life when compared to their peers with healthy weights, according to a new study in the journal Cancer. The study also found that social status, economic status and education levels can all be factors in the development of gastric cancers; poor teens are at twice the risk of developing stomach cancer, as are teens with nine years of fewer of education. The study included more than 1 million male Israeli teens. "We look at obesity as dangerous from cardiovascular aspects at ages 40 and over, but here we can see that it has effects much earlier," said study author Zohar Levi, MD, of the Rabin Medical Center in Israel. However, the study did not prove cause-and-effect, so further research is needed to determine whether losing weight or gaining higher social or economic status later in life can reduce the risks. Read more on cancer.
USDA: California Plants Linked to Salmonella Can Stay Open
After making “immediate substantive changes to their slaughter and processing,” three California poultry processing plants tied to a salmonella outbreak in 17 states will remain open, the U.S. Department of Agriculture (USDA) has determined. The plants will implement new food safety controls and the USDA will monitor the plants products for the next three months. The outbreak has sickened 278 people since May; the normal hospitalization rate is about 20 percent, but antibiotic resistance means about 42 percent of the people sickened in this outbreak were hospitalized. Read more on food safety.
Airport Noise May Increase Heart Disease and Stroke Risk
People who live near busy international airports may be at increased risk of heart disease and stroke due to the high levels of noise, according to two new studies in the British Medical Journal. One study looked at hospital admissions around London Heathrow airport, finding the risks were 10 to 20 percent higher when compared to areas with the least noise. The other study, by researchers at the Harvard School of Public Health and Boston University School of Public Health, analyzed data on more than 60 million Americans ages 65 and older living near 89 airports, finding that areas with 10 decibel higher aircraft noise also saw a 3.5 percent increase in the hospital admission rate. Researchers say the link needs further study to show causation. "The exact role that noise exposure may play in ill health is not well established," said Anna Hansell of Imperial College London, who led the British study. "However, it is plausible that it might be contributing, for example by raising blood pressure or by disturbing people's sleep." The findings indicate that populated areas must be looked at closely when communities consider expanding large airports. Read more on heart health.
Private Talk Sessions with NICU Nurses Ease Anxiety in Mothers of Premature Babies
“Listening matters” when it comes to easing the worries of the mothers of premature infants. One-on-one talks sessions between NICU nurses and the mothers can help reduce feelings of anxiety, confusion and doubt, according to a new study in the Journal of Perinatology. "Having a prematurely born baby is like a nightmare for the mother," said Lisa Segre, an assistant professor in the University of Iowa College of Nursing. "You're expecting to have a healthy baby, and suddenly you're left wondering whether he or she is going to live." The study looked at 23 mothers who when through an average of five 45-minute sessions, find they gave mothers a chance to really talk about their worries and were effective at easing concerns across the board. "Listening is what nurses have done their whole career," said NICU nurse and study co-author Rebecca Siewert. "We've always been the ones to listen and try to problem solve. So, I just think it was a wonderful offshoot of what nursing can do. We just need the time to do it." Read more on maternal and infant health.
Early Puberty Tied to Great Risk of Experimentation with Cigarettes, Alcohol and Marijuana
Early puberty is linked to increased risk of experimentation with cigarettes, alcohol and marijuana, according to a new study in the journal Addiction. Puberty typically begins between the ages of 9 and 10, will girls on average beginning it earlier than boys. "While puberty is often thought of as a solely biological process, our research has shown that pubertal development is a combination of biological, psychological and social processes that all likely interact to influence risk-taking behavior like substance use," said study author Jessica Duncan Cance, a public health researcher at the University of Texas at Austin. "Our study suggests that being the first girl in the class to need a bra, for example, prompts or exacerbates existing psychological and social aspects that can, in turn, lead to substance use and other risky behaviors early in life.” Read more on pediatrics.
Study: Top Athletes Endorse Junk Food More Often Than Healthy Food
A new study of professional athletes’ food and beverage endorsements found that more often than not their paid support is given to products that are energy-dense and nutrient-poor, according to a new study in the journal Pediatrics. The study looked at 512 brands endorsed by 100 different athletes, finding that “Seventy-nine percent of the 62 food products in athlete-endorsed advertisements were energy-dense” and “93.4% of the 46 advertised beverages had 100% of calories from added sugar.” Denver Broncos player Peyton Manning and Miami Heat player LeBron James had the most endorsements for the energy-dense, nutrient-poor food and beverages. "I hope this paper inspires some reflection on the part of America's athletes and professional sports leagues, as well as all other celebrities for that matter,” said Center for Science in the Public Interest Executive Director Michael F. Jacobson, in a statement. Read more on nutrition.
U.S. Task Force Recommends Against Blood Pressure Screening for Kids, Teens
Despite recommendations from several expert groups, the U.S. Preventive Services Task Force is not recommending that health care professionals respond to the growing obesity crisis by screening children and teens for high blood pressure. The panel concluded that more study into the issue is needed, and that in the mean time there are other, known avenues toward lowering youth obesity and improving cardiovascular health. "We don't know if lowering blood pressure in youth leads to improved cardiovascular health in adulthood,” said panel member Kirsten Bibbins-Domingo, MD. “We also don't know the long-term benefits and harms for children and adolescents who initiate blood pressure medications when they are young. While there is much we don't know, we do know that eating a healthy diet, being active, and maintaining a normal weight are ways children and teens can improve their cardiovascular health." Read more on heart health.
Study: Tobacco Advertisements Connecting with Young Kids in Many Low-, Middle-income Countries
The global pervasiveness of tobacco advertisements means that most very young children in many low-and middle-income countries are familiar with cigarette brands, and nearly 70 percent of kids ages 5 and 6 can identify at least one cigarette logo, according to a new study in the journal Pediatrics. The study is from the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health. The findings demonstrate the significant steps countries and public health organizations still need to take to limit the influence of tobacco ads. “Evidence-based strategies exist to reduce the ability of tobacco companies to market their products to children, such as implementing and enforcing bans on tobacco advertising, promotion and sponsorship,” said Joanna Cohen, PhD, co-author of the study and director on the institute. “Putting large picture warnings on the front and back of cigarette packs and requiring plain and standardized packaging, as Australia has done, also helps to reduce the attractiveness of cigarette packs among young children.” Read more on global health.
“Thanks to decades of neuroscience research on brain development, adversity and toxic stress, we now understand how a child who is exposed to violence, or neglect, or homelessness at an early age may develop behavioral and physical health problems later in life,” said Jane Lowe, Senior Adviser for Program Development at the Robert Wood Johnson Foundation (RWJF). “We can now use this rapidly evolving knowledge to create real-world solutions.”
RWJF.org recently pulled together a collection of resources on “adverse childhood experiences”—how common they are and what they can mean for the adults those traumatized children become. The website includes an infographic that illustrates the subject:
NewPublicHealth has previously written about the importance of addressing and changing youth violence, so that these behaviors don’t become even more severe—and more damaging—while spreading from act to act and person to person. In a Q&A, Kristin Schubert, MPH and then-interim director of RWJF’s Public Health, spoke about the Foundation’s approach to the issue of violence prevention and strategies in the field that are working to create change.
“We know that the child who was abused is that much more likely to be a victim or perpetrator of bullying a few years down the line, and then is that much more likely to be a victim or perpetrator of dating violence a few years later in high school, and then is much more likely to be a part of more family violence later on. There’s no form of violence that stands alone,” she said. “It’s a multigenerational phenomenon that is passed down.
“This context is so essential—in considering why someone engages in violent behavior, it’s important to recognize that it’s not just the ‘bad apple,’ it’s not the person. It’s the behavior. As Gary Slutkin of CeaseFire says, ‘Violence is a learned behavior.’”
Schubert pointed to the Adverse Childhood Experiences Study, which found that the more “adverse” events a child faces in their youth—from maltreatment to neglect to abuse to witnessing violence—the more likely they are to have health problems later in life. That includes hypertension, diabetes and heart disease.
>>Read the full NewPublicHealth interview.
>>Read more about Adverse Childhood Experiences.
Every baby should have a chance to celebrate a healthy, happy first birthday. Unfortunately, that is not always the case. And that risk disproportionately affects people with lower income and people of color. This Infant Mortality Awareness Month, we can celebrate some progress in helping more babies reach that first milestone, according to health officials who shared successes at the Association of State and Territorial Health Officials (ASTHO) Annual Meeting in Orlando, Fla., this week.
>>Follow our ASTHO Annual Meeting coverage throughout the week.
“We are collectively moving forward in improving birth outcomes across the nation,” said David Lakey, MD, Commissioner of the Texas Department of State Health Services and former ASTHO president, who took on healthier babies as his President’s Challenge during his tenure. Lakey set out a goal of an 8 percent reduction in premature births by 2014.
“There is a high human cost of prematurity,” said Lakey, and that cost includes low birth weight, increased morbidity and mortality, and an impact on standardized test scores and other outcomes later in life for those who do survive. “Those who are born early have a much lower chance of having a healthy, happy first birthday.”
There is also an economic and societal cost of premature birth, the cost of which is largely paid for by Medicaid. Lakey said that 57 percent of all Texas births are paid for by Medicaid. Extreme preterm birth costs an average of $71,000—while a full-term birth costs an average of $420.
Despite decades of outreach around car seat safety, car crashes remain the number one cause of death for children under the age of 12, according to the U.S. National Highway and Traffic Safety Administration (NHTSA). The numbers from the U.S. Centers for Disease Control and Prevention (CDC) are also stark and troubling: more than 1,200 U.S. children ages 14 years and younger died in motor vehicle crashes in 2010, and approximately 171,000 were injured.
What makes these statistics even more tragic is the fact that many of these deaths and injuries are preventable by following these simple edicts—put kids in the right seat and use it the right way. In fact, NHTSA has identified child seat safety restraints as the most effective way to protect young children in motor vehicle crashes.
Child safety seats reduce the risk of death in passenger cars by 71 percent for infants and by 54 percent for kids ages 1 to 4, according to the CDC. For children ages 4 to 8, booster seats cut the risk of serious injury by 45 percent.
This week is Child Passenger Safety Week. It also marks the launch of the new BuckleUpForLife.org, Cincinnati Children’s and Toyota’s community-based safety program designed to educate families on critical safety behaviors and provide child car seats to families in need.
The website features the “Making Safety a Snap” online tool—a series of quick questions and videos that demonstrate exactly how parents and caregivers can make sure their child has the right safety seat and is using it properly.
You can follow a live Buckle Up for Life Twitter Q&A starting at 2 p.m. today. Use the hashtag #BuckleUpforLife to join the discussion and have your child car seats questions answered by their experts.
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.
‘Hyper-vigilance’ Over Racial Disparities May Be a Factor in Higher Hypertension Rates for Black Americans
“Hyper-vigilance” related to race consciousness may be a factor in why black Americans have a disproportionately high rate of hypertension, according to a new study in the American Journal of Hypertension from researchers at the Johns Hopkins University School of Medicine. While it’s long been known that blacks have, on average, higher blood pressure, the exact environmental factors that contribute to the higher rates are not fully understood, according to Lisa A. Cooper, MD, MPH, a professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine and the study’s senior author. “Hyper-vigilance [is] a heightened awareness of their stigmatized status in society and a feeling that they need to watch their backs constantly,” she said. “African-Americans have higher blood pressure, and it has been difficult to explain why this is true. It doesn’t appear to be genetic, and while things like diet, exercise and reduced access to health care may contribute, we think that a tense social environment, the sense of being treated differently because of your race, could also possibly explain some of what’s behind the higher rates.” Read more on health disparities.
Survey: Most Women Don’t Know their Personal Breast Cancer Risk
A new survey of more than 9,000 women shows that far too few have an accurate idea of their personal risk of developing breast cancer in their lifetime. Study researcher Jonathan Herman, MD, an obstetrician and gynecologist at Hofstra North Shore-LIJ Medical School in New Hyde Park, N.Y., found that only 9.4 percent knew their risk level, nearly 45 percent underestimated their level and nearly 46 percent overestimated their level. The survey also found that about four in 10 women had never even discussed their personal breast cancer risk with a physician. On average, women have a 12 percent lifetime risk of breast cancer, with that number climbing 20 percent if their mother had breast cancer. The BRCA mutations that increase breast cancer risk push the risk to about 70 percent. Mary Daly, MD, chair of clinical genetics at Fox Chase Cancer Center, in Philadelphia, and director of its risk assessment program, said it is critical that women researcher their family history related to breast cancer in order to determine whether they are following the best possible screening schedule. Read more on cancer.
Harsh Verbal Discipline of Teens Only Makes Behavior Worse
Harsh verbal discipline of teenagers not only isn’t effective at changing bad behaviors, but can in fact make them worse, according to a new study in the journal Child Development. "Most parents who yell at their adolescent children wouldn't dream of physically punishing their teens," said study author Ming-Te Wang, an assistant professor with the department of psychology at the University of Pittsburgh School of Education. "Yet, their use of harsh verbal discipline—defined as shouting, cursing or using insults—is just as detrimental to the long-term well-being of adolescents.” A recent survey indicates that about nine in 10 parents have admitted to such behavior. The study found that the emotional pain and discomfort cause by harsh parental verbal abuse can increase anger while dropping inhibition, which in turn can promote behaviors such as lying, cheating, stealing and fighting. It also found that the concept of “parental warmth”—as in a parent was yelling out of love or for the child’s own good—didn’t make things any better. "Parents who wish to modify their teenage children's behavior would do better by communicating with them on an equal level…and explaining their rationale and worries to them,” said Wang. “Parenting programs are in a good position to offer parents insight into how behaviors they may feel the need to resort to, such as shouting or yelling, are ineffective and or harmful, and to offer alternatives to such behaviors." Read more on pediatrics.