Category Archives: Preparedness
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.
Study: Americans Living Longer…But Not Necessarily Healthier
A new study in the Journal of the American Medical Association paints a broad, sweeping picture of life expectancy and health in the United States, finding that while people are living long in general, they’re also spending more of their lives in poor health as illnesses that used to lead to early deaths have been replaced with chronic conditions. The overall average U.S. life expectancy in 2010 was 78.2 years. The new findings are part of the Global Burden of Disease Study, which is a collaboration of 488 researchers in 50 countries. "It's rare these days that you get information or studies that give you the big picture," said study author Christopher Murray, MD, director of the Institute for Health Metrics and Evaluation at the University of Washington, in Seattle. "It's pretty uncommon to step back and say, 'What does all the evidence tell us about the most important health problems, and where does the U.S. fit in that landscape?'" While the United States has been making improvements, they’ve not been coming as quickly as they have in other countries. The main causes of earlier death in the country are heart disease, lung cancer, stroke, chronic obstructive pulmonary disease and road injuries, and the top causes of disability are lower back pain, depression and other musculoskeletal disorders. Read more on global health.
Five Daily Servings of Fruits, Vegetables Tied to Longer Lives
Eating plenty of fruits and vegetables is directly tied to living a longer life, according to a new study in the American Journal of Clinical Nutrition. Researchers found that consuming fewer than five servings a day—the recommended amount by many public health organizations—was tied to a higher chance of early death. They did not find that people who consumed more than the recommended level saw greater returns. They also found that while people who ate fewer fruits and vegetables were more likely to smoke, to eat more red meat, to eat high-fat dairy products and to be undereducated, the overall study results did not change even after accounting for gender, smoking, exercise, alcohol consumption and body weight. Read more on nutrition.
Red Cross: Emergency Call for Blood, Platelet Donations
A recent drop in blood donations has led the American Red Cross to issue an emergency request for more donors of all blood types. Donations were down about 10 percent in June and more is needed to ensure enough blood and platelets for the summer months. "We're asking for the public's help now to prevent a more serious shortage," said spokesperson Stephanie Millian in a release. "Each day donations come up short, less blood is available for patients in need. It's the blood products on the shelves today that help save lives in an emergency." To see if you are eligible to make a donation or to make an appointment either call 1-800-RED CROSS (1-800-733-2767) or go to RedCrossBlood.org. Read more on preparedness.
NewPublicHealth has been conducting a series of interviews with health directors impacted by weather disasters this year. Last month marked the official start of hurricane season in the Atlantic. We recently spoke with Mary O’Dowd, health commissioner of New Jersey, which is continuing its recovery and rebuilding after Hurricane Sandy last fall.
>>Read our interview with Oklahoma Health Commissioner Terry Cline on the tornadoes that struck Oklahoma this summer.
NewPublicHealth: How far along are you in the recovery process?
Mary O’Dowd: One of the things that we’ve learned is that recovery takes years not months when you’re dealing with a disaster of the proportion that Superstorm Sandy was for New Jersey. I would say that we’ve made significant progress. Some communities have very little signs of Sandy left, others are still working to rebuild a significant amount of their property and they’re still in the process of demolition of damaged buildings and properties. Great strides have been made, much progress has already occurred, but there still is a lot of work yet to be done.
NPH: What are some of the public health endeavors you’re still engaged in for the response?
HHS: 2013 So Far Sees 8 Foodborne Outbreaks, 2 New Global Diseases, 37 Disasters
The U.S. Department of Health and Human Services has awarded more than $916 million to continue improving preparedness and health outcomes for a variety of public health threats in every state, eight U.S. territories and four of the nation’s largest metropolitan areas. “Already in 2013, local and state health agencies have responded to eight food borne outbreaks, two new global diseases, and 37 disaster and emergency declarations, a clear indication of the breadth of threats that public health departments must be capable of responding to,” said Ali Khan, MD, director of the Centers for Disease Control and Prevention Office for Public Health Preparedness and Response. The grants have included funding for the Hospital Preparedness Program (HPP) cooperative agreement and the Public Health Emergency Preparedness (PHEP) cooperative agreement. The programs encourage health care and state and local public health departments to work together to maximize resources and prevent duplicative efforts. Such coordination of activities with emergency management and homeland security programs supports “whole community” planning to improve national preparedness efforts.. Read more on preparedness.
DOT Issues New Rules to Reduce Truck Driver Fatigue
The U.S. Department of Transportation (DOT) has announced new safety regulations to reduce truck driver fatigue:
- The maximum hours per week a truck driver can drive has been reduced from 82 to 70.
- Truck drivers who reach the maximum 70 hours of driving within a week can resume driving if they rest for 34 consecutive hours, including at least two nights from 1 to 5 a.m.
- All truck drivers must take a 30-minute break during the first eight hours of a shift.
- As before, truck drivers have a daily 11-hour driving limit.
Read more on injury prevention.
Sleepy Teenagers Often Make Poor Food Choices
Well-rested teenagers tend to make more healthful food choices than those who are sleep deprived, according to a study by preventive medicine researchers at the Stony Brook University School of Medicine in New York State. The findings were presented at the annual meeting of the Associated Professional Sleep Societies and funded in part by the National Institutes of Health. The study looked at the relationship between sleep duration and food choices in a national survey of more than 1,300 teenagers, finding that those teens who reported sleeping less than seven hours per night were more likely to consume fast food two or more times per week and less likely to eat healthful food such as fruits and vegetables. “Teenagers have a fair amount of control over their food and sleep, and the habits they form in adolescence can strongly impact their habits as adults,” said Allison Kruger, MPH, a community health worker at Stony Brook University Hospital and lead author of the study. Read more on obesity.
In several recent and upcoming posts, NewPublicHealth is connecting with communities that have faced severe weather disasters in the last year. New York City, for example, is continuing to regroup and rebuild after Hurricane Sandy struck the region eight months ago. The city, and its health department, recently announced several initiatives aimed at “building back better” while supporting residents still facing housing as well as mental health problems since the storm last October. Some examples are detailed below.
- The New York City Building Resiliency Task Force, an expert panel convened after Hurricane Sandy to help strengthen buildings and building standards, recently issued a report with recommendations for buildings and homes of all sizes in the city. The report recommends establishing backup power in the event that primary networks fail; protecting water supplies and stabilizing interior temperatures if residents need to shelter in place. ”Making our city’s buildings more resilient to coastal flooding and other climate hazards is a challenge that requires collaboration among government, designers, engineers, and building owners, among others,” said City Planning Commissioner Amanda M. Burden. “The Task Force's work exemplifies the kind of innovation and cooperation necessary to prepare our city for a changing climate.” To create the report, the Task Force convened over 200 volunteer experts in architecture, engineering, construction, building codes and real estate.
Less than a month ago cities in Oklahoma were struck by some of the most powerful tornadoes in the state’s history, killing more than 40 people, injuring scores more and destroying thousands of homes and other structures.
As part of an ongoing series on how public health responds to disaster, NewPublicHealth recently spoke with Gary Cox, director of the Oklahoma City-County Health Department.
NewPublicHealth: What roles has your health department had following the tornadoes?
Gary Cox: We do many things. For example, a lot of people are out cleaning up and come into contact with nails and other sharp objects and they get cuts and puncture wounds. We partnered with Blue Cross Blue Shield and we have three mobile vans staffed those vans with nurses who go out into the affected areas and give tetanus shots and minor first aid. Mental health services can also be provided out of the vans. In fact, we put out a call for assistance and many trained professionals signed up within just a couple of days to volunteer their services to work with individuals and with families, particularly over the stress issues related to these tornados and floods. We have a very broad and deep layer of partnerships, and of course we rely on those. And what we try to do is to take a holistic type so that people in need can get a whole range of services from one location.
One important mission has been to deploy food safety inspectors out into all those areas affected to look at each one of those restaurants and to help them assess their food spoilage and food safety and work with them to get back to business if they can and as soon as they can.
Prepared for a Disaster and Building Back Better: Terry Cline on Public Health’s Response to Oklahoma Tornados
Tornadoes that struck Oklahoma just a few weeks ago have left more than 40 people dead, scores injured and billions in losses, including whole neighborhoods wiped out. The devastating weather of the past year—including superstorm Sandy, which wreaked havoc on the Northeast, especially New Jersey and New York City—has called even greater attention to the critical need for public health departments to be ready to respond at all times. Health departments in the communities and states where disasters happen have to be nimble enough to respond to the expected and the unexpected—as you’ll see from three interviews NewPublicHealth recently conducted with the health commissioners of New Jersey and Oklahoma, as well as with the health director of Oklahoma City, the most recent area to be rocked by severe weather.
And because disasters don’t honor state lines and devastated areas may not have the capacity on their own to handle the myriad of disaster health issues, the manpower and equipment of even far-flung health departments can be critical—making preparedness a year-round, 24/7 responsibility for everyone in public health.
Read the first installment in the series, a conversation with Terry Cline, PhD, the Commissioner of Health in Oklahoma.
NPH: With the recent tornadoes, what were you able to prepare for and what was unexpected?
Terry Cline: Unfortunately, in Oklahoma we have a lot of experience in dealing with disasters and we have what I consider to be a well-oiled machine in place. So overall, I think the response to this tragic situation went very well. The multiple tornados were a bit of a surprise though. It’s not unusual to have several tornados in the same area, but it’s unusual to have two significant tornados and then have one of those go through an urban area. I think a critical impact that was not anticipated was the flooding during the most recent tornado. The bottom line is that you need to have a strong infrastructure in place because Mother Nature has a way of always having the upper hand.