Category Archives: Recommended Reading
For anyone who has ever had a mammogram, reminded someone to have a mammogram or sported anything pink for breast cancer awareness month, the New York Times has a thought-provoking article well worth reading. The author battled breast cancer twice and raises the interesting and controversial question of whether the uber-awareness campaign about breast cancer led to more mammograms than were necessary. The author argues that mammograms can result in early treatment—which comes with its own risks—but ultimately doesn’t save many lives. Studies cited show many women died despite early detection and many others, who underwent years of treatment for breast cancer, might never have been bothered by their breast tumors at all.
The article arrives on the heels of a study in the journal Cancer that found that the proportion of women undergoing screening for breast cancer every year did not change after the U.S. Preventive Services Task Force advised that there was not enough evidence to support routine mammograms for women in their 40s.
Otis Brawley, chief medical officer of the American Cancer Society, weighed in on the Times article on the ACS Press room Blog and agreed that it is recommended reading: “This is a powerful and important article, one I believe every breast cancer advocate, and frankly even advocates for prostate and other cancers, should read,” wrote Brawley. “ It lays out the challenge that lies before us in reducing death and suffering from breast cancer, while demonstrating the challenge that we in public health face in how to accurately and truthfully administer information.”
Every two weeks the Agency for Health Care Research and Quality (AHRQ) releases an Innovations Exchange newsletter in order to share innovative health practices from around the country that can be adapted by other communities. The Innovations Exchange supports the Agency's mission to improve the quality of health care and reduce disparities.
The current issue focuses on school-based programs for youth at risk. According to AHRQ, many adolescents—particularly those in minority and low-income communities—lack access to health information, preventive care, and clinical services, leaving them at risk for untreated physical and mental health issues. School-based health care delivery, according to AHRQ, can improve access to care and address the needs of this vulnerable population.
The featured innovations for at risk youth include:
- A school-based program to reduce type 2 diabetes risk factors for children and young adults;
- An inner city school district's reproductive health services model;
- A school-based health center that improved access to mental health services, particularly for minorities.
The newsletter also features quality tools that schools can use to support HIV and STD prevention programs in schools and to facilitate school-based preventive, mental health, nutrition, and oral health services.
>>Read the latest issue of the AHRQ Innovations Exchange.
While twelve states currently have laws regulating sales of electronic cigarettes (known as e-cigarettes) to minors, a new post on the Network for Public Health Law blog calls on more states to restrict sales to minors while the Food and Drug Administration continues their review of the device.
E-cigarettes contain nicotine, but no tobacco and often come in kid-alluring flavors such as chocolate and vanilla. According to the Network post, one small FDA study found carcinogens and toxins in e-cigarettes. Health experts are concerned that the electronic devices may also be a gateway tool for young adults to actual, cancer-causing, tobacco-filled cigarettes.
E-cigarette use has skyrocketed among adults, according to a recent study by researchers funded by the Centers for Disease Control and Prevention. In 2011, about 21 percent of adults who smoke traditional cigarettes had used electronic cigarettes, up from about 10 percent in 2010. Awareness of e-cigarettes rose from about four in 10 adults in 2010 to six in 10 adults in 2011.
Two weeks have passed since the sequester—across the board federal budget cuts of close to $100 billion—went into effect with no roll back in sight. An essay by Abdul El-Sayed, a social epidemiologist and physician-in-training at the Columbia University College of Physicians and Surgeons in New York City, details the impact the cuts will have on public health, which has already seen deep budget slashes in the last two years. El-Sayed says since 2010 public health spending has already decreased by about $2.5 billion—nearly 8 percent—and sequestration doubles that total to nearly 16 percent “with potentially more cuts to come in the next several years.”
Sayed reviewed the programs targeted and says public health impacts include cuts in vaccination rates; HIV testing; breast and cervical cancer screening; food service inspections; training for public health workers in epidemiology; laboratory skills; and outbreak investigations and global heath funding.
“Worse than the short-term impacts of sequestration on public health at home and abroad may be the lasting implications sequestration’s cuts will have for the future of public health,” says El-Sayed. “If unabated, these cuts will extend through fiscal year 2021, crippling our public health infrastructure by starving critical organizations, such as the CDC and the Food and Drug Administration (FDA), of the funds they need to carry out even their most basic operations.”
Read the article.
An article in the New York Times reports that health departments in some states are increasing their efforts on gun safety and suicide prevention in part because of a startling finding by researchers at the Harvard School of Public Health: far more Americans die from guns they aim at themselves than in mass shootings.
By the numbers:
- Nearly 20,000 of the 30,000 deaths from guns in the United States in 2010 were suicides.
- Wyoming, Montana and Alaska are the states with the three highest suicide rates; they’re also on the list of top gun owning states.
- The national suicide rate has climbed by 12 percent since 2003.
- Suicide is the third-leading cause of death for teenagers.
- Suicide attempts using a gun are fatal 85 percent of the time; suicide attempts with pills are successful 2 percent of the time.
State health departments in Missouri, North Carolina and Wyoming, the state with the highest suicide rate, are giving out gunlocks. In New Hampshire some gun shops post flyers with warning signs for suicide and a recommendation to keep guns from people who are at risk of harming themselves. Some gun owners in Maryland are considering a similar outreach project.
>>Read the article.
>>Bonus Link: Read a NewPublicHealth post about the Surgeon General’s National Strategy for Suicide Prevention, launched last year.
A new study funded by Public Health Law Research, a program of the Robert Wood Johnson Foundation at Temple University, addresses the consequences of weak penalties for domestic violence offenders in the U.S.
Domestic violence, also known as intimate partner violence, accounts for an estimated 1,200 deaths and two million injuries among women each year. The new study, authored by Frank Sloan, PhD, professor of health policy and management at Duke University, and published in the journal Risk and Uncertainty, reviewed data from the North Carolina administrative courts and found that there are often repeat offenses for men arrested for domestic violence and that penalties don’t seem to significantly reduce repeat arrests or convictions.
Sloan points to low prosecution rates and minimal fines as reasons behind many repeat offenses. The study did find, however, that defendants who hired a private lawyer are less likely to be arrested or convicted during the follow-up period because the added costs may be a deterrent.
Following the shootings of 26 people, including twenty children, in Newtown earlier this month, three American Medical Association journals have published articles that take a hard look at gun violence in the United States.
- An article in the Journal of the American Medical Association looks at reduced funding in the last few years for gun injury prevention research, while increased funding for other types of injury prevention such as motor vehicle crashes, has resulted in fewer deaths.
- An essay in the Archives of Internal Medicine looks at guns as “weapons of mass destruction” and suggests strategies to reduce citizen casualties and mass shootings.
- Two contributors in the Archives of Pediatric and Adolescent Medicine write about the Florida law that prevents health care professionals from asking patients or families about firearms in the home.
Read a blog post from the Network for Public Health Law on strategies that may help reduce mass shootings in the U.S. The author, Leila Barraza, JD, MPH, Deputy Director, Network for Public Health Law-Western Region, says that while increased mental health coverage and screenings and gun controls alone will likely not be enough to prevent mass shootings, “the public health law community will have a vital role to play as policies are created and evaluated.”
Read a recent NewPublicHealth interview with Jeffrey Swanson, PHD, a professor of psychiatry and behavioral sciences at Duke University School of Medicine, on how laws can help prevent gun violence.
As recovery efforts following Hurricane Sandy continue, homeowners who lost their homes are filing insurance claims or hoping for federal help to rebuild. But there are also calls to require those rebuilding in coastal areas to make changes to the structures, and the seaside, to reduce the potential damage—and its cost—if disaster strikes again. People with ocean view homes, however, typically resist suggestions such as sand dunes or rebuilding homes on higher ground or on raised platforms to reduce flooding, according to a recent article in the New York Times.
Expect the debate to continue. Most flood insurance is issued by the U.S. government because private insurers don’t want to absorb the risk. And the money needed to pay out claims exceeds the premiums collected.
>>Read the full article.
Food banks have been front and center in the news since Hurricane Sandy as resources for shelf-stable food for people without power. But a recent article in the New York Times says the increased attention on the vital assistance the banks are providing right now, is a good opportunity to showcase the many other services they provide, storm or not, including:
- providing fresh produce (some the banks grow fresh, healthy fruits and vegetables themselves)
- nutrition education classes
- cooking demonstrations
- advocacy for ending hunger
- feeding children during non-school hours
- education about food stamps, now known as SNAP.
>>Read the full New York Times article.
The American Public Health Association and the Safe Routes to School National Partnership have joined together to create an active transportation primer, Promoting Active Transportation: An Opportunity for Public Health.
The goal of the primer is to provide public health practitioners with critical background information on the value of active transportation, such as walking, bike riding, jogging and running to help reduce obesity, transportation expenses and the environmental impact of cars and buses in communities. The primer authors say educating public health leaders about active transportation can affect how transportation is built in communities, regions and states, and engage stakeholders to find effective calls for action.
New federal transportation legislation became effective this month and includes opportunities for public health practitioners to take active roles in moving active transportation forward in their communities including:
- Safe bicycling routes
- Improved sidewalks
- Multi-use pathways
>>Bonus Links: Check out a Q&A with Deb Hubsmith, director of the Safe Routes to School National Partnership. Also read a NewPublicHealth interview with Michelle Windmoeller, assistant director of the PedNet Coalition, which promotes active transportation in communities.