Category Archives: Public Health
Electronic Laboratory Reporting Increasing
Federal agencies are reopening today after a 16 day shutdown and public health updates such as FluView from the Centers for Disease Control and Prevention are expected to come back online within the new few days. CDC’s last news release before the shutdown was on the increasing capability of laboratories to report findings to local and state health agencies electronically. The report was published in the most recent issue of Morbidity and Mortality Weekly Report (MMWR).
According to CDC, the number of state and local health departments receiving electronic reports from laboratories has more than doubled since 2005, however, progress is still needed. The MMWR report shows that only about a quarter of the nation’s labs are reporting electronically and that electronic reporting lags for some diseases behind others. For example, 76 percent of reportable lab results for general communicable diseases were sent electronically, compared to 53 percent of HIV results and 63 percent of results for sexually transmitted diseases. Read more on infectious disease.
District Laws and Policies Reduce Sugary Foods and Drinks at School Parties
Schools with a district policy or state law discouraging sugary foods and beverages were 2.5 times more likely to restrict those foods at school parties than were schools with no such policy or law, according to a new study published online in the Journal of Nutrition Education and Behavior.
Researchers at the University of Illinois at Chicago School of Public Health examined the linkages between state laws, district, and school-level policies for classroom birthday and holiday parties through surveys of more than 1,999 schools in 47 states.
About half the schools had either no restrictions or left the decision to teachers; one-third had school-wide policies discouraging sugary items; and fewer than 10 percent actually banned sweets during holiday parties or did not allow parties.
The study was supported by the Robert Wood Johnson Foundation. Read more on nutrition.
Children of Same Sex Marriages Less Likely to be Covered by Health Insurance
Children with same sex parents are less likely to have private health insurance than children with married opposite-sex parents, according to a recent study in Pediatrics. Using data from the 2008-2010 American Community Survey on children aged 0-17 years, the researchers found that 78 percent of children with married opposite-sex parents had private health insurance coverage, compared to 63 percent of children with same-sex fathers and 68 percent of those with same-sex mothers.
However, in states with legal same-sex marriage or civil unions, or in states that allowed second-parent adoptions, the disparities in private health insurance was lower for children of same-sex parents, suggesting that children of gay and lesbian households benefited from these policies. The American Academy of Pediatrics endorsed same-sex marriage in March. Read more on access to health care.
At the recent Place Matters: Exploring the Intersections of Health and Economic Justice conference in Washington, D.C., David J. Erickson, PhD, was a key member of a panel called “What Works for America’s Communities?” Dr. Erickson, who is director of the Center for Community Development Investment at the Federal Reserve Bank of San Francisco, has been a key leader in a Healthy Communities collaboration between the Federal Reserve and the Robert Wood Johnson Foundation. The joint effort has convened more than ten conferences around the country and released numerous publications, including an article in Health Affairs about partnerships to improve the wellbeing of low-income people.
>>Read more reporting from the Place Matters conference, in a Q&A with David Williams of the Harvard School of Public Health and the RWJF Commission to Build a Healthier America.
NewPublicHealth spoke with Dr. Erickson at the Place Matters meeting.
NewPublicHealth: Are the Healthy Communities conferences continuing?
David Erickson: We still have what we call “consciousness raising” meetings planned in Ohio, Florida, Louisiana and other cities, and these are initial meetings that get together the health and community development world. But then there is another phase, we call it phase two—how do you operationalize this idea? What do we do tomorrow? Who do I call? How do I structure the transaction? Who’s my partner? And that’s harder to answer so we’re trying to figure that out. So we need phase two meetings to get hospitals together with banks to talk about how they might blend some of their community benefit dollars with community reinvestment dollars to help alleviate some of the upstream causes of bad health [like poverty and poor housing].
NPH: What would be examples of such a collaboration?
American Heart Association: Doctors Should Routinely Ask About Physical Activity
A new scientific statement from the American Heart Association says that doctors should evaluate their patients’ physical activity habits as routinely as checking blood pressure and other risk factors for cardiovascular diseases. The statement was published in the journal Circulation.
The statement says that an exercise checkup should cover types, frequency, duration and intensity of physical activity at work, home and during leisure time.
The American Heart Association recommends at least 30 minutes of moderate-intensity aerobic activity five days a week or more, or at least 20 minutes of vigorous aerobic activity three days a week or more and moderate- to high-intensity muscle strengthening at least two days a week. Read more on heart health.
People with Mental Health Problems More Likely to be Uninsured
A new University of Minnesota study published in Health Affairs finds that people with mental health problems are more likely to be uninsured and rely on public insurance than people without mental health problems. The study reviewed national insurance coverage rates from 1999 to 2010. The study authors say the implementation of the Affordable Care Act will give many more people with mental health problems access to health insurance – particularly in states such as Minnesota that have that have opted to expand their Medicaid programs. The researchers also say that people with mental health problems on public insurance have better access to care and lower cost barriers than the uninsured or those with private health insurance coverage.
Kathleen Rowan, the lead author of the study and a doctoral student in health services research, policy, and administration at the University of Minnesota School of Public, says, “unfortunately, most persons with mental illness do not receive needed care due in part to a lack of health insurance coverage and the cost of treatment.” Read more on mental health.
Study: Research to Delay Aging is a Better Investment Than Cancer, Heart Disease Research
A new study in current issue of Health Affairs finds that research to delay aging and the infirmities of old age would produce better health and economic returns than advances in some fatal diseases such as cancer or heart disease.
The study found that even modest gains in the scientific understanding of how to slow the aging process would result in an additional 5 percent of adults over the age of 65 remaining healthy rather than disabled every year from 2030 to 2060, or 11.7 million more healthy adults over age 65 remaining healthy by 2060.
The analysis was conducted by scientists from a consortium of research centers. “Even a marginal success in slowing aging is going to have a huge impact on health and quality of life. This is a fundamentally new approach to public health that would attack the underlying risk factors for all fatal and disabling diseases,” said S. Jay Olshansky, professor of epidemiology at the UIC School of Public Health and one of the study’s authors. “We need to begin the research now. We don’t know which mechanisms are going to work to actually delay aging, and there are probably a variety of ways this could be accomplished, but we need to decide now that this is worth pursuing.” Read more on aging.
“What aging is, is the greatest success of public health,” said Ruth Finkelstein, director of the Age-Friendly Initiative of the New York Academy of Medicine.
The City of New York has released a progress report on Age-friendly New York City, a cross-agency, public-private partnership created in 2009 to improve the lives of older New Yorkers. The report highlights progress in several areas including pedestrian safety, parks access and innovative senior centers among others initiatives. New York City is home to 1.3 million older New Yorkers, a number expected to increase by close to 50 percent by 2030. In 2007, the City Council provided funding to the New York Academy of Medicine to begin creating a blueprint to help New York City become a model of an age-friendly city.
The report’s release coincides with the city’s announcement of its recognition as the Best Existing Age-friendly Initiative in the World through a competition sponsored by the International Federation on Aging.
“It’s a fact of life that everyone gets older and we need to make sure our City is prepared to meet the needs of our aging population,” said Department for the Aging Commissioner Lilliam Barrios-Paoli. “Our success is due to the collaborative efforts of our sister City agencies, the New York City Council and the New York Academy of Medicine. Without this uniquely innovative partnership and the grassroots community efforts from local businesses and neighborhood organizations, we would not have been able to build the foundation for what makes New York City a better place to live for our seniors.”
The city’s age-friendly initiatives include:
Add flu surveillance to the list of casualties of the current government shutdown.
Every flu season, states collect data on flu cases — including case reports and viral specimens — and send those to the Centers for Disease Control and Prevention (CDC) in Atlanta for recording and tracking. That tracking is critical in order to:
- provide information on how well-matched the seasonal flu vaccine is to the flu viruses found in the community;
- identify severe outbreaks that require increased supplies of antiviral medicines for people who contract the flu; and
- identify emerging strains that might require a new vaccine to be developed this season, which is what happened several years ago when CDC identified the H1N1 influenza virus toward the end of the flu season, and quickly ramped up for a new vaccine.
Flu season generally runs October through April, with the peak from about January to March. If the shutdown continues then, “as the flu season goes on, our knowledge of what’s happening will be impaired,” says William Schaffner, MD, Professor of Preventive Medicine and Infectious Diseases, Vanderbilt University School of Medicine, and the immediate past president of the National Foundation for Infectious Diseases.
CDC director Thomas Frieden, MD, MPH, underscored his concern in a tweet on the first day of the government shutdown: “CDC had to furlough 8,754 people. They protected you yesterday, can't tomorrow. Microbes/other threats didn't shut down. We are less safe.”
New Report: Most States Not Implementing Enough Proven Strategies to Prevent Prescription Drug Abuse
Prescription drug-related deaths now outnumber deaths from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C.
A new report about prescription drug abuse released today by Trust for America’s Health (TFAH), finds that few states are implementing more than just a few promising strategies that have been identified to help combat the widespread drug abuse that continues to increase across the U.S. The report, Prescription Drug Abuse: Strategies to Stop the Epidemic, which was funded by a grant from the Robert Wood Johnson Foundation, shows that only two states – New Mexico and Vermont – have implemented all ten strategies.
According to the National Center for Injury Prevention and Control (NCIPC), nationally, sales of prescription painkillers per capita have quadrupled since 1999 – and the number of fatal poisonings due to prescription painkillers has also quadrupled. Enough prescription painkillers were prescribed in 2010 to medicate every American adult continually for a month.
>>Watch a one-minute video on the scope of the prescription drug abuse epidemic in the United States.
The report also found that the number of drug overdose deaths – a majority of which are from prescription drugs – has doubled in 29 states, tripled in ten states and quadrupled in four states since 1999.
“The rapid rise of abuse requires nothing short of a full-scale response – starting with prevention and education all the way through to expanding and modernizing treatment,” said Jeffrey Levi, PhD, executive director of TFAH. “There are many promising signs that we can turn this around – but it requires urgent action,” says Levi.
In the new report, TFAH, based on consultations with experts in public and clinical health, injury prevention, law enforcement and community organization, reviewed national recommendations and examined strategies currently in use to help curb the epidemic. Recommendations include expanding access to treatment options; ensuring responsible prescribing practices; and improving Prescription Drug Monitoring Programs.
>> Learn how your state scores on the 10 key steps to curb prescription drug abuse, with a new app from the Robert Wood Johnson Foundation.
Ohio is one of several states that have implemented six of the proven strategies recommended in the report and today, in fact, will introduce new prescriber guidelines.
NewPublicHealth spoke with Ted Wymyslo, MD, director of the Ohio Department of Health about that state’s review of drug abuse and recent efforts to reduce the epidemic through a variety of means, including public and provider education.
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:
Home fires account for 85 percent of fire deaths in the United States, yet the majority of family homes lack fire sprinklers. Since the late 1970s, a grassroots movement has successfully promoted close to 400 local ordinances that mandate fire sprinklers in all new residential construction. In response, the homebuilding industry has sought out state preemption of local authority, a strategy used by other industries as well, in an effort to reduce costs and shield profits. A new study just published in the American Journal of Public Health looks at grassroots public health movements, including the one mobilized to push back against preempting residential fire sprinklers.
To learn more about how preemption can have a negative impact on public health, NewPublicHealth spoke with Marjorie Paloma, MPH, senior policy adviser and senior program officer for the Robert Wood Johnson Foundation’s Health Group, and a co-author of the new AJPH article on preemption, grassroots efforts and public health.
NewPublicHealth: How does the effort to increase installed sprinklers in the U.S. add to the conversation on the grassroots public health movement?
Marjorie Paloma: The residential fire sprinkler story illustrates the power of grassroots movements and the chilling effect preemption can have. I use power very explicitly because when you look at the residential sprinklers movement, over time, you see how much power people have when they come together and act. Families who lost someone to fire, fire officials and others came together first in local communities and then across the nation to advocate sprinklers and save lives. The new article in the American Journal of Public Health shows that over three decades, 34 states passed legislation on this — over 350 local ordinances — and I think that this example shows you the arc of a grassroots movement. This example also shows how powerful preemptive legislation is on a grassroots movement. In those two years between 2009 and 2011, 13 states passed preemptive legislation and that essentially pulled the wind out of the sails of advocates who had been working on this issue. And, it shows you how that tactic, that strategy of preemption can really deflate, thwart, and potentially kill a movement.
NPH: How does the grassroots movement intervene and explain what the impact of preemption is on movements that promote health?
Recent debate about the federal government shutdown that started two days ago for federal employees has included a wide range of concerns and viewpoints from different sides of the spectrum. But Forbes Magazine has a new article that points out that the shutdown means something else entirely for some often overlooked, but very influential, bodies outside the federal government: microbes.
According to the piece in Forbes, the shutdown has the potential:
to pose a threat to public health because [it will] allow microbes to gain footholds as our defenses against them falter.
The article reported that several federal agencies will reduce such critical work as research funding, food inspections and surveillance for the flu and other infectious diseases including the emerging MERS virus, which has caused dozens of deaths overseas. A recent post from The Atlantic also pointed out a related piece of reporting from The Wall Street Journal: "about 200 patients who otherwise would be admitted to the NIH Clinical Center into clinical trials each week will be turned away. This includes about 30 children, most of them cancer patients...."
>>Read more on how researchers are studying microbes in buildings to health create healthier spaces.
On Wednesday October 2nd, the Joint Center for Political and Economic Studies held its third annual National Health Equity Conference, PLACE MATTERS: Exploring the Intersections of Health and Economic Justice. The Joint Center for Political and Economic Studies was founded in 1970 and is the only research and public policy institute that focuses exclusively on social justice issues of particular concern to African Americans and other communities of color.
The conference focused on the relationship between community development and the creation of healthy spaces and places, and convened key stakeholders, including grassroots leaders, elected officials, researchers, public health practitioners, policymakers, community development practitioners, and community organizers. The conference had several goals, including to:
- Illuminate the mechanisms through which neighborhood conditions directly and indirectly shape the health of children, youth, and families, and document differences in neighborhood conditions resulting from residential segregation;
- Identify common goals and strategies of individuals and organizations working in the community development sector and the health equity sector;
- Elevate promising strategies to improve and sustain neighborhood conditions for health that draw upon effective approaches employed in the community development and health equity sectors; and
- Explore means to better communicate these strategies to key audiences, such as community-based development and health equity organizations, public health practitioners, planners, and elected officials.
Leaders at the Joint Center say that by convening national and local leaders, including individuals at the forefront of community development and health equity movements, they hoped to raise awareness regarding community conditions that shape health and develop policy solutions at the intersection of place and health, particularly as it pertains to people of color and health equity.
NewPublicHealth spoke with Brian Smedley, PhD, Vice President and Director of the Joint Center’s Health Policy Institute about the critical issues of community health and its relationship to health equity.
NewPublicHealth: What do we know so far about the impact of place on health, and what do we still need to learn?
Brian Smedley: There’s a large and growing body of research that demonstrates the relationship between the places and spaces where people live, work, study, and play and their health status, and what we’ve been able to determine is that there are many characteristics of neighborhoods, schools and work places that powerfully shape health. Just as an example, more and more people are paying attention to this concept of food deserts — many communities in the United States that don’t have geographic access to healthy foods. And not only do people have to travel a long distance to access these foods, but they’re often financially out of reach as well.