Category Archives: Public Health
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.
GUEST POST by John Skendall, Manager, Web and New Media at the Association of State and Territorial Health Officials (ASTHO).
“How much are we really doing in the area of worksite wellness? Are we walking the talk and serving our employees the way we should?” This question was posed by Paul Jarris, executive director of the Association of State and Territorial Health Officials (ASTHO), in a session on workplace wellness at the organization’s annual meeting last Friday in Orlando.
Jarris said that health departments can do more to foster wellness among employees in the states and territories. “We in public health are not leading in this area,” he said. “We are the laggards.”
>>Follow continued ASTHO Annual Meeting coverage on NewPublicHealth.org.
Terry Dwelle, state health official for the North Dakota Department of Health and moderator of the session, agreed. “Health departments must have a worksite wellness program. We need to practice what we preach,” said Dwelle. He also said that the business case for worksite wellness needs to be made to convince employers of the value of investing in wellness.
The annual meeting of the Association of State and Territorial Health Officials (ASTHO) begins next week in Orlando, Fla., bringing together state health officials and other leaders to talk about the latest critical issues around public health in the United States. NewPublicHealth will be on the ground throughout the meeting covering workshops, sessions and keynote speeches, as well as speaking with program speakers and conference attendees.
Discussions will highlight ways to integrate and coordinate health care and public health, including new opportunities under the Affordable Care Act. We will also explore the new ASTHO President's Challenge around preventing prescription drug abuse, check in on efforts around healthy babies and more. Coverage will also include interviews with thought leaders including Paul Jarris, Terry Cline, José Montero and John Wiesman.
In the 1970s and 80s, residents of the Bronx, one of New York City’s five boroughs, were so anxious to leave the crime-ridden area that many residential and commercial buildings—once majestic and architecturally rich—were torched and empty for decades. Now fifty years later there’s a waiting list of thousands for Via Verde, a new low- and middle-income Bronx housing complex that opened last year. Many features set the complex apart from almost any other housing development in the United States, including an emphasis on greenery from almost every vantage point of the building. This helps create a calming and beautiful atmosphere for the residents, many of whom grew up in crowded housing projects where any nearby parks were usually too dangerous to enjoy.
Why is housing important for health? A lack of affordable rental housing can push more tenants into substandard or overcrowded living situations. Living in unaffordable housing also leaves fewer resources for the things that can keep a family healthy, such as healthy food or preventative health care. Low-income housing also has a reputation for being unhealthy, and for good reason—more than 6 million housing units in the U.S. have deficiencies such as lead paint hazards; allergens, dampness and mold that can trigger asthma; and unsafe structural issues that can cause falls and other injuries. Via Verde and other similar efforts seek to change all that, with housing that is not only affordable but also safe, healthy and even environmentally sound and sustainable (which in turn also saves on costs).
The design for Via Verde was the winner of a 2006 competition hosted by the New York City Department of Housing Preservation and Development; the New York Chapter of the American Institute of Architects; the New York State Energy Research and Development Authority (NYSERDA); and the Enterprise Foundation. It was New York City’s first juried design competition for affordable and sustainable housing.
A recent survey by the American Institute of Certified Public Accountants (AICPA) found that more than half of about 1,000 American adults polled could not correctly define common health insurance financial terms such as premium, deductible or copay. That’s concerning considering that opening day to sign up for health insurance under the Affordable Care Act is October 1. “Half of Americans would fail health insurance 101,” said Ernie Almonte, CPA, chair of the Institute’s National CPA Financial Literacy Commission. “That’s critical insight as consumers prepare to make important decisions with implications for both their physical and fiscal well-being,” says Almonte. “Americans need to take time in the coming weeks to familiarize themselves with key terms and assess their needs so they make the best decisions for their health and financial situations.”
Knowing what the terms mean can help people make informed choices when they sign up for health insurance. For example, a copay is the out of pocket cost to a patient for a health service. Choosing a plan with lower co-pays can help individuals save money, according to the Institute.
The survey found that people with high school diplomas or less education were significantly more likely than those with a college education to be unable to define financial health terms. The survey also found that 41 percent of responders said they were not at all knowledgeable about the Affordable Care Act; just under half of responders said they thought they were somewhat knowledgeable.