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More than 10,000 public health officials, academics and students will gather in Boston next week for the 2013 American Public Health Association Meeting in Boston. This year’s theme is “Think Global, Act Local,” drawing critical attention to the increasingly global world of health where events across the globe—from food safety, to infectious disease outbreaks, to innovative public health solutions—can impact every local neighborhood.
>>NewPublicHealth will be on the ground at the APHA Annual Meeting, with speaker and thought-leader interviews, video perspective pieces and updates from sessions, with a focus on what it takes to build a culture of health. Follow our coverage here.
Ahead of the annual meeting, NewPublicHealth spoke with Georges Benjamin MD, APHA executive director.
NewPublicHealth: Why is the theme “Think Global, Act Local” so important?
Georges Benjamin: We’re in a world in which everything is global. There are no boundaries anymore. Rapid transit through planes, the fact that our borders are so porous...public health has always been a global enterprise, but even more so today. Our food comes no longer from a single farm but from multiple farms and sometimes multiple countries, so foodborne risks for disease and illness are global. We’ve seen that terrorism disasters are global. We’ve seen that obesity, particularly with corporations that sell certain products globally, is a big issue, and tobacco has always been a global issue. So, public health is global, and the idea is that if we can learn from people around the world and then utilize those learnings within our local communities, we’ll be stronger
NPH: What are some of the meeting sessions you’d highlight?
Benjamin: Our opening session will feature Professor Sir Michael Marmot, Director of the International Institute for Society and Health and Research Professor of Epidemiology and Public Health at University College, London, who spoke at our meeting five years ago on the social determinants of health and is going to give us an update. In the closing session, we’ll hear from actor/physician/public health doctor, Evan Adams, MD, the deputy provincial health officer for British Columbia, who will speak about improving the health of native people. So in both our opening and closing sessions we’re looking globally, as well as emphasizing what happens locally. We’ll also hear from the minister of health of Taiwan, who will talk about universal health care as well as violence prevention. And we’ll also be holding sessions that track the many public crises that we’ve already had this year.
FDA Recommends Tighter Regulations for Hydrocodone
The U.S. Food and Drug Administration (FDA) is recommending that products that contain hydrocodone be reclassified more restrictively, possibly putting them in the Schedule II category that already includes other opioid painkillers such as oxycodone and morphine. Products that contain less than 15 milligrams of hydrocodone, such as Vicodin, are currently classified as Schedule III controlled substances. The change would mean patients would need to present a written prescription at a pharmacy and could not get as many refills before returning to their doctors for a new prescription. While this would help limit access by addicts, these greater restrictions would also affect people with legitimate chronic pain, potentially placing undue hardship on their already painful conditions. The Drug Enforcement Agency (DEA) is pushing for the restrictions in an effort to combat the increasing problem of prescription drug abuse;
the change must be approved by the U.S. Department of Health and Human Services and the DEA, which will make a final scheduling decision. This Saturday is also National Prescription Drug Take-Back Day, sponsored by the DEA, when people can anonymously and safely dispose of expired or unused prescription medicines. Read more on prescription drugs.
ONC Releases New Online Security Tool for Disaster Preparedness
The Office of the National Coordinator for Health Information Technology (ONC), part of the U.S. Department of Health and Human Services, has released a new online security training tool to help health care providers and staff with contingency planning in the case of power outages, floods, fires, hurricanes or other events. Such events can damage important patient information, or even make it unavailable. "We know from recent experiences such as Hurricane Sandy, that these events can very adversely impact the delivery of health care," said ONC Chief Privacy Officer Joy Pritts. "We hope that this video game will raise awareness of contingency planning and help practices begin to develop their own disaster plans, backup and recovery processes and other vital activities." The "CyberSecure: Your Medical Practice” tool is available here. Read more on disasters.
Study: Kids with Concussion at Higher Risk for Depression
Children with concussions or other head injuries are at increased risk of later being diagnosed with depression, according to new findings to be presented today at the American Academy of Pediatrics national conference in Orlando, Fla. Researchers found that about 15 percent of children and teenagers who ever suffered a brain injury were later diagnosed with depression, compared to the national average of 4 percent. While the findings did not determine causation, they do suggest that doctors should make assessments or mood and behavior problems part of and follow-up treatment for head injuries. Read more on mental health.
HHS: $8M in Research Grants to Support Hurricane Sandy Recovery
The U.S. Department of Health and Human Services (HHS) has awarded more than $8 million in research grants to support the long-term recovery of areas of the country damaged by Hurricane Sandy in late 2012. The grants, which are part of the Hurricane Sandy Recovery and Rebuilding Supplemental Appropriation Act of 2013, will go toward research on issues such as community resilience; risk communications and the use of social media; health system response and health care access; evacuation and policy decision making; and mental health. “We hope the grants provide a catalyst for the scientific community to put more emphasis on the study of recovery from disasters; much more research is needed to support decision making in the long-term recovery process and ultimately to improve resilience,” said Nicole Lurie, MD, HHS assistant secretary for preparedness and response. “We anticipate that the findings not only will help community leaders make evidence-based decisions about recovery plans and policies in affected areas but also that the knowledge gained can improve resilience across the entire country.” Read more on disasters.
NIH, CDC Launch National Registry on Sudden Deaths in the Young
The U.S. National Institutes of Health (NIH) and the U.S. Centers of Disease Control and Prevention have come together in the launch of the Sudden Death in the Young Registry. The registry will catalogue conditions such as heart disease and epilepsy in order to help researchers better understand the issues and establish future research priorities. According to the NIH, up until now there have not been agreed upon standards or definitions for reporting these deaths, which has impeded efforts to determine the best prevention efforts. "The sudden death of a child is tragic and the impact on families and society is incalculable," said Jonathan Kaltman, MD, chief of the Heart Development and Structural Diseases Branch within the Division of Cardiovascular Sciences at the NIH's National Heart, Lung, and Blood Institute. "This registry will collect comprehensive, population-based information on sudden unexpected death in youths up to age 24 in the United States. It is a critical first step toward figuring out how to best prevent these tragedies." Read more on research.
Mother’s Smoking During Pregnancy Increases Infant’s Risk of Infections, Death
Mothers who smoked during pregnancy are more likely to have children who are at increased risk for hospitalization and death during infancy, according to a new study in the journal Pediatric Infectious Diseases. The study analyzed hospital records and death certificates of approximately 50,000 Washington state infants born between 1987 and 2004. Researchers say a weakening of the child’s immune system may be responsible for the heightened risk. "We've known for a long time that babies born to mothers who smoke during pregnancy are at high risk for serious medical problems relating to low birth weight, premature delivery and poor lung development," said lead author Abigail Halperin, MD. "While respiratory infections have been recognized as a common cause of these sometimes life-threatening illnesses, this study shows that babies exposed to smoke in utero [in the womb] also have increased risk for hospitalization and death from a much broader range of infections—both respiratory and nonrespiratory—than we knew before.” Read more on tobacco.
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.
Three Cases of Dengue Fever Reported in Florida
The Florida Department of Health is reporting three confirmed cases of Dengue Fever in Central Florida. Dengue Fever is an infectious disease transmitted by mosquitoes. While common in Africa, it’s very rare in the United States. The health department has reported that the three patients have not traveled internationally recently, and that they likely contracted the disease from mosquitoes in their home state. The last case of Dengue Fever in Central Florida was in 2011. Symptoms of Dengue Fever, which is treated with supportive care and can in some cases lead to death, include high fever, headache, rash and joint pain.
The Wall Street Journal recently reported on a severe outbreak of Dengue Fever in Southeast Asia that has been especially harsh this year because of an early rainy season, higher than average temperatures and the fact that the virus has mutated in some cases into a more severe version of the disease. Travelers to the region who become infected risk carrying the virus to their home countries, where the virus can spread if an infected person is bitten by a mosquito that then bites other humans.
Guidelines issued by the Florida Department of Health for mosquito control are effective for other diseases transmitted by mosquitoes, including West Nile Virus and some forms of encephalitis, which both have been seen this summer in the United States. The guidelines include:
- Drain water from garbage cans, house gutters, buckets, pool covers, coolers, toys, flower pots or any other containers where sprinkler or rain water has collected.
- Discard old tires, drums, bottles, cans, pots and pans, broken appliances and other items that aren't being used.
- Empty and clean birdbaths and pet's water bowls that are kept outside at least once or twice a week.
- Protect boats and vehicles from rain with tarps that don’t accumulate water.
Read more on infectious disease.
Hurricane Sandy Rebuilding Task Force Releases Report, Recommendations
The Hurricane Sandy Rebuilding Task Force yesterday released its Rebuilding Strategy designed to be a model on how communities can prepare for and respond to extreme weather events. It also includes recommendations on how to continue to help area rebuild from the devastation of Hurricane Sandy. “This Rebuilding Strategy will protect families, small businesses and communities across the region, and the taxpayers’ investment in them, from the risks posed by sea level rise and more extreme weather events – risks that are made worse by the reality of a changing climate,” according to U.S. Department of Housing and Urban Development (HUD) Secretary Shaun Donovan, who chairs the task force. The goals include aligning federal funding with local rebuilding visions; cutting red tape and getting assistance to families, businesses and communities efficiently and effectively; and coordinating the efforts of the federal, state and local governments, with a region-wide approach to rebuilding. Read more on Hurricane Sandy.
Survey: Hispanic Teens More Likely Than White, Black Teens to Abuse Drugs
Hispanic teens are more likely than their white and black counterparts to abuse both legal and illegal drugs, according to a new report, The Partnership Attitude Tracking Study 2012: Hispanic Teens and Hispanic Parents. A survey found that about 54 percent of Hispanic teens had used an illicit drug; 43 percent of white teens and 45 of black teens reported using an illicit drug in the same survey. At the heart of the issue could be that Hispanic teens on average view the drugs as less harmful, said Sean Clarkin, director of strategy and programs at The Partnership at Drugfree.org. "They see drug use among their peers and in their community, and the messages they are not getting from their parents—these all may be contributing to this feeling that drug use is normal," he said. The key to improving on these troubling rates is improved guidance an education on the dangers of drug abuse. Read more on substance abuse.
In the national conversation on the spreading epidemic of obesity and chronic diseases, and the ways in which public health initiatives can fight these issues, architecture and design are continuing to play a leading role in developing fit and healthy solutions. The way a community or a school or a store or a workplace is built can actually influence physical activity, access to healthier food and more to help create an overall fitter nation.
FitNation is an initiative that highlights innovative design strategies across the country to get people healthy and moving. These projects, which stretch across the realms of local and national policy and grassroots-driven action to urban improvements, are brought together in FitNation as inspired by New York City’s Active Design Guidelines and the annual Fit City Conference, which is a partnership between the American Institute of Architects New York and the New York City Department of Health and Mental Hygiene.
Here is a selection of some of the creative solutions featured in FitNation that were developed to help individuals and communities lead happier and healthier lives.
Red Swing Project
Design by Hatch Workshop and University of Texas at Austin Architecture Students
Starting in Austin, Texas, a group of architecture students seeking to make better use of public spaces started the Red Swing Project, an open source initiative to transform some unexpected places into playgrounds. The swings consist of a piece of scrap wood, painted red, and rock climbing rope and have popped up all over the world—transforming areas hit by natural disasters, lining a bicycle path from Paris to Barcelona, and below an interstate overpass. You can track the project online with a geo-tagged map or through #redswingproject on Instagram and Facebook.
Urban Farming Food Chain, Edible Wall
Design by Elmslie Osler, Architect
Los Angeles, CA
We all know that some of the healthiest foods grow on trees, but now in Los Angeles thanks to the Urban Farming Food Chain, they can grow on walls too. The Food Chain consists of “edible walls” that grow fresh fruits, vegetables, and herbs, intended to provide economically disadvantaged populations with healthier food options. The walls are installed on pre-existing structures and have storage for tools, seeds and soil. This project’s vertical angle on community gardens help provide social activities as well as the opportunity to share and develop skills and healthy habits.
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.
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?
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.
Resilience is about how quickly a community bounces back to where they were before a public health emergency—and only a healthy community can do that effectively.
RWJF President and CEO Risa Lavizzo-Mourey, MD, weighed in on what it takes to create healthy, resilient communities—and shared examples of some communities that have done just that—through a post on the professional social networking site, LinkedIn. Dr. Lavizzo-Mourey is one of about 300 LinkedIn Influencers. Read an excerpt of the LinkedIn post below.
It is a testament to the American spirit that less than a day after a tornado brought a 20-mile-wide swath of death and destruction to Moore, OK, public officials and residents unequivocally pledged to rebuild the community. “We will rebuild and we will regain our strength,” Gov. Mary Fallin told a news conference after viewing the devastation.
Similar assertions were made after Hurricane Sandy wiped out entire neighborhoods on the New York and New Jersey coasts eight months ago, and I am sure they will be made again after future natural disasters. I applaud the can-do determination. But I also suggest that we take a minute and think, not just about rebuilding, but creating something better. Why not rebuild communities where health and wellness is a top priority?
Imagine rebuilding neighborhoods that make healthy living an easy and fun choice, that offer more places to safely walk or bike, more open spaces where families can exercise and play, and more restaurants that offer healthy choices and provide nutritional information on their menus.
This is not just some do-gooder’s pipe dream. New Orleans has shown us that it can be done.