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Washington State Secretary of Health Mary Selecky has announced her retirement from state service. Selecky has served under three governors since her initial appointment as acting secretary in October 1998. She also served two terms as president of the Association of State and Territorial Health Officials, served on the board of the National Association of County and City Health Officials and is a past president of the Washington State Association of Local Public Health Officials. In 2010, Selecky received the American Medical Association's Nathan Davis Award for Outstanding Government Service.
NewPublicHealth Health spoke with Mary Selecky about her public health career and accomplishments.
NewPublicHealth: Your tenure has spanned many public health game changers. What stands out to you as the greatest triumphs and greatest threats in Washington State?
Mary Selecky: In terms of greatest triumphs, a key one is that we took on the issue of tobacco use in Washington State. Tobacco would be at the top of my list because of the health impact it has had and because it really is something that can be prevented by getting the right information out to people. It has taken us decades for the public to get it that smoking kills.
We had an announcement about tobacco yesterday, in fact. Among our 10th-graders, 9.5 percent used a cigarette in the last 30 days, and our rate has dropped from two years ago, even though across the nation the rate has flattened. So we’re doing something right. We’re a smoke-free state—not just tobacco-free but smoke free. And that really has the most profound influence on people’s health.
On the other hand, tobacco is also our greatest threat, because the tobacco companies continue to spend more than $140 million in this state to get you to use their product or to switch products, and we know they’ve moved to point-of-sale marketing. If you go into the smaller stores particularly, you’re greeted by all these tobaccos posters on the windows, inside the shop and on the counter. Those kinds of things are going on every single day—and every year there’s a new crop of 10th-graders. So it disturbs me that so many of our states have reduced tobacco prevention programs and that, as a result, nationally we’re not making much headway.
CDC: Daily Caloric Intake Down, But Obesity Rates Still Rising
Obesity rates continue to climb despite the fact that U.S. adults are consuming fewer and fewer calories, according to a survey from the U.S. Centers for Disease Control and Prevention appearing in the American Journal of Clinical Nutrition. Average daily caloric intake dropped by 74 from 2003 to 2010, after rising 314 calories from 1971 to 2003. About 35 percent of U.S. adults are obese. "It's hard to reconcile what these data show, and what is happening with the prevalence of obesity," said co-author William Dietz, MD, former CDC director of Nutrition, Physical Activity and Obesity. Read more on obesity.
Agencies Outline Responsibilities for Restoring Public Transportation after a Disaster
The Federal Transit Administration (FTA) and the Federal Emergency Management Agency (FEMA) have signed a Memorandum of Agreement (MOA) that outlines the roles and responsibilities of both agencies in providing federal assistance to repair and restore public transportation systems in areas the president has declared a major disaster or emergency. “After disasters hit, our federal, state and local partners must be able to move quickly and make the necessary repairs to our nation’s transit systems, roads, rails and bridges,” said U.S. Transportation Secretary Ray LaHood. FEMA will continue to have primary federal responsibility for emergency preparedness, response and recovery in major disasters and emergencies. The new emergency relief authority provides FTA with primary responsibility for reimbursing emergency response and recovery costs after an emergency or disaster that affects public transportation systems and for helping to mitigate the impact of future disasters. Read more on transportation.
Exercise Can Improve Self-Control in Kids, Young Adults
Short bursts of exercise—such as a half hour of running—can help youth and young adults improve their self control, according to a new study in the journal British Journal of Sports Medicine. "Tests conducted immediately after short bouts of exercise showed a clear improvement among higher-order functions like self-control, a cognitive [brain] function that is really important for daily activities in terms of both social life and academic performance," said lead author Lot Verburgh, a doctoral candidate in the department of clinical neuropsychology at VU University in Amsterdam. The results could help in the treatment of disorders associated with impaired inhibition, such as attention-deficit/hyperactivity disorder (ADHD) and autism. Read more on exercise. If exercise can also be linked to long-term improvement in higher-order mental processes, exercise may soon be not only a treatment option for heart disease patients and individuals looking to control their weight, but also for ADHD and Alzheimer's patients," said Ali Weinstein, an assistant professor and deputy director of the Center for Study of Chronic Illness and Disability at George Mason University in Fairfax, Va. Read more on mental health.
Study: Better Fitness Equals Better Grades for Kids
Getting kids more exercise may also make them more likely to get better grades, according to a new study in the Journal of Pediatrics. The study found that physically fit elementary and middle school students were 2.4 times more likely to pass math tests and about 2 times more likely to pass reading tests . The findings are especially significant at a time when schools across the country are cutting physical education programs. "Schools sacrificing physical education and physical activity time in search of more seat time for math and reading instruction could potentially be pursuing a counterproductive approach," said lead researcher Robert Rauner, MD, of Creighton University and Lincoln Public Schools in Lincoln, Neb. Read more on physical activity.
Personalized Risk Assessments Lead to Smarter Patient Decisions
Providing patients with personalized risk assessments instead of generalized assessments makes them more likely to make educated decisions about screening tests, according to a new review of 41 studies published in the Cochrane Library. The personalized evaluations include factors such as age, race, gender, weight, lifestyle and family history. "Knowing your individual risk for a particular health problem may help you make an informed choice about what screening services you might be interested in," said Michael LeFevre, MD, MSPH, co-vice chair of the government-backed U.S. Preventive Services Task Force. "Over time, what would be ideal is that we're able to make more specific, individualized recommendations and fewer population recommendations.” Read more on access to health care.
Study: ADHD, Autism, Depression May Share Genetic Link
Autism, attention-deficit/hyperactivity disorder (ADHD), major depression and other mental disorders may share genetic risk factors, according to a new study in The Lancet. Bipolar disorder and schizophrenia were also linked. Researchers do not yet understand the link between the gene variants and the disorders, but the knowledge may help improve prevention and treatment methods. "This is the first clue that specific genes and pathways may cause a broader susceptibility to a number of disorders,” said lead researcher Jordan Smoller, MD, a professor of psychiatry at Harvard Medical School in Boston. “Now the important work will be to figure out how this actually happens.” Read more on mental health.
Folic Acid Supplements Early in Pregnancy May Reduce Risk of Autism by 40%
Prenatal folic acid supplements appear to reduce the risk for autistic spectrum disorders, according to a study in the Journal of the American Medical Association. The study included more than 85,000 babies born in Norway. Researchers noted prenatal eating habits of the mothers and followed up with families for three to ten years after birth to measure the development of autism spectrum disorders. A total of 270 cases were identified among the children in the study and a review by the researchers found that mothers who took folic acid supplements in early pregnancy had a 40 percent reduced risk of having children with autistic disorders. The researchers say that the timing of a mother’s intake of folic acid appears to be a critical factor. A child’s risk of autism was reduced only when the supplements were taken between 4 weeks before to 8 weeks after the start of pregnancy. Read more on maternal and infant health.
Prescription Drug Abuse Programs in Middle School Reduce Abuse Later in Life
A new study by researchers at the National Institutes of Health (NIH) found that middle school students from small towns and rural communities who were involved in community-based prevention programs were less likely to abuse prescription medications in late adolescence and young adulthood. The study was published in the American Journal of Public Health. According to the NIH, prescription drug abuse is one of the most serious public health problems in the United States. In 2011, about 1.7 million people ages 12 to 25 abused a prescription drug for the first time, according to the National Survey on Drug Use and Health . “The intervention effects were comparable or even stronger for participants who had started misusing substances prior to the middle school interventions, suggesting that these programs also can be successful in higher-risk groups,” said Richard Spoth, PhD, of the Partnerships in Prevention Science Institute at Iowa State University and the lead author of the study. Those findings contrast with a recent study published by the Substance Abuse and Mental Health Administration that found that 12th grade dropouts have higher rates of cigarette, alcohol and illegal drug use. Read more on addiction.
New Study Shows Significant Health Benefits of Americans Reducing Their Sodium Intake
Hundreds of thousands of lives could be saved over 10 years if Americans reduced their sodium consumption to the levels recommended in federal guidelines, which would prevent many heart attacks and strokes, according to a new study by researchers at UC San Francisco, Harvard Medical School and Simon Fraser University in Canada. The study was published in the journal Hypertension. The study resulted from a workshop conducted by the U.S. Centers for Disease Control and Prevention which brought together scientists from the three universities. Each university group used different computer models to estimate the risk reduction of lowering sodium, but all found consistent, substantial benefits of reducing U.S. sodium consumption to a level close to the upper limit of the federal guideline of 2,300 mg/day. According to the study, the overall average sodium consumption in the United States has been estimated at 3,500 mg/day, well above the upper limit of the level recommended by federal agencies and the Institute of Medicine. American men consume twice the recommended level on average. Read more on nutrition.
New York Announces Companies Reducing their Sodium Content
Earlier this week, the city of New York announced that 21 companies met one or more of their voluntary commitments to reduce sodium content in pre-packaged or restaurant foods. Those reductions were the result of the National Salt Reduction Initiative (NSRI), the first-ever nationwide partnership to reduce sodium in the U.S. food supply. The NSRI is a nationwide partnership of more than 90 city and state health authorities and organizations coordinated by New York City since 2009. The NSRI’s goal is to cut excess salt in packaged and restaurant foods by 25 percent over five years through voluntary corporate commitments. Support for the initiative has come from the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, the W.K. Kellogg Foundation, the Robert Wood Johnson Foundation, the New York State Health Foundation and the National Association of County & City Health Officials. The project funding is administered by the Fund for Public Health in New York, a private non-profit organization that supports innovative initiatives of the New York City Department of Health and Mental Hygiene. Read more on prevention.
Health Highlights of 2012
On this last day of the year, the news site HealthDay ticks off some significant health events of the last twelve months:
- The June Supreme Court ruling upholding most of the Affordable Care Act.
- The outbreak of deadly fungal meningitis linked to tainted steroid injections that began during the summer. As of December 17, the outbreak had infected 620 people and killed 39 people across 19 states. On Dec. 20, health officials from all fifty states met with U.S. Food and Drug Administration representatives to discuss proposed regulation to help prevent such events in the future.
- Autism incidence keeps rising. In March, the Centers for Disease Control and Prevention estimated the prevalence of the disorder at one in every 88 children, up from one in 110 in 2010. Cases were also five times more common in boys than girls, the agency found. While changes in how autism is spotted and reported may have played a role in the new numbers, other factors behind the increase are unclear.
- This year saw two major milestones in HIV testing and treatment. In July, the FDA approved OraQuick, the first at-home HIV test, which enables people to privately assess their infection status within 20 minutes. The same month the FDA approved Truvada, the first HIV drug aimed at preventing transmission of the virus to uninfected people who are at high risk.
- Two new diet drugs were approved by the U.S. Food and Drug Administration for the first time in thirteen years. Belviq was approved in July for obese adults with high blood pressure, Osymia, approved for the patient group, got the FDA’s nod a month later.
Read NewPublicHealth News Roundups.
IOM Committee to Explore Sports-related Concussions
Youth sports concussions will be a focus of an Institute of Medicine Committee next year. The committee will conduct a study on youth, from elementary school through young adulthood, including military personnel and their dependents. The committee will also review concussion risk factors; screening and diagnosis; treatment and management; and long-term consequences. Read more on injury prevention.
Scheduling Cardiac Rehab Soon After a Heart Attack Improves Compliance
A new study in Circulation found that scheduling cardiac rehabilitation to begin sooner rather than later following a heart attack increased the chance that patients show up for the first and subsequent sessions. Cardiac rehab, which includes supervised exercise and nutrition counseling, has been linked to a reduction in second heart attacks in patients who complete the multi-week programs. In the new study, patients whose first rehab session was scheduled within ten days of hospital discharge were more likely to come to the first session than were patients whose appointments were scheduled for within 35 days of discharge, which is a standard time frame in the United States. Read more on heart health.
HHS Online Initiative to Protect Patient Information on Mobile Devices
A new initiative from the U.S. Department of Health and Human Services includes online tools with practical tips on how to protect patient health information on mobile devices. Mobile Devices: Know the RISKS. Take the STEPS. PROTECT and SECURE Health Information includes videos, fact sheets and posters. Surveys shows that only about 44 percent of mobiles devices used for clinical purposes are properly encrypted. “It’s important that these tools are used correctly,” said Joy Pritts, HHS’ Office of the National Coordinator for Health Information Technology (ONC) chief privacy officer, in a release. “Health care providers, administrators and their staffs must create a culture of privacy and security across their organizations to ensure the privacy and security of their patients’ protected health information.” Read more on technology.
Study: Daylight Savings Time Slightly Increases Heart Attack Risk
Sleep deprivation caused by setting the clock ahead for Daylight Savings Time may slightly increase the risk of heart attack the following day, according to a new study in the American Journal of Cardiology. "Nowadays, people are looking for how they can reduce their risk of heart disease and other ailments," said Monica Jiddou, lead author and a cardiologist at William Beaumont Hospital in Royal Oak, according to Reuters. "Sleep is something we can potentially control. There are plenty of studies that show sleep can affect a person's health." Researchers said that while the findings could be due to chance, they believe the sleep deprivation increase stress hormones and inflammatory chemicals. Read more on heart health.
Experts: No Link Between Autism, Violence
In the wake of reports that the 20-year-old gunman who killed 27 people—20 of them children—at an elementary school in Newton, Conn. had Asperger's syndrome, health professionals are quickly noting that there is no link between autism (of which Asperger’s is a mild type) and violence. "Research suggests that aggression among people with autism spectrum conditions can occur 20 percent to 30 percent more often than compared to the general population," said Eric Butter, assistant professor of pediatrics and psychology at Ohio State University, according to HealthDay. "But, we are not talking about the kind of planned and intentional type of violence we have seen at Newtown. The new DSM-5 is set to change the designation "autistic disorder" to "autism spectrum disorder," which will include what is currently known as Asperger's. Read more on mental health.
Report Helps Parents Identify Dangerous Toys in Stores
The U.S. Public Interest Research Group’s (U.S. PIRG) 27th annual “Trouble in Toyland” report provides safety guidelines for parents shopping for toys this holiday season. It also identifies toys that are potentially dangerous, either because of the inclusion of toxic substances or because of threats such as choking hazards. “We should be able to trust that the toys we buy are safe. However, until that’s the case, parents need to watch out for common hazards when shopping for toys,” said Nasima Hossain, Public Health Advocate for U.S. PIRG. There is also a mobile site for smartphones. Read more on safety.
Survey: Despite Worries, Most Kids Getting Enough Sleep
Despite concerns that U.S. children don’t get enough sleep, a new report in the Archives of Pediatrics and Adolescent Medicine indicates that kids are generally getting the amount recommended by the U.S. Centers for Disease Control and Prevention. The recommendations are different for different ages, with kids under age to sleeping 12 to 14 hours each day and 16-year-olds sleeping about 9 hours a day. Lack of sleep has been connected to behavior problems and physical health issues. "We can't say this is the amount that they should be sleeping," said Jessica Williams, the study’s lead author and a graduate student at the University of California, Los Angeles, according to Reuters. "All we could really do is compare our estimated norms with what is recommended, and it seems like it falls pretty well in line with the recommendations." The researchers believe their data can help clinicians better identify kids who may not be getting enough sleep. Read more on pediatrics.
Study: Link Between Autism, Air Pollution
Air pollution during pregnancy and the first year of life may increase a child’s risk of autism, according to a new study in the Archives of General Psychiatry. The study found kids exposed to the “highest” levels of air pollution—such as from traffic congestion—were three times more likely to be diagnosed with autism than were kids exposed to the “lowest” levels. The findings support previous research suggesting a link between problems with the immune system and autism. "We are not saying that air pollution causes autism," said Heather Volk, lead researcher and assistant professor of preventive medicine at the University of Southern California, in Los Angeles. "But it does appear that this may be one potential risk for autism. We are beginning to understand that pollution affects the developing fetus." Read more on autism.
Overweight, Obese Women at Higher Risk of Rheumatoid Arthritis
Being overweight increases the chance that a woman will develop rheumatoid arthritis, according to preliminary study findings presented at the American College of Rheumatology in Washington, D.C. Approximately 1.3 million people in the United States have the disease, which causes pain, swelling, stiffness and loss of joint function. The results come from two studies: the Nurses' Health Study for women ages 30-55 and the Nurses' Health Study II for women ages 25-42. Overweight women were at 19 percent higher risk in the first study and 78 percent in the second; obese women were at 18 percent higher risk in the first and 73 percent in the second. While the results support previous studies suggesting a connection between excessive weight and rheumatoid arthritis, researchers were careful to note the study did not prove cause and effect. Read more on obesity.
Low-income Earners Postpone Knee Surgeries, Are Happier with the Results
People who earn less than $35,000 are more inclined to postpone knee-replacement surgery until it’s absolutely needed, meaning they see much greater before/after differences than people with higher incomes and are happier with the results, according to a new study by researchers in the Mayo Clinic in Rochester, Minn. David Lewallen, MD, an orthopedic surgeon, said the area required further study but these preliminary findings provided important information. "This is one small piece of a very large puzzle in understanding patient outcomes following a well-defined surgery that we know is very effective for most." Read more on access to health care.
Study: Flu During Pregnancy May Slightly Raise Risk of ‘Infantile Autism’
Women who have the flu while pregnant are at slightly higher risk of their children being diagnosed with “infantile autism,” according to preliminary research in a new Danish study. The overall risk of autism did not increase over children whose mothers did not have the flu, however. The slight increase could be because of how the fetus’ brain is affected by the mother’s immune response to the flu. Still, Hjordis Osk Atladottir, MD, from the University of Aarhus, said the overall risk of the disorder was no higher and the risk of infantile autism was still incredibly low. "Ninety-nine percent of women with influenza do not have a child with autism," she said to Reuters. "If it were me that was pregnant, I wouldn't do anything different from before, because our research is so early and exploratory." Read more on maternal and infant health.
CDC: 14 Dead, 170 Sick in Meningitis Outbreak
Fourteen people have now died in a meningitis outbreak tied to apparently tainted steroid injections, according to the U.S. Centers for Disease Control and Prevention. There are 170 total cases so far. The methylprednisolone acetate was manufactured at the New England Compounding Center of Framingham, Mass. and given to as many as 13,000 people in 23 states. The outbreak has led many to question current compounding practices. "This incident raises serious concerns about the scope of the practice of pharmacy compounding in the United States and the current patchwork of federal and state laws," read a statement from Rep. Henry Waxman (D-Calif.), Rep. Diana DeGette (D-Colo.) and Rep. Frank Pallone Jr. (D-N.J.). Read more on infectious diseases.
Study: Concussion Diagnosis Inconsistent in College Athletics
Physicians who diagnose concussions in college athletes use inconsistent criteria that could hinder proper patient care, according to a new study in the Journal of Neurosurgery. Refined, universal standards would improve patient outcomes, according to researchers who analyzed 48 diagnosed concussions in 450 college athletes at Brown University, Dartmouth College and Virginia Tech. "The term 'concussion' means different things to different people, and it's not yet clear that the signs and symptoms we now use to make a diagnosis will ultimately prove to be the most important pieces of this complicated puzzle," said Ann-Christine Duhaime, MD, director of the pediatric brain trauma lab at Massachusetts General Hospital. "Some patients who receive a diagnosis of concussion go on to have very few problems, and some who are not diagnosed because they have no immediate symptoms may have sustained a lot of force to the head with potentially serious consequences," she explained. Read more on access to health care.
Researchers to Evaluate Umbilical Stem Cells’ Effect on Children with Autism
Scientists at the Sutter Neuroscience Institute, in Sacramento, Calif. will inject 30 children with autism with stem cells from their own umbilical cord blood to research whether the treatment can improve behavior and language skills. Michael Chez, MD, director of pediatric neurology at the institute, said researchers hope to find scientific support for anecdotal evidence. The 13-month study will involve children ages 2 to 7. One in 88 children are affected by autism, according to the U.S. Centers for Disease Control and Prevention. Read more on pediatrics.
CDC: Meningitis Outbreak Climbs to 91; Pharmacies Identified
There are now 91 people in nine states infected with meningitis due to apparently contaminated steroids, according to the U.S. Centers for Disease Control and Prevention. Seven people have died. Manufacturer New England Compounding Center of Framingham, Mass. has recalled the suspect methylprednisolone acetate. CDC says the length of time it takes for meningitis symptoms to appear means more cases are likely. CDC released a list of pharmacies that received the steroid. Read more on infectious diseases.
Study: Few Patients Ask About Physicians’ Hand Hygiene
Have you ever asked your doctor whether they washed their hands before examining you or performing a procedure? Only about 1 in 5 patients do, according to a new national survey. Hospitals encourage patients to ask, yet only 21% asked in the hospital and 17% asked at their doctor’s office; less than 1 in 10 asked “frequently” or “all the time,” according to the American Medical Association. Poor hygiene contributes to increased infections from doctor’s visits and hospital stays. “One in 20 patients who goes into the hospital is going to get one of these health care-associated infections, and we need to educate patients about ways to prevent them,” said William Jarvis, MD, a pediatric infectious diseases specialist. “As they understand what the risks are, these signs are reminders to them to remind health care workers about hand hygiene.” Read more on prevention.
Study: Half of Kids with Autism Run Away
A new study in the journal Pediatrics shows that about half of children with autism had wandered away from their caregivers at least once. Of the 1,218 kids surveyed, 316 went missing for an average of approximately 40 minutes. The study was headed by the Interactive Autism Network Project at the Kennedy Krieger Institute in Baltimore. Paul Law, MD, the project’s director, said it is the lack of social skills and social bond makes children with autism more likely to wander away. "There's an enormous burden that all families are undergoing to keep their families safe,” Law told Reuters. “The amount of diligence, and not going out in public, and staying up late at night…just the general anxiety that families live under because of concerns with this is just torturous." Read more on safety.