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The American Public Health Association (APHA) is currently accepting applications through April 8 for the association’s one-year Public Health Fellowship in Government. Fellows work in a congressional office on legislative and policy health issues. The position gives Fellows the opportunity to learn about the legislative process in Washington, DC, which can be a critical skill once they return to their positions in public health, since policies are an important tool that can be used to protect Americans and their communities from preventable, serious health threats. And it also allows Fellows to provide critical input, drawing on their knowledge and experience, on the decisions that impact public health at the national policy level.
To get some background on the role of a Fellow and the impact that public health practitioners can have when working in the national policy arena, NewPublicHealth recently spoke with Fern Goodhart, current legislative assistant to Senator Tom Udall (D-New Mexico), who spent the tenure of her fellowship working in the office of Senator Robert Menendez (D-New Jersey). Ms. Goodhart was the first person awarded the APHA policy fellowship and served in 2007-2008.
NewPublicHealth: What was your background before you took the fellowship?
Fern Goodhart: I have worked in public health for 30 years including at a state health department; as director of health education at an ambulatory center; as a medical school instructor; as a member of an autonomous board of health; and as a member of my city council. So I’ve had the opportunity to see how policy was made on the local level and the state level. What brought me to the APHA Fellowship was the desire to see firsthand how policy was made at the federal level.
NPH: What kind of work did that involve?
Analysis: ‘Big Box’ Stores Offer Best Costs on Prescription Drugs
People looking to save money on generic prescription drugs should ask their pharmacists about comparison shopping and should generally look to big box stories rather than smaller pharmacies, according to a new analysis by Consumer Reports. The report found the lowest prices at Costco and the highest at CVS Caremark. "Especially for the independent pharmacies, if they want to retain your business and loyalty, they will help you get the best price," said Lisa Gill, an editor at Consumer Reports. "It really comes down to a store's business model. For example, big box stores tend to use their pharmacies as a way to get consumers through the door with the expectation that they'll buy other things.” Read more on prescription drugs.
CDC: Sharp Increase in Valley Fever in Past Decade
The U.S. Centers for Disease Control and Prevention has identified changes in weather, an increase in population of changes in disease detection and reporting as possible explanations for the dramatic increase in Valley Fever from 1998 to 2011. In Arizona, California, Nevada, New Mexico and Utah there were about 22,000 cases in 2011; there were only 2,265 in 1998. The fungal respiratory infection, caused by a fungus found in the southwestern United States, is caused by flu-like symptoms that can lead to hospitalization. "Valley Fever is causing real health problems for many people living in the southwestern United States," said CDC Director Tom Frieden, MD, MPH. "Because fungus particles spread through the air, it’s nearly impossible to completely avoid exposure to this fungus in these hardest-hit states. It’s important that people be aware of Valley Fever if they live in or have travelled to the southwest United States." Read more on infectious disease.
CDC Study Offers More Proof of Non-link Between Vaccines, Autism
A new study in the Journal of Pediatrics offers yet more scientific proof that there is no link between vaccinations and autism. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found that exposure to vaccine antigens was the same for kids with and without autism. "This should give more reassurance to parents," said lead researcher Frank DeStefano, MD, director of the CDC's Immunization Safety Office. A small study in the Lancet in 1998 originally linked vaccinations and autism; the study has since been retracted. Still, about one-third of parents believe young children receive too many vaccinations and that they could lead to autism. Read more on vaccines.
AAP Policy Statement Supports Same-sex Marriage
The American Academy of Pediatrics (AAP) has released a new policy statement in the journal Pediatrics in support of same-sex marriage, as well as the right for all to adopt kids and provide foster care. "Children thrive in families that are stable and that provide permanent security, and the way we do that is through marriage," said policy statement co-author Benjamin Siegel, MD, chair of the AAP Committee on Psychosocial Aspects of Child and Family Health. "The AAP believes there should be equal opportunity for every couple to access the economic stability and federal supports provided to married couples to raise children.” Added Ellen Perrin, MD, another co-author: "If a child has two loving and capable parents who choose to create a permanent bond, it's in the best interest of their children that legal institutions allow them to do so." Read more on LGBT issues.
1 in 50 U.S. Kids Have Autism
Approximately one in 50 youth ages 6 to 17 had autism from 2011 to 2012, according to a new report from the U.S. Centers for Disease Control and Prevention and the Health Resources and Services Administration. The share was about 1.2 percent in 2007. The greatest increase was seen in boys an in those ages 14 to 17. Health officials say the increase doesn’t mean autism is becoming more prevalent, but that it is being diagnosed more frequently, according to CBS News. Under the new statistics approximately 1 million U.S. children have autism. Read more on mental health.
Study Links Gulf War Syndrome to Brain Damage
A link has been found between Gulf War Syndrome and damage to the brain, according to a new study in the journal PLOS ONE. James Baraniuk, senior author and professor of medicine at Georgetown University Medical Center, said the study clearly demonstrates that Gulf War Syndrome—a collection of symptoms experienced by approximately 250,000 veterans of the 1991 war—is not psychological. Researchers and Georgetown University used fMRI machines to identify “anomalies in the bundle of nerve fibers that interpret pain signals in the brain in 31 Gulf War veterans,” according to USA Today. This quick form of diagnosis could also end up helping people with chronic fatigue syndrome and fibromyalgia. Read more on the military.
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.