Search Results for: cancer
CDC: Reducing High-risk Antibiotic Prescriptions Could Also Reduce Deadly Infections
The most recent Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC) finds that if prescriptions of high-risk antibiotics in hospitals were reduced by just 30 percent, then there could be as many as 26 fewer cases of deadly diarrhea infections with Clostridium difficile. “Improving antibiotic prescribing can save today’s patients from deadly infections and protect lifesaving antibiotics for tomorrow’s patients,” said CDC Director Tom Frieden, MD, MPH. “Health care facilities are an important part of the solution to drug resistance and every hospital in the country should have a strong antibiotic stewardship program.” As part of its ongoing efforts to improve antibiotic prescribing, the CDC has release a checklist of seven core elements for hospitals:
- Leadership commitment: Dedicate the necessary human, financial, and IT resources.
- Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
- Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
- Act: Take at least one prescribing improvement action, such as requiring reassessment of prescriptions within 48 hours to check drug choice, dose, and duration.
- Track: Monitor prescribing and antibiotic resistance patterns.
- Report: Regularly report prescribing and resistance information to clinicians.
- Educate: Offer education about antibiotic resistance and improving prescribing practices.
Read more on infectious diseases.
Poorer Women Most Likely to Be Caught in ‘Vicious’ Caregiving, Financial Well-being Cycle
Low-income women are at increased risk of finding themselves caught in a “vicious cycle” of parental caregiving and financial well-being, according to a new study in The Journals of Gerontology. While women of better financial means can afford additional caregiver assistance and better health care for aging parents, poorer women lack those options. "People who had less household income and less financial resources were more likely to take care of their parents so there is this cycle that they cannot get out of—they are poor, then taking care of parents, then being poor and taking care of their parents—there's this kind of cycle," said lead author Yeonjung Lee, a researcher and professor at the Faculty of Social Work at the University of Calgary in Alberta, Canada, according to Reuters. Read more on aging.
Young Skin Cancer Survivors at Heightened Risk for Other Cancers
Younger skin cancer survivors are at increased risk for additional cancer types later in life, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention. A review of data of more than 500,000 people with a history of nonmelanoma skin cancer found that while all age groups were at heightened risk for melanoma and other types of cancers, the increase was especially significant for people under the age of 25, who were 23 times more likely to develop cancer than people who had never had nonmelanoma cancer. The risk was 3.5 times higher for nonmelanoma survivors ages 25-44, 1.74 times higher for those ages 45-59 and 1.32 times higher for those older than 60. The types of cancer they are at risk for include melanoma skin cancer, and cancers of the breast, colon, bladder, liver, lung, brain, prostate, stomach and pancreas. Read more on cancer.
Several leading cancer organizations recently formed a think tank to address health disparities in cancer research with the goal of improving treatment access and outcomes for underserved populations. “Closing the inequality gap will not happen easily, and won’t get done if any of us goes it alone," said Otis W. Brawley, MD, chief medical officer of the American Cancer Society (ACS), one of four groups involved, in addition to the American Association for Cancer Research (AACR); the American Society of Clinical Oncology (ASCO); and the National Cancer Institute (NCI), a branch of the National Institutes of Health (NIH).
“Cancer mortality rates are decreasing for most minorities, but absolute death rates continue to be higher," said NCI Deputy Director Doug Lowy, MD. Lowy adds that it’s important to understand the sources of the disparities in order to reduce them.
The goal of the collaboration is to address the fact that that some racial and ethnic minorities in the United States are more likely to develop cancer, less likely to access high-quality cancer care and more likely to die from cancer when compared to others and to whites. For example, the death rate for cancer among African-American males is 33 percent higher than among white males, and the rate for African-American females is 16 percent higher than it is for white females.
“We must move from describing the problems to more quickly identifying and implementing solutions to address the racial and economic-based disparities that continue to affect many cancer patients and families in the United States,” said ASCO president Clifford A. Hudis, MD.
NewPublicHealth recently spoke with Hudis about the new collaboration.
NewPublicHealth: What key issues help explain—and then overcome—differences in cancer incidence and severity among different populations?
Clifford A. Hudis: We can’t completely disentangle environmental factors, which include nutrition, access to care, general health behaviors, exercise and education, which relates to behaviors such as tobacco use. And of course underlying that is the socioeconomic status. But there also is a burgeoning understanding of the role of genetic variations that may be clustered in various populations and may influence things such as drug metabolism and diseases.
Study: Increasing Young Men’s Knowledge of Emergency Contraception Could Increase Access, Use
Increasing young men’s knowledge of emergency contraception could increase access to the drug and help prevent unwanted pregnancies, according to a new study in Journal of Family Planning and Reproductive Health Care. Emergency contraception, commonly known as "the morning after pill," prevents pregnancy after unprotected sex or when other methods of contraception fail. Nine U.S. states allow pharmacists to dispense emergency contraception without a prescription under certain conditions. The study gauged the knowledge of 101 males and 97 females ages 18 to in 2008 and 2009. "About half of the women understood basic facts about emergency contraception, how you get it, how you use it, and the fact that male partners were also able to buy it over-the-counter for their female partners," said Sheree Schrager, a member of the study team and a researcher at Children's Hospital Los Angeles, California. “But young men had significantly lower knowledge then the young women did, and this is an opportunity for providers to reach out to young men in the hopes of reaching more young women to use emergency contraception.” According to the researchers, unplanned pregnancies are more common in poor communities, where there are also greater health and economic consequences. Read more on sexual health.
U.S., Global Partners to Joint in Prevention, Detection and Response to Infectious Disease
The United States has joined with 26 countries and other global partners to, over the next five years, work to prevent, detect and effectively respond to naturally occurring, accidental and intentional infectious disease threats. Additional partners in the Global Health Security Agenda include the World Health Organization (WHO), the Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE). “While we have made great progress in fighting and treating diseases, biological threats can emerge anywhere, travel quickly, and take lives,” said Lisa Monaco, Assistant to the President for Homeland Security and Counterterrorism. “The recent outbreaks of H7N9 influenza and Middle East Respiratory Syndrome are reminders of the need to step up our efforts as a global community. The Global Health Security Agenda is about accelerating progress toward a world safe and secure from infectious disease threats.” The U.S. Centers for Disease Control and Prevention (CDC) has pledged $40 million in FY 2014 to advancing Global Health Security Agenda objectives, and its FY 2015 budget will include an additional $45 million to prevent avoidable catastrophes, detect threats early and mobilize effective responses to contain outbreaks. Read more on global health.
CDC: States with Indoor Tanning Laws See Far Less Use by Female High School Students
States with indoor tanning laws—especially those requiring parental permission or setting age restrictions—see lower rates of indoor tanning by female high school students, according to a new study in the American Journal of Public Health. The study was conducted by the U.S. Centers for Disease Control and Prevention. Studies have connected the increased exposure to ultraviolet radiation from indoor tanning to increased risk of melanoma; each year the United States sees 60,000 new melanoma diagnoses and approximately 3.5 million treatments for nonmelanoma skin cancer. The study determined that the odds of female students engaging in indoor tanning in states with any indoor tanning laws were 30 percent less than those in states without such laws, and that the odds in states with systems access, parental permission and age restriction laws were 42 percent less than those in states without any laws. “State indoor tanning laws, especially age restrictions, may be effective in reducing indoor tanning among our nation’s youth,” said Gery Guy, PhD, health economist and the study’s lead author. “We need to address the harms of indoor tanning, especially among children. Indoor tanning laws can be part of a comprehensive effort to prevent skin cancers and change social norms around tanned skin.” Read more on cancer.
Looking for powerful ways to save I love you?
- Send ecards reminding those you love to get a flu shot, make a preparedness plan and wash their hands, courtesy of the American Public Health Association.
- Learn about your own—and loved one’s—risk of heart disease and stroke.
- One in ten teens reports being physically hurt by a boyfriend or girlfriend. Find out how to help prevent teen dating violence.
- Learn the signs of heart attack, stroke and cardiac arrest.
Read more on heart health.
American Society of Clinical Oncology Weighs in on Mammography
In response to a study published this week in the British Medical Journal which called into question the benefit of mammography, the American Society of Clinical Oncology (ASCO) issued a statement today saying that because mammography is similar to many other tests that can detect a condition that may never cause harm, the benefits of screening are likely to be greater for women who are at increased risk of developing breast cancer based on factors such as age and family history, than for women at average risk. It also stated no single study should be used to change screening policy and that all women should be encouraged to speak with their doctors about their personal risk for breast cancer, as well as the potential benefits and harms of mammography screening. ASCO and other cancer advocacy and women’s health groups have announced that they will be monitoring additional mammography studies now being conducted, and the American Cancer Society is expected to release new mammography recommendations later this year. Read more on cancer.
NHTSA Announces New Mandatory Label to Help Owners Instantly Identify Recall Mailings
The U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) today announced that starting February 18, all manufacturers must use a distinctive label on the agency’s required mailings that notify owners of recalled vehicles or equipment.
The requirement was introduced to help owners instantly distinguish important recall notices arriving in their mailboxes from other mail and hopefully avoid mistakenly discarding the safety notices. NHTSA has also just launched the SaferCar app for Android devices that will provide information for car owners and shoppers, including recalls and safety performance. There is already a SaferCar app for iPhone, iPad and iPod Touch users. Other safety notification options from NHTSA include:
- Register Your Cars, Tires and Car Seats: Receive NHTSA email notifications when there is a recall by the federal government. There is no way to locate or notify individual owners of car seats or tires if the product is not registered with the manufacturer or NHTSA.
Check for Open Recalls on Used Cars: Verify with the previous owner or dealer whether a used car has been fixed by using www.safercar.gov, which provides a general search tool to help consumers identify recalls that may affect their vehicle.
Read more on transportation.
Minimum Alcohol Prices Could Help Low-income, High-risk Drinkers
Setting a minimum price for alcohol would have a positive impact on low-income, high-risk drinkers, but little effect on low-income, moderate drinkers, according to a new study in The Lancet. British researchers at the University of Sheffield utilized a computer model to assess the impact of a 73 cents per unit of alcohol minimum on different demographics, finding it would have the greatest positive impact—reducing the amount of alcohol consumption—on the 5 percent of the population defined as high-risk drinkers. "Our study finds no evidence to support the concerns highlighted by government and the alcohol industry that minimum unit pricing would penalize responsible drinkers on low incomes,” said study co-author Petra Meier, director of the Sheffield Alcohol Research Group. “Instead, minimum unit pricing is a policy that is targeted at those who consume large quantities of cheap alcohol. By significantly lowering rates of ill health and premature deaths in this group, it is likely to contribute to the reduction of health inequalities." Read more on alcohol.
Smoking Linked to Most Common Type of Breast Cancer
Adding yet another health risk to the use of tobacco, smoking is linked to an increased risk for the most common type of breast cancer, according to a new study in the journal Cancer. Researchers at the Fred Hutchinson Cancer Research Center in Seattle conducted a population-based study of 778 patients, ages 20-44, with estrogen receptor positive breast cancer (the most common type) and 182 patients with triple-negative breast cancer; there were 938 cancer-free controls. They found that women who were current or recent smokers and had been smoking a pack a day for at least 10 years had a 60 percent increased risk of estrogen receptor positive breast cancer. "The health hazards associated with smoking are numerous and well known. This study adds to our knowledge in suggesting that with respect to breast cancer, smoking may increase the risk of the most common molecular subtype of breast cancer but not influence risk of one of the rarer, more aggressive subtypes," said Christopher Li, MD, PhD. Read more on cancer.
Low Testosterone Drugs Can Double Heart Attack Risk in Some Men
Ads asking men about their “low T”—or low testosterone levels—have become so common of late that in 2013 sales of the testosterone gel Androgel exceeded those of Viagra. However, a recent study indicates that men under the age of 65 with a history of heart disease see their heart attack risk double shortly after beginning testosterone therapy. The joint study from the UCLA Fielding School of Public Health, the National Institutes of Health and Consolidated Research Inc. appears in the journal PLOS ONE. Researchers decided to perform this larger study after three smaller studies raised concerns about the connection. "We decided to investigate cardiovascular risks of this therapy in a large health care database since these previous studies were modest in size and only focused on men 65 and older," said the study's senior author, Sander Greenland, MD, a professor of epidemiology at the UCLA Fielding School of Public Health and a professor of statistics in the UCLA College of Letters and Science. "Our study allowed us to examine cardiovascular risk in men under the age of 65 and to replicate the findings in men over 65." Read more on heart health.
Study: HPV Vaccine Doesn’t Lead to More, Riskier Sex for Young Women
Despite the concerns of some parents, being vaccinated against the human papillomavirus (HPV)—which causes cervical cancer—does not increase young women’s sexual behavior, either in terms of the number of partners or the decision not to use condoms, according to a new study in the journal Pediatrics. Researchers studied 339 women between the ages of 13 and 14, finding that after receiving the first vaccine most agreed it was still necessary to generally practice safe sex. On a scale from zero to 10, where lower scores indicate better understanding of risks, they scored an average of 1.6 on knowledge about safe sex practices. They also scored a 3.9 on their perceptions of the risk of sexually transmitted infections. "To me, the issue is laid to rest," said Jessica Kahn, MD, of the Cincinnati Children's Hospital Medical Center in Ohio. "As clinicians and researchers, we have no concerns that vaccination will lead to riskier sexual behaviors." The U.S. Centers for Disease Control and Prevention recommends HPV vaccinations for both boys and girls. Read more on sexual health.
CDC Set to Launch 2014 ‘Tips From Former Smokers’ Campaign
The U.S. Centers for Disease Control and Prevention (CDC) is set to launch the 2014 phase of "Tips From Former Smokers" (Tips), its annual television, radio and print campaign. The campaign will include Terrie Hall, the then 52-year-old Lexington, N.C., woman shown in a previous ad who had ultimately had her voice box removed as a result of throat cancer caused by a two-pack-a-day habit for 23 years. She since died of tobacco-related illness. "Over 20 million Americans have died because of smoking since 1964...But when you talk about a number that big, people have no way to put their hands around it,” said Tim McAfee, MD, the Atlanta-based director of the CDC's office on smoking and health."So we thought that for smokers and non-smokers, we needed to put a face on this. Because we felt that if we gave the American people an opportunity to get to know the suffering one person has had to go through because of smoking, it could have an enormous impact." Read more on tobacco.
FDA Proposes New Sanitation Rules for Food in Transport
The U.S. Food and Drug Administration (FDA) has proposed new regulations to improve sanitation and prevent contamination of human and animal food during transportation by both motor vehicles and rail. The new rule would be the final major rule in the FDA Food Safety Modernization Act’s central framework. “We are now one step closer to fully implementing the comprehensive regulatory framework for prevention that will strengthen the FDA’s inspection and compliance tools, modernize oversight of the nation’s food safety system, and prevent foodborne illnesses before they happen,” said Michael R. Taylor, the FDA’s deputy commissioner for foods and veterinary medicine. The new criteria would address areas such as properly refrigerating food, adequately cleaning vehicles between loads and properly protecting food during transportation. Read more on food safety.
Many of the sessions at the National Association of Counties (NACo) Health Initiatives Forum meeting in San Diego this week have been moderated by Nick Macchione, director of San Diego’s Health and Human Services Agency and vice chair of the Healthy Counties Initiative Advisory Board. Macchione is a key architect of Live Well San Diego, a program voted in by the San Diego Board of Supervisors that is a long term, comprehensive and innovative strategy on wellness with a goal of helping all San Diego County residents become healthy, safe and thriving.
NewPublicHealth spoke with Nick Macchione ahead of the forum. Senior Policy Advisor Julie Howell and Dale Fleming, director of strategic planning and operational support, joined the conversation.
NewPublicHealth: The buzz about San Diego is that you’re working hard toward population health improvement.
Nick Macchione: I think the excitement about San Diego is that we have earned a reputation as a health innovation zone by having a collective impact on health and wellness. Our deeds demonstrate our words because over the past decade there have been five major broad-based population health improvements: reduction of heart disease and stroke; reduction of cancer rates; reduction of childhood obesity; reduction of infant mortality; and reduction of children in foster care. That reduction is extremely important to population health because we also look at the social determinants of health and not just pure health care.
We've taken an ecological approach to population health—working with partners across all sectors and coming together not just from traditional health care but beyond that to public health, social services, business, community, schools and the faith community.
And we’ve done that in the context of optimizing existing resources to improve outcomes. We’ve been blessed with a lot of competitive federal grants and philanthropy investments, but really the framework is how we leverage and optimize what we have first before we go and seek to augment with other resources. That has worked exceptionally well and that’s earned us that innovation zone reputation.
NPH: Tell us about Live Well San Diego.
Macchione: Live Well San Diego is a comprehensive public health initiative that involves widespread community partnerships to address the root causes of illness and rising health care costs. The tagline is healthy, safe and thriving. We think it’s a great template that communities can use, it’s transferable because San Diego has every imaginable bio-climate except a tropical rainforest. So we have desert towns, we have rural communities, we have mountain villages, we have beach towns and everything in between urban core. We also call it Project 1 Percent because 1 percent of San Diego represents the nation both in its diversity and its population. So, if we can achieve what we're achieving on advancing population based health in a broad scale it can be demonstrated throughout the country.
NewPublicHealth is on the ground at the NACo 2014 Healthy Counties Initiative Forum. The theme of the forum this year is “Improving Health in a Climate of Change.” Ahead of the meeting we spoke with James McDonough, county commissioner in Ramsey, Minn., and chair of the Healthy Counties initiative about the meeting and the health changes he is seeing at the county level.
NewPublicHealth: Can you tell us how the NACo Healthy Counties Initiative got its start?
James McDonough: Three years ago the president of NACo at that time, Lenny Eliason, from Athens County, Ohio, really was concerned about how the majority of health care dollars were being spent on treating preventable conditions and the whole issue of the wellbeing of our constituents and our employees. So he elevated the issue of wellness and health in counties as a presidential initiative. Typically those are short term and last for a year or two, but NACo has embraced this and has continued this on as a task force to really embed it in the work that we do—elevating how counties can have an impact on wellness in communities.
NPH: What are the current goals?
McDonough: To really elevate and get the county commissioners and county managers throughout the country to just pause and take a look at what they're doing and what they could be doing. We’ve been talking about how we can do a better job supporting counties that are already doing great work in this area and helping share those best practices, and then helping counties that haven’t really taken a look at what their role is. That can help us have a better impact on getting ahead of some of the major preventable diseases in our communities.
NPH: How important is county-level action when it comes to health?
McDonough: For the most part, counties really are responsible for the public health departments within their communities. Throughout the country we operate almost 1,000 county hospitals and close to 700 county nursing homes, so we have a lot of responsibility for public health and—just as important—we employ more than 30 million people throughout the country.
Action, responsibility and efforts vary county to county, but for example, in Ramsey County, Minnesota, where I’m the County Commissioner, we run the public health department working with our cities, the state and with the federal government. So for us it’s a really big opportunity to be the convener as well to lead the Healthy Cities Initiatives as well to a larger regional more focused and concentrated effort.
NPH: The focus of the forum includes some critical topics such as behavioral health and key health issues in jails. How much of a financial burden do these health issues place on counties?
CDC Report Details Support of State, Local Health Responses
The U.S. Centers for Disease Control and Prevention (CDC) has released a new report detailing its support of state and local public health responses from 2012 to 2013, as well as assessments of all state and select local public health preparedness. The 2013-2014 National Snapshot of Public Health Preparedness is the sixth annual report from CDC’s Office of Public Health Preparedness and Response. “The lives protected by the public health response to Hurricane Sandy, the fungal meningitis outbreak, and the tornadoes in Joplin are just a few examples of how communities and CDC can work together to protect the public's health when its needed most,” said CDC Director Tom Frieden, MD, MPH.
Among the report’s highlights:
- During outbreaks and emergencies, response time is essential. In 2012, lead state responders reported for immediate duty within 27 minutes of receiving notification of a potential public health emergency—9 minutes faster than the 2011 national average.
- In 2012, across the 62 Public Health Emergency Preparedness (PHEP) cooperative agreement awardees, Emergence Management Program (EMP) activities included 185 engagements and 204 exercises. Internationally, EMP activities across 35 countries included 15 activations, 19 engagements, and 12 exercises.
- The percentage of E. coli-positive tests analyzed and entered into the PulseNet database within four working days increased from 90 percent to 94 percent and timely testing and reporting of Listeria-positive results increased from 88 percent to 92 percent.
“The ability of our local and state health departments to be innovative and maintain a steady level of preparedness despite extensive budget cuts is reassuring,” said Ali Khan, M.D., M. P. H., director CDC’s Office of Public Health Preparedness and Response. “However, preventing an erosion of our nation’s health security will be difficult in the current fiscal environment.” Read more on preparedness.
Study: Overweight Kindergarteners Four Times as Likely to Be Overweight Teens
Children who are overweight at the age of five are four times as likely to be obese by the age of 14 than are children who start their school years at an average weight, according to a new study in the New England Journal of Medicine. Approximately 27 percent of the five-year-olds in the study were overweight. Using data on almost 8,000 children gathered by the Early Childhood Longitudinal Study conducted by the U.S. National Center for Education Statistics, researchers determined that:
- Approximately 32 percent of kids who were overweight when they entered kindergarten had become obese by age 14, compared to 8 percent of normal-weight kindergarteners.
- The obesity rate rose most rapidly between first and third grades—from 13 percent to almost 19 percent—but not significantly between fifth and eighth grades.
- Between kindergarten and eighth grade, the prevalence of obesity rose by 65 percent among white children, 50 percent among Hispanic children and more than doubled among black children.
"If we're just focused on improving weight when kids are adolescents, it may not have as much of an impact as focusing on the preschool-age years," said lead researcher Solveig Cunningham of Emory University, adding that the study "doesn't tell us what to do about it, but it helps tell us when we need to think creatively about what to do." Read more on obesity.
Study: One-third of Americans, Two-Thirds of University Students Have Used Indoor Tanning
Despite clear and widespread data on their link to skin cancer risk, more than a third of Americans and nearly two-thirds of U.S. university students have used indoor tanning, according to a new study in the journal JAMA Dermatology. Approximately 19 percent of teens had also used the machines. Researchers at the University of California, San Francisco based their conclusions on an analysis of 88 surveys covering more than 406,000 people in the United States, Europe and Australia. "It is appalling how often exposure to indoor tanning takes place in presumably educated populations and particularly worrisome that we allow adolescents to be exposed to this carcinogen," said Mark Lebwohl, MD, chairman of the department of dermatology at Mount Sinai Hospital in New York City. "We must do a much better job at educating people of all ages about the risks of indoor tanning.” Read more on cancer.
A tobacco history timeline published today by the Robert Wood Johnson Foundation showcases a decrease in smoking among adults, from 42.2 percent in 1965, shortly after the release of the first Surgeon General’s Report on Smoking and Health in 1964, to about 18 percent today. More than just a repository of changes in smoking rates over the years, 50 Years of Tobacco Control is an interactive look at the events and actions that have prevented more than eight million premature deaths in the ongoing fight to keep communities safe from the dangers of tobacco.
The timeline offers interviews with today’s tobacco control leaders—people such as John Sefrin, the Chief Executive Officer of the American Cancer Society, and Matthew L. Myers, President of the Campaign for Tobacco-Free Kids—who have made enormous strides in tobacco control and have a bold vision for tobacco reduction in the future. While scrolling through the major tobacco control milestones of the last 50 years, viewers can examine historical cigarette advertisements, reports and photos.
The Tobacco Timeline is an excellent resource for understanding the last 50 years of tobacco control, as well as the ambitious goals that health advocates have set for the future. While eight million premature tobacco-related deaths have been prevented by tobacco control efforts, up to 20 million have been lost in the same time frame.
Although smoking rates have dramatically declined, there is much more to the story. At a White House event to release the new Surgeon General’s report, U.S. Secretary of Health and Human Services Kathleen Sebelius shared some urgent facts from the report, including the projection that “approximately 5.6 million American children alive today—or one out of every 13 children under age 18—will die prematurely from smoking-related diseases unless current smoking rates drop.”
The new report ticks off new hazards of smoking in the last fifteen years, including new findings that show more diseases linked to smoking than previously reported including diabetes, colorectal cancer, liver cancer, rheumatoid arthritis, erectile dysfunction, age-related macular degeneration and strokes caused by secondhand smoke. Additionally, according to the report, cigarettes themselves are more lethal than they were fifty years ago.