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Apr 11 2014
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Faces of Public Health: Q&A with Lynn Goldman, The George Washington University

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Last month The George Washington University in Washington, D.C. announced three gifts totaling $80 million for the university’s School of Public Health and public health initiatives from the Milken Institute, the Sumner M. Redstone Charitable Foundation and the Milken Family Foundation. The public health graduate school is now called the Milken Institute School of Public Health and the university has also established the Sumner M. Redstone Global Center for Prevention and Wellness. Redstone is the executive chairman of Viacom and CBS Corp., while Michael Milken is an entrepreneur.

The gifts include:

  • $40 million from the Milken Institute to support new and ongoing research and scholarships
  • $30 million from the Sumner M. Redstone Charitable Foundation to develop and advance innovative strategies to expand wellness and the prevention of disease
  • $10 million from the Milken Family Foundation to support the Milken Institute School dean’s office, including a newly created public health scholarship program

NewPublicHealth recently spoke with Lynn Goldman, MD, MS, MPH, and dean of the School of Public Health, about the impact of the gifts for the school and the public’s health both globally and in the United States.

NewPublicHealth: What changes will the recent gifts bring to the school?

Lynn Goldman: It’s no exaggeration to say the gift is transformational for our school. We have the opportunity to recruit the best talent in the country to work with our school, whether that might be students through the increase that we’ve received in scholarship funding or faculty members, and we have the opportunity to support our current faculty to be able to take their work to the next level.

It also allows us to establish the Sumner M. Redstone Global Center for Prevention and Wellness, which is a very exciting enterprise. We recently announced that William Dietz, MD, MPH, formerly the director of the Division of Nutrition, Physical Activity and Obesity at the U.S. Centers for Disease Control and Prevention (CDC), will be the first director of the Redstone Center. The initial focus of the Center will be childhood obesity. That is so exciting because Dietz was doing research on childhood obesity well before that became the flavor of the month. It has been his lifelong mission to prevent childhood obesity, and what we are charged to do with this center is to very directly engage in efforts that will result in reducing the rates of obesity in the United States and globally. The way we are going to be doing that is by bringing together the evidence that people are generating about efforts that are working and also efforts that are not working, and be able to sift through that research. I think Bill is the perfect person to be the leader of an effort such as this because he is very collaborative, and we want to do this in a collaborative fashion.

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Apr 10 2014
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Future of Public Health: Q&A with Erin Yastrow, BSPH Candidate at Tulane University

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Future of Public Health is an ongoing series focused on the emerging faces in the world of public health. We spoke with Erin Yastrow, a Bachelor of Science in Public Health candidate at the Tulane University School of Public Health and Tropical Medicine, about what helped lead her to the field, her work as a leader in Tulane’s undergraduate student government and where she hopes to go from here.

NewPublicHealth: What encouraged you to pursue a degree and career in public health?

Erin Yastrow: I’ve always been interested in the field of health. I was actually thinking about going into nutrition when I first started looking at undergraduate schools and I had a family friend at one school who had worked in nutrition, but then ended up working at the School of Public Health. When I met with her, she encouraged me to pursue public health with an emphasis on nutrition because it would give me more opportunities. From there, I started my exploration into what public health was and I realized how interesting and fascinating it was and how it was applicable to so many more areas besides just nutrition.

In the meantime, I had also applied to Tulane. I wasn’t really considering it that much because I didn’t know that much about it. My mom was looking through their brochure and told me that they have a great public health program. So, I started looking and I realized how established the Bachelor’s and graduate programs were. They also had an option where you could pursue a combined degree and it was really appealing to me.

NPH: Are you pursuing a Master’s as well?

Yastrow: Not currently, but I’m actually attending Johns Hopkins next year for a Master’s in Public Health. Tulane does have a really great program where you can do a combined degree with your Bachelor’s and Master’s. Part of my undergraduate core, which has now changed, included taking five graduate classes, so I took some classes at that School of Public Health here.

NPH: Within the field of public health, what are your primary interests and why?

Yastrow: That has also sort of shifted as I’ve learned more about public health. As I mentioned, I started out really interested in nutrition and obesity prevention. As I took more electives and did some internships, I became more interested in the similar patterns of risk factors that exist in obesity and other epidemics that aren’t always considered to be health problems, such as violence. That has developed into an interest about addressing inequalities in health and the social determinants, such as socioeconomic status, education and race and how those, to me, are unjust reasons that people are more likely to develop further health conditions.

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Apr 9 2014
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National Minority Health Awareness Month: Roundup of NewPublicHealth Coverage on Health Disparities

April is National Minority Health Awareness Month. A look back at NewPublicHealth’s coverage of health disparities so far this year shows significant steps being taken to both identify and rectify the public health problem. From understanding why certain demographics are at greater risk for cancer, to how income gaps and ethnicity can collide, to how racism can affect overall health, here’s a review of some of the key stories we’ve reported on health disparities in 2014.

Mistrust, Perceived Discrimination Affect Young Adult Latinos’ Satisfaction with Health Care
Mistrust of the medical community and perceived discrimination can affect how satisfied young adult Latinos are with their health care, which in turn can influence health outcomes, affect participation in health care programs under the Affordable Care Act and contribute to disparities in health care access.

Black, Latina Breast Cancer Patients More Likely to Struggle with Health Care-Related Debt
Black and Latina breast cancer patients are far more likely than their white counterparts to have medical debt as a result of treatment or to skip treatments due to costs

Faces of Public Health: Louis W. Sullivan, MD
Louis W. Sullivan, MD, former U.S. Secretary of Health and Human Services under President George H.W. Bush, recently wrote a memoir, Breaking Ground: My Life in Medicine, that offers a wide view of Sullivan’s experiences as a medical student in Boston, the founding dean of the Morehouse School of Medicine in Atlanta and as the country’s chief health officer. NewPublicHealth recently sat down with Sullivan to discuss the book and his thoughts on the history and future of improving the nation’s health.

Study: Many Chronically Ill Adults Forced to Decide Between Medicine, Food
Chronically ill adults who, due to financial instability, lack consistent access to food are far more likely to underuse or even skip their medications completely, according to a new study in The American Journal of Medicine. Researchers analyzed data of 9,696 adults with chronic illness who participated in the National Health Interview Survey, finding that 23.4 percent reported cost-related medication underuse, while 18.8% percent reported food insecurity and 11 percent reported both. Hispanic and non-Hispanic blacks were at the highest risk.

Free to Be You and Me @ 40
Free to Be You and Me, a blockbuster hit album of the 70s and beyond, is still widely available on most music platforms. The television special, filled with skits on gender neutrality, is still a popular kids’ birthday gift, in part because many of the issues it speaks to—especially advancement opportunities and equality—are still being grappled with today.

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Apr 9 2014
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National Public Health Week: ‘Get Out Ahead’

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NewPublicHealth continues its coverage of National Public Health Week with today’s theme—“Get Out Ahead” on prevention.

According to the American Public Health Association (APHA), seven in 10 deaths in the United States are related to preventable diseases such as obesity, diabetes, high blood pressure, heart disease and cancer. And while 75 percent of U.S. health care dollars are spent treating such diseases, only 3 percent of health care dollars go toward prevention.

The APHA says there are now more options than ever when it comes to preventive health measures and that public health and clinical health professionals must work collaboratively to help individuals identify and pursue the best preventative health options.

A strong way to help prevent disease and premature death is to add health observance dates such as National Breast Cancer Awareness Month and National HIV Testing Day to personal and community calendars.

Healthfinder.gov, a website from the U.S. Department of Health and Human Services, lists health observance days, weeks and months which can steer people toward information and resources. Health observances often include community screenings such as blood pressure and cholesterol checks, making it easy to have those tests on a weekend in your neighborhood. Those checks include resources guiding people to community care if tests show a potential health problem.

A critical observance in April is Alcoholism Awareness Month. Decades of data shows that drinking too much alcohol increases people’s risk of health-related injuries, violence, drowning, liver disease and some types of cancer.

Actions communities are taking in observance of Alcoholism Awareness Month include:

  • Partnering with a local high school or youth organization to host an event about alcohol abuse prevention.
  • Alcohol-free community block parties.
  • Many local health clinics will offer free or low-cost screenings for alcohol abuse on National Alcohol Screening Day (April 11).

Many police stations are hosting Family Information Nights about the dangers of drinking and driving. Activities include special goggles that let kids and teens see how drinking can impact their vision behind the wheel.

Apr 3 2014
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Public Health News Roundup: April 3

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Study: Fertility Drugs Not Tied to Increased Risk of Breast Cancer
Fertility drugs are not linked to an increased risk of breast cancer, according to a new long-term study in the journal Cancer Epidemiology, Biomarkers & Prevention. Researchers analyzed records for 9,892 U.S. women who were followed for 30 years after having been evaluated for infertility between 1965 and 1988, finding that about 38 percent of them were exposed to the fertility drug clomiphene and about 10 percent were exposed to drugs known as gonadotropins. There were 749 breast cancers diagnosed during the three decades, but women who were exposed to either drug were just as likely as the women who hadn’t been exposed to fertility drugs to develop breast cancer. The study did note an increased risk of breast cancer for the small group of women exposed to the highest doses of clomiphene. "It's reassuring that if women desire pregnancy and unfortunately have infertility that they can undergo treatment without modification of their overall risk for cancer later," said Kurt Barnhart, MD, president of the Society for Reproductive Endocrinology and Infertility, to Reuters Health. He was not involved in the study. Read more on cancer.

Study: CDC’s Salt Recommendations Are Too Low
The U.S. Centers for Disease Control and Prevention’s (CDC) salt guidelines are too low, according to a new study in the American Journal of Hypertension. Researchers reviewed 25 previous studies, concluding that both too much and too little salt can be harmful. They concluded that the safest intake range was between 2,645 and 4,945 mg of salt a day, although the CDC recommends less than 2,300 mg of salt per day for healthy people under age 50, and less than 1,500 mg per day for most people over age 50. "For most people, there is no reason to change their dietary habits concerning salt, as most people eat what appears to be the safest amount," said review author Niels Graudal, MD, a senior consultant at Copenhagen University Hospital in Denmark, according to HealthDay. Read more on nutrition.

HUD to Provide Disaster Assistance to Washington State Mudslide Victims
Having officially been given a major disaster declaration yesterday, Snohomish County and the Sauk-Suiattle, Stillaguamish and Tulalip Indian Reservations in Washington state will now received federal disaster assistance from the U.S. Department of Housing and Urban Development (HUD) to help recover from the flooding and mudslides that began on March 22. Among the assistance:

  • Offering the State of Washington and other entitlement communities the ability to re-allocate existing federal resources toward disaster relief
  • Granting immediate foreclosure relief
  • Making mortgage insurance available
  • Making insurance available for both mortgages and home rehabilitation
  • Offering Section 108 loan guarantee assistance
  • Information on housing providers and HUD programs  

"Families who may have been forced from their homes need to know that help is available to begin the rebuilding process,” said HUD Secretary Shaun Donovan in a release. "Whether it's foreclosure relief for FHA-insured families or helping these counties to recover, HUD stands ready to help in any way we can." Read more on disasters.

Apr 1 2014
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Public Health News Roundup: April 1

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NHTSA: Rear Cameras for All New Cars by May 2018
All new vehicles under 10,000 pounds will be required to have rear visibility technology—or rear cameras—by May 2018, according to a new rule issued by the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA). According to NHTSA, the technology significantly reduces injuries and fatalities due to backover incidents; there are an average of 210 deaths and 15,000 injuries each year caused by such incidents, with children under age 5 accounting for 31 percent and adults ages 70 and older accounting for 26 percent. "Safety is our highest priority, and we are committed to protecting the most vulnerable victims of backover accidents — our children and seniors," said U.S. Transportation Secretary Anthony Foxx. "As a father, I can only imagine how heart wrenching these types of accidents can be for families, but we hope that today's rule will serve as a significant step toward reducing these tragic accidents." Read more on injury prevention.

Study: Diet of Fruit, Vegetables Linked to Reduced Risk of Death
Diets heavy on fruits and vegetables can reduce the risk of death at any age by as much as 42 percent, according to a new study in the Journal of Epidemiology and Community Health. Using data on the eating habits of more than 65,000 people in England from 2011 to 2013, researchers determined that the risk of death was reduced by 36 percent with five to seven portions, 29 percent with three to five portions and 14 percent with one to three portions. More specifically, they also determined that eating seven or more portions of fruits and vegetables reduced the risk of death from heart disease by 31 percent and the risk of death from cancer by 25 percent. "We all know that eating fruit and vegetables is healthy, but the size of the effect is staggering," study author Oyinlola Oyebode, at the department of epidemiology and public health of University College London, in a release. "Vegetables have a larger effect than fruit, but fruit still makes a real difference. If you're happy to snack on carrots or other vegetables, then that is a great choice but if you fancy something sweeter, a banana or any fruit will also do you good.” Read more on nutrition.

Affordable Care Act Expected to Hit Goal of Coverage for 7 Million
Despite a glitch-filled rollout of HealthCare.gov that allowed few people to enroll over the first month, the Affordable Care Act and its online portals appear to be on track to meet the original goal of enrolling 7 million people by its deadline of yesterday, March 31, according to Obama administration officials. More than 6 million had signed up for health care coverage as of last week and the run up to the deadline saw a surge that should put the total over 7 million. The administration also recently announced an extension of the enrollment deadline for Americans who had attempted to sign up for coverage but were impeded by technological problems. Read more on the Affordable Care Act.

Mar 28 2014
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Public Health News Roundup: March 28

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CDC: 1 in 68 U.S. Children on Autism Spectrum
The U.S. Centers for Disease Control and Prevention (CDC) has significantly increased its estimates of the number of U.S. children with an autism spectrum disorder (ASD). According to a new surveillance summary report, approximately 1 in 68 children—or 14.7 per 1,000 eight-year-olds—are on the spectrum. The new estimate is about 30 percent higher than previous CDC estimates. The report also found that ASD continue to be five times more common among boys than girls; more common among white children than Black of Hispanic children; and that most children are still not diagnosed until after age 4, despite the fact that ASD can be diagnosed as early as age 2. “The number of children identified with autism continues to increase and the characteristics of these children have changed over time,” said Coleen A. Boyle, PhD, MS, director of CDC’s National Center on Birth Defects and Developmental Disabilities, in a release. “While progress has been made, there is an urgent need to continue the search for answers and provide help now for people living with autism.” Read more on pediatrics.

New Cancer Cases Dropped Slightly from 2009 to 2010
Rates of new cancer cases dropped slightly for both men and women in the United States from 2009 to 2010, according to the new U.S. Centers for Disease Control and Prevention report, Invasive Cancer Incidence—United States, 2010. The report saw the incidence rate drop to 446 per 100,000 persons from 459 per 100,000 persons. Rates varied by state, from a high of 511 to a low of 380. The rate was higher for men than it was for women, with the highest rate of all among black Americans. Read more on cancer.

HHS Releases New Security Risk Assessment Tool for Small-to-Medium-Sized Health Care Organizations
The U.S. Department of Health and Human Services (HHS) has released a new security risk assessment (SRA) tool to help health care providers in small-to-medium sized offices conduct risk assessments of their organizations. A collaborative effort of the HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR), the tool enables the organizations to conduct and document a thorough risk assessment at their own pace by allowing them to assess the information security risks under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. The SRA tool’s website contains a User Guide and Tutorial video to help providers begin using the tool. Videos on risk analysis and contingency planning are available at the website to provide further context. The tool is available for both Windows and operating systems and iOS iPads. Read more on technology.

Mar 26 2014
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Public Health News Roundup: March 26

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Study: ‘White Coat Effect’ on Blood Pressure is Real
The “White Coat Effect” is real, according to a new study in the British Journal of General Practice. The effect, wherein a person’s blood pressure is higher when taken by a doctor than when taken by a nurse, has long been assumed, but this is the first study to confirm it. The study analyzed the results of more than 1,000 people who had their blood pressure taken by both a physician and a nurse, finding the results of the physician-administered tests were noticeably higher. "Doctors should continue to measure blood pressure as part of the assessment of an ill patient or a routine check-up, but not where clinical decisions on blood pressure treatment depend on the outcome,” said Christopher Clark, MD, of the University of Exeter Medical School, in a release. “The difference we noted is enough to tip some patients over the threshold for treatment for high blood pressure, and unnecessary medication can lead to unwanted side-effects.” Clark also noted that researchers should also take these findings into account when performing studies on topics such as hypertension. Read more on heart health.

Black, Latina Breast Cancer Patients More Likely to Struggle with Health Care-Related Debt
Black and Latina breast cancer patients are far more likely than their white counterparts to have medical debt as a result of treatment or to skip treatments due to costs, according to a new study in the Journal of Clinical Oncology. In a survey of 1,502 patients, researchers determined that 9 percent of whites, 15 percent of blacks, 17 percent of English-speaking Latinas and 10 percent of Spanish-speaking Latinas reported medical-related debt four years post diagnosis. The study said the findings should “motivate efforts to control costs and ensure communication between patients and providers regarding financial distress, particularly for vulnerable subgroups.” Read more on health disparities.

Lawsuit Challenges New York City’s Ban on E-Cigarettes
A “smoker’s rights” group called New York City Citizens Lobbying Against Smoker Harassment has filed a legal challenge to the city’s ban on electronic cigarettes—or e-cigarettes—in restaurants, parks and certain other public places. The group contends that since e-cigarettes do not contain tobacco or produce smoke, they should not be subject to New York City’s Smoke-Free Air Act. The city council expanding regulations to include e-cigarettes last year and the U.S. Food and Drug Administration has announced its intention to propose government regulations over their use. In the lawsuit, the group wrote that "E-Cig regulation is, even in the Council's words, at best, tangentially related to the subject of smoking, in much the same way that toy water guns are at best tangentially related to authentic firearms.” However, city council spokeswoman Robin Levine said by email to Reuters that "Our legislation ensures the goals of the Smoke-Free Air Act are not undermined and protects the public against these unregulated substances.” Read more on tobacco.

Mar 17 2014
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Public Health News Roundup: March 17

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Poison Prevention Week 2014
March 16-24 is Poison Prevention Week this year, and an important opportunity to remind health officials and consumers about the resources provided by the National Poison Prevention Program and Hotline (1-800-222-1222). The National Poison Control Program is a program of the Health Resource Services Administration (HRSA). Programs include:

  • Poison centers serving all states, Puerto Rico, the District of Columbia, Guam, the Federated States of Micronesia and American Samoa.
  • A single, national toll-free number (1-800-222-1222) that connects callers with the poison center serving their area.
  • A nationwide media campaign to educate the public and health care providers about poison prevention, poison center services and the 1-800 number.
  • Programs to support the enhancement and improvement of poison education, prevention and treatment.
  • Partnership development with other federal agencies and national organizations to advance poison prevention awareness.
  • Development of uniform patient management guidelines so that poison centers can provide uniform treatment recommendations.
  • Improvement of data collection systems and toxic exposure surveillance for enhanced capability to capture national poisoning data.
  • Multilingual interpreter service in 161 languages to anyone who calls the 1-800 number. 

Read an FAQ on assistance available from the Poison Prevention Program for consumers and health providers. Read more on prevention.

Colon Cancer Incidence Rates Decreasing Steeply in Older Americans
Colon cancer incidence rates have dropped 30 percent in the United States in the last 10 years among adults 50 and older because of the widespread use of colonoscopies, according to a new study in CA: A Cancer Journal for Clinicians. The largest decrease has been in people over age 65. Colonoscopy use has almost tripled among adults ages 50-75, from 19 percent in 2000 to 55 percent in 2010. The study relied on data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the U.S. Centers for Disease Control and Prevention's National Program of Cancer Registries.

The "larger declines among Medicare-eligible seniors likely reflect higher rates of screening because of universal insurance coverage," according to the study authors. Mortality rates from colon cancer have also declined most rapidly within the past decade. From 2001 to 2010, death rates from colon cancer decreased by approximately 3 percent per year in both men and women, compared with declines of approximately 2 percent per year during the 1990s. The data is being released as the U.S. Department of Health and Human Services launches a nationwide effort to increase colorectal cancer screening rates to 80 percent by 2018. Read more on cancer.

DOT Proposed Rules on Electronic Log Books for Large and Bus Drivers to Help Reduce Fatalities and Injuries
The U.S. Department of Transportation (DOT) has announced a proposal to require interstate commercial truck and bus companies to use Electronic Logging Devices (ELDs) in their vehicles to improve compliance with the safety rules that govern the number of hours a driver can work. According to DOT, the proposed rule will ultimately reduce hours-of-service violations by making it more difficult for drivers to misrepresent their time on logbooks and—significantly—help reduce crashes by fatigued drivers and prevent approximately 20 fatalities and 434 injuries each year, for an annual safety benefit of $394.8 million. Impaired driving, including fatigue, was a factor in more than 12 percent of the 129,120 total crashes that involved large trucks or buses in 2012. Read more on injury prevention.

Mar 13 2014
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Crowdfunding for Public Health

With just seven days to go until the announced deadline for its first round of funding, the front runner to reach its goal on UCLA Spark—a new crowdfunding platform hosted by the university—is a public health initiative, the UCLA Sex Squad School Tour 2014. The Squad is a multimedia theatre troupe made up of University of California, Los Angeles students and graduates who talk to high school students about sex and sexual health.

Crowdfunding uses social media to encourage contributions from strangers for projects of all kinds. Sites such as Kickstarter have raised millions of dollars for multiple projects, including one by three U.S. State Department officials who raised enough capital to start their own dress sock business.

UCLA Spark’s projects are way loftier. The four other projects in the first round of funding on the site, which debuted last month, include a program to connect ninth-grade girls with technology, a bus to transport campus volunteers to community service projects, funds to help preserve the Watts Towers, (an iconic Los Angeles monument) and expansion of cancer treatment in Ethiopia.

Nancy Katano, Executive Director of Corporate Foundation and Research Relations at UCLA, says the idea for a crowdfunding platform at the university came about because two things converged: The university began getting faculty and student requests for help funding some very small niche projects—beyond the scope for most grants—and Katano began receiving calls from crowdfunding platforms looking to contract with the university. Katano says using an outside platform would have lost too much money for the projects since the platforms take a fee as well as a percentage of funds raised, so instead the university launched its own platform.

To become a UCLA Spark project, faculty and official student organizations propose projects for funding through an online application and a UCLA vetting committee makes the final decision.

“We’ve set up a whole series of guidelines and then we have a face-to-face meeting for applicants to help them think through how the platform can be effective for them—what’s realistic and what their responsibility is going to be,” said Katano. “With most crowdfunding platforms engagement is key. We ask them about their social media reach, do they use Twitter? Do they use Facebook? Are they comfortable shooting video?"

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