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Sep 26 2014
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Public Health News Roundup: September 26

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EBOLA UPDATE: American Physician Declared Ebola-Free, Released From Hospital
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Rick Sacra, MD, an American physician who was working in an obstetrics clinic in Liberia when he became infected with the Ebola virus, has been cleared as disease-free by the U.S. Centers for Disease Control and Prevention and released from The Nebraska Medical Center. He entered the facility, which includes one of the United States’ few biocontainment units, three weeks ago. Kenty Brantly, MD, who was previously and successfully treated for Ebola at Emory Hospital in Atlanta, had donated two pints of his blood for Sacra’s treatment. Read more on Ebola.

UTHealth to Use $1.3M Grant to Study Asthma Risk for Health Care Workers
As asthma prevalence continues to rise across the country, the University of Texas Health Science Center at Houston (UTHealth) School of Public Health will utilize a four-year, $1.3 million grant from the U.S. Centers for Disease Control and Prevention (CDC) to study how the risk of asthma has changed for Texas health care workers over the past decade. The health care field is one of the population groups that see a higher risk for the breathing disorder. For the study, researchers will repeat a 2003 survey which found that, after entering the field, 7.3 percent of nurses and 4.2 to 5.6 percent of doctors, respiratory therapists and occupational therapists developed asthma. “Practices in hospitals have changed in 10 years. There are new cleaning chemicals, including many environmentally friendly ones, but are those products without risk? We want to find out,” said George Delclos, MD, PhD, co-principal investigator and professor in the Division of Epidemiology, Human Genetics & Environmental Sciences at the UTHealth School of Public Health. Read more on health disparities.

HHS: $212M to Strengthen State, Local Programs Designed to Prevent Chronic Diseases
The U.S. Department of Health and Human Services (HHS) announced yesterday that it will award nearly $212 million in grants to help all 50 states and the District of Columbia strengthen efforts to prevent chronic diseases. A total of 193 awards will go to state and local programs, and are funded in part through the Affordable Care Act. “Tobacco use, high blood pressure, and obesity are leading preventable causes of death in the United States,” said U.S. Centers for Disease Control and Prevention Director Tom Frieden, MD, MPH, in a release. “These grants will enable state and local health departments, national and community organizations, and other partners from all sectors of society to help us prevent heart disease, cancer, stroke, and other leading chronic diseases, and help Americans to live longer, healthier, and more productive lives.” Read more on prevention.

Sep 15 2014
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Recommended Reading: Some Drugs—Especially Oncology Medicines—Have Been in Short Supply for Too Many Years

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Health Affairs and the Robert Wood Johnson Foundation recently released an issue brief on the continuing shortages of certain drugs, most frequently injectable drugs for cancer treatment. According to the issue brief, there have been fewer reports of newly unavailable drugs in the last few years, but problems remain, forcing many patients to skip some treatments or sometimes opt for a less-effective drug. U.S. Food and Drug Administration (FDA) updates on drug shortages in just the first two weeks of September found sixteen injectable drugs in short supply, two of them new to the list.

Recent Government Accountability Office reports have found several reasons for the shortages, including:

  • Difficulty acquiring raw materials
  • Manufacturing problems
  • A loss of drug products when factories are updated and modernized
  • Low reimbursement by Medicare and other government payment programs
  • FDA regulations that may slow down new drug approvals

The authors of the issue brief say that it is unlikely that Congress will act, and that the industry has and will make changes likely to help bolster some supplies. Also, thorough reviews such as the current issue brief help remind policymakers that some drug shortages remain.

Read the full issue brief.

Sep 12 2014
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Public Health News Roundup: September 12

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EBOLA OUTBREAK: WHO Says Ebola is Spreading at a Faster Rate than Health Workers Can Handle
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Earlier this week, the World Health Organization (WHO) announced that the Ebola outbreak in West Africa—the largest in history—shows no signs of slowing down. Today the global health organization followed that by declaring that health officials are currently unable to handle the growing number of cases. "In the three hardest hit countries, Guinea, Liberia and Sierra Leone, the number of new cases is moving far faster than the capacity to manage them in the Ebola-specific treatment centers," said Margaret Chan, the WHO director-general, according to CNN. "Today, there is not one single bed available for the treatment of an Ebola patient in the entire country of Liberia." More than 2,400 people have died from Ebola since the start of the outbreak. Read more on Ebola.

Study: Majority of Nursing Home Residents with Advanced Dementia Receive Questionable Medications
The majority of nursing home residents dealing with advanced dementia receive medications that are both questionable—if not outright ineffective—and cost them needless amounts of money, according to a new study in JAMA Internal Medicine. In a review of 5,406 nursing home residents with advanced dementia, researchers determined that slightly more than half (53.9 percent) received at least one medication with questionable benefit; the medications constituted approximately 35.2 percent of the total cost of care for those patients. According to the researchers, the patients’ goals of care should dictate the treatment they receive when dealing with a terminal illness, and medications that don’t promote that primary goal should be minimized. Read more on aging.

Study: ‘Fat Shaming’ is Counterproductive
“Fat shaming” does not promote weight loss and in fact can be counterproductive, according to a new study in the journal Obesity. In an analysis of nearly 3,000 adults tracked over four years, researchers determined that weight discrimination was associated with a weight gain of approximately 2 pounds, while the participants who reported no fat shaming lost an average of 1.5 pounds. "Our study clearly shows that weight discrimination is part of the obesity problem and not the solution," said the study's senior author, Jane Wardle, director of the Cancer Research UK Health Behaviour Centre at University College London (UCL), in a release. "Weight bias has been documented not only among the general public but also among health professionals, and many obese patients report being treated disrespectfully by doctors because of their weight. Everyone, including doctors, should stop blaming and shaming people for their weight and offer support, and where appropriate, treatment.” Read more on obesity.

Sep 8 2014
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Recommended Reading: Helping First Timers Sign up for Health Insurance

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A new Kaiser Health News (KHN) article describes the challenges of helping people who have never had health insurance sign up for coverage. The KHN profile looks at the Arab Community Center for Economic & Social Services (ACCESS) a nonprofit agency that is helping the large Arab-American population in Dearborn, Mich., sign up for coverage and access care.

 The group has found that many of the people they are helping are immigrants who know little to nothing about health insurance concepts such as enrollment, copays and deductibles—an issue that also applies to millions of other people new to health insurance across the country. Immigrant and uninsured populations all over the country face cultural and language barriers to understanding and adopting U.S. insurance practices.

Ten million non-citizens living legally in the U.S. are expected to gain health insurance under the Affordable Care Act, according to KHN. The navigators at ACCESS are also trained to teach immigrants about free public health screenings for conditions such as breast cancer, which requires specialized training and conversations because of cultural stigmas associated with cancer.. At the ACCESS center in Dearborn, for example, women coming for free mammograms enter through an unmarked door.

Read the Kaiser Health News article.

Bonus Links:

  • Kaiser Health News recently reported that, on average, premiums will decline in 16 major cities for the 2015 coverage year.
  • Advertising for health insurance plans has already started across the country. Sign up for the 2015 coverage year begins October 15, 2014 and ends February 15, 2015, a period that is roughly three months shorter than last year’s enrollment period. Find information at healthcare.gov.
Sep 3 2014
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Public Health News Roundup: September 3

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EBOLA UPDATE: HHS Partners with Mapp Biopharmaceutical on Development of Ebola Treatments
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Department of Health and Human Services has contracted with Mapp Biopharmaceutical Inc. for the development of an Ebola treatment. The funding will come through the Assistant Secretary for Preparedness and Response’s Biomedical Advanced Research and Development Authority. Under the 18-month, $24.9 million contract, Mapp will also continue the development and manufacture of its existing Ebola drug, ZMapp, which was used to successfully treat two Americans who were infected in the outbreak in West Africa. “While ZMapp has received a lot of attention, it is one of several treatments under development for Ebola, and we still have very limited data on its safety and efficacy,” said Nicole Lurie, MD, assistant secretary for preparedness and response, in a release. “Developing drugs and vaccines to protect against Ebola as a biological threat has been a long-term goal of the U.S. government, and today’s agreement represents an important step forward.” Read more on Ebola.

CVS Announces All Stores are Now Tobacco Free
Tobacco products are no longer sold at any of the approximately 7,700 CVS/pharmacy locations, the company announced today, almost a month ahead of its planned tobacco-free schedule. The company also announced that is has changed its corporate name to CVS Health. "Every day, all across the country, customers and patients place their trust in our 26,000 pharmacists and nurse practitioners to serve their health care needs," said Helena B. Foulkes, President of CVS/pharmacy, in a release. "The removal of cigarette and other tobacco products from our stores is an important step in helping Americans to quit smoking and get healthy." Read more on tobacco.

Study: Double Mastectomies and Lumpectomies Carry Similar Survival Rates
Double mastectomies for early stage breast cancer are no more effective than lumpectomies at improving survival rates, according to a new study in the Journal of the American Medical Association. Analyzing data on more than 189,000 patients in California, researchers found that while the percentage of women who opted for double mastectomies climbed from 2 percent in 1998 to 12.3 percent in 2011—and that in 2011 approximately one-third of patients younger than 40 chose to have a double mastectomy rather than the potentially breast-conserving lumpectomy—the death rates for the two treatments were similar. The researchers said their findings are especially significant for women at average risk. Read more on cancer.

Aug 19 2014
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Public Health News Roundup: August 19

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EBOLA UPDATE: Death Toll Passes 1,200; Improvement Seen in Three African Doctors Who Received Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The death toll in the ongoing Ebola outbreak in West Africa has passed 1,200, according to the World Health Organization, with infection rates continuing to outpace containment efforts. Concerns over the disease also continue to spread, with a 30-year-old woman in Germany isolated and then taken to a specialist medical unit after being found with a high fever. However, the Liberian information minister was also recently quoted as saying that three African doctors treated with the experimental ZMapp treatment are showing “remarkable signs of improvement.” The drug was used to treat two Americans who are now also showing signs of improvement. Read more on Ebola.

Study: Older Americans Receiving Cancer Screenings Against Recommendations
As many as half of older Americans continue to receive cancer screenings despite the recommendation by several professional societies that certain cancers not be screening for in people who aren’t expected to live for another 10 years, according to a new study in JAMA Internal Medicine. “There is general agreement that routine cancer screening has little likelihood to result in a net benefit for individuals with limited life expectancy,” wrote Trevor Royce, MD, in the study. Keith Bellizzi of the University of Connecticut‘s Center for Public Health and Health Policy in Storrs added that "Each screening test carries different risks and benefits ... Individuals should be counseled about these risks in order to make an informed decision (sometimes involving caregivers or family members)." Read more on cancer.

Study: Dramatic Drop in Deaths, Hospitalization for Heart Disease and Stroke
Lifestyle changes, better treatment and effective preventive measures have caused a dramatic drop in deaths and hospitalizations for heart disease over the past decade, according to a new study in the journal Circulation. In a review of data on nearly 34 million Americans covered by Medicare, researchers found that from 1999 to 2011 hospitalizations rates for heart attacks dropped by 38 percent; rates of unstable angina dropped by almost 85 percent; and hospitalizations for both heart failure and stroke dropped by approximately one-third. "The findings are jaw-dropping," said lead researcher Harlan Krumholz, MD, a professor of cardiology at the Yale School of Medicine in New Haven, Conn, according to HealthDay. "They really show that we have begun to reverse this epidemic of heart disease and stroke." Read more on heart and vascular health.

Aug 15 2014
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Public Health News Roundup: August 15

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HHS: $250M to Expand Access to High-Quality Preschools
The U.S. Department of Health and Human Services (HHS) has announced that applications are now available for the $250 million Preschool Development Grants competition, which was established to build, develop and expand voluntary, high-quality preschool programs in high-need communities for children from low- and moderate-income families. “When we invest in early education, the benefits can last a lifetime,” said HHS Secretary Sylvia M. Burwell, in a release. “Children who attend high-quality early learning and preschool programs are more likely to do well in school and secure good jobs down the road. We all gain when our country has a stronger, more productive workforce, lower crime rates, and less need for public assistance. These Preschool Development Grants will help put more children on the path to opportunity.” Read more on education.

Study: Three Common Respiratory Illnesses Linked to Higher Risk of Lung Cancer
Chronic bronchitis, emphysema and pneumonia are all tied to an increased risk of lung cancer, according to a new study in the American Journal of Respiratory and Critical Care Medicine. Researchers analyzed data on more than 250,000 people, concluding that the reason for the increased risk could relate to underlying disease mechanisms. They also said that a better understanding of the respiratory diseases could affect how doctors monitor and help patients. Read more on prevention.

FDA: More Data Needed on Painkiller’s Abuse-Deterrent Capability
The U.S. Food and Drug Administration (FDA) has requested additional study and information to determine the effectiveness of an abuse-deterrent capability in an experimental painkiller. Acura Pharmaceuticals states that its drug, which contains the common painkillers hydrocodone bitartrate and acetaminophen, cannot be abused by snorting. The drug is designed to cause a burning sensation when snorted or form a gelatinous mixture when prepared for injection. However, the drug failed in a mid-stage trial to show a statistically significant likelihood of reducing abuse. Read more on substance abuse.

Aug 12 2014
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Public Health News Roundup: August 12

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EBOLA UPDATE: Death Toll at 1,013 as Two More Doctors are Set to Receive an Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Two more Ebola-infected doctors are set to receive the experimental ZMapp drug that was given to two American health workers and a Spanish priest. The Americans continue to receive treatment in an Atlanta hospital, while the 75-year-old missionary died early this morning. The death toll of the West African outbreak—the largest Ebola outbreak in history—now stands at 1,013, according to the World Health Organization. Read more on Ebola.

FDA Approves New Colorectal Screening Test
The U.S. Food and Drug Administration (FDA) has approved the first stool-based colorectal screening test to identify cancers such as colon cancer or precursors to cancer. The test can detect red blood cells and DNA mutations that can indicate certain types of abnormal growths. Colorectal cancer is the third most common cancer among those that affect both men and women, and regular screening tests for all people ages 50 and older could reduce related deaths by at least 60 percent, according to the U.S. Centers for Disease Control and Prevention. “This approval offers patients and physicians another option to screen for colorectal cancer,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Health at the FDA’s Center for Devices and Radiological Health, in a release. “Fecal blood testing is a well-established screening tool and the clinical data showed that the test detected more cancers than a commonly used fecal occult test.” Read more on cancer.

Study: Women, Blacks Affected Most by Heart Disease and Stroke
Women and African-Americans are affected the most by chronic diseases linked to increased risk of heart attack or stroke, according to a new population-based study in the journal Circulation. Researchers analyzed the five major risk factors for heart disease—high cholesterol, smoking, high blood pressure, obesity and diabetes—in more than 13,500 Americans from 1987 to 1998, finding that while the combined risk for women dropped from 68 percent to 58 percent, it was still higher than the risk for men, which dropped from 51 percent to 48 percent. The study also found that diabetes more than doubled the risk of heart disease for African-Americans when compared to whites—28 percent versus 13 percent. Researchers said the difference could be because heart disease has been traditionally viewed as a disease of white men, affecting how it is treated. Read more on health disparities.

Aug 6 2014
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Public Health News Roundup: August 6

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EBOLA UPDATE: African Death Toll Hits 932 as Liberia Shuts Down a Major Hospital Over Continued Infections
(NewPublicHealth is monitoring the public health crisis in West Africa.)
St. Joseph's Catholic hospital in the Liberia capital of Monrovia has been shut down after the death of its hospital director from Ebola and the subsequent infections of six staff members, including two nuns and a priest. The World Health Organization reports that there were 45 deaths in the three days leading to August 4—bringing the death toll so far to 932—and is calling for an emergency meeting to determine whether the outbreak constitutes a "Public Health Emergency of International Concern" and to discuss what additional public health measures can be taken. Read more on infectious diseases.

‘Gluten-free’ Labels Must Now Fully Meet FDA Standards
What does a “gluten-free” food label actually mean? Exactly what it says, as of yesterday. August 5 was the deadline for all U.S. foods bearing a gluten-free label claim to meet the U.S. Food and Drug Administration’s (FDA) final rule covering the issue. The rule sets a gluten limit of less than 20 ppm (parts per million) in foods that carry the label, which is the lowest level that can be detected. The agency issued the rule last August, giving manufacturers one year to bring their product lines into compliance. “Gluten-free” labeling is critical to people with celiac disease, which has no cure and can only be treated through diet. "This standard ’gluten-free’ definition eliminates uncertainty about how food producers label their products. People with celiac disease can rest assured that foods labeled 'gluten-free' meet a clear standard established and enforced by FDA," said Felicia Billingslea, director of FDA's division of food labeling and standards, in a release. Read more on food safety.

Study: Daily Aspirin Linked to Reduction in Risk for Some Cancers
A daily dose of aspirin is linked to a reduction in the risk of developing and dying from colon, stomach and esophageal cancers, according to a new study in the Annals of Oncology. Researchers analyzed the results of available studies, determining “that most people between the ages of 50 and 65 would benefit from a daily aspirin," said lead researcher Jack Cuzick, head of the Center for Cancer Prevention at Queen Mary, University of London, adding, “It looks like if everyone took a daily aspirin, there would be less cancer, and that would far outweigh any side effects.” The most serious side effect associated with aspirin is gastrointestinal bleeding. According to HealthDay, Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society, said that while the study does not mean that everyone should be taking aspirin as a cancer-prevention measure, if does mean they should discuss the possibility with their doctors. Read more on cancer.

Jul 30 2014
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Helping the Homeless Quit Smoking: Q&A with Michael Businelle and Darla Kendzor, The University of Texas School of Public Health

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Not surprisingly, a recent study in the American Journal of Public Health found that homeless smokers struggle with quitting more than economically disadvantaged smokers who have their own housing. The study compared homeless smokers receiving treatment at a shelter-based smoking cessation clinic to people enrolled in a smoking cessation program at a Dallas, Texas, safety-net hospital.

“On average, homeless people reported that they found themselves around about 40 smokers every day, while the group getting cessation care at the hospital reported that they were more likely to be around three to four smokers every day,” said Michael S. Businelle, PhD, assistant professor of health promotion and behavioral sciences at The University of Texas School of Public Health Dallas Regional Campus, and the lead author of the study. “Imagine if you had an alcohol problem and were trying to quit drinking—it would be almost impossible to quit if you were surrounded by 40 people drinking every day. That is the situation homeless folks have to overcome when they try to quit smoking.”

Businelle said research shows that about 75 percent of homeless people smoke and that smoking is a leading cause of death in this population. And although homeless smokers are just as likely to try to quit smoking as are other smokers, they are far less successful at quitting, according to Businelle’s work. He said tailored smoking cessation programs are needed for homeless people, including smoke-free zones in shelters.

NewPublicHealth recently spoke with Businelle and his wife, Darla Kendzor, PhD, who is a co-author of the recent study on smoking and the homeless, as well as an assistant professor at The University of Texas.

NPH: Why did you embark on the study?

Michael Businelle: The smoking prevalence in this population is so high and homeless people are not enrolled in clinical trials so we don’t know what will work best for them. We’ve developed, over the last 50 years, really good treatments for the general population of smokers, but there are very few treatments that have been tested in homeless populations.

Darla Kendzor: And cancer and cardiovascular disease, which are in large part due to tobacco smoking, are the leading causes of death among homeless adults. So quitting smoking would make a big difference for them. 

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