NIH Grants $40M to Combat Racial, Ethnic Disparities in Stroke Risk
The National Institutes of Health (NIH) has awarded $40 million in grants over five years to help four research centers investigate and develop strategies to reduce the risk of stroke in racial and ethnic minorities. The funds come from NIH’s National Institute of Neurological Disorders and Stroke (NINDS). Racial and ethnic minorities are at higher risk than non-whites due to higher prevalence of cardiovascular risk factors, according to said Walter J. Koroshetz, MD, deputy director, NINDS. "A few of the grantees are working closely with at-risk populations to develop interventions that give people tools to achieve blood pressure control," he said. "These research efforts will give us the traction we need to control the greatest modifiable stroke risk factor. Together, the Stroke Prevention /Intervention Research Programs represent a much needed effort to address stroke disparities in the United States." Read more on stroke.

People With Congenital Heart Disease Need Physical Activity
A new scientific statement from the American Heart Association serves to remind health professionals and patients that regular physical activity is important for people with congenital heart disease and should be promoted. Congenital heart disease (heart structural problems existing since birth) impacts close to 1 million children and 1 million adults in the United States. Specifics of the new statement include:

• While some irregular heart beat conditions may require a restriction in physical activity, “for most, physical activity can be unlimited and should be strongly promoted.”
• Most patients with congenital heart disease are relatively sedentary.  But the physical, psychological and social health benefits of physical activity are important for this population which is at risk for exercise intolerance, obesity and other diseases. .
• These are general recommendations and physicians may have to tailor some specific guidelines for individual patients.

Read more on heart health.

DOT Announces Funds to Help Improve Road Safety on Tribal Lands
The U.S. Department of Transportation (DOT) has announced the availability of more than $8.6 million in Tribal Transportation Program Safety Funds from the Federal Highway Administration (FHWA). According to Transportation Secretary Ray LaHood, the funds will help improve roads on tribal lands, which have consistently ranked among the nation’s highest road fatality rates. DOT will hold a webinar on May 8 from 4-5 p.m. EDT to provide information on the grants to potential applicants. Find a link to the webinar here. Read more on transportation.

USPSTF Recommends HIV Screening for All Americans 15-65
The U.S. Preventive Services Task Force (USPSTF) now recommends that all Americans ages 15 to 65 be screened for HIV, according to new guidelines appearing in the Annals of Internal Medicine. USPSTF’s previous 2005 guidelines recommended screening for only those people categorized as high-risk. The U.S. Centers for Disease Control and Prevention already recommends this course of action. "We do hope the fact that the guidelines are all very similar will provide an impetus for people to offer screening because it is a very critical public-health problem,” said task force member Douglas Owens, MD, a medical professor at Stanford University. Experts noted that the change will likely mean that testing will be covered as a preventive service under the Affordable Care Act. Read more on HIV/AIDS.

HUD’s $1.83B Plan Will Help Rebuild New Jersey, Prepare for Future Disasters
The U.S. Department of Housing and Urban Development’s (HUD) $1.83 billion New Jersey disaster recovery plan will help residents continue to recover from the damage caused by Hurricane Sandy and better prepare for future extreme weather events. “This infusion of federal funding will help New Jersey continue to recover from Superstorm Sandy and ensure that our state is rebuilt stronger and better prepared for future storms,” said Senator Frank Lautenberg (D-NJ). “Families that are rebuilding their homes, small businesses that are getting back on their feet, and communities that are repairing damaged public infrastructure will all benefit from this federal grant program.” The plan is funded through HUD’s Community Development Block Grant Program. The infrastructure restoration efforts will including elevating some homes to guard against future flooding. Read more on Hurricane Sandy.

Early Obesity Dramatically Increases Men’s Risk of Poor Health, Death
Obesity in the early 20’s can dramatically increased a man’s chance of suffering from serious health problems or even dying by the age of 55, according to a new study in the journal BMJ Open. A study tracking Danish men found that approximately half of the participants who were obese at the age of 22 had developed diabetes, developed high blood pressure, had a heart attack, had a stroke, or experienced blood clots or died by age 55. Men of a normal weight at age 22 saw only a 20 percent risk of developing these problems by age 55. Each unit increase in body mass index raised the risk of heart attack by 5 percent; high blood pressure and clots by 10 percent; and diabetes by 20 percent. In the United States approximately 35.7 percent of adults and 17 percent of children are obese, according to the U. S. Centers for Disease Control and Prevention. Read more on obesity.

Survey: Many Americans Still Unaware of or Confused About the Affordable Care Act
Signup for the Affordable Care Act (ACA) Health Insurance Marketplace begins in October, but a new poll from the Kaiser Family Foundation finds that many Americans are still confused about the law, which will require virtually all Americans to sign up for health insurance coverage that will take effect January 1, 2014.

Key poll findings include:

• More than 40 percent of Americans aren’t aware that the ACA is the law of the land.
• Of those who aren’t aware that the ACA is now law, 12 percent think the law was repealed by Congress and 7 percent think the law was overturned by the Supreme Court.
• About half of the respondents said they did not have enough information about the health reform law to understand how it will impact their family.

The poll findings also showed that people who are currently uninsured and those in low-income households were the most likely groups to say they did not understand how the ACA benefits them and their families. Read more on access to health care.

Study: Single Can of Sugary Soda Can Increase Diabetes Risk 22 Percent
Drinking even a single 12-ounce can of sugary soda once a day can up the risk of diabetes by 22 percent, according to a new study out of Imperial College London. Researchers looked at the data of approximately 350,000 European residents. "Given the increase in sweet beverage consumption in Europe, clear messages on the unhealthy effect of these drinks should be given to the population," said study leader Dora Romaguera, according to Reuters. Previous studies have also shown a link between sugary drinks and increased risk of obesity and type 2 diabetes, which affects approximately 310 million people, according to the World Health Organization. Read more on diabetes.

Teen Years in the ‘Stroke Belt’ Ups Risk of Stroke Later in Life
Growing up as a teenager in the U.S. “stroke belt”—an area in the country’s southeast—can increase the risk of stroke later in life by as much as 17 percent, according to a new study in the journal Neurology. Risk factors including high blood pressure and diabetes are only partially responsible for the increase risk. "Many social and behavioral risk factors, such as smoking, are set in place during the teenage years, and teens are more exposed to external influences and gain the knowledge to challenge or reaffirm their childhood habits and lifestyle," said study author Virginia Howard, with the School of Public Health at the University of Alabama at Birmingham, in a release. Across all age groups the risk was double for black Americans when compared to white Americans. Researchers were careful to note that the findings do not demonstration causation. Read more on strokes.

Poultry Probably Source of China’s New Bird Flu Strain
Researchers believe that poultry-to-human transmission from “wet” markets is likely responsible for the new H7N9 bird flu strain that has killed 22 people in China and infected more than 100. Wet markets sell and immediately slaughter poultry. So far the strain does not seem to pass easily between people, so the researchers feel relatively confident that closing the markets and slaughtering the birds will control the outbreak. “Overall, the evidence, in terms of epidemiology and virology, suggests that it is a pure poultry to human transmission, and that controlling [the epidemic in humans] will therefore depend on controlling the epidemic in poultry,” said Kwok-Yung Yuen of the University of Hong Kong, according to MSNBC. The findings were published in the journal Lancet. Read more on infectious disease.

AAP: Out-of-school Suspensions, Expulsions Harmful to Kids
Out-of-school suspensions and expulsions are generally counterproductive and can have profound long-term negative effects, according to the American Academy of Pediatrics (AAP). Data shows the youth are more likely to drop out of school, more likely to be involved in the juvenile justice system and will earn $400,000 less over a lifetime than a high school graduate. Such discipline also does not address potential underlying issues, such as drug abuse, racial tension, violence and bullying, according to AAP. AAP recommends early intervention programs to recognize and address behavioral and other problems. Recommendations also include a Positive Behavior Intervention and Support program to teach proper behavior at both the individual and school-wide levels. Read more on violence.

Study: 1 in 4 Admit to Bizarre Late-night Snacking
Approximately one in four students admit to creating and eating late-night crazy food concoctions, according to a new report in the International Journal of Eating Disorders. Researchers defined the relevant snacks as “strange food mixtures that you would be too embarrassed or ashamed to share with others” (e.g. sugar-covered scrambled eggs or mayo-smothered vegetables). While there is no inherent health danger in such mixing, health professionals recommend that people try to make healthy choices when selecting late-night snacks. About one-third of U.S. adults and nearly one in five youth ages 2-19 are obese, according to the U.S. Centers for Disease Control and Prevention. Read more on nutrition.

Study: Mediterranean Diet Good for Heart Health
A Mediterranean diet—rich in olive oil, nuts, fresh fruits, fresh vegetables and even red wine—is more effective than a low-fat diet at helping at helping people at high risk for cardiovascular disease to ward off health problems, according to a new report in the New England Journal of Medicine. Researchers found a 30 percent greater reduction in relative risk of a heart attack, stroke or death, according to lead author Miguel Angel Martinez-Gonzalez, MD, MPH, PhD, chairman of preventive medicine and public health at the Universidad de Navarra in Spain. He said the findings are likely to due to the good-quality fats and wide array of nutrients. The findings give further support to the effectiveness of a Mediterranean diet at preventing heart disease. Read more on heart health.

San Diego County in California has set out to become the nation’s first “heart attack and stroke-free zone.” In a collaborative effort, local hospitals and health care providers are using innovative health information technology and focusing heavily on prevention to achieve this important goal, while the public health community continues to work toward making the county a healthier place to live.

The community was inspired to set this unprecedented public health benchmark when the California Department of Managed Health Care (DMHC) launched the Right Care Initiative in 2008, setting a statewide goal of reaching the 90th percentile nationally for controlling many of the factors which lead to heart attacks and strokes. Prior to 2008, 16 million Californians – about 44 percent of the population – were affected by chronic disease, half of whom suffered from more than one chronic condition. 

DMHC has formed key partnerships with California health plans and medical groups, the California Chronic Care Coalition, University of California, American Diabetes Association, American Heart/Stroke Association and community organizations throughout the state. As a result, doctors, patients, and community organizations are saturated with traditional and social media that stress the importance of being proactive.

Communities strive to meet the Right Care Initiative goals through the enhanced practice of patient-centered, evidence-based medicine focusing on the following efforts:

• engaging patients more actively to improve their health with diet and exercise;
• involving pharmacists as part of the patient’s care team; and
• learning proper medication protocol.

Since the Initiative started almost five years ago, eight of the nine largest health plans in California have made overall improvements on heart and diabetes quality measures, 11 groups in California have reached the 90th percentile of clinical control measures, and DMHC has assisted more than one million Californians to resolve their health plan problems.

San Diego is just one community among many waging a battle against chronic disease and the enormous toll it exacts on quality and years of life. Stroke alone takes more than 140,000 lives each year.  According to the American Stroke Association, only two-thirds of Americans know at least one of the seven warning signs of stroke. The American Heart Association (AHA) and American Stroke Association (ASA) partnered with the Ad Council to launch their first national multimedia public service campaign to raise awareness in recognizing and responding to the warning signs of stroke by using the acronym: F.A.S.T.

New Report Widens Information on Veteran Suicide
The Department of Veterans Affairs (VA) has released a comprehensive report on Veterans who die by suicide—include veterans who had not sought VA health care services. Previous reports included information only on those who had sought those services. The VA has recently implemented broader suicide prevention initiatives, including a toll-free Veterans Crisis Line; placement of suicide prevention coordinators at all VA medical centers and large outpatient facilities; and improvements in case management and reporting.  Immediate help for veterans is available at www.VeteransCrisisLine.net or by calling the Crisis Line at 1-800-273-8255 (push 1) or texting 838255. Read more on military.

FDA Approves Generic Version for Cancer Drug Doxil in Short Supply
The U.S. Food and Drug Administration (FDA) has approved the first generic version of widely used cancer drug Doxil (doxorubicin hydrochloride liposome injection). This approval is critical because the drug is currently on the FDA’s drug shortage list. The agency is using a priority review system to expedite the review of generic applications to help stem shortages. Doxil is used for several cancers, including ovarian cancer, multiple myeloma and AIDS-related Kaposi's sarcoma. Read more on prescription drugs.

Stroke Victims Need Therapy Within 60 Minutes of Hospital Arrival
People having an ischemic stroke should receive clot-dissolving therapy within 60 minutes of arriving at the hospital, according to new American Stroke Association guidelines published in the journal Stroke. Ischemic stroke, which accounts for nine in 10 strokes, is caused by a blood clot in the arteries leading to the brain. According to the American Heart Association, calling 9-1-1 immediately after recognizing any of the warning signs of stroke—and getting to a stroke center as fast as possible—are critical steps for optimal stroke care. That’s because during an acute stroke, physicians must quickly evaluate and diagnose patients to determine whether they are eligible to receive the clot-dissolving drug recombinant tissue plasminogen activator which has to be given within hours of symptom starting.

Other new changes to stroke guidelines include:

• If feasible, transfer patients to the closest available certified primary care stroke center or comprehensive stroke center, which might involve air medical transport, though telemedicine with a stroke center may also be appropriate.
• Create multidisciplinary quality improvement committees within hospitals to review and monitor stroke care.

Read more on heart health.

USDA Releases New Regulations on Snack Foods Sold at Schools
New rules proposed by the U.S. Department of Agriculture would require snacks sold at schools to be lower in fat, salt and sugar and include more nutritious items such as whole grains, vegetables and fruits. The rules also require a limit of 200 calories on food items not sold in the school cafeteria. According to Reuters, the rules would apply to about 50 million children who are part of the school lunch program. “These proposed nutrition standards, the first update in more than 30 years, are long overdue and badly needed,” said Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation. The proposed regulations will be open for public comment once the rule is published in the Federal Register, which is likely to be this week. The final rule would probably not take effect before the fall of 2015. Read more on obesity.

Flu Shot May Protect Older People Against Heart Attacks
A new study from researchers at the University Of Iowa College Of Public Health suggests that the flu vaccine may provide protection against heart attacks in older adults, especially people over age 80. The researchers suspected acute infection caused by flu may trigger events leading to heart attacks and strokes, so they created a set of time-series models using inpatient data from a national sample of more than 1,000 hospitals and used flu activity to predict the incidence of heart attack and stroke. The team produced national models, as well as models based on four geographical regions and five age groups and across all models, and found consistent significant associations between heart attacks and influenza activity.

Flu Season 2013 Update: The most recent report from the U.S. Centers for Disease Control and Prevention finds that while there is still widespread flu activity in much of the country, an increasing number of states are starting to see a decline in reported flu cases.

Read more on flu.

Public Health School Partners with Churches to Improve Healthier Living
As part of a project led by the University Of South Carolina Arnold School Of Public Health, about 1,250 members of 74 African Methodist Episcopal churches in South Carolina participated in a program to help members lead healthier lifestyles through increased physical activity and healthier food choices. The five-year project was funded by the National Institutes of Health and found that members of churches who were part of the healthier lifestyle training were more likely to engage in physical activity and eat more fruits and vegetables than members from churches that did not undergo the training. The study's findings were published in the American Journal of Preventive Medicine. “Churches are natural partners to help eliminate health disparities in the African-American community, says Sara Wilcox, PHD, director of the school’s prevention research center. “For many, especially in the South, the church is the center of their life and is a trusted institution.” Read more on prevention.

AAP Calls for Schools to Maintain Daily Recess and Breaks
A new policy statement from the American Academy of Pediatrics (AAP) calls on all schools to have daily recess and breaks in order to promote activity and a healthy lifestyle. According to the AAP, “safe and properly supervised recess offers children cognitive, physical, emotional and social benefits. It should be used as a complement to physical education classes, not a substitute, and whether it’s spent indoors or outdoors, recess should provide free, unstructured play or activity.” The AAP also says that recess should never be withheld as a punishment and the statement authors add that “minimizing or eliminating recess can negatively affect academic achievement, as growing evidence links recess to improved physical health, social skills and cognitive development.” Read more on physical activity.

Support and Solidarity Build Resilience Following Community Disasters
Community solidarity and support have remarkable benefits for communities coping with traumatic mass shootings, according to an American-Finnish research study recently published by the University of Turku. The researchers looked at the responses of four communities that suffered from similar tragedies in the United States and Finland. People in all four communities expressed their need for belonging after the shootings. According to the researchers, after each of the four incidents the communities held events including mass gatherings, communal vigils and spontaneously erected monuments to the victims. The researchers say that all these efforts demonstrated that the community was in shock, yet united, and able to focus attention on their collective loss and on each other. Read more on community health.

FDA Approved Most Drugs in 16 Years
Reuters is reporting that the U.S. Food and Drug Administration (FDA) approved 39 drugs in 2012, the largest number in the past 16 years. Important new drugs approved this year include two weight loss medicines, drugs to treat resistant cystic fibrosis and tuberculosis and a drug to reduce the risk of stroke in people with irregular heartbeats. Read more on the U.S. Food and Drug Administration.

Last year, a new center to help promote physical activity among individuals with disabilities opened at the University of Alabama at Birmingham. NewPublicHealth spoke with James Rimmer, PhD, the center’s director, who has spent decades promoting the importance of people who are disabled engaging in physical activity for both their health and for fun.

NewPublicHealth: Tell us about the new center.

Rimmer: When I moved here from the University of Illinois/Chicago, there was a large donation made to support the needs of people with disabilities in all areas of physical activity, sport and recreation, by the Lakeshore Foundation, a non-profit organization that provides health and fitness services to people with disabilities. They brought me in to build an enterprise between the University of Alabama at Birmingham and the foundation, which is called the UAB Lakeshore Research Collaborative. Subsumed under that are two national centers that have been funded by the Centers for Disease Control and Prevention and the National Institute on Disability and Rehabilitation Research. The first center is the National Center Health, Physical Activity and Disability. The second center is the Rehabilitation Engineering Research Center.

NPH: You have been working in this field for decades. What will be new about your initiatives and efforts in 2013?

Men More Likely than Women to Die of Cancer
Men are more likely than women to both be diagnosed with cancer and to die of the disease, according to a new study in The Journal of Urology. The researchers did not include mortality rates for sex-specific cancers. The gender gap could be due to men's higher rates of smoking and drinking, as well as they fact that men are on average less likely to have frequent doctor visits—meaning cancers are not caught as early. "That means going to screening programs, seeing a general practitioner or primary care provider on a regular basis and as soon as symptoms arise that are new, mentioning that to their primary care physicians," said Yang Yang, a sociologist and cancer researcher from the University of North Carolina at Chapel Hill, who was not part of the study. Read more on cancer.

Survey Finds Major Support for Worksite Wellness Initiatives
The States of Wellness national survey on worksite wellness has found that, more and more, businesses are understanding and embracing the business benefits of wellness initiatives. The poll found that 87 percent of organizations understand the importance of worksite wellness and 74 percent said they would utilize community-based collaborations to learn about and improve wellness initiatives. Read more on physical activity and partnerships.

Study: Simply Cutting Fat Intake Drops Weight, Keeps it Off
Simply switching high-fat foods with low-fat foods isn’t as effective as dieting, but it still lowers weight and the weight stays off, according to a new study in the journal BMJ. Researchers say the findings could have a major effect on dietary recommendations in the ongoing effort to prevent cancer, stroke and heart disease—all of which include excessive weight as a contributing factor. "This means having low-fat milk and yogurt, cutting down on butter and cheese and cutting the fat off meat," said study leader Lee Hooper, MD, of the University of East Anglia’s Norwich Medical School, in a release. "Most importantly, have fruit instead of fatty snacks like biscuits, cake and crisps. And remember, this isn't a diet, so don't take it to extremes, but work out a way of eating that you can stick to permanently." Read more on nutrition and obesity.