In connection with Domestic Violence Awareness Month, held each October, the U.S. Centers for Disease Control and Prevention (CDC) recently issued a stark report which found that sexual violence not only results in high rates of injury and death, but also other long-lasting and even lifetime health impacts. To best share the specifics of the report, the CDC created an infographic with the most striking numbers—including how many men are raped each year and how people under the age of five are sexually abused.
>>View the full infographic.
Perhaps most striking, the CDC found that a substantial proportion of U.S. female and male adults have experienced some form of sexual violence, stalking, or intimate partner violence at least once during their lifetimes.
Among the report’s recommended public health actions:
- Prevention of sexual violence must include the protection of young children.
- Strategies to prevent sexual violence must include strategies that address known risk factors for perpetration and emphasize changing social norms and behaviors by using bystander and other prevention strategies.
- Primary prevention of intimate partner violence should be focused on the promotion of healthy relationship behaviors and other protective factors, with the goal of helping adolescents develop positive behaviors before their first relationships.
>>Bonus Link: CDC’s Center for Injury Prevention and Control offers many resources on sexual violence prevention geared toward people of different ages and communities.
EBOLA UPDATE: 5th U.S. Patient Arrives as Dallas Man Remains in ‘Critical’ Condition
(NewPublicHealth is monitoring the public health crisis in West Africa.)
As a U.S. man being treated for Ebola in Dallas, Texas, remains in critical condition, a fifth American to have contracted the disease while in West Africa has arrived at the Nebraska Medical Center. U.S. Centers for Disease Control and Prevention (CDC) said it will work “very closely” with the Nebraska hospital on the treatment of Ashoka Mukpo, a freelance cameraman for NBC News. It is the same hospital that successfully treated and released Rick Sacra, MD, last month. Meanwhile, Thomas Eric Duncan continues to be treated at Texas Health Presbyterian Hospital. "Our hopes and prayers are with him. We recognize this is a critical time for him and for his family," said CDC Director Thomas Frieden, MD, MPH. Read more on Ebola.
Study: Days of Highest Physical Activity Are Also Days When We Drink the Most
The days when people get the most exercise are also the days when they drink the most alcohol, according to a new study in the journal Health Psychology. Researchers utilized smartphone technology to enable 150 participants ages 18-89 to record their physical activity and alcohol use every day for 21 consecutive days, three times a year. “Perhaps people reward themselves for working out by having more to drink or maybe being physically active leads them to encountering more social situations where alcohol is consumed—we don’t know,” said David E. Conroy, PhD, professor in Preventive Medicine-Behavioral Medicine at the Northwestern Feinberg School of Medicine. “Once we understand the connection between the two variables we can design novel interventions that promote physical activity while curbing alcohol use.” Read more on alcohol.
Study: Children in Walkable Communities Have Lower BMIs
Children who live in walkable neighborhoods also have lower average Body Mass Indexes (BMI), a popular measure used to assess physical health, according to a new study in journal Environmental Health Perspectives. Researcher analyzed geocoded residential address data from the electronic health records of nearly 50,000 children and adolescents, ages 4 to 18 years, finding that several links between walkability and healthier weights, including the fact that quartile of children who lived closest to recreational open spaces had lower BMIs that the quartile of children who lived farthest from such spaces. The researchers concluded that modifying existing neighborhoods to make them more walkable could help reduce childhood obesity. Read more on obesity.
The New York Times recently reported on the deaths of two pedestrians killed by bicyclists in the city’s storied Central Park. New York City has recently ramped up efforts to reduce pedestrian deaths—with a focus on car crashes—but anecdotal and police reports in the city find that the growing number of walkers, skaters, cyclists, pedibikers and other people heeding advice to get out and move is resulting in more injuries and deaths. Other cities have also reported increases in accidents linked to increases in physical activity. NewPublicHealth recently reported on efforts launched this year by the U.S. Department of Transportation to prevent and reduce pedestrian injuries.
Several conferences this year—including the annual meetings of the American Public Health Association, the Transportation Research Board and New Partners for Smart Growth—will have sessions looking at pedestrian safety in the wake of communities creating new opportunities for residents to get exercise outdoors. And Sunday Streets, a growing program across the country, shuts down main city streets to give walkers free reign, often with a booth set up by departments of public health or safety on staying safe when sharing the roads.
Read the full story from the New York Times.
EBOLA UPDATE: U.S. Nurses Unsure of their Ability to Handle Ebola Patients
(NewPublicHealth is monitoring the public health crisis in West Africa.)
While the U.S. Centers for Disease Control and Prevention has repeatedly stated that the U.S. health care system and U.S. hospitals are prepared to treat any and all Ebola-infected patients, a new report from Reuters finds that many nurses aren’t as certain. According to Reuters, many “have gone to hospital managers, seeking training on how to best care for patients and protect themselves and their families from contracting the deadly disease,” and they are also concerned that “inadequate preparation could increase the chances of spreading Ebola if hospital staff fail to recognize a patient coming through their doors, or if personnel are not informed about how to properly protect themselves.” Approximately 3,338 people have died so far from the outbreak originating in West Africa. Read more on Ebola.
CDC: Smoking Prohibitions in Subsidized Housing Could Save $497 Annually
As much as $497 million could be saved each year in assorted costs by prohibiting smoking in government-subsidized housing, including public housing, according to the U.S. Centers for Disease Control and Prevention (CDC). The CDC estimates that the ban would save about $310 million in secondhand smoke-related health care, $134 million in renovation expenses and $53 million in smoking-attributable fire losses. “Already, over 500 public housing agencies have adopted some form of a smoke free policy, protecting approximately 200,000 families,” said Matthew Ammon, Acting Director of the Department of Housing and Urban Development’s (HUD) Office of Lead Hazard Control and Healthy Homes, in a release. “This study reinforces HUD’s work that promotes health and reduces costs by encouraging public housing agencies, multi-family housing owners and agents, as well as residents, to adopt and implement smoke-free housing policies.” Read more on housing.
HUD, VA Announced Grants to Help More than 9,000 Homeless Vets Find Housing
The U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Veterans Affairs (VA) have announced more than $62 million in rental assistance to help more than 9,000 homeless veterans find permanent supportive housing. The grants are provided through the HUD-Veterans Affairs Supportive Housing (HUD-VASH) Program. Approximately $57 million will provide 8,276 Tenant-Based Vouchers for rental units and $5 million will provide for 730 Project-Based Vouchers for existing units or new construction in specific developments. “It is unacceptable that after their service and sacrifice, too many of our veterans find themselves living on our streets and in our shelters,” said HUD Secretary Julián Castro, in a release. “We’ve made significant progress reducing homelessness among veterans by a third in just four years, and these vouchers will continue to help communities build on these gains, providing targeted assistance to those in need to ensure that every veteran has a home.” Read more on the military.
Special Delivery: March of Dimes Honors Arizona State Health Director for Work on Improving Turnaround Times on Newborn Screening
An inaugural honor awarded by the March of Dimes last month—the Newborn Screening Quality Award—is the first in a series of awards to state health directors who have made changes to vastly improve newborn screening programs that help prevent death and disability for new babies.
The inaugural award was presented to Will Humble, MPH, director of the Arizona Department of Health Services. He established a policy of full transparency for the length of time it takes Arizona hospitals to send newborn blood samples to the lab for analysis, with a target of having 95 percent of samples screened within 72 hours.
“When hospitals hold onto blood samples for a few days, or a lab is closed on the weekend, this can lead to deadly delays for newborns,” said Edward McCabe, MD, the March of Dimes chief medical officer. “But under Will Humble’s leadership, Arizona has put in place a process that is a model for other states to follow.”
McCabe says the award—named for Robert Guthrie, MD, who developed the first mass screening test for babies in 1963—recognizes leadership in establishing a culture of safety as a way to avoid deadly delays in states’ newborn screening processes.
All states were put on notice about hazardous newborn screening test shipping practices by a Milwaukee Journal Sentinel investigative series, Deadly Delays, published in 2013. She series found that many hospitals delayed sending tests to labs for a variety of reasons, including staff vacations or shortages, or batched the tests in order to save money on shipping, causing diagnosis delays that resulted in babies’ deaths or disabilities.
EBOLA UPDATE: Texas Ebola Patient Came into Contact with at Least 80 People; Second Man Being Monitored
The known number of people who came into contact with the Ebola patient being treated in Texas—now identified as Thomas Eric Duncan of Liberia—has climbed from 18 to at least 80, according to Dallas Health Director Zack Thompson. Duncan, who is in isolation at Texas Health Presbyterian Hospital Dallas, is the first person to be diagnosed with the disease in the United States. Several members of his family are under a “control order” to stay inside their homes. Texas health authorities are also monitoring a second potential Ebola patient. Read more on Ebola.
HHS: Two Contracts to Improve Earlier, More Accurate Flu Diagnosis
The U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) has issued two contracts to help improve doctors’ abilities to diagnose influenza cases sooner and more accurately. One contract is for 3.5 years and worth $12.9 million, while the other is a two-year, $7.9 million contract that could expand to a $14.7-million contract over four years. “Administering fast and inexpensive tests at the point of care has tangible benefits to personal and public health, particularly in helping doctors prescribe the right therapy immediately,” said Robin Robinson, PhD, director of ASPR’s Biomedical Advanced Research and Development Authority, in a release. “Prescribing medication or other therapies in a more targeted way is good stewardship and will be critical to reducing the risk of antimicrobial resistance.” Read more on influenza.
Health Officials: 500 Confirmed Cases of Enterovirus D68 in 42 States and the District of Columbia
There have now been more than 500 confirmed cases of Enterovirus D68 in forty-two states and the District of Columbia since the severe respiratory illness first began infecting children during the summer. While four patients have died in the past several weeks, health officials are still unsure whether the virus is linked to the deaths. They are also working to determine whether 10 cases of children with muscle weakness and even paralysis are due to the virus. Read more on infectious disease.
The U.S. Department of Health and Human Services last week announced grants totaling almost $100 million aimed specifically at mental health services for young adults. The grants will go to several organizations—including those that work with at-risk kids—within schools and in communities to reduce gun violence.
New private funds have also emerged. For example, in November the National Alliance on Mental Illness (NAMI) will announce the winners of the Connect 4 Mental Health Community Innovations Awards they launched last year along with the National Council for Behavioral Health and several pharmaceutical companies. Applications for the awards close October 3. The goal of the competition is to increase awareness of successful mental health treatment models that can be replicated in other parts of the country.
Recently, NewPublicHealth spoke with NAMI Executive Director Mary Giliberti, JD, about improvements in U.S. mental health care, issues that still need to be addressed and how the work of the award winners can help improve mental health care treatment.
NewPublicHealth: What progress do you point to with respect to treating mental health in the United States and what still needs work?
Mary Giliberti: In terms of progress, I think there is some increased recognition of mental health and substance use conditions as real health conditions, and the need for mental health to be addressed as part of the overall health care system. That includes federal parity requirements in health insurance—including plans offered through state health insurance marketplaces, Medicaid expansion plans and in private insurance—and efforts to coordinate mental health and physical health care, such as incentives and expectations outlined in the Affordable Care Act (ACA). Some examples of this include:
- Incentives for community mental health centers to improve capacity to treat individuals in their care holistically and via integrated care. This latter point is being supported through the distribution of demonstration grants offered as part of the ACA.
- Creative use of technologies, including tele-mental health and future potential through health information technology innovations.
- The evidence of some communities working hard to align and better coordinate systems, including criminal justice solutions.
Other examples of progress include continued development of community-based services, such as adding peers and families as part of the treatment system.
Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. Today, Jeffrey Levi, PhD, Executive Director of Trust for America’s Health (TFAH), writes about the importance of identifying and implementing policies and practices that can benefit health across all populations.
I go to countless meetings where people debate the meaning of “population health”—often for hours and with no resolution.
What’s become clear to me is that no matter what perspective we’re coming from, our actual goal for population health is the same. We want to improve the health of Americans.
But, at the end of day, the problem may be that the hang up on a clear definition is getting in the way of solving one of the health system’s most pressing problems: How do we get the different silos of the system to work better together and improve health inside and outside the doctor’s office?
Because this is so vital, the Robert Wood Johnson Foundation has supported an upcoming National Forum on Hospitals, Health Systems and Population Health, which will go beyond semantics to specifically identify policies and practices that can benefit health, no matter what population you’re talking about. Some of the below examples will be highlighted at the National Forum.
Hennepin Health, a Social Accountable Care Organization (ACO)
When Minnesota expanded Medicaid to a poor, childless adult population in Hennepin County, the relevant parties formed a social ACO, called Hennepin Health. The ACO is comprised of Hennepin County Medical Center; NorthPoint Health and Wellness (a Federally Qualified Health Center); Metropolitan Health Plan; and the county’s Human Services and Public Health Department (including Health Care for the Homeless, the county’s Mental Health Center and other social services). The County has a global budget to spend annually, and the partners take on all the risk as they bill the plan per service and then, at the end of the year, split the gains or losses.
Hennepin Health serves more than 6,000 enrollees. Of this group, 45 percent have chemical dependencies, 42 percent have mental health needs, 32 percent have unstable housing and 30 percent suffer from at least two chronic diseases.
EBOLA UPDATE: First U.S. Case of Ebola Diagnosed in Dallas
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Centers for Disease Control and Prevention (CDC) has confirmed the first Ebola case to be diagnosed in the United States. The patient flew from Liberia—at the time not showing symptoms—and fell ill several days later, seeking treatment at Texas Health Presbyterian Hospital of Dallas. He was admitted on Sept. 28. The CDC is monitoring people he came in contact with and feels confident that the disease will not spread further. “Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” said CDC Director, Tom Frieden, MD, MPH. “While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.” Read more on Ebola.
FDA: New Recommendation to Protect Patients from Cybersecurity Risks
The U.S. Food and Drug Administration (FDA) is taking steps to ensure patient safety and security with the finalization of recommendations to medical device manufacturers for managing cybersecurity risks. Potential risks include malware infections on network-connected medical devices or computers, smartphones, and tablets used to access patient data; unsecured or uncontrolled distribution of passwords; failure to provide timely security software updates and patches to medical devices and networks; and security vulnerabilities in off-the-shelf software designed to prevent unauthorized access to the device or network. “There is no such thing as a threat-proof medical device,” said Suzanne Schwartz, MD, MBA, director of emergency preparedness/operations and medical countermeasures at the FDA’s Center for Devices and Radiological Health. “It is important for medical device manufacturers to remain vigilant about cybersecurity and to appropriately protect patients from those risks.” Read more on technology.
HUD: $112M in Grants to Protect Kids, Families from Lead-Based Paint and Other Housing Dangers
The U.S. Department of Health and Human Services (HHS) has awarded more than $112 million in grants to help protect children and families from the dangers of lead-based paint and other home health and safety hazards. The grants will go to 39 local and state government agencies and research institutions, helping almost 7,000 low-income homes while also supporting research to improve safety efforts. "Millions of families and children are seeing their hope for the future threatened by poor health simply because of where they live," noted Matthew E. Ammon, Acting Director of HUD's Office of Lead Hazard Control and Healthy Homes. "Every child deserves to grow up in a healthy home and yet far too many continue to be exposed to potentially dangerous lead and other health hazards in the home." Read more on housing.
Have a Story about Implementing the National Prevention Strategy? The Office of the Surgeon General Wants to Hear It
The National Prevention Strategy (NPS), a federal-level initiative coordinated by the Office of the Surgeon General (OSG), was launched three years ago with the goal of promoting prevention and improving the nation’s health by engaging all sectors, not just health care.
Communities across the country are hard at work integrating different sectors in the joint purpose. For example, transportation agencies and senior health agencies are working to improve travel logistics for seniors who have different needs and schedules than the average commuter. The benefits for seniors can be many and huge, including engaging in social activities, recreation, timely visits to doctors, access to food shopping and greater independence.
In its 2014 required annual status report to the president and Congress on the progress of implementing the National Prevention Strategy, the OSG shared for the first time stories—called Partner Implementation Models (PIMs)—about communities and organizations implementing the strategies. One PIM showcased the work of the Robert Wood Johnson Foundation (RWJF), including:
- In 2013, RWJF re-convened the Commission to Build a Healthier America—an interdisciplinary group of leaders in the public, nonprofit and private sectors originally brought together in 2008—to develop recommendations to reduce health disparities. The Commission’s January 2014 report references the National Prevention Strategy.
- RWJF’s County Health Rankings & Roadmaps show how health is influenced by where people live, learn, work and play. Counties are ranked using data on health behaviors; clinical care; the physical environment; and social and economic factors such as family and social support. In 2014, new measures related to housing, transit, access to mental health providers, injury-related deaths, food environment and exercise opportunities were added to the Rankings. All of these measures directly reinforce the priorities outlined in the National Prevention Strategy.
Another PIM was shared by the Henry Ford Health System (HFHS) in Detroit, Mich., the fifth-largest employer in the city, which launched Henry Ford LiveWell (HF LiveWell) to improve the health of HFHS employees, patients, and surrounding communities.