Ebola Patient from Sierra Leone Dies of Virus in U.S.
A doctor from Sierra Leone who arrived in the United States on Saturday for treatment for Ebola has died. The doctor was taken to the Nebraska Medical Center in Omaha, one of four U.S. hospitals with specialized units prepared to treat patients with the virus. News reports say the physician may have been sicker than other patients treated for Ebola so far in the United States. Read more on Ebola.
Disparities in Treating Black Children for Ear Infections Actually Results in Treatment that Meets Guidelines
Black children are less likely to be diagnosed with ear infections and less likely to receive broad-spectrum antibiotics for ear infections than are white children, according to a new study in the journal Pediatrics. But the discrepancy in prescribing fewer broad-spectrum antibiotics means black children actually are more likely to receive care in line with recommended guidelines for treating ear infections. Read more on prescription drugs.
Secondhand Marijuana Smoke May Damage Blood Vessels as Much as Tobacco Smoke
Breathing secondhand marijuana smoke could damage heart and blood vessels as much as secondhand cigarette smoke, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2014 meeting this week in Dallas. In the study, blood vessel function in lab rats dropped 70 percent after 30 minutes of exposure to secondhand marijuana smoke. Even when the marijuana contained no tetrahydrocannabinol (THC)—a compound in marijuana that produces intoxication—blood vessel function was still impaired. Reduced blood vessel function may raise the chances of developing atherosclerosis and could lead to a heart attack. “Most people know secondhand cigarette smoke is bad for you, but many don’t realize that secondhand marijuana smoke may also be harmful,” said Matthew Springer, PhD, senior author of the study and cardiovascular researcher and associate professor of Medicine at the University of California, San Francisco’s Cardiology Division. Read more on environment.
The American Public Health Association (APHA) annual meeting begins next week in New Orleans, the first return to the area for the 15,000-strong meeting since Hurricane Katrina nine years ago. This year’s theme is Healthography, or, as APHA Executive Director Georges Benjamin, MD, recently said, “where you live matters.”
Earlier this week, Benjamin spoke with NewPublicHealth about key issues and presentations for this year’s meeting. The following interview has been lightly edited for clarity and length.
NewPublicHealth: “Healthography”—what is it and why is important especially right now?
Georges Benjamin: We know for sure that place matters, and I think New Orleans is an excellent example of that truth. It’s a wonderful city, but certainly has had huge health challenges. In our annual America’s Health Rankings survey that we do with the United Health Foundation and Partnership for Prevention, Louisiana consistently ranks as one of the lowest states in the nation for health. When you also consider the environmental tragedies that the state had—two storms in short succession and then the Gulf oil spill—the challenges of place and health become especially clear.
So the concept of the geography in which you live and your health is taking center stage as we head to New Orleans. As just one example, our opening session speaker, Isabel Wilkerson, wrote the book “The Warmth of Other Suns,” which deals with the great migration of Americans who moved from one place to another to try to achieve a better life.
NPH: What are some of the other highlights of this year’s meeting?
Benjamin: We’ve got the acting U.S. Surgeon General coming, Dr.Boris Lushniak, and he is going to talk a great deal about health and place. He’s an amazing speaker around the issues of place-based health, how we build our communities and things that we can do to make the healthy choice the easy choice.
In addition, Risa Lavizzo-Mourey, the president and CEO of the Robert Wood Johnson Foundation, will be the keynote speaker for the closing session on Wednesday, where she will talk about the foundation’s new Culture of Health and how they are playing a leading role in building a future where every American has the opportunity to live the healthiest life possible, regardless of where they live.
As RWJF clearly knows, when you design things, you get exactly what you design, and we’ve designed an environment and a culture around health that creates an unhealthy environment. So, if we redesign that culture to improve our health, we can make a big difference.
NPH: Why is building a Culture of Health so important?
Benjamin: Most people living in the United States are not as healthy as they can be, and so APHA believes that we need to build a movement to be the healthiest nation, and we think we can do that in a generation. So, this meeting is the first component of our new strategic direction which aligns very closely with RWJF’s strategic direction.
Our goal is for the United States to be number one and not be number 36 in terms of quality of our health. We think there’s an opportunity to do that through the kind of things that APHA does with education, policy development, legislative advocacy, and building grass roots and grass tops movements to get us there.
More than 1 in 5 High School Students Currently Uses Tobacco
Almost 23 percent of high school students currently use a tobacco product, according to new data published by the Centers for Disease Control and Prevention (CDC.) “Nine out of ten smokers tried their first cigarette by age 18,” said Tim McAfee, MD, MPH, director of the CDC’s Office on Smoking and Health. “We must do more to prevent our youth from using tobacco products, or we will see millions of them suffer and die prematurely as adults. Fully implementing proven tobacco control programs would help keep our youth from falling victim to tobacco.” A review by CDC researchers of the agency’s National Youth Tobacco Survey (NYTS) found that in 2013, 22.9 percent of high school students and 6.5 percent of middle school students reported using a tobacco product within the last 30 days and nearly half of all high school students and 17.7 percent of middle school students said they had used a tobacco product at least once in their lifetime. The survey also found that 12.6 percent of high school students say they currently use two or more tobacco products. The researchers found that most young adults who use tobacco believe they will be able to quit, but about three out of four high school smokers continue smoking into adulthood. Read more on tobacco.
Climate Change Expected to Increase Airborne Allergens
Results of a new study by researchers at the University of Massachusetts Amherst strongly suggest that there will be increases in grass pollen production and allergen exposure up to 202 percent in the next 100 years, leading to a significant, worldwide impact on human health because of predicted rises in carbon dioxide. The researchers exposed grass plants to different atmospheric gas concentrations and found that high levels of carbon dioxide increased pollen production per flower by 53 percent. Read more on environment.
Many Asthma Patients Would Like to Talk to Their Doctors about Cost Concerns
Asthma patients concerned about their ability to pay for medical care would like to talk about cost-related concerns with their physicians—but often do not get that opportunity, according to a new study by researchers at the University of Michigan School of Public Health. The study, published in the Annals of the American Thoracic Society, found that less than half of patients who expressed a preference for such discussions with their doctors reported having the conversations. “Financial burden from out-of-pocket health care expenses poses significant safety concerns and risk of poor outcomes to patients and society when patients utilize risky strategies, such as non-adherence, to address these burdens,” said Minal Patel, MD, U-M assistant professor of health behavior and health education and the lead author of the study. “Patients need to communicate with health care providers in order to access affordable options such as free samples, verification to access community assistance programs, and [a prescription change] or to adjust treatment recommendations.” Read more on access to health care.
Yesterday saw the launch of the BUILD Health Challenge, a national award program to create and improve partnerships among health systems, community-based organizations and local health departments with an aim of addressing upstream problems that impact the health of local residents.
On a webinar to announce the challenge yesterday, representatives of the founding partners of the challenge said they were embracing the challenge because “transforming health outcomes requires a coordinated effort to tackle such contributing factors as socio-economic conditions, transportation, housing, environmental issues and access to healthy food.” The evidence base underpinning the new initiative shows that partnerships among health systems, public health agencies and community organizations are the most effective ways to work toward that transformation.
The BUILD Health Challenge will award up to $7.5 million in both financial awards and low-interest loans over two years to support up to 14 community-driven efforts that take Bold, Upstream, Integrated, Local and Data-driven approaches to improving community health and promoting health equity.
>> Bonus Link: Read an FAQ about the Build Health Challenge.
More than 5,000 Lives Lost to Ebola So Far
Ebola has now killed at least 5,160 people and infected at least 14,098, mostly in West Africa, since the outbreak started last spring, according to the World Health Organization. New cases have increased sharply in Sierra Leone, while the incidence of new cases is declining in Guinea and Liberia. Read more on Ebola.
Seniors Need Resources Beyond the Internet for Health Information
Seniors are less likely than others to search for health informtion on the Internet, making it necessary for health providers to provide other health information resources, according to a new study in the Journal of General Internal Medicine. The study found that while huge amounts of money and attention have been invested recently in health information technology in the United States—for example, by providing electronic medical records online—it’s unclear whether older patients are willing and able to use those for personal and general health information. The researchers analyzed data from the 2009 and 2010 Health and Retirement Study, a nationally representative survey of more than 20,000 Americans 65 years and older. About 1,400 of the participants were asked how often they used the Internet in general and, in particular, how often they searched for health and medical information. Just over thirty percent used the Internet regularly and only 9.7 percent identified as having low health literacy used the internet at all. Read more on health literacy.
Predicting Which U.S. Soldiers Could Predict Suicide
A study that looked at predicting suicides in U.S. soldiers after hospitalization for a psychiatric disorder suggests that nearly 53 percent of post-hospital suicides occurred following the 5 percent of hospitalizations with the highest predicted suicide risk. The study, in JAMA Psychiatry, finds that the suicide rate in the U.S. Army has increased since 2004 and now exceeds the rate among civilians, and that a predictive model would help prevent some of the military suicides. The strongest predictors for suicide in this group include being male, late-age of enlistment, criminal offenses, weapons possession, prior suicidality, the number of antidepressant prescriptions filled in the previous year and psychiatric disorders diagnosed during the hospitalizations. Read more on mental health.
Last week the March of Dimes releases its annual Premature Birth report card and gave a “C” grade to the United States. While the U.S. rate has seen improvement in recent years and rates of premature birth—which can cause death and lifelong disability—have dropped, the organization says there is still much room for improvement. With World Prematurity Day next week, NewPublicHealth recently spoke with Jennifer L. Howse, PhD, president of the March of Dimes, about the new report card and new efforts by the organization to study premature birth and vastly reduce the U.S. rates further.
NewPublicHealth: What’s most significant about the 2014 report card?
Jennifer Howse: The 2014 report card on premature birth in the United States shows continued improvement. In fact, rates of pre-term birth in the United States have improved. That is they’ve lowered every year for the last seven years and that means that the United States currently has a pre-term birth rate of 11.4 percent, and that rate of pre-term birth is the lowest that it’s been in the in the last 17 years. So we’re very pleased. Having said that, the United States is still short of the target set by the March of Dimes of 9.6 percent or less. Our state-by-state report card assigns a letter grade to the U.S. composite and then to each state up against that goal of 9.6 percent. So, the United States has a “C” overall, but we continue to see progress and improvements—incremental, but progress in far and away the majority of states. So it’s very important around this critical child health issue to set a target, measure the target, and to hold states and the nation accountable.
NPH: What are the things that March of Dimes is doing, has done and will continue to do that are helping that rate?
Howse: The March of Dimes has mobilized a very strong group of partners in this campaign to end premature birth. We have assembled very strong partnerships with clinicians, with state health officials, with hospital leadership, with governmental leaders—particularly in the area of Medicaid programs—and those partnerships have been activated and expanded over the last decade. Specifically, the March of Dimes has led the charge on a quality improvement program across the nation to reduce and eliminate elective induction and C-section before 39 weeks of completed gestation. That’s the QI 39 program, and now two-thirds of hospitals are showing positive results in that arena.
Study Questions Long Term Success of Some Popular Diets
A new study published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, suggests that popular commercial diets can help people lose some weight in the short term, but keeping the weight off after the first year and the diet’s impact on heart health are unclear. “Despite their popularity and important contributions to the multi-million dollar weight loss industry, we still do not know if these diets are effective to help people lose weight and decrease their risk factors for heart disease,” said Mark J. Eisenberg, MD, MPH, the study’s senior author and Professor of Medicine at Jewish General Hospital/McGill University in Montreal, Quebec, Canada. “With such a small number of trials looking at each diet and their somewhat conflicting results, there is only modest evidence that using these diets is beneficial in the long-term.”
The longest diet studies researchers analyzed lasted for two years, and results were only available for the Atkins or Weight Watchers diets. Those studies found dieters regained some of their weight over time. To better understand the potential benefits from any one or all of these diets, researchers need to conduct large clinical trials directly comparing all four popular diets for long-term weight loss and changes in other heart disease risk factors, said Eisenberg. Read more on obesity.
Bilingual Brains Better Equipped to Process Information
Speaking more than one language is good for the brain, according to new research in the journal Brain and Language that indicates bilingual speakers process information more efficiently and more easily than do those who know a single language. The benefits occur because the bilingual brain is constantly activating both languages and choosing which language to use and which to ignore, said Northwestern University's Viorica Marian, the lead author of the research and a professor in the department of communication sciences and disorders in the School of Communication. When the brain is constantly exercised in this way, it doesn't have to work as hard to perform cognitive tasks, the researchers found. "It's like a stop light," Marian said. "Bilinguals are always giving the green light to one language and red to another. When you have to do that all the time, you get really good at inhibiting the words you don't need." Read more on education.
Alzheimer's-Related Costs Expected to Soar in Coming Decades
Health policy researchers at the University of Southern California have used modeling that incorporates trends in health, health care costs, education and demographics to determine that models show that the number of people expected to be diagnosed with Alzheimer’s disease will soar in the next three decades.
- From 2010 to 2050, the number of individuals aged 70+ with Alzheimer's will increase by 153 percent, from 3.6 to 9.1 million.
- Annual per-person costs of the disease were $71,000 in 2010, which is expected to double by 2050.
- Medicare and Medicaid currently bear 75 percent of the costs of the disease.
"Alzheimer's disease is a progressive disease with symptoms that gradually worsen over time. People don't get better," said Julie Zissimopoulos, lead author of the study and an assistant professor at the USC Price School of Public Policy. "It is so expensive because individuals with Alzheimer's disease need extensive help with daily activities provided by paid caregivers or by family members who may be taking time off of work to care for them, which has a double impact on the economy.” Read more on aging.
In recent years, the state of New Jersey has found itself at the center of high-profile emergencies and public health scares—from the disaster wrought by Superstorm Sandy in 2012 to a controversial plan in recent weeks to quarantine individuals identified as at risk for contracting Ebola. As the 11th-most populous state—and a major hub of international travel and commerce—New Jersey’s public health leadership serves as a case study for the nation.
NewPublicHealth recently spoke with New Jersey Health Commissioner Mary O’Dowd. She has been sharing New Jersey’s preparedness and recovery lessons nationally as a member of the preparedness policy committee of the Association of State and Territorial Health Officials and implementing them as the state addresses potential exposure to Ebola in returning volunteers.
NewPublicHealth: Looking back, what worked well in the health department’s response before, during and after Sandy?
Mary O’Dowd: I think one of the things that really worked well in that immediate response phase was that we employed our lessons learned from Hurricane Irene the year before, in 2011. For example, we used the Emergency Management Assistance Compact, which is an agreement among states to assist each other in times of crisis or emergency, and we specifically used it to bring additional ambulances into New Jersey for our EMS system to enhance our capability, but we didn’t make the request until after the storm. So for the first day or two, we didn’t have the resources on hand.
We learned from that shortfall. The next year, before Sandy made its way to New Jersey, we had already put out the request via the EMAC system and had ambulances from Indiana on the ground before the storm hit. And that was really critical in our ability to immediately respond in particular with Sandy, because with the flooding we had several areas of the state where ambulances actually were flooded out and were no longer available for us. We were very lucky that we had learned that lesson from the year before.
American College of Preventive Medicine Releases Recommendations to Curb Texting While Driving
The American College of Preventive Medicine (ACPM) has released guidelines aimed at reducing death and injuries linked to texting while driving. According to the National Highway Traffic Safety Administration, 12 percent of all fatal crashes involving at least one distracted driver are estimated to be related to cell phone use while driving. “Given the combination of visual, manual and cognitive distractions posed by texting, this is an issue of major public health concern for communities,” the ACPM said it its statement. The guidelines include:
- Encourage state legislatures to develop and pass legislation banning texting while driving, while simultaneously implementing comprehensive and dedicated law enforcement strategies, including penalties for these violations.
- Legislatures should establish a public awareness campaign regarding the dangers of texting while driving as an integral part of this legislation.
- Promote further research into the design and evaluation of educational tools regarding texting while driving that can be incorporated into the issuance of driver’s licenses.
- Provide primary care providers with the appropriate tools to educate patients of all ages.
- Conduct additional studies investigating the risks associated with cell phone usage while driving—particularly texting—with motor vehicle crashes.
Read more on injury prevention.
Skin Cancer Costs Rise
The costs associated with skin cancer increased five times as fast as treatments for other cancers between 2002 and 2011, according to a study by researchers at the U.S. Centers for Disease Control and Prevention (CDC) and published in the American Journal of Preventive Medicine. The average annual cost for skin cancer treatment increased from $3.6 billion during 2002-2006 to $8.1 billion during 2007-2011, or 126 percent. The average annual cost for treatment of all other cancers increased by 25 percent during the same time period. “The findings raise the alarm that not only is skin cancer a growing problem in the United States, but the costs for treating it are skyrocketing relative to other cancers,” said the lead author of the report, Gery Guy, PhD, of the CDC’s Division of Cancer Prevention and Control. “This also underscores the importance of skin cancer prevention efforts.” Read more on cancer.
Childhood Obesity Often Continues into Teen Years
A new study published in the journal Pediatrics reviewed data on close to 4,000 public school students who were measured for height and weight in 5th and 10th grades. In 5th grade, one percent of students were underweight, 53 percent were normal weight, 19 percent were overweight and 26 percent were obese. Sixty-five percent of obese 5th-graders remained obese in 10th grade, 23 percent transitioned down to overweight and only 12 percent became normal weight. The study found that obese 5th graders were more likely to remain obese in 10th grade if they perceived themselves to be much heavier than ideal or came from a less-educated household. However, overweight 5th-graders were more likely to become obese by 10th grade if they had an obese parent or watched more television. The study authors say obese children face many challenges in reducing obesity in adolescence and that health care professionals should be encouraged to educate parents and caregivers to address obesity at a very young age, including advice on healthy eating and physical activity. Read more on childhood obesity.
A national survey conducted in late October by the Harris Poll found that 49 percent of Americans see Ebola as a "moderate" or "major" public health threat to Americans. That’s down from 55 percent in a Harris poll conducted just a few weeks earlier. Experts at the World Health Organization worry that no new cases in the United States will negatively impact the country’s support for the funds and volunteers needed to help stem the outbreak still raging in several West African countries.
Today, the New York Times published the stories of two young boys in Liberia—one who survived the virus, and one who did not. Physicians still do not have accurate methods for predicting who will survive—and what treatment it takes to get them there—so for now the course of the disease, despite best available efforts, simply seems random.
Read the New York Times story.