Category Archives: Prevention
This week, the National Prevention, Health Promotion, and Public Health Council (National Prevention Council) submitted its annual status report to the President and designated Congressional committees describing national progress in meeting specific prevention, health promotion and public health goals defined in the National Prevention Strategy first released three years ago. The National Prevention Strategy is required under the Patient Protection and Affordable Care Act and has the overarching goal of increasing the number of Americans who are healthy at every stage of life.
The goal of the annual report is to show how cabinet-level agencies are working across the federal government to incorporate health in diverse sectors—such as housing, transportation and education—to advance the National Prevention Strategy and influence the health of individuals, families and communities. The status report also highlights how private- and public-sector partners across the country are advancing the National Prevention Strategy in organizations ranging from health care systems to national foundations.
Federal agency highlights for the past twelve months include:
- Continued support for smoke-free housing by the U.S. Department of Health and Human Services
- Smoking cessation initiatives by the U.S. Department of Defense for its troops and their families
- Pedestrian safety promotion efforts from the U.S. Department of Transportation
- School-based healthy food initiatives from the U.S. Department of Education
The report also includes status updates from several partner organization promoting health and wellness, including the American Public Health Association; the Henry Ford Health System; the Delaware Department of Health and Social Services; and the Robert Wood Johnson Foundation. The health promotion efforts of these organizations over the last year includes the fifth annual release of the County Health Rankings, which shows how health is influenced by where we live, learn, work and play.
Read interviews and listen to podcasts with federal agency leaders about the National Prevention Strategy on NewPublicHealth.
A report from a White House Task Force on sexual assaults on campus several weeks ago found that one in five women have been attacked, but only about 12 percent of the attacks are ever reported, often because of a campus climate that places blame on women and sends messages to men that sexual attacks are manly. The task force is asking colleges and universities to survey their students about sexual assault and other “campus climate” issues, and to track assaults and enforcement of campus policies that govern such assaults.
One idea gaining traction for reducing sexual assaults is called bystander intervention, which not only trains individuals to find safe ways to help prevent assaults, but seeks to change the campus cultures that can condone attacks.
NewPublicHealth recently spoke with Dorothy Edwards, executive director of Green Dot etc., which provides training for high schools and colleges on bystander intervention.
NewPublicHealth: Where does the name Green Dot come from?
Dorothy Edwards: Well, two different ways. I started my career in the field in Texas and for whatever reason for Sexual Assault Awareness Month green was the color of the ribbons. What was more intentional was the “dots” piece. That came out of one of the challenges in mobilizing bystanders to prevention, which is that this issue feels so big. People have been hearing about it for decades and I think there’s a kind of resignation that has settled in. Because when you hear the same number over and over and programs come and programs go and it’s an issue this big, people can just feel that there’s nothing they can do about it. “I’m one person, I can’t change this.”
So, one of the original challenges when we were playing with this idea of bystander intervention and highlighting more the integral role of this kind of third character—apart from victim and perpetrator—was that we knew in order for it to be effective it wasn’t just about skill and knowledge, it was about giving people a sense of possibility, giving people a sense of manageability. And when you say the word dot, a dot is small. So instead of saying we’ve got to change the whole culture, we’ve got to change all college campuses, we’ve got to change sexual assault—which feels so big—we can say to people, gosh, all we need you to actually deal with is a single green dot, a single moment, a single choice. And suddenly something very big feels very small and manageable
May is stroke awareness month and a new infographic from the American Stroke Association wants everyone to know minutes count when a stroke hits. The campaign uses research published by the Association this year in the campaign infographic to let people know that for each minute shaved off stroke response in a hospital, patients get back days of healthy living.
The infographic includes the FAST warning signs and symptoms for stroke:
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call 911
>>Bonus Content: The American Stroke Association has a site full of patient education resources on stroke awareness and prevention, including a very effective PSA on body language to help teach the FAST warning signs of stroke. The association also previously created another infographic on the FAST warning signs.
NewPublicHealth continues its coverage of National Public Health Week with today’s theme—“Get Out Ahead” on prevention.
According to the American Public Health Association (APHA), seven in 10 deaths in the United States are related to preventable diseases such as obesity, diabetes, high blood pressure, heart disease and cancer. And while 75 percent of U.S. health care dollars are spent treating such diseases, only 3 percent of health care dollars go toward prevention.
The APHA says there are now more options than ever when it comes to preventive health measures and that public health and clinical health professionals must work collaboratively to help individuals identify and pursue the best preventative health options.
A strong way to help prevent disease and premature death is to add health observance dates such as National Breast Cancer Awareness Month and National HIV Testing Day to personal and community calendars.
Healthfinder.gov, a website from the U.S. Department of Health and Human Services, lists health observance days, weeks and months which can steer people toward information and resources. Health observances often include community screenings such as blood pressure and cholesterol checks, making it easy to have those tests on a weekend in your neighborhood. Those checks include resources guiding people to community care if tests show a potential health problem.
A critical observance in April is Alcoholism Awareness Month. Decades of data shows that drinking too much alcohol increases people’s risk of health-related injuries, violence, drowning, liver disease and some types of cancer.
Actions communities are taking in observance of Alcoholism Awareness Month include:
- Partnering with a local high school or youth organization to host an event about alcohol abuse prevention.
- Alcohol-free community block parties.
- Many local health clinics will offer free or low-cost screenings for alcohol abuse on National Alcohol Screening Day (April 11).
Many police stations are hosting Family Information Nights about the dangers of drinking and driving. Activities include special goggles that let kids and teens see how drinking can impact their vision behind the wheel.
Recently, we’ve been pleased to see increased engagement across a number of posts on NewPublicHealth, particularly from public health students. Reader comments have pointed a justly critical eye toward the way studies are often interpreted and presented. This level of conversation is critical to informing and bolstering NewPublicHealth’s coverage of public health news and issues.
We have compiled a handful of reader comments below, in an effort to continue the discussion.
- Readers shared their opinions on a survey showing that Hispanic adults are not confident in their understanding of insurance terms:
- “Although the concern of this study was the disparity between white literacy and non-white literacy, general focus should be placed on understanding for people in all racial categories. A lack of health literacy leads to many issues in health care, often resulting in ineffectiveness of care.” — Jessica H.
- “The study regarding the lack of understanding of key insurance terms is interesting because while it specifically shows low-literacy levels in Hispanics, it points to a larger problem in America. Relative to this study, literacy levels were highest in Whites and lowest in Hispanics. Overall, the literacy levels were universally low. This is a problem because being unable to understand insurance terms would lead to less effective use of the insurance, or no insurance at all.” — Michael
- Readers also questioned the validity of a study that found many parents support flu shots at school, based on concerns regarding data collection methods and information presentation biases:
- “Regarding the study that found that many parents support flu shots at school: The survey used in this study was given in English, but it was found that people most likely to agree to have their children vaccinated in a school setting included parents of uninsured children...If children are not insured, it usually means the parents are not insured and have jobs that do not provide health benefits. Immigrants usually work these kinds of jobs, and probably do not speak English well. So, if the survey was only given in English, this could influence the results of the study...” — Brittany
- “Surveys aren’t the best method of collecting data. Secondly, the convenience portion, which includes vaccine beliefs and or skipping past vaccines greatly contributed to the unwillingness to consent...And this would create a high stated consent rate, due to parental preferences based on location...Lastly, although the author wrote this study with intentions of public health official’s consideration to this topic I would be concerned since this study is the first to provide this information and does however contain many biases.” — Cora Neville
- “The article mentions that only parents who answered with a yes or not sure were asked follow up questions. If a parent answered no, was there a question that asked why they would not consent?...I think collecting data on those who declined the school-located vaccination would help future researchers find a way to get those parents who originally declined to consent.” — Shannen Mincey
- Many people in the public health field have publicly weighed in on the U.S. Food and Drug Administration’s proposed changes to food labels, including NewPublicHealth readers:
- I think some parts of this new regulation will be good for consumers while others will simply be a futile effort to help consumers eat better. For example, I believe adding “added sugars” to the label will be effective in identifying the bad sugar...One change that could be helpful for consumers would be to identify the types of fiber. Although the label includes total dietary fiber, this can be misleading to consumers who may not realize they are not getting nutritional value out of all of it.” — Jessica H.
- “Food labels need to be more understandable and consumer friendly. The Healthy People Campaign and health advocates, such as Michelle Obama want America to take responsibility for their health, yet the consumers have to dissect every food label to get a proper gauge of the nature of the food they’re consuming... On the same token, I think it is going to take a great deal of further research to determine what would be considered “better align[ed] with how much people really eat.’” — Vanessa Moses
Thank you to all our readers who have made their opinions known. Let’s keep these conversations going!
A recent report from the Institute of Medicine found that young athletes in the United States face a "culture of resistance" to reporting when they might have a concussion and to complying with treatment decisions. That culture can result in students heading back to school too quickly—when they should be resting their brains to prevent short- and long-term complications.
"The findings of our report justify the concerns about sports concussions in young people," said Robert Graham, chair of the committee and director of the national program office for Aligning Forces for Quality, at George Washington University, Washington, D.C. (Aligning Forces is a program of the Robert Wood Johnson Foundation.) "However,” says Graham, “there are numerous areas in which we need more and better data. Until we have that information, we urge parents, schools, athletic departments, and the public to examine carefully what we do know, as with any decision regarding risk, so they can make more informed decisions about young athletes playing sports."
Recently, Righttime Medical Care, a chain of urgent care centers in Maryland, opened a number of HeadFirst sports injury and concussion centers in the state, staffed with health professionals who can assess injuries for concussions as well as evaluate students for return to play—in consolation with a team of experts who work with HeadFirst staff. HeadFirst will this year be presenting and publishing data on the more than 10,000 youth it has examined and treated for concussion in just the past two years.
NewPublicHealth recently spoke with Robert Graw, MD, head of Righttime and HeadFirst, about the need for better prevention, evaluation and treatment of concussions to prevent long-term health problems and disability.
NewPublicHealth: Why did Righttime add concussion care to the services provided?
Robert Graw: My son is an orthopedic surgeon and talked to me about the number of injuries he was seeing. We decided a few years ago that we’d learn as much as we could about preventing head injury and the consequences of head injury, and then promote that information through Righttime’s call center and through the visits that people made to our sites.
In the process of learning as much as we could we realized that the knowledge base of how people evaluate and manage concussions had changed drastically in the last five years as people have done more research. So, we then gathered together a group of consultant physicians and neuropsychologists to determine best practices. We met with them frequently, and then had them train our provider staff so that all of them became much more informed about what a concussion really is, the best way to evaluate them and the guidelines for management going forward.
A new infographic from the Office of the U.S. Surgeon General highlights collaborations within the federal government and between the health and healthcare sectors to help improve prevention outreach. These efforts are part of the cross sector National Prevention Strategy launched by the office several years ago.
Current examples of collaboration include Million Hearts, an initiative of the U.S. Department of Health and Human Services to prevent one million heart attacks by 2017. The initiative includes a commitment by close to 150 large private medical practices in the United States to get hypertension control rates above 80 percent in their communities.
You can also view the fully interactive infographic here.
>>Bonus Link: Read interviews and listen to podcasts about the National Prevention Strategy conducted with former and current U.S. Cabinet Secretaries and agency heads.
IOM Report: More Evidence-Based Practices Needed to Help Treat and Prevent Psychological Disorders among Service Members and Families
Between 2000 and 2011, almost 1 million service members or former service members were diagnosed with at least one psychological disorder either during or after deployment, according to recent research by the Institute of Medicine (IOM). As a follow up, the U.S. Department of Defense (DOD) asked the IOM to evaluate the department’s efforts to prevent psychological disorders among active-duty service members and their families. That report was recently released.
The report includes recommendations on how the DOD can improve care.
Finding 1: DOD has implemented numerous resilience and prevention programs for service members and their families, but it faces a number of challenges, including an insufficient evidence base to support its interventions and a lack of systematic evaluation and performance measures.
Recommendation 1: By targeting resources to develop the evidence base and disseminate that evidence, DOD’s prevention efforts can be both more effective and cost effective.
Finding 2: There is a need for DOD to improve approaches for identifying and intervening with service members and their members who may already have or may be at risk for developing a psychological disorder.
Recommendation 2: DOD should dedicate funding, staffing and logistical support for data analysis and evaluation to support performance monitoring of programs for accountability and continuous improvement.
Finding 3: Screening, assessment and treatment approaches for psychological health problems are not always implemented between and within the DOD and the U.S. Department of Veterans Affairs (VA) in a consistent manner or aligned with the evidence base, which threatens the delivery of high-quality care and hampers evaluation efforts.
- There are opportunities to improve processes of training and evaluating clinicians, including the incorporation of continuing education and supervision; standardized periodic evaluation; and a greater emphasis on coordination and interdisciplinarity.
- The DOD and VA should invest in research to determine the efficacy of treatments that do not have a strong evidence base.
- Both departments should conduct systematic assessments to determine whether screening and treatment interventions are being implemented according to clinical guidelines and departmental policy.
- Accessible inter-department data systems should be developed to assess treatment outcomes, variations among treatment facilities and barriers to the use of evidence-based treatment.
- Read the complete report.
- Read a NewPublicHealth interview with Jonathan Woodson, MD, Assistant Secretary of Defense for Health Affairs about the National Prevention Strategy.
- Learn more about the state of mental health in the military from this infographic from the American Psychiatric Association embedded below.
While it has been decades since polio was a critical threat for much of the developed world, the disease—a virus that can spread from person to person and affect the brain and spinal cord with the potential for paralysis—still causes disease and death in the developing world. Earlier this year cases were reported in Syria, while in Israel the polio virus was found in soil likely from human waste infected with the disease, prompting a revaccination campaign among children age 5 and under. Polio has continued to spread in Afghanistan, Nigeria and Pakistan, and has been reintroduced and continues to spread in Chad and in the Horn of Africa after the spread of the virus was previously stopped. Other countries have seen small numbers of cases recently after no cases for decades.
Because even a small spread of the disease could reach the United States if infected individuals carry the virus here, the U.S. Centers for Disease Control and Prevention (CDC) several years ago made polio one focus of their Emergency Operations Center. CDC staff work with the World Health Organization and foreign health departments on vaccination campaigns aimed at fully eradicating the disease.
>>Bonus Content: View the CDC's infographic, "The Time to Eradicate Polio is Now."
NewPublicHealth spoke recently with Sona Bari, senior communications officer at the World Health Organization about the efforts underway to eradicate polio globally.
NPH: How are you able to detect polio outbreaks?
Sona Bari: We have a global surveillance system for polio and know from it that since 1988 the reduction of the disease has been over 99 percent. Polio is now endemic, which means indigenous polio virus transmission has never been stopped in parts of three countries: Nigeria, Afghanistan and Pakistan. So the surveillance is important because you can get polio down to very low levels like you do now, but it can reemerge. To completely eradicate polio you have to have an effective intervention, which is largely by vaccination. And you can be bring polio under very tight control by massive vaccination, but the virus is very good at finding children who are unvaccinated or under-vaccinated, and in Nigeria, Afghanistan and Pakistan we still have large groups of unvaccinated children. So the reason that polio transmission has not been stopped in these areas is that not enough children are vaccinated.
NPH: Why is there insufficient vaccination in those countries?
Bari: The basic reason is the quality of vaccination activities. Do these countries have decent health systems—strong routine immunization systems where children are regularly taken to a medical facility for their immunizations? When there are mass vaccination campaigns, are we reaching all children? Then there are, on top of that, layers of political complexities. In one part of Pakistan, for example, there is a ban on polio vaccinations by the local warlords. So there are access and security issues, layered on top of the difficultly of reaching all who need vaccines in countries such as Nigeria or Pakistan. That said, we know that these circumstances are not unique. They may differ from country to country, and each country does have a unique combination of the obstacles, but polio has been eradicated in countries that are far poorer than Nigeria or Pakistan, that have had worse conflict and that have perhaps much worse health systems. So it can be done.
New reports from the U.S. Centers for Disease Control and Prevention (CDC) show that 39 percent of adults and 41 percent of children six months and older got their flu shots for the 2013-2014 season by early November—a rate similar to flu vaccination coverage last season at the same time.
Other flu shot statistics of note this year include:
- Vaccination among pregnant women (41 percent) and health care providers (63 percent) is about the same as it was this time last year
- High rates were seen again this year among health care providers including pharmacists (90 percent), physicians (84 percent) and nurses (79 percent), but the CDC reported much lower vaccination rates among assistants or aides (49 percent) and health care providers working in long-term care facilities (53 percent)
“We are happy that annual flu vaccination is becoming a habit for many people, but there is still much room for improvement,” says Anne Schuchat, MD, director of the National Center for Immunization and Respiratory Diseases at CDC. “The bottom line is that influenza can cause a tremendous amount of illness and can be severe. Even when our flu vaccines are not as effective as we want them to be, they can reduce flu illnesses, doctors' visits, and flu-related hospitalizations and deaths.”
Seasonal influenza activity is increasing in parts of the United States. Further increases in influenza activity across the country are expected in the coming weeks. “If you have not gotten your flu vaccine yet this season, you should get one now,” said Schuchat.
The CDC’s report comes just ahead of the observance next week of National Influenza Vaccination Week (NIVW), which is scheduled each year for the second week in December because vaccination rates tend to fall off toward the end of November. It’s hardly too late to get the flu vaccine: flu season usually peaks January through March, and the virus—and the potential to catch it—often lasts as late as May.
People who haven’t had the flu shot should make it a priority to do so as soon as possible for at least two reasons. One, providers tend to return their unused vaccines toward the end of the year, which can make it hard to find a vaccine if you still need the shot (check this flu vaccine finder for providers in your area, and call ahead to be sure they have supplies on hand). Two, it takes two weeks for the flu vaccine to take full effect, so the sooner you get it the more protected you are against people harboring the flu during the upcoming holiday party season.
Still on the sidelines about getting the shot? The CDC has some impressive numbers from last year’s flu season: flu vaccination prevented an estimated 6.6 million influenza-associated illnesses and 79,000 hospitalizations during the 2012-2013 flu season.
>>Bonus Links: Learn more about preventing and treating influenza on NewPublicHealth.
>>Bonus Content: CDC's infographic on the benefits of the flu vaccine (full size PDF).