Category Archives: Disease Prevention and Health Promotion
U.S. public health officials have continually said that it is highly unlikely that the Ebola virus will spread in the United States, even if infected travelers land here. Officials at the U.S. Centers for Disease Control and Prevention (CDC) say that the disease is most contagious when people come into contact with the bodily fluids of someone who is ill—and someone that ill would be very likely be identified by border and airline personnel quickly. If hospital admission became necessary, U.S. infection control procedures could stem an outbreak, according to Tom Frieden, MD, the CDC’s director and the point person for the U.S. government on the current Ebola outbreak. Frieden has discussed the issue repeatedly during several news conferences in the last few weeks.
Of course, that changes if the virus becomes transmissible through the air, rather than just via bodily fluids, as Michael T. Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, suggested in the New York Times last week. While Osterholm often addresses the direst potential outcomes of infectious disease outbreaks, it’s prudent to at least know what to do, which is why agencies such as the CDC and the Network for Public Health Law say what’s needed is information and procedures...but not panic.
Last month, the Network held an online webinar on preparedness measures and Ebola which was watched by more than 1,200 public health officials. Following the webinar, Network experts posted answers to follow-up questions, including one about the right of public health or hospital workers to refuse to care for/help with someone suspected of having Ebola.
The Network also recently created an online primer on preparedness and legal issues surrounding the Ebola outbreak, both for public health officials engaged in the response overseas and for those with current or future responsibility for handling Ebola-related issues in the United States.
>>Bonus Link: Richard Besser, MD, now the chief health editor for ABC News, was formerly the CDC’s head of disaster response and led the early response to the H1N1 outbreak in the United States several years ago. In a recent opinion piece for the Washington Post, Besser laid out what’s being accomplished and what still needs to be done to stem the Ebola outbreak in West Africa.
Frontline, the Public Broadcasting Service documentary series, has a unique football stats blog, Concussion Watch, which is now in its third year. The blog tallies—game by game—the number of National Football League (NFL) players sidelined by a possible concussion and how soon they return to play.
Based on tracking for the last two years, the blog predicts that 150 players will suffer concussions during the current season, which in many cases could lead to lifetime debilitating problems. This is despite new playing rules and ever-evolving helmets.
The impact of concussions on the players’ heath and lives is startling. Based on Concussion Watch data, 306 players have suffered a combined 323 concussions over the past two seasons. In half of the cases where a concussion occurs, players return to the field without having missed a single game. According to the blog, although there’s no standard recovery time for a diagnosed concussion, guidelines developed by the American Academy of Neurology and endorsed by the NFL Players Association indicate that athletes are at the greatest risk for repeat injury in the first 10 days after a concussion. And the more head injuries a person suffers, the more likely they may be to develop complications later on.
In fact, the NFL is due a decision by mid-October from thousands of league retirees on whether they will accept a proposed settlement in a class-action concussion case brought by more than 4,500 former players. Papers filed in the case show that the NFL expects more than thirty percent of all retired players to develop some form of long-term cognitive problem—such as Alzheimer’s disease or dementia—in their lifetime as a result of head injuries suffered during games. During the preseason and the first week of official play, 15 players suffered head injuries and 12 have already returned to their positions.
Following the Announcement of New Antibiotic Resistance Initiative, Advocates Call for Increased Emphasis on Prevention in Livestock
Despite growing awareness of the dangers, antibiotic resistance continues to sicken two million Americans and kill 23,000 each year, according to a 2013 report from the U.S. Centers for Disease Control and Prevention. Late last week the Obama administration announced a series of efforts targeting the public health issue. Among them:
- A Cabinet-level task force to create a national action plan on antibiotic resistance
- Improved federal oversight of antibiotic use in the United States, including better tracking of outbreaks
- Incentives for developing new generations of antibiotics aimed at treating currently resistant microbes
- A $20-million prize for the development of a rapid diagnostic laboratory test that doctors can use to identify highly resistant bacterial infections
Many in the public health field are quick to note that more should be done to address a key source of antibiotic resistance—widespread use of antibiotics to prevent infection and promote growth in livestock. There have been concerns that, in addition to over-prescription by physicians overuse, of the antibiotics in farm animals has also contributed to the growing trend of antibiotic resistance. A recent study found that livestock workers can harbor resistant bacteria acquired on the job and introduce it into the community.
Ed Silverman, who writes the Pharmalot blog for the Wall Street Journal, said that an administration report calls for the U.S. Food and Drug Administration (FDA), the U.S. Department of Agriculture, the National Science Foundation and the U.S. Department of Homeland Security to work together to develop an analytic model to assess the relationship between antibiotic use in livestock and the development of antibiotic resistance. The FDA currently has voluntary guidelines for livestock producers on limiting antibiotic use that go into effect in 2016, but advocates had hoped for an actual ban.
>>Bonus Link: The Association for Professionals in Infection Control and Epidemiology (APIC) has released a useful infographic for public health professionals and physicians to share with consumers about their roles in preventing antibiotic resistance.
Faces of Public Health: Q&A with Andrea Gielen, the Johns Hopkins Center for Injury Research and Policy
The U.S. Centers for Disease Control and Prevention (CDC) recently awarded $4 million to the Johns Hopkins Center for Injury Research and Policy at the Bloomberg School of Public Health to further fund its work on injury prevention research and policy development. According to the CDC, injuries are the leading cause of death in the United States among people ages 1 to 44, costing the country $406 billion each year. And across the globe, 16,000 people die from largely preventable injuries every day.
“This funding will allow us to advance our work in closing the gap between research and practice in new and innovative ways,” said Andrea Gielen, ScD, ScM, the center’s director. “Whether fatal or non-fatal, injuries take an enormous toll on communities. Our faculty, staff and students are dedicated to preventing injuries and ameliorating their effects through better design of products and environments, more effective policies, increased education and improved treatment.”
The five-year grant will support several innovative research projects on key issues, including evaluating motor vehicle ignition interlock laws, studying universal bicycle helmet policies, testing m-Health tools to reduce prescription drug overdose and evaluating programs to prevent falls among older adults. The center will also continue to offer training and education to public health students and practitioners, as well as to new audiences that can contribute to injury prevention.
NewPublicHealth recently spoke with Gielen about the CDC grant
NewPublicHealth: What are the goals for each of the four research areas for which you’ve received funding?
Andrea Gielen: Each of the four is a full research projects with specific aims. For example, with ignition interlock laws—which are car ignitions that can’t start unless a breathalyzer confirms that a driver is sober—there’s been a little bit of evidence that they reduce alcohol-related motor vehicle crash injuries and deaths, but there are two gaps. There has never been a national study of the impact of these laws, and we don’t know a whole lot about how they’re implemented. What is it about ignition interlock policies and how they’re implemented that’s really related to their impact on reducing fatal crashes?
We want to look at all four projects in the same way: We’ll be looking at barriers and facilitators to how policies that we think are effective are adopted and implemented, and what it is about that adoption and implementation of the processes that make these policies effective.
Mandatory Policies Increase Flu Shot Rates for Health Care Workers
Hospitals can improve their flu vaccination rate among health care workers by using a mandatory employee vaccination policy, according to a study by researchers at the Henry Ford Health System in Detroit. At Henry Ford, getting the flu shot is a condition of employment and the health system now has a 99 percent compliance rate. Nationally, only 63 percent of health care workers were immunized against the flu in the past two years, according to the Centers for Disease Control and Prevention, which poses a risk to patients. The study was presented this weekend at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Washington D.C.
Before making flu vaccination mandatory, the vaccination rate at Henry Ford was between 41 percent and 55 percent. An increasing number of health systems are making flu shots mandatory for employees. At Henry Ford, employees can opt out for religious or medical reasons so long as they have documentation from clergy or a physician and then must take other precautions against the flu, such as wearing a mask when caring for patients.
Many doctors’ offices, pharmacies and clinics already have the flu shot on hand for the upcoming flu season. The HealthMap flu shot locator has been updated for the 2014-2015 flu season.
Read more on the flu.
Study: Alcohol Ad Reminders to “Drink Responsibly” Promote Drinking
A new study by researchers at the Johns Hopkins School of Public Health finds that magazine ads from the alcohol industry that advise readers to “drink responsibly” or “enjoy in moderation” fail to convey important information about dangers associated with alcohol consumption.
The study, published in Drug and Alcohol Dependence, analyzed all alcohol ads that appeared in U.S. magazines from 2008 to 2010 to determine whether messages about responsibility define responsible drinking or provide clear warnings about the risks associated with alcohol consumption.
According to the study, 87 percent of the ads analyzed included a responsibility message, but none actually defined responsible drinking or promoted abstinence at particular times or in certain situations. When responsibility messages were accompanied by a product tagline or slogan, the messages were displayed in smaller font than the company’s tagline or slogan 95 percent of the time.
Responsibility statements are voluntary and are also frequently included in ads appearing in other media including radio and online ads. The researchers say more effective ads would have prominently placed tested warning messages that directly address behaviors and that do not reinforce marketing messages. “We know from experience with tobacco that warning messages on product containers and in advertising can affect consumption of potentially dangerous products,” say Katherine Clegg Smith, a professor at the Johns Hopkins Bloomberg School of Public Health and a lead author of the study. “We should apply that [tobacco ad] knowledge to alcohol ads and provide real warnings about the negative effects of excessive alcohol use.”
Read more on alcohol.
NYC Health Department Investigating Meningitis Outbreak among HIV Positive Men
The New York City Health Department is currently investigating a cluster of meningitis cases among HIV-positive men who have sex with men. Three cases of meningitis have occurred in Brooklyn and Queens since August 24, with the last two cases reported since early September.
Meningitis is a severe bacterial infection that has a high fatality rate. A previous outbreak of the disease among men who have sex with men ended in February 2013 after 22 cases were reported, including seven fatal cases.
The Health Department recommends meningitis vaccination for all HIV-positive men who have sex with men. Meningitis vaccinations are also recommended for men, regardless of HIV status, who regularly have intimate contact with other men met through a website, digital application (“app”), or at a bar or party.
People living with HIV are at a greater risk than the general population of acquiring meningitis and, if infected, dying from infection. This disease is spread by prolonged close contact with nose or throat discharges from an infected person.
Read more on sexual health.
In the last few days, the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and the medical aid group Doctors Without Borders have sounded alarms on the growing needs of several countries in West Africa fighting the Ebola outbreak. The groups have called for increased funding, equipment and expert health personnel to help stem the rapidly increasing numbers of infections.
As of last week, there have been more than 3,000 cases and more than 1,500 deaths, making it by far the largest outbreak since Ebola was discovered during the 1970s, according to the WHO. CDC Director Tom Frieden, MD, MPH, who last week visited the main West African countries dealing with the Ebola outbreak, said the number of cases could spike to 20,000 if more isn’t done to stem spread of the disease in those countries.
In addition, a recent post on ForeignPolicy.com said that the epidemic must be controlled before it also poses a security threat. Liberia, which has seen the highest number of Ebola cases and deaths in the region so far, has been under the watch of an international United Nations (U.N.) peacekeeping force since a civil war ended in 2003. While the U.N. had planned to begin drawing down the force next year, U.N. Secretary General Ban Ki-moon said he’d like to delay any drawdown for at least three months because of the virus outbreak, which has needed troops to help secure order.
However, several countries want to pull out troops now in order to reduce the risk to their personnel and to citizens at home who they worry could be infected by returning soldiers. Ban has said that the nature of the illness poses little risk to the troops, who are unlikely to have contact with the bodily fluids of people who are ill—which is the way the virus spreads—and some of the countries involved are considering sending their own experts to assess the risks.
The start of the school year also means a return to team sports. There’s no question that playing a team sport provides clear benefits for kids, including the opportunity to develop physical fitness and other healthy habits, good sportsmanship, self-esteem and self-discipline. Kids who play sports are also less likely to engage in risky behaviors such as smoking or substance abuse.
But there is a potential dark side: An increased risk of sports-related injuries, with concussions at the top of the list of current concerns. Each year nearly 250,000 kids go to emergency departments for suspected sports-related concussions and there’s growing recognition that continuing to play with a concussion can lead to long-term effects on the brain, especially for kids. Girls also now have a higher rate of sports-related concussions than do boys, according to the Children’s Safety Network.
Because of all of these reasons there’s a major push underway to prevent concussions in all youth sports, not just in football, since concussions also commonly occur in girls’ and boys’ soccer, lacrosse, basketball and other sports, according to the American Academy of Pediatrics. In May, the White House hosted the first-ever Healthy Kids & Safe Sports Concussion Summit to promote and expand research on sports-related concussions among kids and raise awareness of steps that can be taken to help prevent, identify and respond to concussions in young athletes.
Meanwhile, the U.S. Centers for Disease Control and Prevention (CDC) launched the Heads Up: Concussion in High School Sports initiative to help coaches, athletes and parents take steps to prevent concussions and respond appropriately if they occur. Among the prevention measures being introduced are modifications to protective gear (including new helmet technology for various sports), rule changes (such as limits on heading drills in soccer practices and tackling drills in football), identifying athletes who are at risk (by looking for genetic markers of risk) and educating everyone involved with youth sports about the dangers of concussions.
There are also stricter guidelines about when it’s appropriate for athletes to return to play after a concussion, based on their physical and cognitive symptoms; concussion history; and adherence to a step-by-step process for returning to the field or court. The CDC now recommends that coaches and parents consider whether their league or school should conduct baseline testing—a pre-season exam to assess an athlete’s balance and brain function—so that if a concussion is suspected to have occurred, the baseline results can help establish the extent of the head injury.
“Players, coaches and parents are demanding that we find a way to reduce concussion risk in sports,” said Michael Sims, head athletic trainer for football at Baylor University and a board member of the National Operating Committee on Standards for Athletic Equipment. “But equipment can’t do it alone. It’s critical that safe play and return to play practices are enforced.”
Sexual assaults on college campuses have grabbed headlines in recent months and for good reason: One in five U.S. women are raped or otherwise sexually assaulted during their college years, often during their freshman or sophomore year and often by someone they know. Last winter, President Obama established the White House Task Force to Protect Students from Sexual Assault. This marked a call to action to help prevent sexual assaults on campuses; to help schools respond effectively when an assault does occur; and strengthen federal enforcement efforts, including the launch of a website to make with various resources for students and schools.
Meanwhile, various colleges and universities have stepped up their own sexual assault prevention efforts. The Indiana Campus Sexual Assault Primary Prevention Project guides Indiana colleges and universities in the prevention of sexual violence through education and technical assistance; as well as the promotion of bystander intervention skills and healthy, respectful relationships.
Earlier this year, the University of Massachusetts Amherst launched a program called UMatter at UMass, which promotes “active bystander intervention” to prevent sexual assaults. The program uses “Three Ds” to help someone who witnesses a situation where a sexual assault is threatened know what to do:
- “Direct": Stepping in and confronting dangerous behavior in a direct and clear—but non-confrontational—way
- “Distract”: Using tactics that will divert behavior before it becomes violent or harmful
- “Delegate”: Enlisting help from acquaintances or law enforcement professionals to help prevent an assault
“Our simple starting point was our determination to build a more caring community, cementing the idea that we care about each other at UMass and that we demonstrate that care without first having a crisis or tragedy,” said Enku Gelaye, vice chancellor for student affairs and campus life at UMass. “With active bystanders, we want to reinforce a culture of active engagement. This is a very specific concept. The idea is that students have to take an active role in monitoring their environment and being engaged and caring about each other.”
This week, NewPublicHealth will run a series on new and creative public health campaigns that aim to improve the health of communities across the country through the use of public service announcements, infographics and more. Stay tuned to learn more about a new campaign each day.
In an effort to reduce missed school days, theEnvironmental Protection Agency (EPA), in partnership with the Ad Council, has launched a campaign to teach parents how to prevent asthma attacks in kids by identifying common asthma triggers. The “No Attacks” campaign urges parents to learn how to control factors that make a child’s asthma worse, use asthma medicines effectively and recognize when to call the doctor.
Asthma affects nearly 9 million U.S. children, with poor and minority children suffering a greater burden from the disease. Asthma can be especially serious in kids because of their small airways.
Through a series of Public Service Advertisements (PSAs) featuring a rock band of puppet characters called the “Breathe Easies,” the campaign includes online videos, radio spots and online banners (available in English and Spanish) with songs about asthma triggers at home, at school and outside. These entertaining messages inform viewers about how to prevent asthma attacks by cleaning up mold, vacuuming regularly and eliminating smoking at home; making sure their child’s school has a plan for controlling cockroaches and other pests, banning furry class pets and minimizing the use of chemical irritants in cleaning products, air fresheners and pesticides; and postponing outdoor sports and other high-energy activities to avoid exposure to high air pollution levels.
“Too many Americans, particularly children, minorities and people living in poverty, suffer from asthma, spending their time at doctor visits and hospitals instead of at school, work and play,” said Janet McCabe, acting assistant administrator for the EPA’s Office of Air and Radiation. “By working with the Ad Council and other partners in communities across the country, we can make a real difference in the lives of millions of Americans dealing with asthma.”
Asthma causes U.S. children to miss 14 million school days each year, which is especially worrisome because more frequent school absences are consistently linked with worse academic performance. The good news: “School absences due to asthma can be avoided by appropriate asthma management, including appropriate use of medications and reduced exposure to triggers,” noted a report from the U.S. Centers for Disease Control and Prevention. Since there’s no cure for asthma, preventing attacks—by reducing exposure to environmental triggers and using medications appropriately—is the primary focus of treatment.
The new PSAs stem from The Childhood Asthma Campaign, which was first launched by the EPA and the Ad Council in 2001. Since the debut of that campaign, the percentage of parents who feel they can make “a lot of difference” in preventing asthma attacks has risen from 49 percent to 67 percent, according to the Ad Council’s tracking surveys. The hope is that the new PSAs will improve that percentage even more.
If you’re reading this, then YOU can prevent wildfires. Also forest fires.
Both are indelible messages from Smokey Bear—an icon of public health and a friendly face from everyone’s childhood—who is celebrating his 70th birthday. Born August 9, 1944, the creation of the U.S. Forest Service and the Ad Council has over the decades become the center of the longest-running PSA campaign in U.S. history.
As part of the birthday celebration, the U.S. Forest Service and the National Association of State Foresters have launched a new round of PSAs featuring outdoor enthusiasts thanking Smokey for his years of work.
Since the campaign’s launch in 1944, the average number of acres burned by wildfires has decreased from 22 million to 6.7 million. However, they still remain one of the country’s most critical environmental issues—as well as one of its most misunderstood. While many people believe that lightning is the cause of most wildfires, the reality is the vast majority—9 out of 10—are manmade. The causes range from unattended campfires and burning debris on a windy day to improperly discarded smoking materials and operating equipment without spark arrestors.