Category Archives: Public health
Future of Public Health is an ongoing series focused on the emerging faces in the world of public health. We spoke with Patrick Ten Eyck, MS, a PhD candidate in the Department of Biostatistics at the University of Iowa’s College of Public Health, about what helped lead him to the field, his work in biostatistics to determine the impact of anti-bullying policies and where he hopes to go from here.
NewPublicHealth: What encouraged you to pursue a degree and career in public health?
Patrick Ten Eyck: I received my undergraduate degree in math because it’s been an interest of mine and then I got my Master’s in statistics because I found it to be the most interesting. I wasn’t really interested so much in the theory of statistics as much as the application. So, when I decided to pursue my PhD I thought biostatistics would be the perfect route because it applied my knowledge of statistics to really practical applications in the real world, especially public health. It’s convenient that the Biostatistics Department is in the College of Public Health at the University of Iowa. I have the opportunity to collaborate with other departments and help share our knowledge of statistics. Together, we can make sense of large data sets and hopefully get some very useful results out of it.
NPH: Do you have primary interests on the public health side of biostatistics?
Ten Eyck: Actually, when I started at the program I really didn’t have any particular area that I was that interested in researching. Obviously, one of the big areas that the Biostatistics Department pursues is medical data, but we also work with more broad areas than just medical data. We help out with occupational, environmental, community and behavioral health topics, too. These topics opened many more doors as far as piquing my interest in different areas. So, I still don’t have a particular area that I’m focused on, but I like to get involved in a lot of different areas because it’s really interesting to see what’s going on in the different fields.
NPH: Tell us more about the work you’ve done to analyze the bullying data in the Iowa Youth Survey?
Ten Eyck: Obviously, bullying has been quite a large focus, especially in the media lately with many stories of students being bullied in schools. So, the Iowa Youth Survey looks at data from 2005, 2008 and 2010 and now we just got the data set for 2012. There was an anti-bullying law passed in 2007 in the state of Iowa that outlines what bullying is and helps teachers to recognize bullying and intervene to prevent it as best as possible. A survey was given to sixth-, eighth- and eleventh-grade students throughout the state of Iowa and more than 250,000 students filled out the survey and gave information.
Study: More ‘Masculine’ and ‘Feminine’ Youth at Higher Risk for Cancer-risk Behaviors
The most “feminine” girls and the most “masculine” boys are also the most likely to engage in behaviors that pose cancer risks, according to a new study in the Journal of Adolescent Health. Researchers at the Harvard School of Public Health (HSPH) analyzed data on 9,354 adolescents in the ongoing Growing Up Today Study, finding that cancer-risk behaviors such as tobacco use, indoor tanning and physical inactivity were significantly more common in adolescents who more closely adhered to the traditional societal norms of masculinity and femininity. "Our findings indicate that socially constructed ideas of masculinity and femininity heavily influence teens' behaviors and put them at increased risk for cancer,” said lead author Andrea Roberts, research associate in the Department of Social and Behavioral Sciences at HSPH. “Though there is nothing inherently masculine about chewing tobacco, or inherently feminine about using a tanning booth, these industries have convinced some teens that these behaviors are a way to express their masculinity or femininity." Read more on cancer.
Study: Casual Marijuana Use Can Cause Dangerous Changes in Youths’ Brains
Casual marijuana use in young people can lead to potentially harmful changes in the brain, according to a new study in the Journal of Neuroscience. Researchers from Northwestern University's medical school, Massachusetts General Hospital and Harvard Medical School determined that casual marijuana smoking—defined as one to seven joints per week—could lead to changes to the nucleus accumbens and the nucleus amygdale, which help regulate emotion and motivation. "What we're seeing is changes in people who are 18 to 25 in core brain regions that you never, ever want to fool around with," said co-senior study author Hans Beiter, PhD, professor of psychiatry and behavioral sciences at Northwestern University, according to Reuters, adding, "Our hypothesis from this early work is that these changes may be an early sign of what later becomes amotivation, where people aren't focused on their goals.” Read more on substance abuse.
CDC: ‘Herd Immunity’ Helped Reduce H1N1 Flu Strain’s Impact This Season
While the H1N1 influenza strain was the predominant strain in the United States this past flu season, prior widespread exposure and its inclusion in the current flu vaccine meant it did not have nearly the impact it did in 2009, according to the U.S. Centers for Disease Control and Prevention (CDC). According to Michael Jhung, MD, a medical officer in the CDC’s influenza division, an overall “herd immunity” helped stop this season from turning into the worldwide pandemic seen in 2009. "This year, not only do we have a vaccine that works well, but millions of people have already been exposed to the H1N1 virus," he said, according to HealthDay. The flu strain also hit differently this season, peaking earlier, although once again younger adults were affected more than the elderly. Read more on the flu.
Urban Gardeners May Be Unaware of Harmful Soil Contaminants
In their quest to consume healthier foods, urban gardeners may actually be unaware of the presence of soil contaminants and how to deal with the issue, putting both gardeners and consumers at risk, according to a new study in PLOS One. Potential contaminants include heavy metals, petroleum products and asbestos, which can result when urban soil is near pollution sources, such as industrial areas and roads with heavy traffic. “Our study suggests gardeners generally recognize the importance of knowing a garden site’s prior uses, but they may lack the information and expertise to determine accurately the prior use of their garden site and potential contaminants in the soil,” said Keeve Nachman, PhD, senior author of the study and director of the Food Production and Public Health Program with the Johns Hopkins Center for a Livable Future. “They may also have misperceptions or gaps in knowledge about how best to minimize their risk of exposure to contaminants that may be in urban soil.” Read more food safety.
Study: 1 in 10 U.S. Adults Have Diabetes
Nearly one in 10 U.S. adults had diabetes in 2010, nearly double the percentage a little more than two decades ago, in 1988, according to a new study in the Annals of Internal Medicine. The study determined that 21 million American adults—or 9.3 percent of all American adults—had either type 1 or type 2 diabetes in 2010. As many as 95 percent of diabetes cases are type 2 cases. "This study also highlights that the increase in diabetes really tracks closely with the epidemic of obesity,” said Elizabeth Selvin, the study's lead author and an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “The diabetes epidemic is really a direct consequence of the rise in obesity.” However, the report did find that cases of undiagnosed diabetes were down, indicating new screen techniques are effective. It also found that overall blood sugar control was improved. Read more on obesity.
U.S. Health Care Costs Climbed 3.2% in 2013, to $329.2 Billion
The cost of new medicines, price increases on some branded drugs and patent expirations helped cause the first rise in the overall cost of health services in the United States in three years, according to a new report from IMS Health Holdings Inc., a health care information company. Americans spent a total of $329.2 billion on health services in 2013, up from 3.2 percent from 2012, which had seen a 1 percent decline. However, the report noted that expanded use of cheaper generic drugs—86 percent of all prescription drugs—did help costs from rising even higher. Read more on access to health care.
Study: Mean Devices Approved for Pediatric Use Never Tested on Kids
The majority of medical devices recently approved for pediatric use were never actually tested on kids, but rather only on people ages 18 and older, according to a new study in the journal Pediatrics. Researchers analyzed the clinical data used to get each device approved, finding that 11 of 25 examined devices were not tested on any patient age 21 and younger, and that only four had been tested on patients under the age of 18; three devices were specifically approved for patients under age 18, while the test were approved for people ages 18 to 21. "Children are not simply 'small adults,' and a device found to be safe and effective in adults may have a very different safety and effectiveness profile when used in a pediatric population," said Brigham and Women's Hospital and Harvard Medical School research fellow Thomas J. Hwang, one of the study’s authors, according to Reuters. "Without this data, it is difficult for clinicians and parents to make informed treatment decisions that weigh the risks and benefits of a particular treatment.” Read more on pediatrics.
Kaiser Report Examines Employer-Sponsored Retiree Health Benefits
A new report from the Kaiser Family Foundation on employer-sponsored retiree health benefits for pre-65 and Medicare-eligible retirees finds that the percentage of employers sponsoring retiree health coverage has declined, while employers that offer coverage are redesigning their plans almost annually in response to rising health care costs. The report, Retiree Health Benefits At the Crossroads, also examines the effect of recent legislation on retiree health coverage, such as the Medicare drug benefit and the Affordable Care Act. Read more on aging.
Study: Fewer Blood Transfusions Would Mean Fewer Infections
The increased use of blood transfusions in hospitals also leads to the increased risk of infection, according to a new study in the Journal of the American Medical Association. In a review of 21 randomized control trials, researchers from the University of Michigan School of Public Health determined that for every 38 patients considered for a red blood cell transfusion, the reduction of transfusions would mean one patient did not develop a serious infection, with the elderly undergoing hip and knee surgeries benefiting the most. “The fewer the red blood cell transfusions, the less likely hospitalized patients were to develop infections, “ says lead author Jeffrey M. Rohde, MD, assistant professor of internal medicine in the division of general medicine at the U-M Medical School, in a release. “This is most likely due to the patient’s immune system reacting to donor blood (known as transfusion-associated immunomodulation or TRIM). Transfusions may benefit patients with severe anemia or blood loss; however, for patients with higher red blood cell levels, the risks may outweigh the benefits.” Read more on prevention.
Sebelius to Step Down as Head of HHS
Kathleen Sebelius is resigning as secretary of the U.S. Department of Health and Human Services (HHS). The formal announcement is expected to come at 11 a.m. this morning, with President Obama to name Office of Management and Budget Director Sylvia Mathews Burwell as the replacement for the former Kansas governor. Sebelius assumed the HHS position in April 2009. Read more on the HHS.
FDA Expands Approved Use of Certain Pacemakers, Defibrillators
The U.S. Food and Drug Administration (FDA) has expanded the approved application of certain pacemakers and defibrillators, allowing them to also be used for patients with atrioventricular (AV) block and less severe heart failure. Previously the devices—which provide electrical impulses to the heart through implanted leads in the ventricles—were approved only for people with more severe heart failure as evaluated by their physician using specific criteria. The expansion covers two cardiac resynchronization pacemakers (CRT-P) and eight cardiac resynchronization defibrillators produced by Medtronic. Approximately 5.1 million people in the United States have heart failure. Read more on heart health.
Study: Doctor’s ‘Bedside Manner’ Has Real Effect on Patient Health
The doctor-patient relationship can have a real and significant impact on patient health, with doctors with better “beside manner” also having patients who fare better in efforts to lose weight, lower their blood pressure or manage pain, according to a new study in the journal PLOS One. Researchers reviewed 13 clinical trials, finding that improved patient outcomes were linked directly to doctors who had undergone training to hone their people skills. "I think that intuitively, people think that if you have an open, caring relationship with your provider, that's beneficial," said Helen Riess, the senior researcher on the new study, according to HealthDay. Read more on access to health care.
HHS Releases Data Giving Consumers Greater Transparency on Costs of Medical Procedures
The U.S. Department of Health and Human (HHS) services has released of new, privacy-protected data on services and procedures provided to Medicare beneficiaries by physicians and other health care professionals. The new data—which includes payment and submitted charges, or bills, for those services and procedures by provider—provides consumers with more information on how physicians and other health care professionals practice medicine, according to HHS Secretary Kathleen Sebelius. “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice,” she said. “The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns.” The release includes information for more than 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program. Read more on access to care.
HUD Grants $1.6B to Support 7,100 Local Homeless Housing and Service Programs
The U.S. Department of Housing and Urban Development (HUD) has announced approximately $1.6 billion in grants to continue support for 7,100 local homeless housing and service programs in all 50 states, as well as Puerto Rico, Guam and the U.S. Virgin Islands. The grants, which come through HUD’s Continuum of Care Program, support programs such as street outreach; client assessment; and direct housing assistance to individuals and families with children who are experiencing homelessness. "Whether it's helping to rapidly re-house families with young children or finding a permanent home for an individual with serious health conditions, HUD is working with our local partners to end homelessness as we know it," said HUD Secretary Shaun Donovan. Read more on housing.
Study: Concussion Symptoms May Be Worse For Girls than for Boys
Concussions may have a more severe and longer-lasting effect for girls than they do for boys, according to new research. Shayne Fehr, MD, a pediatrician at Children's Hospital of Wisconsin, tracked 549 patients who sought treatment at a pediatric concussion clinic, finding that girls on average reported more severe symptoms than boys and needed an additional 22 days to recover (56 days for girls, compared to 34 for boys). Approximately 76 percent of the injuries were sports related and the top five reported symptoms were headache, trouble concentrating, sensitivity to light, sensitivity to sound and dizziness. More research is needed to determine the cause of the disparity. Read more on injury prevention.
One in Four Teen Births Are Among Younger Teens Ages 15 to 17
While births to younger teens ages 15 to 17 years have declined, they still represent over a quarter of teen births and nearly 1,700 births a week, according to this month’s Vital Signs, the monthly health indicator report from the U.S. Centers for Disease Control and Prevention (CDC). “Although we have made significant progress reducing teen pregnancy, far too many teens are still having babies,” said CDC Director Tom Frieden, MD, MPH. “Births to younger teens pose the greatest risk of poor medical, social and economic outcomes. Efforts to prevent teen childbearing need to focus on evidence-based approaches to delaying sexual activity and increasing use of the most effective methods of contraception for those teens who are sexually active.” Read more on sexual health.
Study: Rural Girls Get More Daily Exercise than Those in Suburban, Urban Communities
While the level of urbanicty—whether they live in rural, suburban or urban communities—does not seem to affect boys’ levels of moderate-to-vigorous physical activity, there is a noticeable effect for girls, according to a new study in the American Journal of Preventive Medicine. Researchers determined that girls from rural areas are 4.6 times more likely than those in suburban areas and 2.8 times more likely than those in urban areas to exceed the national physical activity recommendation of 60 or more minutes of moderate-to-vigorous physical activity each day. The study tracked the daily activity of a random selection of 1,354 youth in 20 counties in North Carolina. Read more on physical activity.
Study: Mentions of Alcohol Brands in Popular Music Increase Youth Alcohol Use
The average young person in the United States hears approximately eight alcohol brand names each day while listening to music, increasing the risk they will use and abuse alcohol, according to a new study in the journal Alcoholism: Clinical & Experimental Research. Using information collected from more than 3,400 males and females ages 15 to 23, researchers determined that the average youth in that age group listens to 2.5 hours of music per day, with 3-4 brand mentions each hour. Lisa Henriksen, senior research scientist at the Stanford Prevention Research Center, called the findings “worrisome” in a release. "It would be foolish to think that the alcohol industry is unaware of and uninvolved with alcohol-brand mentions in music," said Henriksen. "The strategy of associating products with hip culture and celebrities who are attractive to youth comes straight from a playbook written by the tobacco industry." Approximately 39 percent of U.S. teens are current drinkers and about 22 percent are binge drinkers, according to the U.S. Centers for Disease Control and Prevention. Read more on alcohol.
At this year’s Preparedness Summit, which met last week in Atlanta, the American Red Cross was a first-time partner for the annual event which brings together more than 1,000 preparedness experts from around the country.
“It was important for us to partner with the American Red Cross because they have a major role and responsibility in disasters,” said Jack Herrmann, the Summit chair and Chief of Public Health Preparedness at the National Association of County and City Health Officials (NACCHO), the lead partner for the Summit. “We felt that it was important that the public health and health care communities understand the Red Cross’ role and authority during a disaster and look for ways to foster and build partnerships [among] local health departments, state health departments and American Red Cross chapters across the country.”
Just prior to the Summit, NewPublicHealth conducted an interview by email with Russ Paulsen, Executive Director, Community Preparedness and Resilience Services of the American Red Cross.
NewPublicHealth: What are the key issues that communities should focus on now to get themselves better prepared for a disaster should it occur?
Russ Paulsen: Everyone has a role to play in getting communities better prepared for disasters.
As a first step, individuals, organizations and communities should understand the problem: What hazards are in their area? How likely are any of these hazards to become actual disasters? What have people already put in place to deal with them? Local Red Cross chapters can help with this assessment.
Once people understand the problem, the next step is to make a plan. Plan what to do in case you are separated from your family or household members during an emergency, and plan what to do if you must evacuate your home. Coordinate your household plan with your household members’ schools, daycare facilities, workplaces and with your community’s emergency plans.
HHS: Significant Improvement on Leading Health Indicators that Influence Reduction in Preventable Disease and Death
A new report from the U.S. Department of Health and Human Services (HHS), Healthy People 2020, finds that the country’s health is importing in more than half—14 of 26—of the critical measures known to have a major influence in reducing preventable disease and death. The Leading Health Indicators include categories such as access to care; maternal and child health; tobacco use; nutrition; and physical activity. “The Leading Health Indicators are intended to motivate action to improve the health of the whole population,” said Howard Koh, MD, Assistant Secretary for Health, in a release. “Today’s LHI Progress Report shows that we are doing just that.” Among the indicators that been met or are improving:
- Fewer adults smoking cigarettes
- Fewer children exposed to secondhand smoke
- More adults meeting physical activity targets
- Fewer adolescents using alcohol or illicit drugs
Read more on HHS.
Study: Americans Twice as Likely to Get Food Poisoning from Restaurants than at Home
Americans are twice as likely to get food poisoning from food at a restaurant than they are from food at home, according to a new study from the nonprofit Center for Science in the Public Interest (CSPI). The organization analyzed “solved” outbreaks over a ten-year period, finding that 1,610 outbreaks in restaurants sickened more than 28,000 people while 893 outbreaks linked to private homes sickened approximately 13,000 people. The study also determined that of the 104 outbreaks linked to milk, about 70 percent were caused by raw milk—meaning that while less than one percent of consumers drink raw milk, they account for 70 percent of the illnesses caused by milk-borne outbreaks. The researchers also expressed concern over the 42 percent drop in reported outbreaks from 2011 to 2012. "Underreporting of outbreaks has reached epidemic proportions," said CSPI food safety director Caroline Smith DeWaal. "Yet the details gleaned from outbreak investigations provide essential information so public health officials can shape food safety policy and make science-based recommendations to consumers. Despite the improvements in food safety policy in the past decade, far too many Americans still are getting sick, being hospitalized, or even dying due to contaminated food." Read more on food safety.
Study: Antipsychotic Medications for Foster Care Youth Remain High
Use of antipsychotic medications for unlabeled indications such as treatment for attention-deficit hyperactivity disorder (ADHD) is increasing among youth in foster care, according to a new study in the Journal of Adolescent Psychopharmacology. Researchers from the University of Maryland, Morgan State University and the Johns Hopkins Medical Institutions analyzed data on 266,590 youth ages 2-17 years and continuously enrolled in a mid-Atlantic state Medicaid program in 2006, finding that approximately one-third of the ADHD-diagnosed foster care youth included in the assessment received atypical antipsychotics. This study adds critical hard data to our understanding of a persistent and unacceptable trend in pediatric psychiatry," said Harold S. Koplewicz, MD, Editor-in-Chief of Journal of Child and Adolescent Psychopharmacology, and President, Child Mind Institute, in a release. "Our poorest, most vulnerable children, lacking access to evidence-based care, are receiving potentially harmful treatment with little oversight. The highlight of Burcu et al.'s paper for any reader should be the simple but necessary recommendations for antipsychotic prescribing and monitoring in these populations." Read more on prescription drugs.
On Friday, April 4, the Robert Wood Johnson Foundation held a First Friday Google+ Hangout to explore how the 2014 County Health Rankings can be used to move the needle toward healthy communities. Hosted by Susan Dentzer, RWJF senior policy advisor, the Hangout featured four panelists from various sectors working to improve the health of U.S. communities.
Marjorie Paloma, Senior Policy Advisor at the Foundation, provided viewers with an overview of the County Health Rankings and Roadmaps, explaining that the rankings continue to show that where we live matters to our health. The rankings allow each state to see how counties compare on a number of health factors, including housing, education, income and safety. The Rankings offer a look at health trends across the country in addition to county-level information. This year’s Rankings find that people who live in the least health communities are twice as likely to live shorter lives and that we are slowly seeing an uptick in the number of children living in poverty. However, there have been significant declines in smoking rates and violent crime.
“The Rankings really help us to see how we’re doing and also where we can improve on health,” said Paloma. “The Roadmaps are really a call to action. They are really helping to move communities from awareness to driving action.”
Paloma also highlighted the broad range of resources available through the County Health Rankings website for communities to find and develop health solutions.
According to Brian Smedley, Vice President and Director, Health Policy Institute, Joint Center for Political and Economic Studies, the County Health Rankings is critical in understanding the importance of place as an upstream driver of health. Transportation, housing, opportunities for experience, quality of greenspace and more can be critical in determining the health of a community and the individuals who call it home. He explained that successful Roadmaps communities are ones that have built coalitions across different sectors and have health policy strategies that are local.
“We need to look at smaller geographic areas to see how neighborhoods affect health,” said Smedley. “A lens on place can be powerful in helping us to understand how we can reduce risks at the individual level and the community level.” He also offered additional tools for acquiring even finer cuts of data, such as Community Commons, local health departments and the U.S. Census Bureau.
Mary Lou Goeke, Executive Director, United Way of Santa Cruz County, offered a look at how the County Health Rankings and Roadmaps are used to improve health in Santa Cruz by shining a light on areas that need improvement and mobilizing the community to action. In particular, Goeke highlighted Santa Cruz’s efforts to reconcile a correlation between drinking rates and violent crime with the city’s new entertainment district. By using the data, the community was able to mitigate the potential harm of the entertainment district by implementing evidence-based practices to decrease drinking and crime.
“The County Health Rankings hold us accountable for things that aren’t working and encourages us to find new approaches,” said Goeke.
Katie Loovis, Director of U.S. Partnerships and Stakeholder Engagement, GlaxoSmithKline, explained how her company uses the rankings to shape its philanthropic efforts across the country. In the past few years, GlaxoSmithKline employees have overwhelming expressed support for the company to improve health in communities.
“If you want to improve health in your community, you have to know where you’re starting,” said Loovis. “The rankings do just that.” GlaxoSmithKline relies on the roadmaps to help highlight which interventions have the science to back them up and to identify which nonprofits to partner with in their target communities.
In addition, Loovis encourages local health departments and non-profits to reach out to local businesses directly and invite them to get involved in the solutions.