Category Archives: Public health

Sep 17 2014
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Public Health News Roundup: September 17

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White House Announces Significant Increase in U.S. Ebola Response
Yesterday, NewPublicHealth reported President Obama’s initial planned response to the ongoing Ebola outbreak in West Africa. The White House has since expanded on the plans. They will include:

  • A military command center in Liberia.
  • A staging area in Senegal to help dispatch personnel and aid to affected communities more quickly
  • Personnel from the U.S. Public Health Service will deploy to a new field hospitals the U.S. is setting up in Liberia.
  • US AID will help distribute home kits with items such as gloves and masks to help reduce the number of Ebola cases.

Read more about Ebola.

Survey Finds Doctors are Overextended or At Capacity for Patients
A new survey of 20,000 doctors by the Physicians Foundation, a non-profit group that works with practicing physicians, finds that 81 percent of doctors say they are over-extended or at full capacity and only 19 percent indicate they have time to see more patients. Forty-four percent of doctors responding say they plan to take steps that would reduce patient access to their practices , including cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking non-clinical jobs, leading to the potential loss of tens of thousands of physicians in the United States. The timing of the survey is significant because signup for health insurance coverage under the Affordable Care Act begins in just a few weeks. Read more about access to care.

Number of Smokers Increases in New York City
Earlier this week the New York City Health Department released new 2013 data showing that 16.1 percent of adult New Yorkers are smokers, a significant increase from the city’s lowest recorded adult smoking rate of 14 percent in 2010. For the first time since 2007, there are more than one million smokers in New York City who are at risk of developing a smoking-related illness, including heart disease, stroke, diabetes, emphysema, lung and other cancers, according to the health department. So far, the city does not have strong data to explain the uptick in smoking. Nationally, the U.S. Centers for Disease Control and Prevention estimates that 18 percent of U.S. adults are smokers, down from 20 percent several years ago. However, New York City is often a bellwether for public health issues, and the health experts across the country will be looking to see whether the city’s tobacco control efforts—including a new ad campaign that focuses on both daily and occasional smokers—have an impact on smoking rates. Read more on tobacco.

Sep 16 2014
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Public Health News Roundup: September 16

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EBOLA UPDATE: Obama to Commit as Many as 3,000 Troops to Epidemic Response
(NewPublicHealth is monitoring the public health crisis in West Africa.)
President Obama will today announce an expansion of military and medical resources that could send as many as 3,000 people to West Africa to help combat the ongoing Ebola outbreak. According to The New York Times, the United States will help train health workers and build as many as 17 Ebola treatment centers, which will house approximately 1,700 treatment beds. The U.S. Department of Defense will also open a joint command operation in Liberia in order to coordinate an international response to the outbreak. Read more on Ebola.

Report: 1 in 9 People Worldwide are Chronically Undernourished
An estimated 805 million people in the world are chronically undernourished, according to a new report, The State of Food Insecurity in the World 2014, from the Food and Agriculture Organization of the United Nations. While that means that approximately one in every nine people are undernourished, the number is down more than 100 million over the past decade and 209 million since 1990-1992. In the past two decades the prevalence of undernourishment has also dropped from 23.4 percent to 13.5 percent in developing countries. According to the health agency, the eradication of hunger requires a sustained political commitment that emphasizes food security and nutrition. Read more on global health.

SAMHSA: Percentage of Youth Using Illegal Drugs is Down Over the Past Decade
The percentage of U.S. teens using illegal drugs is down over the past decade, according to a new study from the Substance Abuse and Mental Health Services Administration’s (SAMHSA). The report, the 2013 National Survey on Drug Use and Health, found that the rate of illicit drug use in the past month for adolescents ages 12-17 was 8.8 percent, down from 9.5 percent in 2012 and 11.6 percent in 2002. From 2002 to 2013, the percentage of youth in that age group with a substance abuse or dependence problem dropped from 8.9 percent to 5.2 percent. “This report shows that we have made important progress in some key areas, but that we need to rejuvenate our efforts to promote prevention, treatment and recovery to reach all aspects of our community,” said SAMHSA Administrator Pamela S. Hyde, in a release. “The real lives represented by these statistics deserve our protection and help from the ravages of substance use disorders. Through a comprehensive, national effort we can help people avoid, or recover from substance use problems and lead, healthy, productive lives.” Read more on substance abuse.

Sep 15 2014
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Public Health News Roundup: September 15

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EBOLA UPDATE: Obama to Announce New Ebola Plan Tomorrow
(NewPublicHealth is monitoring the public health crisis in West Africa.)
President Obama is expected to make an announcement tomorrow detailing the United States’ increased involvement in combatting the Ebola outbreak in West Africa. The plan would likely involve an increased U.S. military presence; the government has already committed approximately $100 million related to protective equipment for health care workers; food; water; and medical and hygiene equipment. More than 2,400 people have so far died in the outbreak. Read more on Ebola.

HHS: $295M to Expand Health Services for 1.5M New Patients
Late last week, the U.S. Department of Health and Human Services (HHS) announced $295 million in funds to enable 1,195 health centers across the country to hire approximately 4,750 new staff, stay open later and expand their services to cover areas such as oral health, behavioral health, pharmacy and vision services. The funds are available through the Affordable Care Act. HHS estimates that this will help 1.5 million new patients. “These funds will enable health centers to provide high-quality primary health care to more people including the newly insured, many of whom may be accessing primary care for the first time,” said HHS Secretary Sylvia M. Burwell, in a release. Read more on the Affordable Care Act.

Study: 11 Million Unnecessary Antibiotic Prescriptions for Kids Annually
Physicians prescribe antibiotics for kids approximately twice as often than they are needed, contributing to the growing problem of antibiotic resistance, according to a new study in the journal Pediatrics. Researchers analyzed a selection of studies published between 2000 and 2011, as well as data on children examined at outpatient clinics, finding that an estimated 27 percent of U.S. children with infections of the ear, sinus area, throat or upper respiratory tract had illnesses caused by bacteria, yet antibiotics were prescribed for approximately 57 percent of these visits. They estimate that there are more than 11 million such unnecessary prescriptions for kids each year. Read more on prescription drugs.

Sep 12 2014
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Public Health News Roundup: September 12

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EBOLA OUTBREAK: WHO Says Ebola is Spreading at a Faster Rate than Health Workers Can Handle
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Earlier this week, the World Health Organization (WHO) announced that the Ebola outbreak in West Africa—the largest in history—shows no signs of slowing down. Today the global health organization followed that by declaring that health officials are currently unable to handle the growing number of cases. "In the three hardest hit countries, Guinea, Liberia and Sierra Leone, the number of new cases is moving far faster than the capacity to manage them in the Ebola-specific treatment centers," said Margaret Chan, the WHO director-general, according to CNN. "Today, there is not one single bed available for the treatment of an Ebola patient in the entire country of Liberia." More than 2,400 people have died from Ebola since the start of the outbreak. Read more on Ebola.

Study: Majority of Nursing Home Residents with Advanced Dementia Receive Questionable Medications
The majority of nursing home residents dealing with advanced dementia receive medications that are both questionable—if not outright ineffective—and cost them needless amounts of money, according to a new study in JAMA Internal Medicine. In a review of 5,406 nursing home residents with advanced dementia, researchers determined that slightly more than half (53.9 percent) received at least one medication with questionable benefit; the medications constituted approximately 35.2 percent of the total cost of care for those patients. According to the researchers, the patients’ goals of care should dictate the treatment they receive when dealing with a terminal illness, and medications that don’t promote that primary goal should be minimized. Read more on aging.

Study: ‘Fat Shaming’ is Counterproductive
“Fat shaming” does not promote weight loss and in fact can be counterproductive, according to a new study in the journal Obesity. In an analysis of nearly 3,000 adults tracked over four years, researchers determined that weight discrimination was associated with a weight gain of approximately 2 pounds, while the participants who reported no fat shaming lost an average of 1.5 pounds. "Our study clearly shows that weight discrimination is part of the obesity problem and not the solution," said the study's senior author, Jane Wardle, director of the Cancer Research UK Health Behaviour Centre at University College London (UCL), in a release. "Weight bias has been documented not only among the general public but also among health professionals, and many obese patients report being treated disrespectfully by doctors because of their weight. Everyone, including doctors, should stop blaming and shaming people for their weight and offer support, and where appropriate, treatment.” Read more on obesity.

Sep 11 2014
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Public Health News Roundup: September 11

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EBOLA UPDATE: Gates Foundation Commits $50M to Fight Ebola Epidemic
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The Bill & Melinda Gates Foundation will commit $50 million to combat the ongoing Ebola outbreak in West Africa. The flexible funds will enable United Nations agencies and international organizations to purchase supplies and scale up their operations; the funds will also go toward the development of Ebola treatments. The foundation has already committed $5 million to the World Health Organization for emergency operations and R&D assessments and $5 million to the U.S. Fund for UNICEF to support public health efforts in Liberia, Sierra Leone and Guinea. “We are working urgently with our partners to identify the most effective ways to help them save lives now and stop transmission of this deadly disease,” said Sue Desmond-Hellmann, CEO of the Gates Foundation, in a release. “We also want to accelerate the development of treatments, vaccines and diagnostics that can help end this epidemic and prevent future outbreaks.” Read more on Ebola.

CDC: Millions of U.S. Kids Don’t Receive Proper Preventive Care
Millions of U.S. infants, children and adolescents do not receive key clinical preventive services, according to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Weekly Report (MMWR) Supplement. Preventive services from doctors, dentists, nurses and allied health providers help prevent and detect diseases in their earliest stages, when they are the most treatable. Among the report’s findings:

  • In 2007, parents of 79 percent of children aged 10-47 months reported that they were not asked by health care providers to complete a formal screen for developmental delays in the past year.
  • In 2009, 56 percent of children and adolescents did not visit the dentist in the past year and 86 percent of children and adolescents did not receive a dental sealant or a topical fluoride application in the past year.
  • 47 percent of females aged 13-17 years had not received their recommended first dose of HPV vaccine in 2011.
  • Approximately 31 percent of outpatient clinic visits made by 11-21 year-olds during 2004–2010 had no documentation of tobacco use status; 80 percent of those who screened positive for tobacco use did not receive any cessation assistance.
  • Approximately 24 percent of outpatient clinic visits for preventive care made by 3-17 year olds during 2009-2010 had no documentation of blood pressure measurement.

“We must protect the health of all children and ensure that they receive recommended screenings and services. Together, parents and the public health and healthcare communities can work to ensure that children have health insurance and receive vital preventive services,” said Stuart K. Shapira, MD, PhD, chief medical officer and associate director for science in CDC’s National Center on Birth Defects and Developmental Disabilities. “Increased use of clinical preventive services could improve the health of infants, children and teens and promote healthy lifestyles that will enable them to achieve their full potential.” Read more on pediatrics.

GAO: More Data Needed to Help Veterans Readjust to Civilian Life
More information is needed in order to best provide services to military veterans readjusting to civilian life, according to a new review by the U.S. Government Accountability Office (GAO). The review found that while many veterans readjust with little difficulty, others experience financial, employment, relationship, legal, housing and substance abuse difficulties. While the U.S. Department of Veterans Affairs is working to improve veteran wellness and economic security, “there is limited and incomplete data to assess the extent to which veterans experience readjustment difficulties,” according to the GAO. Read more on the military.

Sep 10 2014
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Public Health News Roundup: September 10

EBOLA UPDATE: Death Toll Now to at Least 2,296
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The death toll from the ongoing Ebola outbreak in West Africa is now at least 2,296, according to the World Health Organization. However, the global health agency does not have the latest figures from Liberia—the country that has been hit hardest by the disease—making the true toll likely much higher. "It remains a very grave situation," said Liberian President Ellen Johnson Sirleaf on Tuesday, according to Reuters. "It is taking a long time to respond effectively .... We expect it to accelerate for at least another two or three weeks before we can look forward to a decline." As of Sept. 6 there were 4,293 recorded cases in five countries. Read more on Ebola.

Johns Hopkins Bloomberg School of Public Health, Clinton Foundation Announce Consensus Statement on Treating Prescription Drug Abuse and Misuse
The Johns Hopkins Bloomberg School of Public Health and the Clinton Foundation have released a consensus statement calling for a public health frame to analyze and disseminate proven, evidence-based intervention to combat prescription drug abuse and misuse. The statement is in response to President Clinton’s call-to-action on the subject in May of this year. “Prescription drug abuse and misuse, as well as widespread addiction and diversion of these products to the illicit market, represents one of the greatest challenges to our country’s public health in recent memory,” said Michael J. Klag, MD, MPH, dean of the Johns Hopkins Bloomberg School of Public Health, in a release. “This consensus statement marks a continuation of our school’s commitment, as well as that of the Clinton Foundation, to address epidemic rates of poisonings and deaths that are occurring due to prescription opioids and other prescription drugs that are highly prone to abuse and misuse.” According to the U.S. Centers for Disease Control and Prevention, drug overdoses killed 41,430 people in 2011, making it the leading cause of injury deaths. Read more on substance abuse.

CDC: 90% of Youth Ages 6-18 Consume Too Much Sodium
Approximately 9 in 10 U.S. children ages 6-18 consume more than the recommended amount of sodium, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC). The report also found that approximately 43 percent of the sodium comes from the ten foods they eat the most often: pizza; bread and rolls; cold cuts/cured meats; savory snacks; sandwiches; cheese; chicken patties/nuggets/tenders; pasta mixed dishes; Mexican mixed dishes; and soups. “Too many children are consuming way too much sodium, and the result will be risks of high blood pressure and heart disease in the future,” said CDC Director Tom Frieden, MD, MPH, in a release. “Most sodium is from processed and restaurant food, not the salt shaker. Reducing sodium intake will help our children avoid tragic and expensive health problems.” Read more on nutrition.

Sep 9 2014
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The Ebola Response: Q&A with Laurie Garrett, Council on Foreign Relations

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Almost every day brings reports of new cases of Ebola, the often-fatal virus now impacting multiple countries in West Africa. According to the U.S. Centers for Disease Control and Prevention (CDC), the 2014 Ebola outbreak is the largest Ebola outbreak in history. Spread of the disease to the United States is unlikely—although not impossible—and efforts are underway to find vaccines and cures, including scale-ups of drug development and manufacturing, as well as human trials for vaccines both in the United States and around the world. However, in West Africa the epidemic is impacting lives, economies, health care infrastructure and even security as countries try a variety of methods—including troop control—to get citizens to obey quarantines and other potentially life-saving instructions.

Late last week, NewPublicHealth spoke with Laurie Garrett, senior fellow for global health at the Council on Foreign Relations. Garrett has written extensively on global health issues and was on the ground as a reporter during the Ebola outbreak in Zaire in 1995.

NewPublicHealth: What are your key concerns with respect to the current Ebola outbreak?

Laurie Garrett: My main concern has been about the nature of the international response, which could be characterized as non-response until very recently. And now that the leadership of the international global health community has finally taken the epidemic seriously, it’s too late to easily stop it. We’ve gone through the whole list of all the usual ways that we stop Ebola and every single one of them was initiated far too late with far too few resources and far too few people—and now we’re in uncharted territory. We’re now trying to tackle a problem that has never reached this stage before and we don’t know what to do. The international response is pitiful, disgusting and woeful.

NPH: How do you account for such a poor response?

Garrett: First of all, the World Health Organization (WHO) is a mere shadow of its former self. When I was involved in the Ebola epidemic in 1995 in Kikwit, Zaire, the WHO was recognized worldwide as the leader of everything associated with outbreaks and infection, and it acted aggressively. It didn’t have a huge budget, but it still was able to take the problem very seriously and the resources that were needed were available, and more importantly a very talented leadership team combining the resources of the U.S. Centers for Disease Control and Prevention; WHO; Medicin San Frontiers (Doctors Without Borders); and the University of Kinshasa, Zaire, came together. They respected each other. They were on board together. They worked very closely with the local Red Cross, and they were able to conquer the problem pretty swiftly. 

Read more

Sep 9 2014
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Public Health News Roundup: September 9

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EBOLA UPDATE: Liberia Experiencing an Exponential Increase in Infections
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The World Health Organization (WHO) estimates that Liberia will see thousands of new Ebola cases over the next several weeks. "Transmission of the Ebola virus in Liberia is already intense and the number of new cases is increasing exponentially," according to a WHO statement. "The number of new cases is moving far faster than the capacity to manage them in Ebola-specific treatment centers." So far, 1,089 people have died of the disease in Liberia—the highest toll for any country. Approximately 2,100 people have been killed overall, and WHO estimates that as many as 20,000 people could be infected before public health workers are able to bring the epidemic under control. Read more on Ebola.

CDC Expands National Violent Death Reporting System to Cover 32 States
The U.S. Centers for Disease Control and Prevention (CDC) has awarded $7.5 million to expand the National Violent Death Reporting System (NVDRS) to cover 32 states. The NVDRS—which currently covers 18 states—links data from law enforcement, coroners, medical examiners, crime laboratories and other sources to help states understand when and how violent deaths occur. “More than 55,000 Americans died because of homicide or suicide in 2011. That’s an average of more than six people dying a violent death every hour,” said Daniel M. Sosin, MD, MPH, FACP, acting director of CDC’s National Center for Injury Prevention and Control, in a release. “This is disheartening and we know many of these deaths can be prevented. Participating states will be better able to use state-level data to develop, implement, and evaluate prevention and intervention efforts to stop violent deaths.” Read more on violence.

NIAAA to Conduct Trials on New Alcohol Use Disorder Treatment
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is preparing to conduct clinical trials of a potential treatment for alcohol use disorders. “Current medications for alcohol dependence are effective for some, but not all, patients. New medications are needed to provide effective therapy to a broader spectrum of alcohol dependent individuals,” said George F. Koob, PhD, director of the NIAAA, a part of the National Institutes of Health (NIH), in a release. “Prior clinical studies of gabapentin, the active metabolite of the molecule called gabapentin enacarbil, have shown positive results in patients with AUD. We believe that the time is right to conduct a multi-site, well-controlled clinical trial.” The NIH estimates that approximately 17 million people in the United States are affected by an alcohol use disorder, with lost productivity, health care costs and property damage costs amounting to an estimated societal cost of $223.5 billion annually. Real more on alcohol.

Sep 8 2014
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Recommended Reading: Helping First Timers Sign up for Health Insurance

Recommended Reading

A new Kaiser Health News (KHN) article describes the challenges of helping people who have never had health insurance sign up for coverage. The KHN profile looks at the Arab Community Center for Economic & Social Services (ACCESS) a nonprofit agency that is helping the large Arab-American population in Dearborn, Mich., sign up for coverage and access care.

 The group has found that many of the people they are helping are immigrants who know little to nothing about health insurance concepts such as enrollment, copays and deductibles—an issue that also applies to millions of other people new to health insurance across the country. Immigrant and uninsured populations all over the country face cultural and language barriers to understanding and adopting U.S. insurance practices.

Ten million non-citizens living legally in the U.S. are expected to gain health insurance under the Affordable Care Act, according to KHN. The navigators at ACCESS are also trained to teach immigrants about free public health screenings for conditions such as breast cancer, which requires specialized training and conversations because of cultural stigmas associated with cancer.. At the ACCESS center in Dearborn, for example, women coming for free mammograms enter through an unmarked door.

Read the Kaiser Health News article.

Bonus Links:

  • Kaiser Health News recently reported that, on average, premiums will decline in 16 major cities for the 2015 coverage year.
  • Advertising for health insurance plans has already started across the country. Sign up for the 2015 coverage year begins October 15, 2014 and ends February 15, 2015, a period that is roughly three months shorter than last year’s enrollment period. Find information at healthcare.gov.
Sep 8 2014
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Public Health News Roundup: September 8

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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.