Category Archives: Public health
Some Will Be Able to Enroll After March 31 Affordable Care Act Deadline
Some people will be able to enroll for coverage under the Affordable Care Act after the official enrollment deadline of March 31, according to new guidelines expected to be issued by the Obama administration. The new guidelines would allow people had previously tried to enroll by were prevented by systems problems such as technical difficulties, according to Reuters. "Open enrollment ends March 31. We are preparing for a surge in enrollment, and if consumers are in line on the 31st and can't finish, we won't shut the door on them. To be clear, if you don't have health insurance and do not start to sign up by the deadline, you can't get coverage again until next year," said U.S. Department of Health and Human Services spokeswoman Joanne Peters in a statement. Read more on the Affordable Care Act.
Study: Alcohol-Related Vehicle Crashes Greatly Underreported
Alcohol is a far greater factor in U.S. motor vehicle deaths than has been reported, according to a new study in the Journal of Studies on Alcohol and Drugs. Using Fatality Analysis Reporting System (FARS) data from the U.S. National Highway Traffic Safety Administration, researchers determined that in the decade from 1999 to 2009 while only a little more than 3 percent of the death certificates for traffic deaths included alcohol as a contributing cause, about 21 percent of the deaths were legally drunk. Approximately 450,000 Americans were killed in traffic crashes during the period. The time that it takes coroners to take and process blood alcohol tests could be a reason for the underreported figures. Ralph Hingson, Sc.D., of the U.S. National Institute on Alcohol Abuse and Alcoholism, said the vast discrepancy demonstrates the need for more reliable data. "We need to have a handle on what's contributing to the leading cause of death among young people," he said in a release. "You want to know how big the problem is, and if we can track it. Is it going up, or going down? And what policy measures are working?" Read more on alcohol.
NIH Identifies Genetic Markers Tied to Stroke, Cardiovascular Disease
Researchers and the National Institutes of Health have identified a genetic variant linked to increased risk for stroke, as well as a metabolic pathway tied to several common diseases, which taken together could improve how doctors identify and treat major diseases. “Our findings have the potential to identify new targets in the prevention and treatment of stroke, cardiovascular disease and many other common diseases,” said Stephen R. Williams, PhD, a postdoctoral fellow at the University of Virginia Cardiovascular Research Center and the University of Virginia Center for Public Health Genomics, Charlottesville. The genetic markers were found through the analysis of nearly 5,000 genomes. The results were published in the journal PLoS Genetics. About 600,000 Americans die of heart disease each year—one in every four deaths—and stroke is the fourth-leading cause of death in the United States. Read more on heart health.
Study Finds Dramatic Increase in Opioid Prescriptions by Emergency Rooms
The past decade has seen a dramatic increase in opioid analgesic prescriptions by emergency rooms, despite only a modest increase in pain-related complaints, according to a new study in the journal Academic Emergency Medicine. Using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2001 and 2010, researchers found that there was a 49 percent increase in prescriptions for potentially addictive narcotic painkillers such as OxyContin, Percocet and Vicodin. Approximately 12 million Americans abused prescription painkillers in 2010 and approximately 15,000 die annually due to overdoses, according to the U.S. Centers for Disease Control and Prevention. Read more on prescription drugs.
Study: Many Chronically Ill Adults Forced to Decide Between Medicine, Food
Chronically ill adults who due to financial instability lack consistent access to food are far more likely to underuse or even skip their medications completely, according to a new study in The American Journal of Medicine. Researchers analyzed data of 9,696 adults with chronic illness who participated in the National Health Interview Survey (NHIS), finding that 23.4 percent reported cost-related medication underuse, while 18.8% percent reported food insecurity and 11 percent reported both. Hispanic and non-Hispanic blacks were at the highest risk. "The high overall prevalence of food insecurity and cost-related medication underuse highlights how difficult successful chronic disease management in the current social environment is," said lead investigator Seth A. Berkowitz, MD, Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, in a release. "These findings suggest residual unmet needs for food-insecure participants and thus have clear implications for health policy." Read more on health disparities.
FDA Approves Implantable Device for Adults with a Certain Type of Hearing Loss
The U.S. Food and Drug Administration (FDA) has approved the first implantable hearing device for adults with severe or profound sensorineural hearing loss of high-frequency sounds in both ears, but who can still hear low-frequency sounds with or without a hearing aid. Sensorineural hearing loss is the most common form of hearing loss and can be caused by aging, heredity, exposure to loud noise, drugs that are toxic to the inner ear and certain other illnesses. “Hearing loss greatly impacts the education, employment, and well-being of many Americans,” said Christy Foreman, director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health, in a release. “This device may provide improved speech recognition for people with this kind of hearing loss, who have limited treatment options.” Read more on technology.
Don’t judge a change agent by its vinyl. Free to Be You and Me, a blockbuster hit album of the 70s and beyond, and still widely available on most music platforms, was the "Born This Way" by Lady Gaga of its time, with songs, stories and ideas that told kids they could be whoever they wanted.
Stars who recorded songs for the album included Mel Brooks and Diana Ross. Songs included “Parents are People,” about the many professions open to men and women and sung by album creators Marlo Thomas and Harry Belafonte, as well as “It’s Alright to Cry” sung by football player Rosie Grier.
“We wanted to let children know that their wildest dreams were not just OK, but wonderful—and completely achievable,” said Thomas at a recent anniversary celebration for the album at the Paley Center for Media in New York City.
The television special, filled with skits on gender neutrality, is still a popular kids’ birthday gift, in part because many of the issues it speaks to—especially advancement opportunities and equality—are still being grappled with today:
- According to a recent Institute of Medicine report, African Americans live, on average, five years less than other Americans.
- According to the Society for Women’s Health Research, in some cases critical data on sex, age, race and ethnicity does not exist for new drugs, biologics and devices. For instance, women made up less than one-third of the participants in clinical trials on three different coronary stents (which open up blockages), even though 43 percent of patients with coronary heart disease are women.
- According to the Institute for Women’s Policy Research, in 2012 female full-time workers made only 77 cents for every dollar earned by men, a gender wage gap of 23 percent.
>>Bonus Link: Watch a panel discussion among several of the original Free to Be You and Me stars filmed earlier this month at the Paley Center.
Study: School Hearing Tests Cannot Detect Adolescent High-Frequency Hearing Loss
School-administered hearing tests cannot detect the sort of adolescent high-frequency hearing loss associated with exposure to loud noises, according to a new study in the Journal of Medical Screening. Researchers at Penn State College of Medicine compared the results for 282 11th graders of a special hearing screening designed to detect noise-related high-frequency hearing loss with the results of the standard Pennsylvania school hearing test. Each tests for the ability to hear a tone at a specific loudness. "More participants failed the initial screening than we predicted," said study author Deepa Sekhar, assistant professor of pediatrics, in a release, "Even with the effort and care put in by school nurses across the state, the current Pennsylvania school screen just isn't designed to detect high-frequency hearing loss in adolescents," adding "The results of this study have the potential to reach schools across the nation, as many use screens similar to those used in Pennsylvania schools." Read more on pediatrics.
HUD Gives $1.8B to Support 3,100 Public Housing Authorities
The U.S. Department of Housing and Urban Development (HUD) has awarded almost $1.8 billion to approximately 3,100 public housing authorities across all 50 states, as well as the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. The grants, which come through HUD’s Capital Fund Program, will go toward building, repairing, renovating and modernizing public housing, from large scale improvements such as replacing roofs or smaller tasks such as energy-efficient upgrades. “This funding is critically important to public housing agencies as they work to provide the best housing possible for their residents,” said HUD Secretary Shaun Donovan. There are 1.1 million public housing units in the United States. Read more on housing.
New Heart Health Guidelines Would Increase Adults Eligible for Statins to 12.8M
New guidelines from the American College of Cardiology and the American Heart Association (ACC–AHA) for the treatment of cholesterol would increase the number of adults who would be eligible for statin therapy by 12.8 million, according to a new study in the New England Journal of Medicine. Roughly half of the U.S. population between 40 and 75 years of age—or 56 million people—would be eligible. Most of the increase would be among older adults without cardiovascular disease. Read more on heart health.
HHS: Common Sports Injuries Mean High Costs for People Without Insurance
The ASPE Office of Health Policy, part of the U.S. Department of Health and Human Services (HHS), has released a new issue brief analyzing the incidence and average health care charges associated with common sports injuries. The injuries range from minor sprains and strains to more serious injuries such as broken bones and concussions, where direct medical bills can be significant, placing an especially heavy burden on people without health insurance. Such individuals could be made to pay not just out-of-pocket costs, but also providers’ full stated charges. Breaking down health care costs by age and sometimes gender, the brief found, for example, that the average cost to fix a leg fracture for a person 10-19 years old was $4,689 and for those ages 25-40 was $3,403. Read more on injury prevention.
CDC: Drexel Meningitis Death Linked to Princeton Outbreak
Researchers at the U.S. Centers for Disease Control and Prevention have confirmed through “genetic fingerprinting” that a Drexel University student who died March 10 from meningitis died from the same serogroup B meningococcal strain that previously caused an outbreak at Princeton University. Health department officials confirmed that the Drexel student had been in close contact with Princeton students a week before becoming ill, indicating that the strain may still be present in the Princeton University community. Health officials have already administered antibiotic prophylaxis to prevent additional cases of meningococcal disease in people who had been close to the Drexel student. No new cases have since been reported. Read more on infectious diseases.
Study: ICU Survivors Face Heightened Risk for Mental Health Problems
Critically ill people who survive a stay in a hospital intensive care unit (ICU) are at heightened risk for mental health problems such as depression and anxiety in the following months, according to a new study in the Journal of the American Medical Association. Examining the records of more than 24,000 Danish ICU patients, researchers found that in the three months post-discharge that about 0.5 percent had a new diagnosis—which was 22 times higher than the rate in the general population. Approximately 13 percent received a new prescription for a psychiatric medication, including antidepressants and drugs for anxiety and insomnia, during that period. Researchers said the findings indicate that as doctors become better at saving the lives of critically ill patients, more people will also be at risk for problems beyond their physical health. Read more on mental health.
Study: Prescriptions for Opioids Steadying After Nearly Tripling over Two Decades
After nearly tripling from 1991 to 2010—from 76 million annually to 210 million annually—prescriptions for opioid analgesics in the United States are stabilizing, according to a new reporting in the journal Public Health Reports. Researchers at Columbia University’s Mailman School of Public Health attributed much of the success to stopping the soaring number of prescriptions to state-implemented prescription drug monitoring programs (PDMPs). “We found that PDMPs administered by state health departments appeared to be more effective than those administered by other government agencies, such as the bureau of narcotics and the board of pharmacy, ” said senior author Guohua Li, MD, professor of epidemiology and director of the Center for Injury Epidemiology and Prevention. Read more on prescription drugs.
Study: Mother’s Monitoring of Kids’ Media Consumption Tied to Changes in Weight
Children whose mothers pay more attention to their kids’ media habits—how much time they spend watching television or playing video games—are more likely to weigh less than children who do not receive the same sort of supervision, according to a new study in JAMA Pediatrics. Researchers found that kids with mothers who monitored their media consumption were thinner at age seven and gained less weight over the following few years. While the authors said they cannot point to the exact reason for the relationship, possibilities include vigilant mothers who encourage more physical activity and the fact that the kids are exposed to fewer food advertisements. The study used a questionnaire to asses 112 mothers, 103 fathers and their 213 children; media monitoring by fathers was not linked to weight gain or loss. Stacey Tiberio, the study's lead author from the Oregon Social Learning Center in Eugene, told Reuters Health that the results emphasize the important role that early adolescence plays with weight. "It's basically a one-way door," she said. "If you are obese by middle childhood, you have an increased likelihood of staying in that group." Read more on obesity.
Finding Unlisted Milk Protein, FDA Announces Recall of Certain Simply Lite Chocolate Products
The U.S. Food and Drug Administration (FDA) has announced a recall of certain lots of Simply Lite brand dark chocolate bars after finding significant amounts of milk protein, which the product does not list as an ingredient. FDA testing found more than 3,500 parts per million of milk protein in single 3-ounce bars of the chocolate—or the equivalent found in about 4 teaspoons of whole milk. People with milk allergies or sensitivity to milk could have serious or even life-threatening reactions to the product. Consumers with questions about food safety can contact the FDA at 1-888-SAFEFOOD Monday through Friday between 10 a.m. and 4 p.m. Eastern Daylight Time. Go here for complete information on the recall. Read more on food safety.
Poison Prevention Week 2014
March 16-24 is Poison Prevention Week this year, and an important opportunity to remind health officials and consumers about the resources provided by the National Poison Prevention Program and Hotline (1-800-222-1222). The National Poison Control Program is a program of the Health Resource Services Administration (HRSA). Programs include:
- Poison centers serving all states, Puerto Rico, the District of Columbia, Guam, the Federated States of Micronesia and American Samoa.
- A single, national toll-free number (1-800-222-1222) that connects callers with the poison center serving their area.
- A nationwide media campaign to educate the public and health care providers about poison prevention, poison center services and the 1-800 number.
- Programs to support the enhancement and improvement of poison education, prevention and treatment.
- Partnership development with other federal agencies and national organizations to advance poison prevention awareness.
- Development of uniform patient management guidelines so that poison centers can provide uniform treatment recommendations.
- Improvement of data collection systems and toxic exposure surveillance for enhanced capability to capture national poisoning data.
- Multilingual interpreter service in 161 languages to anyone who calls the 1-800 number.
Colon Cancer Incidence Rates Decreasing Steeply in Older Americans
Colon cancer incidence rates have dropped 30 percent in the United States in the last 10 years among adults 50 and older because of the widespread use of colonoscopies, according to a new study in CA: A Cancer Journal for Clinicians. The largest decrease has been in people over age 65. Colonoscopy use has almost tripled among adults ages 50-75, from 19 percent in 2000 to 55 percent in 2010. The study relied on data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the U.S. Centers for Disease Control and Prevention's National Program of Cancer Registries.
The "larger declines among Medicare-eligible seniors likely reflect higher rates of screening because of universal insurance coverage," according to the study authors. Mortality rates from colon cancer have also declined most rapidly within the past decade. From 2001 to 2010, death rates from colon cancer decreased by approximately 3 percent per year in both men and women, compared with declines of approximately 2 percent per year during the 1990s. The data is being released as the U.S. Department of Health and Human Services launches a nationwide effort to increase colorectal cancer screening rates to 80 percent by 2018. Read more on cancer.
DOT Proposed Rules on Electronic Log Books for Large and Bus Drivers to Help Reduce Fatalities and Injuries
The U.S. Department of Transportation (DOT) has announced a proposal to require interstate commercial truck and bus companies to use Electronic Logging Devices (ELDs) in their vehicles to improve compliance with the safety rules that govern the number of hours a driver can work. According to DOT, the proposed rule will ultimately reduce hours-of-service violations by making it more difficult for drivers to misrepresent their time on logbooks and—significantly—help reduce crashes by fatigued drivers and prevent approximately 20 fatalities and 434 injuries each year, for an annual safety benefit of $394.8 million. Impaired driving, including fatigue, was a factor in more than 12 percent of the 129,120 total crashes that involved large trucks or buses in 2012. Read more on injury prevention.
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!
Teens who Leave Gangs Still Face Consequences as Adults
A new study in the American Journal of Public Health finds that joining a gang during teen years has significant consequences in adulthood beyond criminal behavior, even after a person leaves the gang.
The study authors followed 808 fifth-grade students from 18 elementary schools in high-crime neighborhoods in Seattle, beginning in 1985. Participants were interviewed every year until the age of 18, then every three years until the age of 33.
Researchers used 23 risk factors, including poverty and associating with kids with problem behaviors, to calculate a child’s propensity for joining a gang, and then compared 173 youth who had joined a gang with 173 who did not but showed a similar propensity for doing so. The average age of joining a gang was just under 15 years old and the majority (60 percent) were in a gang for three years or less.
The study found that subjects between ages 27 and 33 who had joined a gang in adolescence were:
- Nearly three times more likely to report committing a crime,
- More than three times more likely to receive income from illegal sources
- More than twice as likely to have been jailed in the previous year
- Nearly three times more likely to have drug-abuse problems
- Nearly twice as likely to say they were in poor health
- Twice as likely to be receiving public assistanÎ
- Half as likely to graduate from high school.
The study was funded by the National Institute on Drug Abuse the Robert Wood Johnson Foundation, and the National Institute on Mental Health.
Read more on poverty
Stroke Survivors May Lose a Month of Healthy Life for Every 15-Minute Delay in Treatment
Every 15-minute delay in delivering a clot-busting drug after stroke takes away about a month of a healthy life for stroke survivors, according to a new study in the journal Stroke. Researchers at the University of Melbourne in Australia analyzed data from clot-busting trials and applied the time to efficacy to over 2,000 stroke cases in Australia and Finland to calculate what the patient outcomes would have been if they had been treated faster or slower. They found that for every minute the treatment could be delivered faster, patients gained an average 1.8 days of extra healthy life. The researchers also found that while all patients benefited from faster treatment, younger patients with longer life expectancies gained more than older patients
Read more on access to health care
One in Five Older Americans Take Medications that Work Against Each Other
More than 20 percent of older Americans take Medicines that work at odds with each other, and in some cases the medication being used for one condition can actually make the other condition worse, according to a new study in the online journal PLUS One by researchers at Oregon State University and the Yale School of Medicine. The study was conducted by researchers from OSU and Yale with 5,815 community-living adults over a two year period.
“Many physicians are aware of these concerns but there isn’t much information available on what to do about it,” says David Lee, an assistant professor in the Oregon State University/Oregon Health & Science University College of Pharmacy. “As a result,” says Lee, “right now we’re probably treating too many conditions with too many medications. There may be times it’s best to just focus on the most serious health problem, rather than use a drug to treat a different condition that could make the more serious health problem even worse.”
The chronic conditions in which competing therapies are common include coronary artery disease, diabetes, COPD, dementia, heart failure, hypertension, high cholesterol and osteoarthritis and others.
Read more on prescription drugs
With just seven days to go until the announced deadline for its first round of funding, the front runner to reach its goal on UCLA Spark—a new crowdfunding platform hosted by the university—is a public health initiative, the UCLA Sex Squad School Tour 2014. The Squad is a multimedia theatre troupe made up of University of California, Los Angeles students and graduates who talk to high school students about sex and sexual health.
Crowdfunding uses social media to encourage contributions from strangers for projects of all kinds. Sites such as Kickstarter have raised millions of dollars for multiple projects, including one by three U.S. State Department officials who raised enough capital to start their own dress sock business.
UCLA Spark’s projects are way loftier. The four other projects in the first round of funding on the site, which debuted last month, include a program to connect ninth-grade girls with technology, a bus to transport campus volunteers to community service projects, funds to help preserve the Watts Towers, (an iconic Los Angeles monument) and expansion of cancer treatment in Ethiopia.
Nancy Katano, Executive Director of Corporate Foundation and Research Relations at UCLA, says the idea for a crowdfunding platform at the university came about because two things converged: The university began getting faculty and student requests for help funding some very small niche projects—beyond the scope for most grants—and Katano began receiving calls from crowdfunding platforms looking to contract with the university. Katano says using an outside platform would have lost too much money for the projects since the platforms take a fee as well as a percentage of funds raised, so instead the university launched its own platform.
To become a UCLA Spark project, faculty and official student organizations propose projects for funding through an online application and a UCLA vetting committee makes the final decision.
“We’ve set up a whole series of guidelines and then we have a face-to-face meeting for applicants to help them think through how the platform can be effective for them—what’s realistic and what their responsibility is going to be,” said Katano. “With most crowdfunding platforms engagement is key. We ask them about their social media reach, do they use Twitter? Do they use Facebook? Are they comfortable shooting video?"