Category Archives: Transportation
Decrease in Pediatric Antibiotic Leveling Off
The number of children taking antibiotics has decreased over the past decade, but that decrease has stalled in recent years in certain age groups and geographic locations, according to a study in Pediatrics. Researchers reviewed pharmacy and outpatient claims over a 10-year period (2000 to 2010) in three health plans located in three different geographic locations to determine the number of antibiotics dispensed each year for children ages 3 months to 18 years. Although the overall antibiotic-dispensing rate in each age group and health plan was lower in 2009-2010 than in 2000-2001, the rate of decline in antibiotic use has slowed. The highest rate of antibiotic use was in children age 3 months to less than 24 months of age in all years of the study.
The study authors say the previous downward trend in antibiotic use in children may have reached a plateau, and continued improvements in judicious antibiotic dispensing are needed. Read more on pediatrics.
NHTSA Gives Okay for Vehicle to Vehicle Communication to Help Prevent Crashes
The National Highway Traffic Safety Administration has announced that it will begin taking steps to allow vehicle-to-vehicle (V2V) communication technology for light vehicles, which will allow vehicles to "talk" to each other and ultimately avoid many crashes by exchanging basic safety data, such as speed and position, ten times per second.
The safety applications currently being developed provide warnings to drivers so that they can prevent imminent collisions, but do not automatically operate any vehicle systems, such as braking or steering, although NHTSA is also considering future actions on active safety technologies that rely on on-board sensors.
V2V communications can provide the vehicle and driver with 360-degree situational awareness to address additional crash situations — including those, for example, in which a driver needs to decide if it is safe to pass on a two-lane road (potential head-on collision), make a left turn across the path of oncoming traffic, or in which a vehicle approaching at an intersection appears to be on a collision course. In those situations, V2V communications can detect threats hundreds of yards from other vehicles that cannot be seen, often in situations in which on-board sensors alone cannot detect the threat. Read more on transportation.
Many Hospital ICUs Don't Follow Infection Prevention Rules
While most hospitals have evidence-based guidelines in place to prevent health care-associated infections in intensive care units (ICUs), clinicians often fail to follow them according to new research from the Columbia University School of Nursing published in the American Journal of Infection Control. The study, on over 1600 ICUs, found lax compliance in intensive care units where patients are more likely to be treated with devices linked to preventable infections – such as central lines, urinary catheters and ventilators.
The study focused on three of the most common preventable infections — central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections and determined that despite decades of research, establishing best practices for prevention of these infections, approximately one in 10 hospitals lack checklists to prevent bloodstream infections, and one in four lack checklists to help avoid pneumonia in ventilator patients, and that in hospitals with checklists, they are followed only about half of the time.
Health care-associated infections kill an estimated 100,000 Americans a year and result in over $30 billion in excess medical costs, according to the Centers for Disease Control and Prevention. Read more on injury prevention.
If you’re looking for a sneak preview of the movie Robocop, set for release next February, try the National Highway Traffic Safety Administration (NHTSA). NHTSA has paid for a proprietary video that has the cop reminding drivers to stay sober behind the wheel. NHTSA just released the public service announcement as part of its annual Drive Sober or Get Pulled Over campaign, which runs through January 1.
Last year, according to NHTSA, deaths in crashes involving drunk drivers increased 4.6 percent — 10,322 lives were lost, compared to 9,865 in 2011. The majority of those crashes involved drivers with a blood alcohol concentration of .15 or higher — nearly double the legal limit. During last year’s holiday season alone, 830 lives were lost in drunk driving crashes.
The campaign also includes state model guidelines for ignition interlock devices. These devices can be added to the car of a driver with a history of drunk driving. Before starting the vehicle, the driver must breathe into the device and if the driver’s blood alcohol limit is too high, the ignition lock will not allow the car to start.
Previous NHTSA research of convicted drunk drivers show that those with ignition locks installed are 75 percent less likely to repeat the behavior compared to those who do not. The guidelines emphasize several programs to maximize effectiveness – including legislation, education, program administration, and implementation.
“It is unacceptable and downright offensive that anyone would get behind the wheel drunk, let alone at twice the legal limit,” said NHTSA Administrator David Strickland. “I urge the states to adopt our new guidelines to protect sober motorists and ensure that individuals convicted of drunk driving learn from their mistakes.”
According to NHTSA, over the past decade, almost two of every five (41 percent) deaths that occur around the New Year’s holiday and the Christmas holiday (37 percent) were alcohol-impaired.
>>Bonus Link: NHTSA has safety tips and information on sober driving during the holidays. View NHTSA's Safety 1n Numbers newsletter for safety tips and information on sober driving during the holidays.
Atlantic Cities recently reported on a ride sharing program called Lyft, which requires riders to join up and input credit card information to be eligible for the carpool-like rides. Lyft’s licensed drivers are pinged to pick up passengers whom the system tracks as headed in the same direction as other riders already in the car.
The article focuses on the "cool" factor, and the potential for building social relationships, making it a great solution for college kids or young adults looking for a safe way to get home on nights out—a critical public health service, particularly when research released earlier this year found that more than one-third of designated drivers end up drinking.
But another potential future use could be to help alleviate massive transportation challenges in rural areas, particularly for those with limited income or no access to a car for other reasons. One Department of Transportation study found, "Close to 40 percent of all rural counties are not served by rural transit, while another 28 percent have limited service. And, nearly 57 percent of the rural poor do not own a car, while 1 in every 14 households in rural America has no vehicle." In the future, perhaps ride sharing programs could catch on as a viable transportation option in rural towns far away from the neon lights.
>>Bonus Link: A second transportation article in Atlantic Cities this week finds that despite the growth in ridership of bike share programs across the country, PBSC, a Montreal-based major supplier of city bikeshare equipment and software faces major transportation woes. PBSC bike share customers include London, D.C. and Chicago, the city with the largest bike-share program in the nation.
DOT and HUD Release Neighborhood Affordability Tool
The U.S. Departments of Housing and Transportation (HUD and DOT, respectively) have released a Location Affordability Portal, a new tool that lets users estimate housing and transportation costs for neighborhoods across the country.
“Many consumers make the mistake of thinking they can afford to live in a certain neighborhood or region just because they can afford the rent or mortgage payment. Housing affordability encompasses much more than that,” said HUD Secretary Donovan. “The combined cost of housing and transportation consumes close to half of a working family’s monthly budget, and the [Portal] will help to better inform consumers, help them save money, and provide them with a broader perspective of their housing and transportation options.”
The new tool was developed with the input of real-estate industry professionals, academics, and staff from HUD and DOT, and uses statistical models that were developed from various sources that capture key neighborhood characteristics including population density, transit and job access, average number of commuters and distance of commutes, average household income and size, median selected monthly owner costs. and median gross rent. Read more on housing and transportation.
Health Index May Reduce Hospital Readmissions
A health risk score used during hospital stays using routine data from hospital electronic medical records may be able to identify patients at high risk of unplanned hospital readmission, according to a study published in Medical Care.
The score is calculated automatically using patient data such as vital signs, nursing assessments, skin condition, heart rhythms and laboratory tests. Lower Rothman Index scores (from a maximum of 100) indicate a higher risk of readmission. The study evaluated the ability of the Rothman Index to predict hospital readmission, based on data from more than 2,700 patients hospitalized during 2011. The researchers found that patients whom the Index calculated as being high risk for readmission were 2.5 times as likely to be readmitted within 30 days of discharge as patients calculated by the Index to be low risk.
About 20 percent of Medicare patients are readmitted to the hospital within 30 days of discharge, at an estimated cost of $17 billion per year, according to the study authors. Medicare has begun reducing payments by up to 2 percent for hospitals with high readmission rates. Read more on community health.
Rapid Flu Testing in the ER Leads to More Effective Treatment
Using rapid influenza tests to diagnose flu in patients who come to the emergency room results in fewer unnecessary antibiotics, increased prescriptions for antiviral medicines, and fewer additional lab tests compared to patients diagnosed with influenza without testing, according to a new study the Journal of the Pediatrics Infectious Diseases Society.
Among patients diagnosed with influenza without rapid testing, 23 percent of the emergency department visits included a prescription for antibiotics, which are not effective in to treat influenza because it is a viral infection. However, for patients who were diagnosed by rapid testing, only 11 percent of visits resulted in the patient getting antibiotics. Additional laboratory tests, including chest X-rays, blood tests, and urinalysis, were also ordered less frequently for patients whose influenza illness was diagnosed with a rapid test.
"While other studies have shown that physicians can accurately diagnose influenza without testing, our results suggest that using an influenza test increases diagnostic certainty and leads to the physician providing more specific and appropriate care,” says Anne J. Blaschke, MD, PhD, of the University of Utah School of Medicine, the study’s lead author. Read more on infectious disease.
Despite decades of outreach around car seat safety, car crashes remain the number one cause of death for children under the age of 12, according to the U.S. National Highway and Traffic Safety Administration (NHTSA). The numbers from the U.S. Centers for Disease Control and Prevention (CDC) are also stark and troubling: more than 1,200 U.S. children ages 14 years and younger died in motor vehicle crashes in 2010, and approximately 171,000 were injured.
What makes these statistics even more tragic is the fact that many of these deaths and injuries are preventable by following these simple edicts—put kids in the right seat and use it the right way. In fact, NHTSA has identified child seat safety restraints as the most effective way to protect young children in motor vehicle crashes.
Child safety seats reduce the risk of death in passenger cars by 71 percent for infants and by 54 percent for kids ages 1 to 4, according to the CDC. For children ages 4 to 8, booster seats cut the risk of serious injury by 45 percent.
This week is Child Passenger Safety Week. It also marks the launch of the new BuckleUpForLife.org, Cincinnati Children’s and Toyota’s community-based safety program designed to educate families on critical safety behaviors and provide child car seats to families in need.
The website features the “Making Safety a Snap” online tool—a series of quick questions and videos that demonstrate exactly how parents and caregivers can make sure their child has the right safety seat and is using it properly.
You can follow a live Buckle Up for Life Twitter Q&A starting at 2 p.m. today. Use the hashtag #BuckleUpforLife to join the discussion and have your child car seats questions answered by their experts.
Kids and their parents aren’t the only ones who need to do some back-to-school prep as the fall term starts. A new survey of U.S. school bus drivers released by the National Association of Directors of Pupil Transportation Services (NADPTS) last week found that more than 80,000 vehicles illegally passed a stopped school bus on a single day this past year. That translates to nearly 15 million violations during the 180-day school year, according to the association.
Laws and regulations can vary somewhat by state, but generally drivers must come to a full stop when they are behind or across the street from a school bus when it has its stop sign out and its lights are flashing. The NADPTS maintains a list of state laws regarding what cars must do when they see a stopped school bus.
No one organization keeps tabs on all children injured and killed by drivers who didn’t stop for a school bus, but three children were killed in such accidents in North Carolina alone last year, bringing that state’s total of children killed in such accidents to a dozen since 1998.
“There are nearly a half million school buses on the road each day in the United States,” said Max Christensen, NADPTS president, and, “any driver who passes a stopped school bus illegally is gambling with a child’s life.” According to the association, some states are adopting more stringent safety measures, such as improved motorist education, increased fines, and more law enforcement, including the use of photo evidence in court cases from cameras mounted on the sides of school buses.
>>Recommended Reading: To help reduce the number of injuries and fatalities related to school bus accidents, the National Highway Traffic Safety Administration has a school bus safety website stocked with information.
>>NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to info@newPublichealth.org.
“Oh my gosh, what have I done?” That’s the first question a man asked himself after he looked up from texting “I Love You” to his wife, to find that his car had crashed into a buggy carrying an Amish family and killing three of their children. That story, and three others, make up a new 36-minute video by acclaimed documentary film maker Werner Herzog, “From One Second to the Next.” The video was produced for AT&T and supported by Sprint, T-Mobile and Verizon, to show drivers of all ages what can happen when texting while driving. In the documentary, what happens is that five people die, two have their health ruined and bills pile up into the millions, and one sees his injuries put an end to his career.
Wireless firms hope to distribute the film to tens of thousands of high schools, safety organizations and through government agencies for maximum impact.
According to the National Highway Safety Administration, 3,000 people were killed in distracted driving accidents in 2011 alone. “When you get a message while driving, it’s hard not to pick up your phone,” said Herzog. “With this film, we want to help make people more aware of the potential consequences of that action.”
Almost everything touches public health. From understanding care options to access to nutritious food to being able to breathe clean air—it all works together to prevent disease and promote healthy living. That includes the types of available transportation.
>>View NewPublicHealth’s infographic exploring the role of transportation in the health of our communities, “Better Transportation Options = Healthier Lives.”
The Transportation Research Board Subcommittee on Health and Transportation (H+T) was formed in the Summer of 2011 to provide a variety of disciplines the opportunity to share and compare transportation-related health research in an academic environment. It’s a place where engineers, public health professionals, planners, epidemiologists, advocates and others can identify, advance and publish research that advances our understanding of transportation infrastructure and policies affect public health. [Editor’s Note: Read NewPublicHealth’s coverage of last year’s Transportation Research Board conference.]
The H+T Subcommittee’s areas of interest and study include sustainable and active transportation modes (e.g., walking, biking, transit); mobility and accessibility; safety; transportation-related air pollution and noise impacts; and social cohesion and other social, physical and mental health impacts.
State and local government across the country are already utilizing engineering and design solutions to improve public health in their communities, according to The Network for Public Health Law, which provides information and technical assistance on issues related to public health and is funded by the Robert Wood Johnson Foundation.
“In Massachusetts and Minnesota, transportation officials are exploring infrastructures that allow for ‘active transportation’—like walking and bicycling—which can help prevent weight gain and lower the risks of obesity, diabetes and heart disease. In Washington and California, programs are incorporating transit-oriented development strategies to improve environmental health and access to healthy foods.”
>>Read more on how transportation can impact health.
It has been a busy month for the Department of Transportation’s National Highway Traffic Safety Administration (NHTSA). Car safety innovations released by the organization in just the last few weeks include:
- A free app to help consumers find the safest cars when buying or renting, as well as nearby sites for car seat installation services and checks.
- New guidelines for auto-makers to help reduce the use of electronic devices while driving, and with that reduce the number of people killed and injured by distracted driving every day. A recent NHTSA survey found that 600,000 drivers talk on their cell phones or use electronic devices at any given daylight moment. More than 3,300 people were killed in 2011 and 387,000 were injured in crashes involving a distracted driver, according to NHTSA data.
- A reminder that during the spring and summer highway construction kicks into high gear and drivers need to pay attention to road changes and warnings. In 2011, the most recent year for which data are available, 587 people died in highway work-zone fatalities—an increase of 11 fatalities over 2010.
There’s good reason for NHTSA’s steady supply of information and action. Recent statistics from the Centers for Disease Control and Prevention (CDC), which has designated the high motor vehicle injury rate as a winnable battle, shows that in the United States, motor vehicle-related injuries are the leading cause of death for people age 5 through 34.
The Transportation Research Board, a division of the National Research Council, is holding its annual meeting this week including a critical session later today that will bring together several subcommittees to talk about the intersection of transportation and health.
>>Read our coverage from last year’s Transportation Research Board meeting.
Ed Christopher, who is with the Federal Highway Administration Resource Center Planning Team and co-chair of the health subcommittee, says that over the last ten years people in the transportation sector have become more aware of the connections between health and transportation including physical activity, safety, air quality, equity, and access, but that collaboration is still in its early stages. “Health and transportation professionals often come from different scientific backgrounds and have separate institutional structures,” says Christopher. Today’s session bring together the health subcommittee along with several others including committees on policy, legal resources, safety and public transportation.
Christopher says the session will help “demystify” the connections between health and transportation, and identify promising opportunities for research and collaboration.
The keynote speaker at today’s session is Andrew Dannenberg, MD, MPH, an Affiliate Professor at the University of Washington’s School of Public Health Department of Environmental and Occupational Health Sciences and the Department of Urban Design and Planning in the College of Built Environments.
Dr. Dannenberg is also a consultant to and former team lead of the Healthy Community Design Initiative at the Center for Disease Control and Prevention, where he works on activities related to the health aspects of community design including land use, transportation, urban planning, and the built environment. In advance of today’s meeting, NewPublicHealth spoke with Dr. Dannenberg about synergies between transportation and health.
NewPublicHealth: What is the intersection of health and transportation and why does it matter?