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Nov 13 2014
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BUILD: Going Upstream to Improve Community Health

Yesterday saw the launch of the BUILD Health Challenge, a national award program to create and improve partnerships among health systems, community-based organizations and local health departments with an aim of addressing upstream problems that impact the health of local residents.

On a webinar to announce the challenge yesterday, representatives of the founding partners of the challenge said they were embracing the challenge because “transforming health outcomes requires a coordinated effort to tackle such contributing factors as socio-economic conditions, transportation, housing, environmental issues and access to healthy food.” The evidence base underpinning the new initiative shows that partnerships among health systems, public health agencies and community organizations are the most effective ways to work toward that transformation.

The BUILD Health Challenge will award up to $7.5 million in both financial awards and low-interest loans over two years to support up to 14 community-driven efforts that take Bold, Upstream, Integrated, Local and Data-driven approaches to improving community health and promoting health equity.

BUILD’s partners include the Advisory Company, the deBeaumont Foundation, the Kresge Foundation and the Robert Wood Johnson Foundation.

>> Bonus Link: Read an FAQ about the Build Health Challenge.

Nov 13 2014
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Public Health News Roundup: November 13

More than 5,000 Lives Lost to Ebola So Far
Ebola has now killed at least 5,160 people and infected at least 14,098, mostly in West Africa, since the outbreak started last spring, according to the World Health Organization. New cases have increased sharply in Sierra Leone, while the incidence of new cases is declining in Guinea and Liberia. Read more on Ebola.

Seniors Need Resources Beyond the Internet for Health Information
Seniors are less likely than others to search for health informtion on the Internet, making it necessary for health providers to provide other health information resources, according to a new study in the Journal of General Internal Medicine. The study found that while huge amounts of money and attention have been invested recently in health information technology in the United States—for example, by providing electronic medical records online—it’s unclear whether older patients are willing and able to use those for personal and general health information. The researchers analyzed data from the 2009 and 2010 Health and Retirement Study, a nationally representative survey of more than 20,000 Americans 65 years and older. About 1,400 of the participants were asked how often they used the Internet in general and, in particular, how often they searched for health and medical information. Just over thirty percent used the Internet regularly and only 9.7 percent identified as having low health literacy used the internet at all. Read more on health literacy.

Predicting Which U.S. Soldiers Could Predict Suicide
A study that looked at predicting suicides in U.S. soldiers after hospitalization for a psychiatric disorder suggests that nearly 53 percent of post-hospital suicides occurred following the 5 percent of hospitalizations with the highest predicted suicide risk. The study, in JAMA Psychiatry, finds that the suicide rate in the U.S. Army has increased since 2004 and now exceeds the rate among civilians, and that a predictive model would help prevent some of the military suicides. The strongest predictors for suicide in this group include being male, late-age of enlistment, criminal offenses, weapons possession, prior suicidality, the number of antidepressant prescriptions filled in the previous year and psychiatric disorders diagnosed during the hospitalizations. Read more on mental health.

Nov 12 2014
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U.S. Preterm Birth Rate Still Too High: Q&A with Jennifer L. Howse, PhD, the March of Dimes

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Last week the March of Dimes releases its annual Premature Birth report card and gave a “C” grade to the United States. While the U.S. rate has seen improvement in recent years and rates of premature birth—which can cause death and lifelong disability—have dropped, the organization says there is still much room for improvement. With World Prematurity Day next week, NewPublicHealth recently spoke with Jennifer L. Howse, PhD, president of the March of Dimes, about the new report card and new efforts by the organization to study premature birth and vastly reduce the U.S. rates further.

NewPublicHealth: What’s most significant about the 2014 report card?

Jennifer Howse: The 2014 report card on premature birth in the United States shows continued improvement. In fact, rates of pre-term birth in the United States have improved. That is they’ve lowered every year for the last seven years and that means that the United States currently has a pre-term birth rate of 11.4 percent, and that rate of pre-term birth is the lowest that it’s been in the in the last 17 years. So we’re very pleased. Having said that, the United States is still short of the target set by the March of Dimes of 9.6 percent or less. Our state-by-state report card assigns a letter grade to the U.S. composite and then to each state up against that goal of 9.6 percent. So, the United States has a “C” overall, but we continue to see progress and improvements—incremental, but progress in far and away the majority of states. So it’s very important around this critical child health issue to set a target, measure the target, and to hold states and the nation accountable.

NPH: What are the things that March of Dimes is doing, has done and will continue to do that are helping that rate?

Howse: The March of Dimes has mobilized a very strong group of partners in this campaign to end premature birth. We have assembled very strong partnerships with clinicians, with state health officials, with hospital leadership, with governmental leaders—particularly in the area of Medicaid programs—and those partnerships have been activated and expanded over the last decade. Specifically, the March of Dimes has led the charge on a quality improvement program across the nation to reduce and eliminate elective induction and C-section before 39 weeks of completed gestation. That’s the QI 39 program, and now two-thirds of hospitals are showing positive results in that arena. 

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Nov 12 2014
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Public Health News Roundup: November 12

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Study Questions Long Term Success of Some Popular Diets
A new study published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, suggests that popular commercial diets can help people lose some weight in the short term, but keeping the weight off after the first year and the diet’s impact on heart health are unclear. “Despite their popularity and important contributions to the multi-million dollar weight loss industry, we still do not know if these diets are effective to help people lose weight and decrease their risk factors for heart disease,” said Mark J. Eisenberg, MD, MPH, the study’s senior author and Professor of Medicine at Jewish General Hospital/McGill University in Montreal, Quebec, Canada. “With such a small number of trials looking at each diet and their somewhat conflicting results, there is only modest evidence that using these diets is beneficial in the long-term.”

The longest diet studies researchers analyzed lasted for two years, and results were only available for the Atkins or Weight Watchers diets. Those studies found dieters regained some of their weight over time. To better understand the potential benefits from any one or all of these diets, researchers need to conduct large clinical trials directly comparing all four popular diets for long-term weight loss and changes in other heart disease risk factors, said Eisenberg. Read more on obesity.

Bilingual Brains Better Equipped to Process Information
Speaking more than one language is good for the brain, according to new research in the journal Brain and Language that indicates bilingual speakers process information more efficiently and more easily than do those who know a single language. The benefits occur because the bilingual brain is constantly activating both languages and choosing which language to use and which to ignore, said Northwestern University's Viorica Marian, the lead author of the research and a professor in the department of communication sciences and disorders in the School of Communication. When the brain is constantly exercised in this way, it doesn't have to work as hard to perform cognitive tasks, the researchers found. "It's like a stop light," Marian said. "Bilinguals are always giving the green light to one language and red to another. When you have to do that all the time, you get really good at inhibiting the words you don't need." Read more on education.

Alzheimer's-Related Costs Expected to Soar in Coming Decades
Health policy researchers at the University of Southern California have used modeling that incorporates trends in health, health care costs, education and demographics to determine that models show that the number of people expected to be diagnosed with Alzheimer’s disease will soar in the next three decades.

Key findings:

  • From 2010 to 2050, the number of individuals aged 70+ with Alzheimer's will increase by 153 percent, from 3.6 to 9.1 million.

  • Annual per-person costs of the disease were $71,000 in 2010, which is expected to double by 2050.

  • Medicare and Medicaid currently bear 75 percent of the costs of the disease.

"Alzheimer's disease is a progressive disease with symptoms that gradually worsen over time. People don't get better," said Julie Zissimopoulos, lead author of the study and an assistant professor at the USC Price School of Public Policy. "It is so expensive because individuals with Alzheimer's disease need extensive help with daily activities provided by paid caregivers or by family members who may be taking time off of work to care for them, which has a double impact on the economy.” Read more on aging.

Nov 11 2014
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Building Back Better: New Jersey as a Case Study for Improving Preparedness

In recent years, the state of New Jersey has found itself at the center of high-profile emergencies and public health scares—from the disaster wrought by Superstorm Sandy in 2012 to a controversial plan in recent weeks to quarantine individuals identified as at risk for contracting Ebola. As the 11th-most populous state—and a major hub of international travel and commerce—New Jersey’s public health leadership serves as a case study for the nation.

NewPublicHealth recently spoke with New Jersey Health Commissioner Mary O’Dowd. She has been sharing New Jersey’s preparedness and recovery lessons nationally as a member of the preparedness policy committee of the Association of State and Territorial Health Officials and implementing them as the state addresses potential exposure to Ebola in returning volunteers.

NewPublicHealth: Looking back, what worked well in the health department’s response before, during and after Sandy?

Mary O’Dowd: I think one of the things that really worked well in that immediate response phase was that we employed our lessons learned from Hurricane Irene the year before, in 2011. For example, we used the Emergency Management Assistance Compact, which is an agreement among states to assist each other in times of crisis or emergency, and we specifically used it to bring additional ambulances into New Jersey for our EMS system to enhance our capability, but we didn’t make the request until after the storm. So for the first day or two, we didn’t have the resources on hand.

We learned from that shortfall. The next year, before Sandy made its way to New Jersey, we had already put out the request via the EMAC system and had ambulances from Indiana on the ground before the storm hit. And that was really critical in our ability to immediately respond in particular with Sandy, because with the flooding we had several areas of the state where ambulances actually were flooded out and were no longer available for us. We were very lucky that we had learned that lesson from the year before. 

Watch a NewPublicHealth video about the public health response to Hurricane Sandy featurining Mary O'Dowd and other public health officials.

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Nov 11 2014
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Public Health News Roundup: November 11

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American College of Preventive Medicine Releases Recommendations to Curb Texting While Driving
The American College of Preventive Medicine (ACPM) has released guidelines aimed at reducing death and injuries linked to texting while driving. According to the National Highway Traffic Safety Administration, 12 percent of all fatal crashes involving at least one distracted driver are estimated to be related to cell phone use while driving. “Given the combination of visual, manual and cognitive distractions posed by texting, this is an issue of major public health concern for communities,” the ACPM said it its statement. The guidelines include:

  • Encourage state legislatures to develop and pass legislation banning texting while driving, while simultaneously implementing comprehensive and dedicated law enforcement strategies, including penalties for these violations.
  • Legislatures should establish a public awareness campaign regarding the dangers of texting while driving as an integral part of this legislation.
  • Promote further research into the design and evaluation of educational tools regarding texting while driving that can be incorporated into the issuance of driver’s licenses.
  • Provide primary care providers with the appropriate tools to educate patients of all ages.
  • Conduct additional studies investigating the risks associated with cell phone usage while driving—particularly texting—with motor vehicle crashes.

Read more on injury prevention.

Skin Cancer Costs Rise
The costs associated with skin cancer increased five times as fast as treatments for other cancers between 2002 and 2011, according to a study by researchers at the U.S. Centers for Disease Control and Prevention (CDC) and published in the American Journal of Preventive Medicine. The average annual cost for skin cancer treatment increased from $3.6 billion during 2002-2006 to $8.1 billion during 2007-2011, or 126 percent. The average annual cost for treatment of all other cancers increased by 25 percent during the same time period. “The findings raise the alarm that not only is skin cancer a growing problem in the United States, but the costs for treating it are skyrocketing relative to other cancers,” said the lead author of the report, Gery Guy, PhD, of the CDC’s Division of Cancer Prevention and Control. “This also underscores the importance of skin cancer prevention efforts.” Read more on cancer.

 

Childhood Obesity Often Continues into Teen Years
A new study published in the journal Pediatrics reviewed data on close to 4,000 public school students who were measured for height and weight in 5th and 10th grades. In 5th grade, one percent of students were underweight, 53 percent were normal weight, 19 percent were overweight and 26 percent were obese. Sixty-five percent of obese 5th-graders remained obese in 10th grade, 23 percent transitioned down to overweight and only 12 percent became normal weight. The study found that obese 5th graders were more likely to remain obese in 10th grade if they perceived themselves to be much heavier than ideal or came from a less-educated household. However, overweight 5th-graders were more likely to become obese by 10th grade if they had an obese parent or watched more television. The study authors say obese children face many challenges in reducing obesity in adolescence and that health care professionals should be encouraged to educate parents and caregivers to address obesity at a very young age, including advice on healthy eating and physical activity. Read more on childhood obesity.

Nov 10 2014
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Recommended Reading: In Africa, No Clear Answers on Who Lives and Who Dies of Ebola

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A national survey conducted in late October by the Harris Poll found that 49 percent of Americans see Ebola as a "moderate" or "major" public health threat to Americans. That’s down from 55 percent in a Harris poll conducted just a few weeks earlier. Experts at the World Health Organization worry that no new cases in the United States will negatively impact the country’s support for the funds and volunteers needed to help stem the outbreak still raging in several West African countries.

Today, the New York Times published the stories of two young boys in Liberia—one who survived the virus, and one who did not.  Physicians still do not have accurate methods for predicting who will survive—and what treatment it takes to get them there—so for now the course of the disease, despite best available efforts, simply seems random.

Read the New York Times story. 

Nov 10 2014
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Public Health News Roundup: November 10

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Child Mortality Rates Improve in Many Developing Countries
The child mortality gap has narrowed between the poorest and wealthiest households in a majority of more than 50 developing countries, according to a new study by researchers at the Stanford University School of Medicine. And the rates have dropped fastest among the poorest families. The researchers found four common factors in countries with a narrowing child-mortality gap: Government effectiveness, rule of law, control of corruption and regulatory quality. Read more on global health.

State Level Heart Disease Data from CDC Can Help Improve Interventions
New state heart disease specific data compiled and evaluated by researchers at the U.S. Centers for Disease Control and Prevention (CDC) provide information at the state level for the first time, a key tool for creating targeted intervention programs, according to the agency. Nearly 800,000 people die each year from heart disease, making it the leading cause of death in the United States. Although heart disease has continued to decline during the past 40 years, the rates of decline vary significantly by state.  Factors, and interventions that can impact heart disease—and its successful prevention and treatment—include hypertension, smoking, high blood cholesterol, diabetes, overweight/obesity, physical inactivity and little consumption of vegetables and fruits. Read more on heart and vascular health.

New Study Finds Cigars as Risky as Cigarettes
Many smokers think cigars are less likely than cigarettes to cause cancer and other diseases and rates of cigar smoking doubled between 2000 and 2011. However, a new study in the journal Cancer Epidemiology, Biomarkers & Prevention finds that cigar smoke—just like cigarette smoke—emits toxic chemicals. The researchers say this is an important study because cigar smoking has increased among kids and teens, who often think that cigars don’t pose the same health risk as cigarettes. Read more on tobacco.

Nov 7 2014
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Allergic to Eggs? You Can Safety Get the Flu Shot—and Other Life-Threatening Allergy and Asthma Myths

Major medical conferences often showcase a study, perhaps two, that can change the field of practice and the health for thousands to millions. At this year’s annual meeting of the American College of Allergy, Asthma and Immunology, four studies made such an impact that the College created an infographic to better help share the findings:

  • Many—perhaps even most—people who think they’re allergic to penicillin really aren’t. And taking alternative antibiotics can cost more, be less effective and bring side effects.
  • A study in Chicago found that stocking epinephrine pens in public schools saved lives for more than a dozen kids who had potentially fatal allergic reactions, but who hadn’t been told to carry their own pen. The researchers say the lesson learned is that more schools and other public spaces need to keep supplies of the low-cost devices on hand.
  • Many doctors don’t keep up with the most recent allergy information—which means their patients may not be getting the most effective treatment. For example, 85 percent of internists polled think an egg allergy is a contraindication for the flu shot. Evidence shows the shot to be safe for people with an egg allergy.
  • Some YouTube asthma videos promote incorrect and dangerous alternative treatments for asthma that pose a risk of death if used rather than treatment based on clinical trials and scientific evidence. 
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Nov 7 2014
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Public Health News Roundup: November 7

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Public Perceptions on Obesity Are Changing
New research that looked at the opinions of both the public and health care professionals during the past year finds a shift away from seeing obesity as a personal problem resulting from bad choices. Health care professionals were already less likely than the public to view obesity as a personal problem of bad choices, according to the study was presented earlier this week at the Obesity Society Annual Meeting in Boston. The study used an online survey of more than 50,000 members of the public and more than 5,000 health care professionals, finding that the percentage of Americans seeing obesity as a community problem increased by 13 percent in 2014 over the previous year and the percent of health care professionals increased by 18 percent, although that was a smaller increase than the previous year. Wealthier and younger respondents were more likely to view obesity as a medical problem. Male and rural respondents more likely view obesity as a personal problem of bad choices. Read more on obesity.

Many People, Who Think They Have a Penicillin Allergy, Don’t
Many people have been incorrectly told that they're allergic to penicillin, and have not had testing to confirm an allergy, according to a two new studies presented this week at the annual conference of the American College of Allergy, Asthma and Immunology. The studies are very important, according to the researchers, because giving alternative antibiotics to people who don’t need them results in inferior treatment, higher costs and higher toxicity for patients. Of 384 people in one study who thought they were allergic to penicillin, 94 tested negative. In the second study, 38 people who believed they were allergic to penicillin had skin testing and all tested negative. "A large number of people in our study who had a history of penicillin allergy were actually not allergic," said Thanai Pongdee, MD, a member of the ACAAI and the author of one study. "They may have had an unfavorable response to penicillin at some point in the past, such as hives or swelling, but they did not demonstrate any evidence of penicillin allergy at the current time.” Read more on infectious disease.

School Lunches Often Healthier than Packed Lunches
Researchers from Virginia Tech recently conducted a study that compared school lunches with home-packed lunches and found that school lunches were typically more nutritious. The researchers reviewed more than 1,000 lunches—about half packed and half prepared by three public schools—and found that rates of calories, carbohydrates, fat, saturated fat, sugar, vitamin C, and iron were significantly higher for packed lunches compared to school lunches. Protein, sodium, fiber, vitamin A and calcium were significantly lower for packed lunches compared to school lunches. "Habits develop in early childhood and continue into adolescence and adulthood. Therefore, this is a critical time to promote healthy eating. Determining the many factors which influence the decision to participate in the [school lunch program] or bring a packed lunch from home is vital to addressing the poor quality of packed lunches," says Elena L. Serrano, PhD, Family Nutrition Program Project Director, and Department of Human Nutrition, Foods and Exercise at Virginia Tech and the lead author of the study. Read more on nutrition.