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.
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.
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.
One in five children in the United States has a learning or attention challenge, often undiagnosed. Those challenges can contribute to kids falling behind in their classes or even dropping out of school. That’s not just an education problem. As the National Prevention Strategy from the Office of the Surgeon General shows, education deficits lead to shorter lives, poorer health and smaller incomes.
Recently, the Ad Council launched a series of radio, television and display public service announcements aimed at getting parents to go to Understood.org. The website is a collaboration of fifteen education and community partners that offers parents resources such as recommendations for trained area experts and tools parents can use to help their children with a range of learning challenges, including reading skills and comprehension.
The television ads show parents speaking commands into a smartphone, which mistakes their words and directs them to useless information—a proxy, and a pretty good one, for the frustration children facing learning challenges often feel.
- View a NewPublicHealth infographic on the connections between education and health.
- View the “Understood” videos.
EBOLA UPDATE: Administration Asks Congress for $6.18 Billion in Emergency Funds
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The Obama administration has asked the U.S. Congress to approve $6.18 billion in new emergency funds to combat the ongoing Ebola outbreak in West Africa. More than 5,000 people have died so far from the outbreak. The new funds would include:
- $1.83 billion for the U.S. Centers for Disease Control and Prevention to prevent, detect and respond to the Ebola epidemic and other diseases and public health emergencies abroad and in the United States.
- $1.98 billion for the U.S. Agency for International Development for foreign assistance in the Ebola crisis.
- $127 million would go to the U.S. Department of State to expand its medical support and evacuation capacity.
- $112 million for the U.S. Department of Defense including funding to support efforts to develop technologies relevant to the Ebola crisis.
- $1.54 billion for a contingency fund, divided between the U.S. Department of Health and Human Services, USAID and State to ensure resources are available to adapt as the crisis evolves.
Read more on Ebola.
CDC: 8 Million Women Ages 21-65 Haven’t Been Screened for Cervical Cancer
Approximately eight million women ages 21-65 years have not been screened for cervical cancer in the past five years, according to the latest Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). More than half of the women who receive a diagnosis of cervical cancer have never been or are rarely screened. “Every visit to a provider can be an opportunity to prevent cervical cancer by making sure women are referred for screening appropriately,” said CDC Principal Deputy Director Ileana Arias, PhD, in a release. “We must increase our efforts to make sure that all women understand the importance of getting screened for cervical cancer. No woman should die from cervical cancer.” Read more on prevention.
U.S. Premature Birth Rate to 11.4 Percent; March of Dimes Gives the Country a ‘C’
The national preterm birth rate has fallen to the Health People 2020 goal of 11.4 percent seven years early. Despite this, the 7th annual March of Dimes Premature Birth Report Card gave the U.S. health care system a “C” for not reaching the organization’s lower target of 9.6 percent. More than 450,000 U.S. babies were born premature in 2013, which leads to increased risks to their health as well as billions of dollars in health care costs. "Achieving the Healthy People 2020 goal is reason for celebration, but the U.S. still has one of the highest rates of preterm birth of any high resource country and we must change that," said March of Dimes President Jennifer L. Howse, MD, in a release. "We are investing in a network of five prematurity research centers to find solutions to this still too-common, costly, and serious problem." Read more on maternal and infant health.
Several heart disease associations—including the American Heart Association and the American College of Cardiology—have released a report that calls on patients to take responsibility for following doctor’s orders when it comes to improving heart heath. The report authors say that while performance measures for improvements in heart disease have traditionally been doctor-focused, patient actions are also needed.
Those actions can include:
- Following treatment plans
- Taking medications as prescribed
- Going to follow-up appointments
- Maintaining lifestyle changes such as weight loss and regular exercise
The report calls on doctors to facilitate shared goal setting; shared decision making; and shared care planning and monitoring with their patients. It also pushes doctors to look at not just short-term measures, but long-term goals for patients and how they do on those goals.
One example from the report is tracking how well a patient adheres to a medication regimen—not just whether a drug was prescribed—and whether the prescribed treatment actually achieved its goal, such as lowering blood pressure or preventing a subsequent heart attack.
“The goal of performance measurement is to improve patient outcomes, including improving the patient’s health status, and reducing their morbidity and mortality. Therefore, it is important to engage everyone that can have an impact on these goals including patients, family members or caregivers, clinicians, and the healthcare system,” said Eric D. Peterson, MD, MPH, director at the Duke Clinical Research Institute and writing committee co-chair. “Shared-accountability performance measures explicitly acknowledge these interdependencies so that everyone can work together towards the improved health of the patient.”
Massachusetts Now Has the Nation’s Strongest Paid Sick Leave Requirements
Massachusetts now has the nation’s strongest requirement for providing paid sick leave. Under a ballot question passed yesterday, people who work for businesses with 11 or more employees are now entitled to up to 40 hours of paid sick time each year. Workers at smaller companies will receive 40 hours of annual unpaid sick time. NewPublicHealth has previously written on the benefits of paid sick leave, including about an American Journal of Public Health study which found that a lack of paid sick leave can be a significant factor in the spread of disease. Read more on business.
Study: Fast Food Marketing to Children Disproportionately Affects Certain Communities
Fast food marketing directed toward children disproportionately affects black, middle-income and rural communities, according to a new study out of Arizona State University (ASU). Researchers studied the marketing practices of 6,716 fast food restaurants, determining that “while most fast food restaurants sampled were located in non-Hispanic and majority white neighborhoods, those situated in middle-income neighborhoods, rural communities and majority black neighborhoods had higher odds of using child-directed marketing tactics.” “Marketing food to children is of great concern not only because it affects their current consumption patterns, but also because it may affect their taste and preferences,” said ASU researcher Punam Ohri-Vachaspati, an associate professor of nutrition in the School of Nutrition and Health Promotion. “We know that consumption of fast food in children may lead to obesity or poorer health, and that low income and minority children eat fast food more often.” Read more on nutrition.
Study: No Link Between Media Violence and Real-Life Violence
Despite the popular notion that media violence is a factor in real-life crime, homicide rates have actually fallen over the past several decades as media violence—in movies, on television and in video games—has increased, according to two new studies in the Journal of Communication. One of the studies examined the level of violence in 90 movies from 1920 to 2005, while the other looked for links between violence in video games and real-life violence among American young people from 1996 to 2011. "The idea that media has big effects on us or shapes our society is probably untenable," said author Christopher Ferguson, chair of the psychology department at Stetson University in Florida. "This doesn't mean media has no effect at all, of course, only that we need to try to move media research out of these culture wars if we're going to make any progress." Read more on technology.
WHO: Wider Use of Naloxone Could Prevent 20,000 U.S. Drug Overdose Deaths Each Year
More than 20,000 U.S. deaths from drug overdoses could be prevented each year if naloxone were more widely available, according to the World Health Organization (WHO). Approximately 69,000 people around the world die each year from overdoses of heroin or other opioids. Opioids are commonly prescribed for chronic non-cancer pain and are the most addictive substances in common use. Naloxone can be used to counter opioid overdoses. "If opioids are easily available in people's bathroom cabinets, it might make sense for naloxone to be equally available," said WHO expert Nicolas Clark. Read more on substance abuse.
Obesity During Pregnancy Linked to Higher Risk of Kidney, Urinary Tract Abnormalities in Infants
Children of women who are obese are more likely to be born with congenital abnormalities of the kidney and urinary tract, according to a new study to be presented at ASN Kidney Week 2014 in Philadelphia, Penn. While such abnormalities are diagnosed in only 1 percent of pregnancies, they account for 20-30 percent of all prenatal abnormalities. Researchers based their findings on linked birth-hospital discharge records from Washington State from 2003 to 2012. "Our findings add to the public health importance of obesity, particularly as a modifiable risk factor," said study author Ian Macumber, MD. "The data supplement the literature regarding obesity's association with congenital abnormalities and highlight the importance of future research needed to clarify the mechanisms of these associations." Read more on maternal and infant health.
Study: Increased in Autism Cases Due to Changes in How the Condition is Defined
The dramatic increasing in the number of autism cases among children since the mid-1990s is in larger part due to how the condition is reported and defined, with today’s classification system more broader than the one used in the past, according to a new study in JAMA Pediatrics. Danish researchers determined that 60 percent of the increase in cases “can be attributed to changes in diagnostic criteria and the inclusion of out-of-hospital diagnoses.” "That the increase until now has been left more or less unexplained has undoubtedly raised considerable concern among the public and might, in fact, have affected some parents' health decisions regarding their child," said lead researcher Stefan Hansen, from the section for biostatistics in the department of public health at Aarhus University, according to HealthDay. "As our study shows, much of the increase can be attributed to the redefinition of what autism is and which diagnoses are reported. The increase in the observed autism prevalence is not due alone to environmental factors that we have not yet discovered." Read more on pediatrics.
Deaths and injuries from falls in people older than age 65 have doubled in the last decade. Last year, 24,000 older people died after a fall and more than two million sustained severe injuries—which can often lead to permanent disability. To find ways to prevent those falls and the injuries, deaths and costs that come with them, earlier this year the National Institutes of Health (NIH) and the Patient-Centered Outcomes Research Institute (PCORI) joined forces on the Falls Injuries Prevention Partnership, which will fund clinical trials at ten U.S. centers over the next five years.
The trials include some implementation of proven fall prevention strategies at the ten research sites. NIH researchers say a key goal is to help change physician behavior about fall prevention, because recent education efforts through conventional medical education channels and other methods have not been very effective.
“With this trial, we will be able to evaluate interventions on a comprehensive and very large scale,” said Richard J. Hodes, MD, director of the National Institute on Aging, which is a division of NIH. “This study will focus on people at increased risk for injuries from falls, the specific care plans that should be implemented—including interventions tailored to individual patients—and how physicians and others in health care and in the community can be involved.”
Each person in the trial will be assessed for their risk of falling, and receive either the current standard of care—information about preventing falls—or individualized care plans first shared with the trial participant’s primary care physician for review, modification and approval. They will include proven fall risk reduction interventions that can be implemented by the research team, physicians and other health care providers, caregivers and community-based organizations.
The trial directors hope to enroll 6,000 adults age 75 and older who have one or more risk factors for falls. The first year of the study is a pilot phase; if the go-ahead is given by NIH and PCORI to proceed with the study after that, enrollment for the full trial will start in June 2015, with participants followed for up to three years. The main goals of the trial are reductions in serious injuries from falls.
“With active input from patients and other stakeholders from the very beginning of this study, we think we can have a major impact, changing practice to make a real difference in the lives of older people,” says PCORI Executive Director Joe Selby, MD, MPH.
The ten trial sites and regions they serve are:
- Essentia Health, Duluth, Minnesota (Midwest)
- HealthCare Partners, Torrance, California (Southern California)
- Johns Hopkins Medicine, Baltimore (Mid-Atlantic)
- Mount Sinai Health System, New York City (Northeast)
- Partners HealthCare, Waltham, Massachusetts (Northeast)
- Reliant Medical Group, Worcester, Massachusetts (Northeast)
- University of Iowa Health Alliance, Iowa City (Midwest)
- University of Pittsburgh Medical Center (Mid-Atlantic)
- University of Texas Medical Branch, Galveston Health (Southwest)
- University of Michigan, Ann Arbor (Midwest)
Data management and analysis will be coordinated by the Yale School of Public Health.
EBOLA UPDATE: UN’s Secretary-General Calls Travel Bans ‘Unnecessarily’ Strict
(NewPublicHealth is monitoring the public health crisis in West Africa.)
U.N. Secretary-General Ban Ki-moon again came out strongly against travels bans related to Ebola, calling them “unnecessarily” strict in a Monday news conference. Some U.S. state officials have imposed quarantines on health workers returning from West Africa, but there is no federal ban; Canada and Australia have barred citizens from Liberia, Sierra Leone and Guinea. "The best way to stop this virus is to stop the virus at its source rather than limiting, restricting the movement of people or trade," said Ban, according to Reuters. "Particularly when there are some unnecessarily extra restrictions and discriminations against health workers. They are extraordinary people who are giving of themselves, they are risking their own lives." Read more on Ebola.
HUD Accepting Cities’ Applications for Economic Revitalization Assistance
The U.S. Department of Housing and Urban Development (HUD) is now accepting applications for cities looking to spur economic revitalization through the National Resource Network, which brings together national experts to work with cities to improve economic competiveness while reversing population decline, job loss and high poverty rates. “Knowledge is fuel for progress and innovation,” said HUD Secretary Julián Castro, in a release. “The National Resource Network will be a valuable tool in helping local governments address their challenges and achieve their goals. It will provide on-the-ground technical assistance and human resources that cities can use to build for the future.” Eligibility is based on economic and demographic criteria, with approximately 275 cities eligible to apply. Read more on community development.
Study: High School Football Players Need More Education on Concussion
More needs to be done to educate high school football players on the dangers of concussions, according to a new study in the Journal of Athletic Training. Researchers surveyed 334 varsity players from 11 Florida schools. Based on a written questionnaire, while most know that headache, dizziness and confusion were potential concussion signs, they did not know the link to other signs such as nausea, neck pain and difficulty concentrating. In addition, 25 percent said they had no education about concussions at all. "Our results showed that high school football players did not have appropriate knowledge of concussion. Even with parents or guardians signing a consent form indicating they discussed concussion awareness with their child, nearly half of the athletes suggested they had not," study co-author Brady Tripp, from the University of Florida, said in a National Athletic Trainers' Association news release. Emergency rooms treat more than 300,000 people for brain injuries related to sports each year. Read more on injury prevention.