Apr 28, 2015, 8:53 AM, Posted by
The CDC just released alarming data on the new rise of electronic cigarette use among U.S. teens. Unless the FDA acts now, it may get worse with each passing day which is a gamble we can't take.
If the health debate coalescing around e-cigarettes feels familiar, there’s good reason. The uncertainty and questions about this relatively new—and unregulated—product harken back to an age when it was chic for Hollywood stars to blow smoke at the screen, and cigarette brands were plastered all over race cars.
The tobacco industry knew just what to do to entice young people, and this formula hooked millions upon millions of them and locked in a lifetime of smoking—tragically shortening lives in countless cases.
Even today, just over 50 years since the Surgeon General’s first landmark report on Smoking and Health, tobacco addiction causes a host of cancers and other illnesses. Smoking is still the leading preventable cause of death in the U.S., killing 480,000 people annually and costing over $325 billion in medical expenditures and lost productivity.
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Jan 30, 2015, 5:47 PM, Posted by
“When you hear hoofbeats, think of horses, not zebras,” the late Theodore Woodward, a professor at the University of Maryland School of Medicine, cautioned his students in the 1940s. Woodward’s warning is still invoked to discourage doctors from making rare medical diagnoses for sick patients, when more common ones are usually the cause.
And while many Americans have worried about contracting Ebola—in viral terms, a kind of “zebra”—more commonplace microbial “horses,” such as influenza and measles viruses, continue to pose far greater threats. For instance, a large multistate measles outbreak has been traced to Disneyland theme parks in California—while this year’s strain of seasonal flu has turned out to be severe and widespread.
One obvious conclusion is that many microbes remain a harmful health menace, expected to kill hundreds of thousands of Americans this year. Another—speaking of Disneyland—is that much of America appears to live in a kind of fantasyland, thinking that it is protected against infectious disease.
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Jan 27, 2015, 9:00 AM, Posted by
At Virginia Commonwealth University School of Medicine, Briana Mezuk, PhD, is an assistant professor in the Department of Family Medicine and Population Health, Division of Epidemiology; and Tiffany L. Green, PhD, is an assistant professor in the Department of Healthcare Policy and Research. Both are alumnae of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program.
Approximately 30 million U.S. adults currently have diabetes, and an additional 86 million have pre-diabetes. The incidence of diabetes has increased substantially over the past 30 years, including among children. Estimates place the direct and indirect costs of diabetes at a staggering $218 billion annually.1 Like many other diseases, disparities on the basis of race and income are apparent with diabetes. Non-Hispanic blacks, Hispanics, Native Americans, and socioeconomically disadvantaged groups are more likely to develop diabetes than non-Hispanic whites and socioeconomically advantaged groups.
Despite the enormous economic and social costs associated with diabetes, it remains a struggle to apply what we know about diabetes prevention to communities at the highest risk. We have robust evidence from randomized controlled trials that changing health behaviors, including adopting a healthy diet and regular exercise routine and subsequent weight loss, will significantly lower the risk of diabetes. Unfortunately, these promising findings only appear to apply to the short-term. Even worse, results from community-based translation efforts have been much more modest than expected, and show only limited promise of reducing long-term diabetes risk. In response, leaders at the National Institutes of Health have noted that many efforts at translating clinical findings into community settings are “limited in scope and applicability, underemphasizing the value of context.”2
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Jan 12, 2015, 9:00 AM, Posted by
Chevy Williams, PhD, MPH, is a fellow at Experience Institute, where she is learning and applying design thinking to social problems. Williams is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of Pennsylvania.
Today, we can get access to just about anything in minutes or hours. Smartphones put a world of information literally at our fingertips. Within minutes, most of us can get food we want, entertainment we desire, even travel to another city. But seeing a doctor, an arguably more immediate need, is not so easy. Creating a Culture of Health requires our collective interdisciplinary expertise to make health and health care as accessible and user-friendly as other products and services we use on a regular basis.
Before I left academia, I heard the word “interdisciplinary” tossed around a lot, but I saw it practiced in very safe ways. Typical research teams of grants I was on or would review comprised researchers from only the social, psychological, and health and medical sciences. As public health faculty, I’d hear statements like “Public health is inherently interdisciplinary.” This may be true since public health draws from multiple disciplines, but I couldn’t help but feel that such statements were more a reflection of inertia than anything else.
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Dec 22, 2014, 5:08 PM, Posted by
In the shadow of this year’s Ebola outbreak, the Trust for America’s Health and the Robert Wood Johnson Foundation released a new report, Outbreaks: Protecting Americans from Infectious Diseases.
The report finds that while significant advances have been made in preparing for, responding to, and recovering from emergencies, gaps in preparedness remain and have been exacerbated as resources have been cut over time.
On the eve of the report’s release, I spoke with Jeffrey Levi, PhD, executive director of the Trust for America’s Health to get his thoughts on today’s preparedness landscape—think, Ebola—what to do about shrinking budgets and growing infectious disease threats, and where to go from here.
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Nov 21, 2014, 1:00 PM, Posted by
Jennifer Schroeder, Stephanie M. DeLong, Shannon Heintz, Maya Nadimpalli, Jennifer Yourkavitch, and Allison Aiello, PhD, MS, professor at the Gillings School of Global Public Health, University of North Carolina at Chapel Hill and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. This blog was developed under the guidance of Aiello’s social epidemiology seminar course.
Ebola is an infectious disease that the world has seen before in more moderate outbreaks in Africa. As the devastating Ebola outbreak in West Africa has taken a global turn, fear, misinformation and long-standing stigma and discrimination have acted as major contributors to the epidemic and response. Stigma is a mark upon someone, whether visible or invisible, that society judgmentally acts upon. Ebola has become a significant source of stigma among West Africans and the Western world.
In many ways, the source of this discrimination can be traced back to the legacy of colonialism and the western approach to infectious disease response in Africa. The history of foreign humanitarian aid has sometimes dismissed cultural traditions and beliefs. As a consequence, trust in westerners has eroded and has been compounded by a disconnect between western humanitarian aid approaches and a lack of overall infrastructure investment on the part of African national health systems. This is apparent in the Ebola epidemic in West Africa. Some don’t actually think that Ebola exists; instead they believe that it is a hoax carried out by the Western world. All of these factors are facilitating the rapid spread of the disease.
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Nov 17, 2014, 11:00 AM, Posted by
Meredith Barrett, PhD, is vice president of science and research at Propeller Health, a health technology company working to reduce the burden of asthma and chronic obstructive pulmonary disease (COPD). She is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of California (UC), Berkeley and UC, San Francisco. Learn about the RWJF Briefings @ the Booth at the APHA Annual Meeting on Monday, November 17 and Tuesday, November 18.
Leaders in Louisville, Kentucky, know first-hand that where you live and work affects your health and well-being. During a special session at the American Public Health Association’s meeting this week in New Orleans, we explore how the air quality in Louisville neighborhoods impacts the health, economy and overall vibrancy of the community. And we’ll highlight how Louisville is the poster child for tackling tough issues like asthma head-on, top-down and bottom-up, through data and collaboration among individual residents, corporate execs, community organizers and public leaders.
Asthma attacks are sneaky, expensive and debilitating, yet almost entirely preventable.
Asthma is one of the most common and costly chronic diseases in the United States, affecting more than 8 percent of the U.S. population. Despite decades of research and the development of effective treatments, rates of morbidity have not declined and health care costs reach more than $50 billion a year. Asthma also leads to more than 13 million missed days of school and 10 million missed days of work, negatively affecting educational achievement, employee productivity and regional business growth. But the most frustrating part is that a large proportion of these hefty impacts could be avoided with improvements in self-management, community policy and advances in digital health care.
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Nov 12, 2014, 1:00 PM, Posted by
Mitesh S. Patel, MD, MBA, MS, is an assistant professor of medicine and health care management at the Perelman School of Medicine and the Wharton School at the University of Pennsylvania. He is a staff physician and core investigator at the Center for Health Equity Research and Promotion at the Philadelphia Veterans Administration (VA) Medical Center. Patel is an alumnus of the VA/Robert Wood Johnson Foundation (RWJF) Clinical Scholars Program at the University of Pennsylvania (2012-2014).
Cardiovascular disease is the number one cause of hospitalizations, morbidity and mortality among the veteran population. Building a Culture of Health could address this issue by focusing on individual health behaviors that contribute to risk factors associated with cardiovascular disease such as physical inactivity, diet, obesity, smoking, hyperlipidemia and hypertension.
The current health system is reactive and visit-based. However, veterans spend most of their lives outside of the doctor’s office. They make everyday choices that affect their health such as how often to exercise, what types of food to eat, and whether or not to take their medications.
Connected health is a model for using technology to coordinate care and monitor outcomes remotely. By leveraging connected health approaches, care providers have the opportunity to improve the health of veterans at broader scale and within the setting in which veterans spend most of their time (outside of the health care system). The Veteran’s Health Administration (VHA) is a leader in launching connected health technologies. VHA efforts began in 2003 and included technologies such as My HealtheVet (serving approximately 2 million veterans) and telemedicine (serving about 600,000 veterans).
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Nov 5, 2014, 11:00 AM, Posted by
Steven J. Palazzo, PhD, MN, RN, CNE, is an assistant professor in the College of Nursing at Seattle University, and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2013 – 2016. ) His research focuses on evaluating the effectiveness of the Teen Take Heart program in mitigating cardiovascular risk factors in at-risk high school students.
Difficult problems demand innovative solutions. Teen Take Heart (TTH) is a program I’ve worked to develop, in partnership with The Hope Heart Institute and with support from the RWJF Nurse Faulty Scholars Program, to address locally a problem we face nationally: an alarming increase in obesity and other modifiable cardiovascular risk factors among teenagers. The problem is substantial and costly in both economic and human terms. We developed TTH as a solution that could, if it proves effective in trials that begin this fall in my native Washington state, be translated to communities across the country.
The State of Obesity: Better Policies for a Healthier America, released recently by the Trust for America’s Health and RWJF, makes it clear that as a nation we are not winning the battle on obesity. The report reveals that a staggering 31.8 percent of children in the United States are overweight or obese and only 25 percent get the recommended 60 minutes of daily physical activity. The report also finds that only 5 percent of school districts nationwide have a wellness program that meets the physical education time requirement.
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