[News article] Britain’s poor ‘will die before they retire’ if pension reforms aren’t matched by health improvements
Thousands of Britain’s poorest people “will be dead before they can retire” if sweeping pension reforms are not matched by urgent action on health inequalities between rich and poor, experts have said.
Plans to raise the basic state pension age to 70 for people currently in their twenties were laid out in the George Osborne’s Autumn Statement this week. But with male life expectancy at birth as low as 66 in some of the most deprived parts of the country, public health experts have warned that a “one size fits all” pension age risks condemning many to a life without retirement.
Average UK life expectancy at birth was 78.2 in 2010. Nationally, the figure is increasing, but huge variations exist and progress has been slower in deprived communities where poverty leads to poor diets, smoking rates are higher and alcohol abuse more common.
In Glasgow City, where male life expectancy at birth is 71.6, boys born in 2010 are expected to die on average 13.5 years earlier than those born in the London borough Kensington and Chelsea, where life expectancy is 85.1. Girls in born in the London borough in 2010 can expect 12 more years of life than those in Glasgow. Even these figures veil vast inequalities that exist within regions, with life expectancies as low as 66 years in some of Glasgow’s most deprived areas.
Martin McKee, professor of European Public Health at the London School of Hygiene and Tropical Medicine, and fellow of the Faculty of Public Health, said that if the Government wanted to raise the pension age, they must first tackle health inequalities.
“George Osborne is thinking about the average life expectancy. The average life expectancy is fairly meaningless if you’re living in a former coal mining village in Nottinghamshire or in inner-city Glasgow,” he toldThe Independent. “There are many parts of the country where people have nowhere near the average life expectancy and, crucially, nowhere near the average healthy life expectancy. It’s not just the fact people will be dead before they reach pensionable age, it’s that they will be unfit to work.”
David Walsh, a public health expert at the Glasgow Population Health Centre said that a single pension age across all areas of the country was “at the very least problematic”.
- Britain’s Poor Will Die Before They Retire (sorendreier.com)
- Britain’s poor ‘will die before they retire’ if pension reforms aren’t matched by health improvements (engineeringevil.com)
- Living Longer…and Longer…. (worthwhile.typepad.com)
- Work until you’re 70: Chancellor George Osborne accused of ‘living in fantasy land’ over Autumn Statement pension reforms (independent.co.uk)
- Ever receding retirement? (centrallobby.politicshome.com)
- State pension: age-old problems | Editorial (theguardian.com)
Measles Still Threatens Health Security
On 50th Anniversary of Measles Vaccine, Spike in Imported Measles Cases
Fifty years after the approval of an extremely effective vaccine against measles, one of the world’s most contagious diseases, the virus still poses a threat to domestic and global health security.
On an average day, 430 children – 18 every hour – die of measles worldwide. In 2011, there were an estimated 158,000 measles deaths.
In an article published on December 5 by JAMA Pediatrics, CDC’s Mark J. Papania, M.D., M.P.H., and colleagues report that United States measles elimination, announced in 2000, has been sustained through 2011. Elimination is defined as absence of continuous disease transmission for greater than 12 months. Dr. Papania and colleagues warn, however, that international importation continues, and that American doctors should suspect measles in children with high fever and rash, “especially when associated with international travel or international visitors,” and should report suspected cases to the local health department. Before the U.S. vaccination program started in 1963, measles was a year-round threat in this country. Nearly every child became infected; each year 450 to 500 people died each year, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness.
People infected abroad continue to spark outbreaks among pockets of unvaccinated people, including infants and young children. It is still a serious illness: 1 in 5 children with measles is hospitalized. Usually there are about 60 cases per year, but 2013 saw a spike in American communities – some 175 cases and counting – virtually all linked to people who brought the infection home after foreign travel.
“A measles outbreak anywhere is a risk everywhere,” said CDC Director Tom Frieden, M.D., M.P.H. “The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day. Someday, it won’t be only measles at the international arrival gate; so, detecting diseases before they arrive is a wise investment in U.S. health security.
Eliminating measles worldwide has benefits beyond the lives saved each year. Actions taken to stop measles can also help us stop other diseases in their tracks. CDC and its partners are building a global health security infrastructure that can be scaled up to deal with multiple emerging health threats.
Currently, only 1 in 5 countries can rapidly detect, respond to, or prevent global health threats caused by emerging infections. Improvements overseas, such as strengthening surveillance and lab systems, training disease detectives, and building facilities to investigate disease outbreaks make the world — and the United States — more secure.
“There may be a misconception that infectious diseases are over in the industrialized world. But in fact, infectious diseases continue to be, and will always be, with us. Global health and protecting our country go hand in hand,” Dr. Frieden said.
Today’s health security threats come from at least five sources:
- The emergence and spread of new microbes
- The globalization of travel and food supply
- The rise of drug-resistant pathogens
- The acceleration of biological science capabilities and the risk that these capabilities may cause the inadvertent or intentional release of pathogens
- Continued concerns about terrorist acquisition, development, and use of biological agents.
“With patterns of global travel and trade, disease can spread nearly anywhere within 24 hours,” Dr. Frieden said. “That’s why the ability to detect, fight, and prevent these diseases must be developed and strengthened overseas, and not just here in the United States.”
The threat from measles would be far greater were it not for the vaccine and the man who played a major role in creating it, Samuel L. Katz, M.D., emeritus professor of medicine at Duke University. Today, CDC is honoring Dr. Katz 50 years after his historic achievement. During the ceremony, global leaders in public health are highlighting the domestic importance of global health security, how far we have come in reducing the burden of measles, and the prospects for eliminating the disease worldwide.
Measles, like smallpox, can be eliminated. However, measles is so contagious that the vast majority of a population must be vaccinated to prevent sustained outbreaks. Major strides already have been made. Since 2001, a global partnership that includes the CDC has vaccinated 1.1 billion children. Over the last decade, these vaccinations averted 10 million deaths – one fifth of all deaths prevented by modern medicine.
“The challenge is not whether we shall see a world without measles, but when,” Dr. Katz said.
“No vaccine is the work of a single person, but no single person had more to do with the creation of the measles vaccine than Dr. Katz,” said Alan Hinman, M.D., M.P.H., Director for Programs, Center for Vaccine Equity, Task Force for Global Health. “Although the measles virus had been isolated by others, it was Dr. Katz’s painstaking work passing the virus from one culture to another that finally resulted in a safe form of the virus that could be used as a vaccine.”
- Measles still poses threat to U.S. despite being “eliminated” (cbsnews.com)
- CDC: Rise in Imported Measles Cases Threatens US (health.yahoo.net)
- CDC: Measles Still A Threat (radio.foxnews.com)
- US Measles Cases This Year Are Triple The Annual Average: CDC – Huffington Post (huffingtonpost.com)
- Measles still a risk, 50 years after the introduction of the vaccine (theglobaldispatch.com)
- RT @Fischblog: “Before the measles vaccine was achieved 50 years ago, the disease killed 2.6 mio people around the world every year” http:/… (wired.com)
[Magazine article] Long-Term Disease Database Proves the Value of Vaccines | Observations, Scientific American Blog Network
To find out when whooping cough started making a comeback in Ohio, or how often measles kills in America, we turn to historical records. But those records aren’t very useful when they’re squirreled away in a distant office basement. The same goes for when they are embedded in a report—you can only look at them in the same way you might admire a painting, but you cannot drop the data into a spreadsheet and hunt for statistical significance. If you are only looking at a couple years’ worth of information that formatting dilemma is not such a big deal. You can scour the data and manually punch it into your analysis. It only becomes a huge problem when you are looking at hundreds or thousands of data points.
Such is the problem that public health experts at University of Pittsburgh encountered when they were exploring old medical data and developing models that predict future outbreaks. “We found ourselves going back and pulling out historical datasets repeatedly. We kept doing it over and over and finally got to the point where we thought it would be not only a service to ourselves but everybody if all the data was made digital and open access,” says Donald Burke, the dean of Pittsburgh’s graduate school of public health.
Four years ago, buoyed by funds from the National Institutes of Health and the Gates Foundation, they started the process of digitalizing 125 years worth of medical records. The endeavor was dubbed Project Tycho, named for the Danish nobleman Tycho Brahe who made the voluminous astronomical observations that Kepler later tapped to develop the laws of planetary motion. (But no pressure, right?)
The online, open-access resource now features accounts of 47 diseases between 1888 and today. It includes data from the weekly Nationally Notifiable Disease Surveillance reports for the United States, standardized in such a way that the data can be immediately analyzed.
In the research world, that’s a big accomplishment. Making this data usable takes more than casually monitoring a scanner while sipping coffee. The data has to be made uniform, a tedious process of manual input with unenviable tasks like removing periods, dashes and other inconsistencies while identifying data gaps.
Pittsburgh researchers also gave their new data trove a test drive to illustrate what could be done with the data. They mined Tycho for information on eight common diseases detailed in the records—polio, measles, rubella, mumps, hepatitis A, diphtheria and pertussis. Looking at available records before and after vaccines were discovered for those diseases, they estimated that 103 million cases of those contagious diseases have been prevented since 1924, (assuming the reductions were all attributable to vaccination programs). Their findings are published in this week’sNew England Journal of Medicine. The data also points to what can happen when communities become too lax about vaccinations (among other factors). They quantified the resurgence in recent years of pertussis throughout the country, particularly in the Midwest to Northwest and in the Northeast and also ongoing cases of mumps. “Reported rates of vaccine refusal or delay are increasing,” the authors write. “Failure to vaccinate is believed to have contributed to the reemergence of pertussis, including the large 2012 epidemic.”
When vaccines work well, sometimes “people no longer fear the disease and they undervalue the vaccine and in some ways that is what is going on right now,” says Burke, pointing to the discredited vaccine-autism link which prompted some parents to turn away from childhood vaccines. With this newly available data collection, more can be done than simply looking at where the disease is happening—or not happening. Researchers can begin looking for drivers of disease and identifying patterns about the burden of disease by say, climate or socioeconomic-status.
Flip through some of the data yourself here after it becomes searchable to the public on November 28.
[One has to register to view data, for institution I just entered private citizen and my registration was accepted. The database interface is very user friendly!]
- Vaccines work. Period. (sciencebasedmedicine.org)
- Researchers develop massive database to help fight deadly diseases… (medicalxpress.com)
- A rebuke to the antivaccine movement: A hundred million cases of disease prevented and millions of lives saved by vaccines [Respectful Insolence] (scienceblogs.com)
- Childhood vaccines prevent disease but risks remain (triblive.com)
- FDA scientist discusses recent pertussis vaccine study (theglobaldispatch.com)
- Trove of Public Health Data Unlocked by Pitt Researchers to Help Fight Deadly Contagious Diseases (medindia.net)
- Anti-Vaxxers Take Note: Vaccines Have Prevented 100 Million Serious Childhood Diseases In U.S. Since 1888 (reason.com)
- Katie Couric promotes dangerous fear mongering with show on the HPV vaccine (richarddawkins.net)
The release and publication of Project Tycho™ data has been featured in an article of the New York Times online and print version of Thursday November 28th entitled “The Vaccination Effect: 100 Million Cases of Contagious Disease Prevented”. It emphasizes that the large amount of data digitized by the project provides an invaluable resource for science and policy and the importance of vaccination programs in the United States.
Through a collaboration with the Open Government Initiative, Project Tycho™ data have been listed on HealthData.gov as new open access resource for governmental data. In addition on the listing, HealthData.gov has agreed to host Project Tycho™ level 1 and level 2 data that can each be downloaded from this site as a one CSV file with a single click. Comments on this release have been made in the HealthData.gov blog.
After four years of data digitization and processing, the Project Tycho™ Web site provites open access to newly digitized and integrated data from the entire 125 years history of United States weekly nationally notifiable disease surveillance data since 1888. These data can now be used by scientists, decision makers, investors, and the general public for any purpose. The Project Tycho™ aim is to advance the availability and use of public health data for science and decision making in public health, leading to better programs and more efficient control of diseases. Read full press release.
Three levels of data have been made available: Level 1 data include data that have been standardized for specific analyses, Level 2 datainclude standardized data that can be used immediately for analysis, and Level 3 data are raw data that cannot be used for analysis without extensive data management. See the video tutoral.
November 28, 2013 |A Project Tycho™ study estimates that 100 million cases of contagious diseases have been prevented by vaccination programs in the United States since 1924
In a paper published in the New England Journal of Medicine entitled “Contagious diseases in the United States from 1888 to the present,” aProject Tycho™ study estimates that over 100 million cases have been prevented in the U.S. since 1924 by vaccination programs against polio, measles, mumps, rubella, hepatitis A, diphtheria, and pertussis (whooping cough). Vaccination programs against these diseases have been in place for decades but epidemics continue to occur. Despite the availability of a pertussis vaccine since the 1920s, the largest pertussis epidemic in the U.S. since 1959 occurred last year. This study was funded by the Bill & Melinda Gates Foundation and the National Institutes of Health and all data used for this study have been released through the online Project Tycho™ data system as level 1 data.
“Historical records are a precious yet undervalued resource. As Danish philosopher Soren Kierkegaard said, we live forward but understand backward,” explained Dr. Burke, senior author on the paper. “By ‘rescuing’ these historical disease data and combining them into a single, open-access, computable system, we can now better understand the devastating impact of epidemic diseases, and the remarkable value of vaccines in preventing illness and death.” See an interview with the authors and an animation on the analysis.
Not sure if this is the right approach. I was brought unto be personally responsible for my actions and not rely on others to create ways to help me do the right things. Part of my thinks money spent on these grants could be better spent elsewhere. These ideas seem to be only shotgun approaches and do not really address underlying issues.
Still, I think their hearts are in the right place.
Through a series of small grants, we’re is exploring the utility of applying behavioral economic principles to perplexing health and health care problems—everything from getting seniors to walk more to forgoing low-value health care.
At a recent meeting in Philadelphia we challenged grantees to compete in an Innovation Tournament. The goal was to identify testable ideas that leverage behavioral economic principles to help make people healthier by working with commercial entities. Participants were assigned to groups and made their best pitches to their colleagues. And of course we used a behavioral economics principle (financial incentives) to increase participation: Each member of the first, second and third place teams received Amazon gift cards.
Eight teams made the finals:
1. Love Lock: This team addressed the issue of driving and texting by proposing an app that could be installed on your cell phone that would send reminders not to text while driving. This team would work with car insurance and mobile phone carrier companies and provide discounts to those who get it installed. The behavioral economics principles being tested are default choice and opt-out.
2. McQuick & Fit: Too many people eat unhealthy food. This team’s idea was to have a rewards card that can only be used to purchase healthy food. With each purchase, the customer would earn points toward free, healthy foods. Online orders would be placed through a website that would feature salient labeling and allow for defaults to order healthy meals. The behavioral economics principles at play include pre-commitment, default choice, labeling, and incentives.
3. Just Bring Me Water: The problem tackled by this team is “regrettable” calories—mindlessly consuming whatever is put in front of you, such as free bread at a restaurant, or soda on a plane. The innovation: when booking a table online or calling for a reservation, you could ask to “opt-out” of the complimentary bread or chips that are offered. This would reduce the consumption of regrettable calories.
4. Lunch Club: This group looked at addressing gluttony through a partnership with a chain restaurant. When going out for a meal, portions are typically bigger and diners consume more. But what if you had the option of doggy-bagging one third of the meal for another meal—framed as “buy dinner and get lunch free”? And, if you took this option, you would get a scratch off as an enhanced incentive and immediate reward. The behavioral economic principles being tested here include loss aversion, active choice, and incentives.
5. Snooze, But Don’t Lose: People don’t get enough good sleep, which leads to poor executive functioning and safety issues. To increase safety, productivity, and efficiency, this group proposed using a Fitbit to build in reminders to go to bed earlier and provide feedback on good sleep. The behavioral economic principles at play are pre-commitment and loss aversion.
6. Google Coach: This team’s idea was to create good habit formation, specifically commitment to a health plan, whether it was getting more sleep, adhering to a diet, or taking vitamins regularly. The group proposed partnering with Google and using its calendar and mobile phone platform to program smart defaults that are personalized to the individual. For example, people could actively schedule exercise or sleep based on their schedule on Google calendar. The group hypothesized that intelligent defaults are better than people planning themselves (without defaults).
7. The Basketeers: This team wanted to optimize consumers’ baskets at grocery stores and supermarkets, increasing the amount of healthy items purchased. The group suggested partnering with an online supermarket to create different packages of food for customers to purchase. For example, there could be the J-Lo package, which would bundle together food items that this aspirational star would most likely eat. In addition, when checking out, the website would assess the customer’s basket for healthier options, such as switching whole milk for skim milk. As a reward, consumers would get discounts and express delivery for choosing healthier options.
8. Team REV (Re-Engineering Vending): Soda and other sugar sweetened beverages lead to obesity. This team proposed partnering with beverage companies to make vending machines more fun, while optimizing them to help people make healthier beverage selections. For instance, the vending machine would have sensors and as you approach the unhealthy items, the healthier item buttons would light up. The behavioral economics principle applied here is choice architecture.
The participants voted for their top three choices. Lunch Club came in third while Love Lock and Google Coach tied for first place. And, you might wonder, how does a group of behavioral economists and psychologists break a tie? By playing rock, paper, scissors. Team Love Lock won.
This post originally appeared in the RWJF Pioneering Ideas Blog.
- How a behavioral economist eats Thanksgiving dinner (washingtonpost.com)
- What behavioral economics is and what it is not.. (mostlyeconomics.wordpress.com)
- Meet the ‘Genius’ Whose Ideas About Behavioral Economics Could (Someday) Change Lives (psmag.com)
- Decisions, Decisions…Behavioral Economics and Behavioral Change (rwjfblogs.typepad.com)
- Eight Innovative Ideas to Influence Health Behavior (rwjfblogs.typepad.com)
- Next challenges in behavioral economics (alessandroinnocenti.wordpress.com)
- Lose weight, Get Gold in Dubai (blogs.wsj.com)
Twelve ideas to help you stay healthy during flu season
The 2013 flu season has begun, and while it is still early in the season, cases have already been reported in the U.S. Winter gatherings can bring together people who are vulnerable to the cold & flu virus.
People who get together for the winter holidays can be exposed to viruses from other parts of the region and can pick up and spread the illness from wherever they’ve been. Here are some small, individual changes you can make lending to a healthy winter season.
- Drink black or green tea with lemon and honey. Drinking hot tea while breathing in the steam stimulates the cilia – the hair follicles in the nose – to move out germs more efficiently. Lemon thins mucus and honey is antibacterial.
- Consume enough protein. Diets that are too low in protein can deplete the immune system. The current recommendation for protein intake is at least 60 grams per day for adult women and at least 75 grams per day for adult men, depending on age, activity level and if they need to gain/lose weight.
- Slowly exhale. When walking past a person who is sneezing or coughing, slowly exhale until you’re past them. This avoids you inhaling contaminated air.
- Try Zinc lozenges. If you get a scratchy throat, zinc lozenges can relieve cold symptoms faster.
- Eat your fruits and vegetables. Eating 5 or more fruits and vegetables each day will provide many vitamins and minerals necessary for your immune system to function properly. Try to choose more vegetables than fruit.
- Sanitize your space. You can sanitize commonly touched items (cell phones, grocery carts, keyboards, gym equipment) to help the spread of germs. Remember, rhinoviruses causing cold & flu symptoms can live on surfaces for up to 48 hours!
- Pamper your nose. The job of your nose is to filter allergens, bacteria, and viruses floating in the air. By using saline nasal rinses, you can help flush germs and clear secretions in your upper airway.
- Consume enough water. The urge to drink water can decrease in colder months, but the need for water is still important. Consuming enough fluids will eliminate toxins from your lymph system which keeps your immune system functioning properly.
- Get a massage for your immune system! Massage increases circulation which boosts immunity by nourishing cells with more oxygen filled blood. Click here to learn about our massage services.
- Sanitize your brushes. Think about the items you may reuse every day and consider cleaning or replacing them (cosmetics and make up brushes, toothbrushes, hair brushes, hand towels). A quick swipe of an alcohol wipe on a tube of lipstick or washing make up brushes in an antibacterial soap can support a healthy immune system.
- Sleep. Research shows that adults need 7-8 hours of sleep to stimulate an immune response from our natural killer cells which are the cells that attack viruses.
- Humidity. Dry air in the winter can cause your lips, mouth, & nose to become dry and cracked. Cracked skin can be an entry point for bacteria and viruses. Consider a humidifier to help keep moisture in the air.
Homemade Sani Wipes:
Fold or cut paper towels or napkins and put them into a wipe container. Use 1 1/2 cup of warm water, add 1 Tbsp. of coconut oil, and 1 tsp. of alcohol. Add 3 drops of lavender oil if you like. Then mix well and pour the mixture into the container of napkins to saturate them. Makes 2 containers.
Your health and wellness crew in WELLAWARE wish you a healthy winter season.
- Patz, A. (2013, December). Live healthy. Health 27(10).
- CDC. (2013, November 22). Seasonal Influenza. Retrieved fromhttp://www.cdc.gov/flu/
- CDC. (2012, October). Nutrition for everyone: protein. Retrieved fromhttp://www.cdc.gov/nutrition/everyone/basics/protein.html
- Beyond an Apple a Day: 10 Germ-Busting Tips for Cold and Flu Season (redtri.com)
- Study Finds How Flu Evolves to Escape Immunity (medindia.net)
- Above the inFLUence > If you’re sick, don’t work. If your work requires you to come in sick, let us know. (newsreview.com)
- Tip of the Week: Cold and Flu Season (pacusher.wordpress.com)
- Personalized Flu Vaccines Approved By FDA: New, Unique Options For The Elderly, Children, And People With Allergies (medicaldaily.com)
- 5 Tips on How to Stay Flu Free (roserenea91.wordpress.com)
- Vaccines, Flu & Other Seasonal Ailments: What You Need To Know (whnt.com)
“This season the forecasts will be more readily available to the public on a website hosted by Columbia’s Mailman School of Public Health expected to launch in the coming weeks.”
Researchers take a page from weather forecasting to predict seasonal influenza outbreaks in 108 cities across the country
Scientists were able to reliably predict the timing of the 2012-2013 influenza season up to nine weeks in advance of its peak. The first large-scale demonstration of the flu forecasting system by scientists at Columbia University’s Mailman School of Public Health was carried out in 108 cities across the United States.
Results are published online in the journal Nature Communications.
The flu forecasting system adapts techniques used in modern weather prediction to turn real-time, Web-based estimates of influenza infection into local forecasts of the seasonal peak by locality. Influenza activity peaked in cities in the southeast as early as December 2012, but crested in most of the country in the first weeks of 2013.
Year to year, the flu season is highly variable. It can happen anywhere from December to April. But when it arrives, cities can go from practically no cases to thousands in a very short time. “Having greater advance warning of the timing and intensity of influenza outbreaks could prevent a portion of these influenza infections by providing actionable information to officials and the general public,” says first author Jeffrey Shaman, PhD, assistant professor of Environmental Health Sciences at Columbia University’s Mailman School of Public Health.
For the public, the flu forecast could promote greater vaccination, the exercise of care around people sneezing and coughing, and a better awareness of personal health. For health officials, it could inform decisions on how many vaccines and antiviral drugs to stockpile, and in the case of a virulent outbreak, whether other measures, like closing schools, are necessary.
The new study builds on the researchers’ 2012 study that used the system to retrospectively predict the peak of the flu in New York City for the years 2003-2008. That research was limited to one city and performed as a test of the system. The current study is the first to make predictions in actual real-time and for the whole country.
Beginning in late November of 2012, the researchers used the flu forecasting system to perform weekly estimates for 108 cities. They shared the results with the CDC and posted them online in an academic archive. Near the end of 2012, four weeks into the flu season, the system had predicted 63% of cities accurately. As the season progressed, the accuracy increased. By week four, it successfully predicted the seasonal peak in 70% of the country. It was able to give accurate lead-times up to nine weeks in advance of the peak; most lead-times were two to four weeks.
The flu forecasts were also much more reliable than those made using alternate, approaches that rely on historical data. “Our method greatly outperformed these alternate schemes,” says Dr. Shaman.
The researchers saw regional differences in the accuracy of the system, but they were likely within normal variation. “As an example, retrospectively, we’ve been able to predict the flu in Chicago very well; this year we did a terrible job in that city. For other cities, the opposite held. It averages out. On the whole the system performed very well,” Dr. Shaman says. However, there were hints of geographical differences. “We were able make better predictions in smaller cities. Population density may also be important. It suggests that in a city like New York, we may need to predict at a finer granularity, perhaps at the borough level. In a big sprawling city like Los Angeles, we may need to predict influenza at the level of individual neighborhoods.”
Google Flu Trends Goes “Off the Rails”
The researchers designed the flu forecasting system to use combined data from 1) Google Flu Trends, which makes estimates of outbreaks based on the number of flu-related search queries, and 2) region-specific reports from the Centers for Disease Control on verified cases of flu. The system approach is analogous to weather forecasting, which employs real-time observational data to reduce model forecasts error. In the last year, the researchers slightly modified the system to be more representative of flu rather than flu and other respiratory problems. Nevertheless, there was unusual level of “noise” in the data related to problems with Google Flu Trends.
How did this happen? One explanation is the high number of media stories about the flu, including some about the flu forecasting system itself. The result was a spike in people using Google to research the flu, which could have overloaded the Flu Trends algorithm. It’s an irony not lost on Dr. Shaman. “There was a tremendous amount of media attention accorded to the flu last year. I was part of the problem myself,” he says. Another factor may have been the particular strain of flu in circulation. “The flu was very virulent and was making people very sick, more so than previous seasons,” says Dr. Shaman. Again this could have led to spike in flu-related Google search queries. (In October, Google announced that it has revised the Flu Trends, which Dr. Shaman hopes will make flu forecasting more accurate.)
The system will be put back in action as soon as the flu season begins again. “Right now there are few cases of the flu, but as soon as the needle starts to move, we will start making predictions,” says Dr. Shaman. This season the forecasts will be more readily available to the public on a website hosted by Columbia’s Mailman School of Public Health expected to launch in the coming weeks.
Worldwide, influenza kills an estimated 250,000 to 500,000 people each year, according to the World Health Organization. In the U.S. 3,000-49,000 die from the flu every year, and about 45% of Americans were vaccinated for the flu, according to the CDC.
Co-authors include Wan Yang and James Tamerius, post-doctoral students of Dr. Shaman (Dr. Tamerius is currently at the University of Iowa); Alicia Karspeck at the National Center for Atmospheric Research; and Marc Lipsitch at the Harvard School of Public Health.
Funding was provided by the National Institutes of Health (GM100467, ES009089) and the Department of Homeland Security. Dr. Lipsitch discloses consulting or honorarium income from the Avian/Pandemic Flu Registry (Outcomes Sciences; funded in part by Roche), AIR Worldwide, Pfizer and Novartis. All other authors declare no competing financial interests.
- Will You Get the Flu? This Real-Time Flu Forecaster Could Tell You (healthland.time.com)
- Flu predictions get more accurate (philedufutureboytech.wordpress.com)
- Flu predictions get more accurate (news.cnet.com)
- Flu predictions get more accurate (news.cnet.com)
- First real-time flu forecast successful (eurekalert.org)
- Scientists Use Weather Forecasting Methods to Predict Flu Season Peak (usnews.com)
- Real-Time Flu Forecast Predicts Outbreaks in Each US City (livescience.com)
- Flu Forecast: Scientists Develop Predict Influenza By Utilizing Weather Forecasting Ideas (wonderfultips.wordpress.com)
After years of state spending cuts, mental health budgets increased in 37 states this year, according to a new report by the National Alliance on Mental Illness.
“Arguably the most notable development was that Texas increased mental health spending by $259 million over two years, the largest increase in its history,” NAMI said in a statement accompanying the report. South Carolina, which had cut mental health programs the deepest in recent years, was also among those states to increase funding this year.
Overall, the increased investment in mental health, spurred in part by the deadly shootings last year in Aurora, Colo., and Newtown, Conn., represents a dramatic reversal from recent years. Between 2009 and 2012, state spending in mental health services dropped by $4.35 billion.
According to NAMI, only six states decreased mental health funding this year – Alaska, Wyoming, Nebraska, Louisiana, North Carolina and Maine.
Aside from money, the NAMI report said states enacted other measures related to mental health. Five states passed legislation to improve the early identification of mental illness in children and youth. Seventeen states adopted laws to tighten restrictions on gun ownership by those considered dangerously mentally ill. And 19 states tinkered with laws pertaining to court-ordered treatment of those with mental illness.
- Newtown shooting prompts increase in mental health funding, not gun control – CTV News (knlive.ctvnews.ca)
- Funding cuts puts Atlanta mental health program at risk (onlineathens.com)
- Gov. McDonnell launches investigation into mental health policies (wtvr.com)
- Newtown Prompts Flood of Mental-Health Spending by U.S. States (bloomberg.com)
- Study examines delivery of outpatient mental health treatment (medicalnewstoday.com)
- NAMI co-hosting mental health discussion (mercedsunstar.com)
- Increasing Access to Psychotropic Medications | Mental Health Summit (pharmaceuticalintelligence.com)
- Mental health conditions cause greater stigma in families than physical problems (psypost.org)
About three years ago, the nation’s top public health agency picked its battles. Now, it’s issuing its own report card on reaching those goals: Pretty good but needs improvement.
The seven “winnable battles” singled out by the Centers for Disease Control and Prevention set goals for 2015, such as cutting adult smoking to 17 percent and pushing childhood obesity down to about 15 percent.
The agency released its first progress report Thursday, and CDC officials said they’re mostly pleased.
To keep pace with emerging public health challenges and to address the leading causes of illness, injury, disability, and death, the Centers for Disease Control and Prevention (CDC) initiated an effort to achieve measurable impact on selected Winnable Battles. These Winnable Battles were chosen based on the magnitude of the health problems and our ability to make significant progress to improve outcomes.
There are evidence-based strategies available now to address the critical health challenges presented by each of the Winnable Battles areas. We have established important indicators and targets for measuring progress. Together with our partners, we can have a meaningful impact on health through a dedicated focus on these Winnable Battles.
In 2010, CDC identified the following Winnable Battles:
- Tobacco – Tobacco use is the leading preventable cause of disease, disability, and death in the U.S.
- Nutrition, Physical Activity, and Obesity – More than 72 million adults and 12 million youth in the U.S. are obese
- Food Safety – Foodborne diseases sicken 1 out of 6 Americans each year
- Healthcare-Associated Infections (HAIs) – 1 out of 20 hospitalized patients contracts an HAI
- Motor Vehicle Safety – Motor vehicle crashes are a leading cause of death among Americans ages 1 to 54
- Teen Pregnancy – The U.S. has one of the highest rates of teen pregnancy of any developed nation in the world
- HIV – More than 1 million people in the U.S. are living with HIV
- CDC report card on priorities: Pretty good, needs improvement (globalnews.ca)
- How The CDC Did On Its Most Recent Report Card (wonderfultips.wordpress.com)
- CDC report card: Good, bad marks on target battles (boston.com)
- CDC report card: Good, bad marks on target battles (star-telegram.com)
Antibiotics aren’t doing what they’re supposed to do anymore. You know, kill infections. Since Alexander Fleming invented penicillin 75 years ago, nearly all bacteria have mutated into strains impervious to antibiotics. Those souped up bacteria now kill hundreds of thousands of people, at a minimum, each year. And according to a new issue of medical journal The Lancet focused on antibiotic-resistant bacteria, things could soon get a whole lot scarier.+
“Rarely has modern medicine faced such a grave threat. Without antibiotics, treatments for minor surgery to major transplants could become impossible…,” argue a team of UK medical experts in one article in a series on antibiotic resistance (paywall) in The Lancet. ”Infection-related mortality rates in developed countries might return to those of the early 20th century,” they say.
The reason antibiotics are no longer doing what they’re supposed to is mainly that they’re being given to the wrong patient. Instead of people with severe infections or risk of infection, the majority of antibiotics are consumed by animals and people who aren’t sick enough to justify their use.
Pigs, chickens, cows, fish and other animals consume the majority of the 100,000-200,000 tonnes (110,000-220,000 tons) of antibiotics manufactured each year, as farmers try to keep growing large and healthy animals under unsanitary conditions. The bacterial strains created in these conditions can spread to humans.
At the same time, perverse incentives in poor countries encourage overuse. People often take antibiotics available over-the-counter, says The Lancet’s report on global resistance, and self-medication by consumers is common. The lack of sound medical care in some areas means that pharmaceutical companies are the chief source of information on when to take antibiotics and in what dose.
- Superbugs are spreading in Europe as antibiotics are overused (qz.com)
- IL Expert: Antibiotic-Resistant Superbugs a Growing Threat (publicnewsservice.org)
- Guess What Happens When The Antibiotics Stop Working (theawl.com)
- ‘Re-engineer healthcare to develop antibiotic resistance’ (thehindu.com)
- New warning says ‘superbugs’ could erase century of medical advances (foxnews.com)
- Worldwide Antibiotics Warning: Resistance ‘Growing’ (prayingforoneday.wordpress.com)
- Antibiotics Warning: Resistance ‘Growing’ (news.sky.com)
According to recent news reports, the city of Edinburgh is getting tough on those who seek sensual pleasures outside of the confines of their own homes. The police have asked that condoms be banned from saunas as a way of trying to prevent sexual activity on the premises, and city Councillors have been asked to stop issuing licenses for saunas and massage parlours.
Besides being a naïve and impractical way to prevent people from having sex, there has been, unsurprisingly, a strong condemnation of such a move on the grounds of its potential negative effect on public health. The charity Scot-pep, for instance, has warned that implementing the police proposal on condoms could lead a HIV epidemic, as well as the proposal to limit establishments where sex workers can meet clients puts them at greater risk from some of the inherent hazards of plying their trade outdoors.
There has been a long history in the United Kingdom of a connection between the criminal justice system and public health. In some cases, it has been a beneficial relationship in which everything from firearms restrictions, requirements for seat belts, motorcycle helmets and child safety seats and restrictions on intoxicating substances, provide examples where the criminal justice system has been used to mitigate or prevent behaviours that are harmful to individual and population health. Nevertheless, not all intersections of criminal justice and public health are mutually beneficial. What is most notable is the distinct progression that has been made from a so-called “policing model of public health”, that often focused on ideas of moral hygiene and legal moralism, which remained influential in Britain into the 19th century, towards more social models of public health that focus on health promotion, harm reduction and social justice.
HUNTSVILLE, TX (11/13/13) — The Crime Victims’ Institute (CVI) at Sam Houston State University initiated a new series of reports to help victim advocates translate the latest research in the field into practical services and resources for victims, beginning with a study on firearms and intimate partner violence.
The report provides a summary of laws and policies that can be used to better protect victims of domestic violence.
In 2012, 114 women were killed by current or former intimate partners in Texas. Sixty percent of these victims were killed with firearms, and many of the incidents resulted in the death or injury of bystanders, including children.
Research has consistently demonstrated a link between firearms and lethal intimate partner violence. One study showed the most significant factor for predicting homicide in domestic violence cases was gun ownership by the abuser. Another study found that women living with a gun in the home have a significantly higher risk of being murdered, and that risk is 20 times higher when there is a history of abuse combined with gun ownership.
To protect victims of domestic violence, several laws and policies have been enacted. They include:
- The federal Gun Control Act of 1968 makes it illegal to purchase or possess firearms or ammunition by a person who has been convicted of a felony, who is the subject of a protective order, or who has been convicted of misdemeanor domestic violence.
- For protective orders to fall under this federal law, several factors have to be met, including a qualifying relationship, a hearing process, and a specific prohibition against the threat or use of force against the petitioner or child. There is an exception for government employees who use firearms to perform their duties, such as law enforcement officers or military personnel.
- Under the Lautenberg Amendment of 1996, the weapons prohibition was added to the federal law for a misdemeanor domestic violence conviction. Under this provision, the charge must include the threat or use of physical force or a deadly weapon against a spouse, co-habitant, parent or guardian. The law is retroactive, there are no exemptions for those who use weapons in their official duties, and the ban on gun ownership is effective for a lifetime.
- Texas law is similar to federal statues, but also prohibits concealed handgun licenses.
- Several Texas judges have required the surrender of firearms in domestic violence cases, verification of compliance by county attorneys, and notification of victims if weapons are returned. Many of these steps are identified in Texas Family Violence Bench Book.
- A manual published by the National Center on Protective Orders and Full Faith & Credit, “Enforcing Domestic Violence Firearms Prohibitions,” includes a firearms checklist for advocates, law enforcement, prosecutors and judges. It is available at http://www.fullfaithandcredit.org.
- As part of safety planning, advocates should discuss issues with victims about the ownership or use of weapons by the abuser.###
A copy of the report is available at http://www.crimevictimsinstitute.org/publications/.
- Putting research into practice on firearms and domestic violence (medicalnewstoday.com)
- Study: Doctors undertrained on diagnosing domestic violence injuries (kmov.com)
- Contextualizing Domestic Violence (beyondbinaries.org)
- Study: Domestic Violence Stays In Families Through Generations (houston.cbslocal.com)
- Speaking up to stop domestic violence (wpri.com)
- Study: Domestic Violence Costs Tennessee Nearly $1 Billion Annually (wreg.com)
- Every Domestic Violence Survivor Deserves Safe Housing (washingtonlegalclinic.wordpress.com)
- Survey Finds Significant Link Between Chronic Health Conditions and Domestic Violence (prnewswire.com)
Local health departments (LHDs) can play pivotal roles in U.S. communities by helping to link people with medical services and assuring access to care when it is otherwise unavailable. However, a new study in the American Journal of Preventive Medicine finds that many LHDs aren’t able to meet these goals, which could spell trouble for the uninsured and underinsured.
“Our report shows that in 2010, about 28 percent of LHDs had not conducted any of the three targeted activities in our study,” which looked at how LHDs assessed gaps in care, increased access to health services and used strategies to meet the health needs of the underserved, said lead author Huabin Luo, Ph.D, former research fellow with the Centers for Disease Control and Prevention and assistant professor in the department of public health at the Brody School of Medicine at East Carolina University.
In recent years, deep funding cuts have impacted local health departments. For example, between 2008 and 2009 alone, over 23,000 LHD jobs were eliminated. This combined with an increase in demand for health care services can mean an increase in health disparities for those who rely on community health care.
The study found that LHDs with larger budgets in bigger population centers were more likely to provide access to health services compared to smaller LHDs with fewer financial resources, where they may be needed more.
Hanen noted that as health insurance coverage becomes more widespread, LHDs will continue to identify and link people without health insurance to programs that provide health care services. “It cannot be overstated enough that poor housing, education, low income, unemployment and lack of transportation in a neighborhood are all interconnected and are all factors that determine health.”
- Cuts to Local Health Departments Hurt Communities (publichealthwatch.wordpress.com)
- Health cuts hurt inspections, but flu programs OK (news-journalonline.com)
- Health department warns of scam targeting restaurants (wkyt.com)
- Erie County Council discusses merging health, human services departments (goerie.com)
Yes to Calories on Menus, No to Soda Limits
Most Americans (69%) see obesity as a very serious public health problem, substantially more than the percentages viewing alcohol abuse, cigarette smoking and AIDS in the same terms. In addition, a broad majority believes that obesity is not just a problem that affects individuals: 63% say obesity has consequences for society beyond the personal impact on individuals. Just 31% say it impacts the individuals who are obese but not society more broadly.
Yet, the public has mixed opinions about what, if anything, the government should do about the issue. A 54% majority does not want the government to play a significant role in reducing obesity, while 42% say the government should play a significant role. And while some proposals for reducing obesity draw broad support, others are decidedly unpopular.
(The survey was conducted before the Food and Drug Administration’s proposal last Thursday to severely restrict trans fats nationwide.) 1
- When should we start addressing obesity in America? (consumersresearch.org)
- Roadmap to treat adults affected by obesity, overweight (medicalnewstoday.com)
The International Diabetes Federation released a report Thursday that said that 10% of the global population will have diabetes by 2035.
The report, which was released on International Diabetes Day, said that 382 million people will have diabetes by the end of this year, and that 592 million will be diabetic by 2035, CBS news reports. Many of those millions will be living in developing countries.
The IDF report also estimates that the percentage of diabetic Americans will jump from 8% to 11% by 2035. One person dies from diabetes every six seconds, which amounts to 1.5 million annual deaths.
IDF points out that the number of people with diabetes, especially the Type 2 form, has increased in every country. The number of total diabetes cases have increased 4.4 percent over the last two years, now affecting more than 5 percent of the global population.
“We haven’t seen any kind of stabilizing, any kind of reversal,” Leonor Guariguata, an epidemiologist and project coordinator for IDF’s Diabetes Atlas, said to Businessweek. “Diabetes continues to be a very big problem and is increasing even beyond previous projections.”
According to the report, despite better treatments and improving education strategies, the battle to protect people from diabetes and its complications “is being lost.”
Dr. Juliana Chan, a professor of medicine and therapeutics at the Chinese University of Hong Kong, told the BBC that in China, she feels the rising rates of diabetes are due to different genetic, lifestyle and environmental factors not helped by the fact that the country is becoming modernized rapidly.
China had the highest total number of citizens with the disease, with an estimated 98.4 million to be diagnosed by the end of 2013.
“It is typically an ageing disease, but the data shows that the young and middle-aged are most vulnerable. It is prevalent in obese people but emerging data suggests that for lean people with diabetes the outcome can be worse,” she explained.
- One in Ten People Could Suffer from Diabetes by 2035, Reveals Report (medindia.net)
- Diabetes: Asia’s ‘silent killer’ (bbc.co.uk)
Although a number of my posts voice my concerns about “Big Pharm”, I still get an annual flu shot and keep up with vaccines.
Why? Overall I believe they are good public health measures. Still believe in herd immunity and my responsibility to others.
From the 14 November 2013 post by at KevinMD.com
(Please read the comments also for good additional information.)
Dr. Google, you’ve let a whole lot of people down.
If you Google a vaccine question, and many parents have, you’re very likely to find a good, science-based answer — but it will be buried among dozens of sites with anti-science, pro-disease propaganda. The mountain of misinformation is staggering, with multiple anti-vaccine sites repeating each other in a seemingly endless loop of worry and dread. Let neither facts nor truth nor glimmer of honesty stay them from the swift completion of their self-appointed fear mongering rounds.
Fortunately, there are ways to make sure you’re getting reliable answers to your questions.
Start with the CDC’s vaccine home page, which leads to comprehensive information about just about any vaccine health topic.
Prefer an academic center over a government site? The Children’s Hospital of Philadelphia (perhaps the best children’s medical center in the world) has their own very comprehensive vaccine site, and even their own vaccine information app.
Looking for a more global view? Try the World Health Organization’s vaccine page.
Willing to put up with a little snark? Several good science bloggers frequently discuss vaccine topics, no holds barred, and end up with some robust back-and-forth in the comments. Try Respectful Insolence, The Skeptical Raptor, or Neurologica.
Finally, if what you’d like is a meta-search that looks at only the best vaccine information sources, and weeds out the crap, try this science based vaccine search engine.
Parents don’t have the time to wade through the idiocy — they want real, genuine information to help make decisions. Google won’t do that for you, but these links will.
Roy Benaroch is a pediatrician who blogs at The Pediatric Insider. He is also the author of Solving Health and Behavioral Problems from Birth through Preschool: A Parent’s Guide and A Guide to Getting the Best Health Care for Your Child.
This author is spot on in addressing a real problem: these mercola-type internet sites are very harmful. They have the right to free speech but we must combat what is clearly destructive and unsubstantiated ‘health’ information. These sites have found a niche and strike a nerve for a lot of people who have come to the realization that western medicine doesn’t always have a cure for what ails them.
These sites play off this reality and work to trump up a sense of conspiracy which we as humans seem to have a weakness for.
Some people are distrustful of major ‘government’ websites like CDC.
On my site, I am honest about each vaccine’s effectiveness and potential side effects. I also explain why I support their use, one at a time:
I hope it helps
- May Wright Along the same lines: what would be handy for people who want to try to refute anti-vaccine memes on social media (FB, Twitter, blogs) is a resource page which features some of the most popular “arguments” against vaccines, all in one place, and then has links to science-based refutations on various sites. So, for instance, it would have the meme I saw doing the rounds of Facebook this morning, that “Gardasil has killed and injured more women than the disease it’s meant to protect!!11!!”, or the one about “I’m not injecting aborted fetuses into my baby, #ProLife SAY NO TO VACCINES!!” and then a few links to credible sources of information which provide the relevant facts?
Maybe such a page or site already exists, if so I’d love a link to it.
- Vaccinations, “For the Greater Good” (vaccinesforchildren.wordpress.com)
- Vaccines: how they work & why they’re important (wgno.com)
- Homecoming week offers flu vaccine for first time (digitalbullpen.com)
[Journal Article] Public Engagement with Biotechnologies Offers Lessons for the Governance of Geoengineering Research and Beyond
In this paper, we reflect on our involvement in one of the first major research projects in the emerging area of geoengineering (the deliberate intervention in the planetary climate). The project, Stratospheric Particle Injection for Climate Engineering (SPICE), proposed an outdoor experiment that attracted substantial public scrutiny despite a strong consensus that the experiment posed no direct environmental risk. A programme of stakeholder engagement took place that sought a deep understanding of the views about the proposed experiment. The lessons from this experiment build on insights from public engagement with the biosciences and biotechnology. In particular, we see the importance of questions of context and purpose for scientific research. This has important implications for the governance of geoengineering research. Efforts to detach areas of research from public scrutiny by using thresholds, whether these are drawn at a particular level of environmental effect or at the doors of a laboratory, will encounter problems of public credibility. Geoengineering is unavoidably entangled in a political discussion that scientists should seek to understand and engage with.
The progress of biotechnology brings the potential for ever more intimate and disruptive interventions into human bodies and the natural environment. As previous papers in this series have described, there have been various attempts, especially in the last decade, to improve engagement between scientists and public groups on issues involving biotechnology . Engagement exercises, whether with particular non-science stakeholders or members of the general public, reveal layers of societal concern with these technologies. There is typically concern with the eventual downstream risks and the ethical implications of technologies. But these things are hard to assess in advance due to the profound uncertainty that surrounds emerging technology. Public engagement typically also reveals a set of “upstream” concerns.
When brought into dialogue about emerging technologies, before it is clear what the risks are likely to be, members of the public will typically express concern about the trajectory of technological pathways. A report of one large public dialogue exercise on Synthetic Biology drew out five questions for scientists that characterised public concerns about this nascent technology:
- What is the purpose?
- Why do you want to do it?
- What are you going to gain from it?
- What else is it going to do?
- How do you know you are right?
These questions get to the heart of the politics of emerging technologies and the foundations of public trust in scientific research. Conventional technology assessment considers the downstream products of research and innovation with a focus on technological risk and ethics. More recent anticipatory governance approaches, such as “constructive technology assessment” , “real-time technology assessment” , and “responsible innovation” , attempt to broaden the debate to include consideration of the processes and purposes of research, in line with the five questions above. Such approaches emphasise the importance of democratic deliberation in “opening up” the technological options and trajectories for appraisal. Geoengineering in general and the SPICE project in particular have become important test cases for this new mode of governance .
- New Study: ‘Geoengineering to Cause Drought Worldwide’ (intellihub.com)
- Retooling the Planet: The False Promise of Geoengineering (resilience.org)
- We Don’t Geoengineer the Planet But We Have to Continue! (freeasthysweetmountainair.wordpress.com)
- Playing God: 4 Geoengineering Projects Doomed To Fail While Polluting The Earth (wakingtimes.com)
- Climate Change and Geoengineering (therebel.org)
- Strange Bedfellows? Climate Change Denial and Support for Geoengineering (yaleclimatemediaforum.org)
Seems to be a very humane law, even though it is controversial.
Oklahoma House Bill 1782 allows a medical provider to prescribe naloxone to a family member of someone who has a chance of overdosing. The drug helps restart breathing of someone who has overdosed.
Gail Box said she knows it can be difficult for parents to have conversations with their children about drug use.
But parents should consider talking to their children and also carrying naloxone if they think it could help save their children’s lives, she said.
“I wish, if I could go back, I would try to act on those feelings that I had at that time,” she said. “You can tell me anything you want, but I will always shoulder a great deal of guilt as a result of what happened to my son because as a parent, as a mother, it’s my job to protect him, and I didn’t.”
“There are people who have complete unintentional overdose who think they’re taking the right amount of pain medication, or they legitimately have a prescription but it’s not working so they take a little bit more,” White said. “This can also be critical in saving lives of people who are trying to use their pain medication appropriately.”
The law comes at a time when Oklahoma continues to see high rates of prescription drug abuse and overdose deaths.
Oklahoma ranks among the top five states with the highest rate of prescription overdose deaths. And prescription drug abuse is one of the fastest growing types of drug abuse in the state.
Prescription drug overdoses kill more people in Oklahoma than car accidents.
Oklahoma leaders plan to release the state’s strategy for combating prescription drugs in the next few months.
“It’s really good that we’re addressing this now as opposed to 10 years from now,” White said.
Before House Bill 1782 passed, naloxone was carried on many, if not all, paramedic ambulances and fire engines across Oklahoma, said Dr. Jeffrey Goodloe, the medical director for the emergency medical services system for Oklahoma City and Tulsa metros.
However, the law expands who can administer the drug. That’s where Goodloe’s concern comes in. Goodloe said he’s concerned about whether people who aren’t trained in medicine, such as law enforcement officers, will be able to deliver the drug appropriately.
“The first tenet of medicine … is do no harm, so in the process of helping people, we take an oath not to purposely harm them, and my concern with this bill is that, while its intent is nothing but admirable, the end result is I truly believe we will harm some people in fully executing its authority in the commission of trying to help people,” Goodloe said.
Goodloe said when people are given naloxone, they can wake up into a life-threatening withdrawal situation, suffering from horrific vomiting, extreme sweating and dangerously high heart rate and blood pressure.
Not every person given naloxone will go into this type of withdrawal, he said. However, it does occur.
- [Press Release] Prescription Drug Abuse: Strategies to Stop the Epidemic (jflahiff.wordpress.com)
- Oklahoma ranks 5th in drug overdose, expert explains how to lower that rank (kfor.com)
- Report says states are failing to curb prescription drug abuse (wqad.com)
- NM senator takes on prescription drug abuse (kansascity.com)
- Five more laws to help stop Maine’s prescription drug epidemic (bangordailynews.com)
- Prescription drug legislation unveiled (krqe.com)
- Report: W.Va. has highest rate of fatal overdoses (kansascity.com)
[News article] More Research Needed Into Substitution Principle and Regulation of Potentially Hazardous Chemical Materials, Experts Urge
Professor Ragnar Lofstedt, Professor of Risk Management and the Director of the King’s Institute for Risk Research, King’s College London and Editor of the Journal of Risk Research, has published a paper suggesting that the substitution principle is not the “white knight” as described by a number of regulatory agencies and NGOs and proposes that chemical substitution can only work effectively on a case-by-case basis.
The paper, published in the Journal of Risk Research, highlights how the Chemical Substitution Principle (where a potentially harmful chemical used in manufacturing or industry, is substituted for less dangerous alternative) has grown in popularity with chemical governing bodies and organizations in recent years. It highlights how a number of bodies are currently working on ‘substitution databases’ to aid companies in reducing the amount of harmful chemicals they use. The paper draws on three key case studies and states that the chemical substitution principle is a ‘blunt and imprecise regulatory instrument’ that is ‘surprisingly under-researched’ and ‘in need of further rigorous academic and regulatory analysis before it can be further used and promoted satisfactory in the chemical control area.’
Lofstedt uses evidence discussed in the paper to make recommendations for the future use of the chemical substitution principle, including the abolition of numerical targets set by regulatory bodies such as the European Chemical Agency for listing chemical substances of very high concern (SVHCs), and that, if the substitution principle is to be properly implemented, there is a need to do ‘comparative risk evaluations or risk-ranking exercises, to uncover how great the risk profile of the chemical in question actually is’.
The paper further suggests that greater support for evidence-based substitution and academic research into the scientific underpinnings of the chemical substitution principle is needed, along with a need for clear case studies and scientifically informed debates to help politicians become better informed about the pros and cons of the substitution principle.
- OSHA Releases New Resources to Help Employers Protect Workers from Hazardous Chemicals (workers-compensation.blogspot.com)
- The Future of the Toxic Substances Control Act: A Look at How Reform is Measuring Up (gielr.wordpress.com)
- Making regrettable substitution a thing of the past (blogs.edf.org)
- Stand Up For Safer Chemicals (workers-compensation.blogspot.com)
- Toxic Chemical Reform Must Help, Not Hinder, States and Victims’ Rights (huffingtonpost.com)
- EPA Web Tool Expands Access to Scientific, Regulatory Information on Chemicals (jflahiff.wordpress.com)
- [Repost] Getting Real About Chemical Risks (jflahiff.wordpress.com)
International Council on Clean Transportation / by Sarah Chambliss, Josh Miller, Cristiano Façanha, Ray Minjares and Kate Blumberg
[Green Car Congress] Although many countries have adopted emission control regulations patterned on the European regulations, the significant majority of these have not implemented the latest and most stringent Euro 6/VI stage. A study by a team at the the International Council on Clean Transportation (ICCT) finds that if that lag persists and present trends in vehicle activity continue, early deaths from vehicle-related PM2.5 exposure in urban areas will increase 50% by 2030, compared to 2013.
Conversely, the report finds, if all countries were to follow an accelerated roadmap to Euro 6/VI-level regulations, in tandem with fuel-quality regulations limiting sulfur content to 10 to 15 parts per million (ppm), early deaths globally from road vehicle emissions would fall by 75% (200,000) in the year 2030, representing a cumulative savings of 25 million additional years of life…
- ICCT report finds global implementation of advanced emissions and fuel-quality regs could cut early deaths from vehicle emissions by 75% in 2030 (greencarcongress.com)
- Tsinghua study concludes existing regulations for diesel trucks and buses insufficient to reach NOx reduction target by 2015 (greencarcongress.com)
- MIT Study: Vehicle Emissions Cause 58,000 Premature Deaths Yearly in U.S. (dc.streetsblog.org)
- Study finds biodiesel use in HD trucks in Canada will result in very minimal changes in air quality and health benefits (greencarcongress.com)
- Five Bad Arguments From the Coal Industry – Bloomberg (bloomberg.com)
- Region to implement new law on fuel sulphur emissions in 2015 (theeastafrican.co.ke)
- Lawsuit Accuses EPA Of Not Doing Enough To Regulate Toxic Soot (thinkprogress.org)
- Air pollution death rate up in half of boroughs (standard.co.uk)
- Air pollution death rate up in half of London boroughs (standard.co.uk)
[Magazine Article] Can the Defense Budget Shrink Without Risking National Security? (and yes, this is a public health issue)
Why is this related to public health? Because wasteful and duplicate military spending is a drain on the economy. Some of the duplicate spending could be spent in areas affecting public health as public transportation, basic health care, and education.
Of all the services that critics complain the Pentagon needlessly duplicates—from schools and rec centers to scientific research and grocery stores—the most expensive is health care. Ten percent of the Pentagon’s non-war budget—$53 billion—goes to health care. As with civilian health care, savings are achievable here but face implacable opposition from military retirees. But as no less a military enthusiast than John McCain said last year on the Senate floor, “We are going to have to get serious about entitlements for the military just as we are going to have to get serious about entitlements for nonmilitary.”
Fortunately, there are ways to cut defense spending without hurting military capabilities. Besides maintaining its war-fighting capability, DoD, like any entity, maintains a back-office bureaucracy to oversee its business functions. That overhead accounts for roughly 40 percent of its budget. It’s hard to compare different industries, or even government agencies, but one examination of 25 industries showed average overhead rates ranging from 13 to 50 percent, with the average across all industries being 25 percent. A RAND study of overhead and administration costs among defense contractors found them to be “tremendous drivers” of weapon costs at 35 percent. The largest domestic programs—Social Security and Medicare—get by with costs in the single-digits.
Cutting Pentagon overhead to the average would save roughly $80 billion a year. Looked at another way, the department employs 800,000 civilians. Not only is that more than the population of four states, it’s not quite half of all civilian federal employees, more than twice as many as the next-largest agency (Veterans Affairs), four times the number of civilian employees at the Department of Homeland Security and basically the size of all the remaining federal agencies combined. Think there might be some savings possible there?
- How to Cut Defense Spending Without Hurting the Military (defenseone.com)
- Pentagon leaning toward cutting troops, beefing up tech (stripes.com)
- Military Must Do More With Less (fortunascorner.wordpress.com)
- Ralph Nader: Giant Pentagon Budget Is Unauditable Year After Year (huffingtonpost.com)
- Pentagon offset budget cut impact in key areas -watchdog (reuters.com)
..Taking trans fats off the GRAS list won’t remove them from the food supply. Manufacturers can still petition the FDA for exceptions. But it goes a long way toward getting them out.
what the announcement really shows is how public health works: slowly, based on mounting scientific evidence, against constant and mounting headwinds of public ridicule and, much more important, industry lobbying and advertising.
..Companies seldom change unless they have to, which they say means unless consumers ask them to. If you don’t want trans fats or gluten or genetically modified organisms, fine with us! Just tell us with your food dollars! This is of course a way of saying that they don’t want government telling them what to do, and gives them a chance to shape the public opinion they say they simply obey, with millions of dollars in ad campaigns and lobbying.
The lesson, though, is not that the public shouldn’t trust science, because one year’s saturated-fats-are-evil message will eventually become next year’s hey-butter-is-great-when-you-look-at-Crisco. The road to strong public recommendations isn’t clear, as scientific research is slow and zigzags. Both food makers and scientists can be guilty of jumping the gun, depending on what they think they can sell or who they can get to fund big studies and endowed chairs.
The analogy I’m building toward is, of course, sugar-sweetened drinks. Scientific consensus has built to practically the bursting point that sodas make kids fat. Soda makers deride the officials who try to do something about it, and work as hard as they can to cast doubt on science. Mayor Bloomberg, though fairly trim, was their fattest target, in the Mrs. Doubtfire costume they dressed him up in when he tried to impost a portion limit on sodas in restaurants and movie theaters. Now that he’s leaving, they’ll find another target.
But opinion will change, national bodies start to fall into line as they did on trans fats and are doing with sugary drinks. The most outspoken enemies of sugar, like Robert Lustig, are trying to take it off the GRAS list–something that CSPI petitioned the FDA to do last February, asking it to study and determine safe levels of high-fructose corn syrup. The chance of an FDA announcement of that in six years seems pretty unlikely now. But soda makers already have more than dozens of low-sugar and sugar-free drinks: they have scores and scores of them. They’ve quietly been working to solve the problem, while spending (often literally) untold sums not to risk their core products. The advocates against trans fats who seemed so crazy even six years ago, when the New York trans fat ban went into effect, are seeming a lot less crazy today.
- NYC’s Bloomberg led the way on trans fats ban (miamiherald.com)
- Trans fat doesn’t stir much ‘nanny state’ debate (fngnutrition.ca)
- FDA’s Proposed Trans Fat Ban: An Attack on Freedom (heritage.org)
- No more trans fat: FDA banning the artery-clogger (webpronews.com)
- No more trans fat: FDA banning the artery-clogger (conservativeread.com)
- FDA to ban trans fats (cbs6albany.com)
- Trans Fat Ban?; Bullying and Bonding; Ask an Astronaut (wnyc.org)
- FDA To Ban Trans Fats (nycfitfoodfashion.com)
From the OECD (Organization for Economic Co-operation and Development]**
Every person aspires to a good life. But what does “a good or a better life” mean? The second edition of How’s Life? paints a comprehensive picture of well-being in OECD countries and other major economies, by looking at people’s material living conditions and quality of life across the population. In addition, the report contains in-depth studies of four key cross-cutting issues in well-being that are particularly relevant: how has well-being evolved during the global economic and financial crisis?; how big are gender differences in well-being?; how can we assess well-being in the workplace?; and how to define and measure the sustainability of well-being over time?
Read the book by chapter
What drives people’s and nations’ well-being and where do countries need to improve to achieve greater progress for all? The OECD Better Life Initiative launched in 2011 addresses these questions by measuring well-being outcomesin 11 dimensions.
This chapter shows that OECD countries have made considerable progress in many well-being areas over the past 20 years or so, although progress has been uneven across the 11 dimensions included in the OECD well-being framework. Similarly, there is great diversity in patterns amongst different countries as well as disparity in well-being achievements of different groups of the population within a country.
This chapter analyses how well-being has changed during the global economic and financial crisis. Even though some effects of the crisis may become visible only in the long-term, the report finds that the crisis has had large implications for some economic and non-economic aspects of people’s well-being. Clear negative trends have emerged in subjective well-being and civic engagement, with increasing levels of stress, lower life satisfaction and decreasing trust in national governments.
The chapter looks at gender differences in well-being, showing that the traditional gender gap in favour of men has narrowed but has not disappeared. It also finds that women and men do well in different areas of well-being and that they are increasingly sharing tasks and roles.
This chapter looks at the quality of employment and well-being in the workplace. The report presents evidence on the main factors that drive people’s commitment at work and are key to strengthening their capacity to cope with demanding jobs.
The last chapter of the report studies the links between current and future well-being. It looks at ways to define and measure sustainability of well-being over time. This chapter focuses on four types of resources (or “capital”) that can be measured today, and that matter for future well-being: economic, natural, human, and social capital.
Our origins date back to 1960, when 18 European countries plus the United States and Canada joined forces to create an organisation dedicated to global development. Today, our 34 member countries span the globe, from North and South America to Europe and the Asia-Pacific region. They include many of the world’s most advanced countries but also emerging countries like Mexico, Chile and Turkey. We also work closely with emerging giants like China, India and Brazil and developing economies in Africa, Asia, Latin America and the Caribbean. Together, our goal continues to be to build a stronger, cleaner, fairer world.
- UK a great place to live and work, says OECD (theguardian.com)
- OECD says young Irish are among main victims of the crisis (independent.ie)
- Euro zone crisis bearing heavy human toll – OECD (dnaindia.com)
- OECD: Well-Being in Euro Zone Has Suffered Since Crisis (online.wsj.com)
- Britons happier than before financial crisis as contentment plummets in Europe – OECD (telegraph.co.uk)
- UK scores highly in world quality of life rankings, says OECD (oddonion.com)
- Mixed Praise For Chile’s Economic Performance – Analysis (eurasiareview.com)
- Canadians among top seven nations for living well, says OECD ranking (canadianbusiness.com)
Behavioral Health United States 2012
SAMHSA’s newly-released publication, Behavioral Health, United States, 2012, the latest in a series of publications issued by SAMHSA biannually since 1980, provides in-depth information regarding the current status of the mental health and substance abuse field. It includes behavioral health statistics at the national and State levels from 40 different data sources. The report includes three analytic chapters:
- Behavioral Health Disorders across the Life Span
- Mental Health and Substance Use Disorders: Impairment in Functioning
- Mental Health and Substance Use Disorders: Treatment Landscape
The volume also includes 172 tables, which are organized into four sections:
- Behavioral Health of the Population: the mental health status of the U.S. population and prevalence of mental illness;
- Behavioral Health Service Utilization: providers and settings for behavioral health services; types of behavioral health services provided; and rates of utilization;
- Behavioral Health Treatment Capacity: number of facilities providing mental health and substance abuse services; numbers of qualified specialty mental health and substance abuse providers; and
- Payer and Payment Mechanisms: expenditures and sources of funding for behavioral health services.
No other HHS publication provides this type of comprehensive information regarding behavioral health services delivery in the U.S. This publication is the only available comprehensive source of national-level statistical information on trends in both private and public sector behavioral health services, costs, and clients. Drawing on 40 different data sources, this publication also includes State-level data, and information on behavioral health treatment for special populations such as children, military personnel, nursing home residents, and incarcerated individuals.
- Two behavioral health nonprofits agree to repay $4.2 million (abqjournal.com)
- Mental health providers to pay NM for overbilling (kansascity.com)
- Innovation in behavioral health (whyy.org)
- A public health approach for mental health (jsonline.com)
- Judges and Psychiatrists Discuss Mental Health Treatment in the Judicial System (namisouthbay.com)
- Reports possible soon on some mental health fraud (miamiherald.com)
- NH schools awarded behavioral health grants (mysanantonio.com)
The 2007-2008 food price crisis was a wake-up call for the international community, reigniting the discussion about the need to refocus attention on agricultural development. In sub-Saharan Africa, however, member governments of the African Union (AU) had already been grappling with the issue for several years. In 2001, AU members agreed to establish a process to help spur economic growth and political transformation on the continent. The majority of poor people in Africa— approximately 75 percent—live in rural areas and depend on
agriculture for their livelihood.1 Yet between 1995 and 2003, most African countries spent very little public money on agriculture—well below 1 percent of their Gross Domestic Products (GDP).2
Realizing this contradiction, the AU’s New Partnership for Africa’s Development (NEPAD) launched the Comprehensive Africa Agriculture Development Program (CAADP). African heads of state met in Maputo, Mozambique, in 2003, and agreed in the Maputo Declaration both to begin devoting 10 percent of their national budgets to agriculture by 2008, and to set a goal of achieving an average annual growth rate of 6 percent in the agricultural sector by 2015.3 Nonetheless, donor funding for agriculture was very limited until 2009.
CAADP, an ambitious and comprehensive vision for agricultural reform in Africa, is an example of how initiatives with effective local ownership are making strides toward the U.N. Millennium Development Goals (MDGs).
A good example of what is possible is Tanzania, whose economy has been growing steadily over the past 10 years. On average, the economy expanded by 6.9 percent a year. Five sectors were the source of almost 60 percent of Tanzania’s economic growth between 2008 and 2012:
- CommunicationGDPalmostdoubledinlessthanfour years, growing on average more than 20 percent a year.
- Banking and financial services, which has expandedby 11 percent a year since 2008.
- Retail trade, which increased by almost 40 percentbetween 2008 and 2012.
- Construction,withaverageannualgrowthof9percentover the same period.
- Manufacturing, which grew by 8.4 percent annuallyduring the past four years.Agriculture also contributed to Tanzania’s economic growth, but this was a given because it makes up a significant share of GDP, about 25 percent. In fact, during the period 2008-2012, agriculture’s growth rate was consistently below the overall economic growth rate.
Nutrition: Investing in nutrition is extremely cost-effective yet critically underfunded. In fact, of the “10 best buys in development” identified by a group of top economists, five are nutrition interventions.15 But although relatively simple, very affordable interventions to treat malnutrition are available, nutrition remains the “forgotten MDG.” Both overseas development assistance for nutrition, and national budget allocations have been very low.
Since 2009, the United States has worked through its global food security initiative, Feed the Future, to emphasize the urgent need to improve nutrition in the “1,000 Days” window between pregnancy and age 2.16 Because malnutrition in this critical age group causes irreversible physical and cognitive damage, countries with a high proportion of malnourished babies and toddlers pay the price in diminished productivity and economic growth. On the other hand, research shows that $1 invested in nutrition generates as much as $138 in better health and increased productivity.17 In sub-Saharan Africa, an estimated 41 percent of all children younger than 5 are malnourished.18 It is the only world region where the number of child deaths is increasing, and the only one expected to see further increases in food insecurity and absolute poverty.19
In spite of the currently tight budget climate, the United States and other development partners should not back off. Rather, they should press forward to support and help strengthen county-led initiatives such as CAADP. As the African Union prepares for the January 2014 African Union summit, which marks the start of “the Year of Agriculture in Africa,” there is real opportunity for this renewed commitment to have an impact on hunger. On July 1, 2013, African heads of state and government of AU Member States, together with representatives of international organizations, civil society organizations, the private sector, cooperatives, farmers, youths, academia, and other partners unanimously adopted a Declaration to End Hunger in Africa by 2025. This High Level Meeting, Renewed Partnership for a Unified Approach to End Hunger in Africa by 2025 within the CAADP Framework, took place at the initiative of the African Union, FAO, and the Lula Institute along with a broad range of non-state actors.22 With this renewed commitment to end hunger, African countries still have a chance to fulfill their Maputo commitments since that deadline coincides with the MDG deadline, two years away in 2015.
- Ten Years of Transforming Agriculture in Africa (drbausman.wordpress.com)
- Zambia agro-sector given $31.5 million (daily-mail.co.zm)
- African leaders to tackle malnutrition in Niger forum (nation.co.ke)
- Sub Saharan Africa to Meet Only 25% of Food Demand by 2030-gap Report Reveals (modernghana.com)
- 4 Things the FAO says nations must do to reach global hunger MDG by 2015 (one.org)
- Africa Land Grab Unacceptable (developmentpublications2011.wordpress.com)
- Global hunger down, but millions still chronically hungry / 842 million people undernourished in 2011-13 – Developing countries make progress but more efforts needed to reach MDG target (appablog.wordpress.com)
- Poor Numbers: How We Are Misled by African Development Statistics (independentsciencenews.org)
- Governments in Africa fail to reduce poverty despite economic progress (irishtimes.com)
- Half of population face malnutrition in Madagascar (vancouverdesi.com)
[Brookings Institute report] Isabel V. Sawhill and Quentin Karpilow – Three Facts about Birth Control and Social Mobility
The ability to control our fertility, to have children when—and with whom—we want, is a precious gift of modern science. For women in particular, birth control has also been a boost for social mobility. But there is still progress to be made.
1. The Pill Transformed Women’s Life Chances
The Pill gave American women something genuinely new: a convenient and highly effective means of controlling their own fertility. Although the Pill was licensed by the by the FDA (as Enovid) in 1960, state and federal laws limited the access of young single women to oral contraception. But as those laws changed in the late 60s and early 70s, oral contraceptive use jumped among young single women. And look what happened to the gender mix of professional college courses:
Of course this could be coincidence. But the best researchers in the field don’t think so. Using sophisticated research designs, that isolate the causal effects of the Pill, scholars have shown that the diffusion of the Pill raised women’s college attendance and graduation rates (Hock, 2007), increased the representation of women in professional occupations (Goldin and Katz, 2002), and boosted female earnings (Bailey et al., 2012).
2. Unintended Pregnancies Still Too Common
But unintended pregnancy rates – 3 million or more a year - remain stubbornly high in the U.S. The benefits of birth control are being only partially realized. Half of all pregnancies are mistimed or unwanted – and 95 percent of all unintended pregnancies occur among women who either aren’t using contraception at all or aren’t using their contraceptive method consistently:
It is time for a new revolution in family planning, with even better contraception than the pill. Long-acting reversible contraceptives (LARCs) such as intra-uterine devices (IUDs) have a big role to play in solving America’s contraception deficit. Because these highly effective methods don’t require the daily maintenance that the Pill does, LARCs could potentially eliminate the problems of inconsistent use, as a study conducted in St Louis suggests.
3. Most Disadvantaged Need More To Lose
Early, unwed pregnancy rates are highest in the most disadvantaged communities. Recent research suggests that for those with starkly limited opportunities, better family planning may do little to improve their life trajectories. The impact of better contraception for this cohort is small for the depressing reason that they have so little to lose in the first place. These women need better family planning, but they also need better educational and work opportunities. In short, they need more to lose.
Earlier this week, I talked about these issues at an event sponsored by AEI and the Institute of Family Studies. In tomorrow’s blog post, I’ll set out the gains we could realize from getting better at birth control.
Senior Fellow, Economic Studies
A nationally known budget expert, Isabel Sawhill focuses on domestic poverty and federal fiscal policy. She is also co-director of the Center on Children and Families and the Budgeting for National Priorities Project at Brookings.
Senior Research Assistant, Center on Children and Families
- Family structure’s impact on children’s education and social mobility (aei-ideas.org)
- An Anti-Birth Control Employer Just Beat Obamacare in Federal Court (theatlanticwire.com)
- Obamacare Birth Control Mandate Struck Down By Appeals Court Over Religious Freedom Concerns (huffingtonpost.com)
- Birth Control Options: Think Outside the Pill (spreadthehealthbu.com)
This brought back memories of a road accident in Liberia back in 1980. It was late at night in a rural area. Three of us (all sober!) were returning home after a Christmas get-together. The main highway (a dirt road, barely two lanes) was unlit, as all rural roads are, even if they are main highways. The driver swerved to avoid an accident, an oncoming car was straddling the middle of the road (not uncommon). Our Chevy truck rolled over at least twice down a steep embankment. I was nearest to the door on the passenger side. My leg went out the open window. The truck landed on its side, and my leg was pinned underneath the truck.
A bus stopped. Several passengers came down the embankment. By that time Ann (a fellow Peace Corps volunteer) who was in the middle, and the driver (a Malaysian ex-pat who was managing a nearby farm) had got out the truck. They raised the truck, and I pulled my numb leg out out. Miraculously my leg was not broken. (Could it be the gravel absorbed the shock?)
I did have some nasty gashes on the inside of my right thigh, and it was bleeding some. The window had only been partially rolled down. So the glass had shattered and ripped some of my flesh.
Somehow I got up the embankment with help. We went into the bus, which did a U-turn and took us to the hospital, about 10 miles away. Found out later, this was the second time the bus had stopped to pick up an accident victim and transfer them to a hospital. No ambulances in the country that I know of. [Just realized, we never gave the bus driver any money to cover his expenses, or properly thanked anyone, some of the passengers probably had two hours tacked on to their travel time.]
Anyways, I got stitched up (about 34 in the leg, another 8 or so around my right elbow). Thankfully no complications. Although when I do go hiking, I have to use a walking stick when going downhill. Word traveled fast about the accident in the Peace Corps community. Several weeks later I got a letter from the Peace Corps nurse (at HQ- 120 miles away) to get down to her office. Didn’t want to go, I was healing fine, and it meant a 5 hour taxi ride over bumpy dirt roads, but went anyway where I got chewed out royally. Well, I got X-rayed. Confirmed nothing was broken, and the other tests also confirmed what I knew – that I was OK. The nice thing- Peace Corps paid for my travel and medical expenses when I went down to HQ.
ANN ARBOR—Wealthier nations, whose residents own a majority of the world’s vehicles, have the lowest roadway fatality rates, say University of Michigan researchers.
In a new study on road safety in 170 countries, Michael Sivak and Brandon Schoettle of the U-M Transportation Research Institute found that the average fatality rate per million vehicles is 313 in high-income countries, 2,165 in middle-income countries and 6,040 in low-income countries.
Further, the average percentage of pedestrian deaths out of all roadway fatalities is lower in high-income nations (21 percent) compared with middle-income (31 percent) and low-income (35 percent) countries.
Using data from the World Health Organization on countries with populations of at least 100,000, Sivak and Schoettle examined differences in road safety based on gross national income per person: high (more than $12,275), middle ($1,006 to $12,275) and low (less than $1,006).
“The goal was to identify relevant commonalities that may assist in the creation of road-safety policies common to countries at a similar level of development,” Sivak said.
The researchers also found income-level effects for 31 aspects related to institutional framework, safer roads and mobility, safer vehicles, safer road users and post-crash care.
According to the results, low-income countries are less likely to have national road-safety strategies; standard vehicle regulations; laws on the installation of safety belts, airbags and electronic stability controls; laws on the use of safety belts, child restraints, motorcycle helmets and mobile phones; strict driver penalty systems; effective drunk driving enforcement measures; universal emergency access phone numbers; and policies to promote walking, cycling and public transport.
Interestingly, maximum speed limits on rural roads and near schools tend to be lower in low-income countries, but the effectiveness of speed-limit enforcement is higher in high-income countries.
- UK’s riskiest roads: A537 revealed as most dangerous (metro.co.uk)
- How National Income Predicts Traffic Safety (theatlanticcities.com)
- Road deaths fall to historic low (theage.com.au)
- Global Burden of Injuries (globalemergencyhealth.wordpress.com)
- Walk this way: pedestrian road safety must be stepped up worldwide (theguardian.com)
- Cost of not wearing seat belts – Georgia (slideshare.net)
“statistics show that the likelihood of accidentally being shot and killed in a home with guns is much higher than in one without, or with the guns locked”
“people may claim they need assault rifles in case the government comes after them; if the government does come after them, however, it will use weapons that will overwhelm anything that a private citizen would own.”
From the 30 October 2013 blog item at charlettelobueno
The recent outbreak of mass shootings, including one that occurred on October 21 at a junior high school in Sparks, Nevada, has reignited the debate in the U.S. over gun ownership and Americans’ right to bear arms. How can incidents such as the recent one in Nevada, and the shooting that happened last December at Sandy Hook Elementary School in Newtown, Conn., be prevented in a country where the right to own a gun is constitutionally guaranteed?
The first step is addressing gun safety from a public health standpoint, using a multi-pronged approach, similar to that used to reduce the number of car accident fatalities, said Dariush Mozaffarian, an associate professor of medicine and epidemiology at Harvard University in Cambridge, Mass. Such an approach involves making guns safer and educating gun owners and establishing strict licensing standards and conducting thorough background checks. Public awareness campaigns about gun safety and more careful consideration of how gun violence is portrayed in popular media such as video games, movies and TV are also necessary.
A multifaceted approach is required because neither guns nor humans exist in a vacuum. A relationship exists between a human and a gun, much the way it exists between a human and a car, said Don Ihde, distinguished professor of philosophy at Stony Brook University. Ihde explained that humans plus technology, and the range of interactions that can occur between them, determine what patterns of behavior will occur.
The article continues under the headings of Safer Guns, Educating Owners, and Raising Awareness
Here is an audio clip from her interview with Dr David Hemenway:
- [Reblog] If Gun Violence is a Health Epidemic, Can We Quarantine It Like a Virus? (jflahiff.wordpress.com)
- A gun issue upon which we can all agree (napavalleyregister.com)
- Poll: Americans buy guns for safety (rinf.com)
- Gun Safety Instructor Shoots Student In Ohio (huffingtonpost.com)
- Gun-Safety Bills Getting Attention at Statehouse (publicnewsservice.org)
Millions of Americans like her pay dearly for their dependence on automobiles, losing hours a day that would be better spent exercising, socializing with family and friends, preparing home-cooked meals or simplygetting enough sleep. The resulting costs to both physical and mental healthare hardly trivial.
Suburban sprawl “has taken a huge toll on our health,” wrote Ms. Gallagher, an editor at Fortune magazine. “Research has been piling up that establishes a link between the spread of sprawl and the rise of obesity in our country. Researchers have also found that people get less exercise as the distances among where we live, work, shop and socialize increase.
“In places where people walk more, obesity rates are much lower,” she noted. “New Yorkers, perhaps the ultimate walkers, weigh six or seven pounds less on average than suburban Americans.”
A recent study of 4,297 Texans compared their health with the distances they commuted to and from work.It showed that as these distances increased, physical activity and cardiovascular fitness dropped, and blood pressure, body weight, waist circumference and metabolic risks rose.
The report, published last year in The American Journal of Preventive Medicine by Christine M. Hoehner and colleagues from the Washington University School of Medicine in St. Louis and the Cooper Institute in Dallas, provided causal evidence for earlier findings that linked the time spent driving to an increased risk of cardiovascular death. The study examined the effects of a lengthy commute on health over the course of seven years. It revealed that driving more than 10 miles one way, to and from work, five days a week was associated with an increased risk of developing high blood sugar and high cholesterol. The researchers also linked long driving commutes to a greater risk of depression, anxiety and social isolation, all of which can impair the quality and length of life
- The American Dream is killing us (dtjoyce.com)
- Your commute is killing you. (treehugger.com)
- Well: Commuting’s Hidden Cost (well.blogs.nytimes.com)
- The New York Times Pays A Woman With A $2.85M Home To Lecture You About Being A Commuter Prole (thetruthaboutcars.com)
- The U.S. Cities Where the Fewest Commuters Get to Work By Car (theatlanticcities.com)
- Gray Lady Joins the Attack on the Commute (blogs.the-american-interest.com)
mplementation of national surveys where the population can estimate and assess their own health may give policy makers important insights into the different health interventions that should be implemented. According Siddhivinayak Hirve, PhD student at Umeå University, this may include a simple tool that harmonizes the assessment of health in developing countries with the rest of the world.
When the World Health Organization, WHO, conducted a study of aging in a global context and health among adults, in 2007, they asked the simple question “In general, how would you rate your health today?” The results showed that every other elderly person, over 50, who lived in rural areas in India said that they felt very bad, bad, or moderate.
In his thesis, Siddhivinayak Hirve has examined the factors that influence the assessment of own estimated health in older individuals in the population in rural India. The thesis shows that women report worse health than men. Self-reported health also deteriorated with age. The effect of age in terms of self-rated health was affected by participants’ ability to move, ability to see, hearing, relationships, pain, sleeping problems, and more.
“Smoking and use of tobacco were factors that could be linked to at least one chronic disease, which in turn affected the self-reported health effects,” says Siddhivinayak Hirve. “Our studies also demonstrate that a large social network results in better self-rated health and also a higher quality of life.”
A four-year follow-up study that Siddhivinayak Hirve has conducted showed that the risk of dying was larger in those who reported poorer health compared with those who reported that they had good or very good health at the start of the study
Siddhivinayak Hirve concludes, based on his findings, that it is possible to use information on self-rated health from major national surveys, such as the planning of health care, even in small, isolated areas.
“My goal of this thesis has been to put aging on the agenda, both among scholars and policy makers,” says Siddhivinayak Hirve. “This is particularly important in countries where it has a rapidly aging population. The value of asking the simple question, “In general, how do you feel today?” Is very high and can be very helpful to identify health needs, and plan for targeted interventions in health. This is particularly true in developing countries.”
He also points out that measurements of self-rated health provides a driving force to strengthen research on health for the adult and aging populations in low-and middle-income countries that harmonize with international research.
Thesis is available for viewing at: http://umu.diva-portal.org/smash/record.jsf?pid=diva2:653335
- Self-rated health puts aging and health needs on the agenda (medicalxpress.com)
Realize this is a long post.
Guess I opted to include the full press release largely because I served in Africa as a Peace Corps volunteer.
Kudos to the Canadian government and all who work to alleviate pain and foster development everywhere.
So good to see an ever growing list of health applications for cell phones. Below is an example of an application for community health workers. Also good to see one project involving fathers!
10 projects nominated for grants up to $2 million; 10 projects awarded $270,000, including one to reduce harm to brains of pre-term babies caused by pain of multiple daily hospital needles, other procedures
Grand Challenges Canada, funded by the Government of Canada, today extended a total of $10.1 million to 14 bold, creative projects aimed at improving the early brain development of kids in low-resource countries.
Projects in Jamaica, Colombia, Bangladesh and Indonesia are scale-up award nominees (board-approved grants up to CDN $2 million, pending successful contract negotiations).
Seed grants of CDN $270,000 each are given to seven organizations overseas — in Vietnam (2 grants), Bangladesh, India, Kenya, Zambia and Peru. And three seed grants are given to Canadian organizations: the Hospital for Sick Kids, Toronto (two grants), and the University Health Network, Toronto.
All 14 projects will be implemented in developing countries: five in Africa, six in Asia and three in Latin America and the Caribbean.
“Impoverished brains result in impoverished countries,” says Dr. Peter A. Singer, CEO of Grand Challenges Canada. “For a wide range of sad, all-too-familiar and preventable reasons, an estimated 200 million children under 5 years old in the world’s 112 low- and middle-income countries will fail to reach their brain’s full development potential.”
“These projects illustrate well the success of our search for ‘bold ideas with big impact,’ pioneering new approaches worldwide to maximize the number of kids in low-resource countries who achieve and contribute to their fullest capabilities,” Dr. Singer added.
Says Mrs. Laureen Harper, honourary chairperson of the program: “The Grand Challenges Canada Saving Brains program is designed to help millions of children in developing countries who fail to reach their full development potential due to such factors as malnutrition, infection, birth complications, or a lack of nurturing and stimulation at an early age.”
Says the Honourable Christian Paradis, Canadian Minister of International Development and Minister for La Francophonie: “Our Government, under the leadership of Prime Minister Harper, is committed to advancing the health of the world’s most vulnerable mothers, newborns and children. We are proud to partner with Grand Challenges Canada to find innovative solutions to the most pressing global health challenges. The Saving Brains program is just one example of how innovation can help improve the lives of children in their earliest days. “
Seed grant awards
Hospital procedures: mitigating harm of pain to brain development of a tiny preterm baby
The Centre for Global Child Health, Hospital for Sick Children (Toronto, Canada)
Working in Ghana, this project will introduce ways of alleviating pain for infants born prematurely and treated in special neonatal intensive care units (NICU)s — the tiniest of kids who experience moderate to severe pain several times daily due to diagnostic and therapeutic procedures such as blood sample collections and medicine injections.
Project leader Dr. Bonnie Stevens of Toronto’s Hospital for Sick Children says the severity of brain defects found later among children born preterm can be linked to the number of painful procedures experienced in the NICU.
“Higher volumes of painful procedures with inadequately managed pain have also been associated with cognitive, language and motor problems, and low academic achievement,” says Dr. Stevens. “Although the consequences of pain are known, procedural pain is frequently under-managed and under-prioritized.”
Worldwide, about 13 million infants are born preterm each year — a number growing steadily thanks to modern technologies. And even in North America, Europe and Australia, surveys show “neonates” are exposed to an average of 4 to 14 painful procedures daily, with only about 1 in 3 receiving pain relief.
Less is known about neonatal pain management in low- and middle-income countries, where the incidence of neonatal sickness and death is highest. However, a survey in Kenya showed that infants in seven special care newborn nurseries experienced, on average, four painful procedures daily, half of them injections and blood sample withdrawals. No form of analgesia was documented.
The project will introduce Ghanaian caregivers and parents to an integrated “Toolkit for Minimizing the Impact of Pain in Infants,” adapted from successful practices in Canada. Videos and other educational materials will detail simple, universally affordable, proven ways to mitigate procedural pain for an infant, such as:
- Sweet solutions (e.g., sucrose or glucose) administered orally prior to a painful procedure;
- Kangaroo care, where infants are held in skin-to-skin contact with a parent;
- Facilitated tucking, where infants are held in a fetal-like position to provide support and boundaries;
Combined, these interventions have a demonstrated cumulative pain-relieving effect.
“Inadequate resources are cited as the major impediment to pain management in infants as well as a lack of knowledge, severe staff shortages and formal training about pain. The proposed Toolkit intervention will address these issues,” says Dr. Stevens.
The project draws on existing partnerships between the University of Ghana School of Nursing, Korle Bu Teaching Hospital in Accra and Toronto’s Hospital for Sick Children, together training 1,000 pediatric nurses in Ghana over the next 10-15 years, supported by a Canadian government grant. Plans calls for the toolkit’s integration into the curriculum at the School of Nursing (where there is limited pain content) and its use scaled up to reach additional countries.
Says Dr. Stevens: “Decreasing the intensity of painful procedures in hospitalized infants using simple, inexpensive, evidence-based strategies has the potential to minimize both immediate stress and suffering, and the known longer-term impact of pain on the developing neonatal brain and cognitive deficits.”
Malaria in the womb: New malaria policies to protect early brain development in Malawi
University Health Network (Canada)
Each year, about 125 million pregnant women are at risk of placental malaria (PM) and about 25% of all pregnancies in sub-Saharan Africa are complicated by PM at delivery.
PM has profound maternal and fetal health consequences, including increased risk of anemia, preterm birth, fetal growth restriction and delivery of low birth weight infants. The impact of in-utero malaria exposure on fetal neurodevelopment is unknown, however researchers with the project team recently linked malaria-exposure in animals with persistent and long-term deficits in memory and behaviour.
Dr. Kevin Kain of the Toronto-based University Health Network, leader of this project in Malawi, says malaria exposure in the womb “may derail the developmental trajectory of generations of children.” And a shift in understanding — that malaria exposure may result not just in infant mortality and low birth weight but affects also long-term neurodevelopment “represents a change in paradigm that will initiate a re-evaluation of public health policies designed to protect women and children from the deleterious consequences of PM.”
Today’s approach to this problem — intermittent preventive treatment of pregnant women with sulfadoxine-pyrimethamine — is losing effectiveness due to rising drug resistance, resulting in persistent infections.
The new project involves a novel antenatal care policy that focuses resources on accurate point-of-care malaria diagnosis and effective case- management of infection to reduce the burden of malaria in pregnancy and protect early brain development.
The work is expected to provide “compelling evidence that will directly impact national and international policies on the prevention of malaria in pregnancy. If our findings support an intervention that leads to improved neurocognitive outcome for exposed infants, it will refocus public health policies towards protecting fetal brain development.”
Project collaborators include the University of Malawi, and the University of Liverpool, UK.
An Integrated Toolkit to Save Newborns’ Brains in Kenya
The Centre for Global Child Health, Hospital for Sick Children (Toronto, Canada)
The first month of life is a critical period in brain growth and development that can be affected in many ways, including from hypothermia and infection.
Reducing the number of these impediments to young brain growth is the aim of a toolkit created by Toronto’s Hospital for Sick Kids for use initially by mothers in Kenya.
Contents of the tool kit (which costs less than $5) include:
- A clean delivery kit to minimize infection at time of delivery
- A sterilizing gel that, applied to the umbilical stump, reduces certain severe infections by 75% and mortality from all causes by 25 to 40%;
- An emollient to promote skin integrity, helping to reduce infection and prevent hypothermia (and shown to reduce mortality in hospitalized preterm infants)
- A handheld scale to spot early warnings signaled by an infant’s weight, and a ThermoSpot to identify hypothermia and fever
- A mylar infant sleeve and reusable heating device to treat hypothermia
Information on infant stimulation, involving play and communication strategies proven beneficial to neurodevelopment in low birth weight newborns.
If any danger signals are found, community health workers will refer cases to appropriate health care.
“We believe that improved neurodevelopment outcomes at age 1 will translate into sustainable longer term gains in academic performance, employment, productivity, and ultimately more human capital,” says project leader Dr. Shaun Morris of the Hospital for Sick Kids.
Project collaborators include the Aga Khan University, Kenya.
Iron-fortified biscuits to reduce maternal and child anemia
St John’s Research Institute, Unit ofCBCI Society for Medical Education, Bangalore, (India)
Anemia — a low level of red blood cells causing a body’s reduced capacity to carry oxygen — results from micronutrient deficiencies, most often iron.
India has one of the highest rates of anemia globally: over 79% of children aged 6 to 8 months and 58% of the 26 million pregnant women each year. Some 17 million of these women have access to iron pills yet 11 million do not take them for the recommend time (adherence rate: 35%). Why? The pill is big and tastes metallic.
Yet iron deficiency anemia dramatically affects the health of a pregnant woman and her unborn baby, increasing risks of death and sickness during childbirth, including hemorrhage and low-birth weight. Long-term, iron deficiency anemia delays psychomotor development and impairs cognitive development in infants, preschool and school-aged children around the world.
Moreover, researchers say, the effects of anemia are, “not likely to be corrected by subsequent iron therapy… anemic children will have impaired performance in tests of language skills, motor skills, and coordination, reportedly equivalent to a 5 to 10 point deficit in IQ.”
Part of the answer may be an iron-fortified biscuit for use by pregnant women, indistinguishable in taste from popular Indian biscuits.
Coupled with marketing, project leaders say their new biscuit is more likely to be used by previously non-adherent pregnant women, and increase iron stores in newborns, “which translates to more sustainable and protected early brain development.”
“After extensive consumer research, the nutrition team led by Dr A.V. Kurpad and the project collaborators, Violet Health Inc have developed several prototypes specifically designed with the tastes and preferences of pregnant women in India,” says project leader Dr. Pratibha Dwarkanath of St John’s Research Institute, unit of CBCI Society for Medical Education.
“We estimate our solution to be more cost-effective than the iron pill, while reaching more anemic women and their children”
“After proof of concept, we anticipate a scaled trial in Karnataka within three years and reducing anemia in women and infants.”
Project collaborators include Violet Health, Inc., NY, and the Indian Institute of Management, India Bangalore.
Early childhood development in low-resource settings: There’s an app for that.
“CommCare” project empowers community health workers with new mobile software for health workers, parents and caregivers
Ugunja Community Resource Center (Kenya)
In an unprecedented effort, Kenya’s Ugunja Community Resource Center will empower community health workers in Western Kenya with field-tested, mobile phone software to individualize early child development care in the family home and monitor progress via the Internet.
Calling it “the world’s first mobile phone-based early childhood development software platform for low-resource settings,” project leader Aggey Omondi says the software suite will include “apps” for community health workers, for parents and for caregivers, offering practical advice, tools, educational aids and forms for assessing, fostering early childhood development, including cognitive development, nutritional support, management of common illnesses, and counselling on cognitive stimulation for parents and caregivers.
Equipped with mobile phones carrying the software, 30 community health workers will serve 1500households with at least one child under age 3, and 10 parents will receive mobile phones containing the relevant application.
The online monitoring program features a “dashboard” to help users visualize key process and performance indicators, as well as outcome metrics and an analytics suite to enable program managers to analyze trends.
Project collaborators include the Harvard Business School and Dimagi Inc. of Cambridge MA, the University of Pennsylvania and the Kenya Methodist University School of Medicine and Health.
Managing maternal depression and stimulating kids to promote neurodevelopment
International Centre for Diarrheal Disease Research (Dhaka, Bangladesh)
Almost 60% of kids in Bangladesh are at risk of poor development due to low body weight (22%) and undernutrition (41%), poverty, and sub-optimal stimulation due to low parenting knowledge.
The mother is usually the key childcare provider and her physical and mental health is a major predictor of child development, particularly in low and middle-income countries.
Using the service of home-based workers of community health clinics in rural Bangladesh, the International Centre for Diarrheal Disease Research will offer a combined intervention that includes both a “Thinking Healthy” program for mothers of children 6 to 12 months old with depressive symptoms and psycho-social stimulation for their children.
Says project leader Dr. Fahmida Tofail: “Previous projects have used only one or the other of the interventions — depression treatment or child’s psychosocial stimulation. In this approach, we address the mother and child together to produce an optimal child-friendly environment to maximize the investment.”
Project collaborators include the International Centre for Diarrheal Disease Research, Bangladesh, the University of the West Indies, and the Institute for Child Health at University College, London UK.
Community-based family coaching for children with developmental risks
Partners in Health / Socios En Salud Surcursal (Peru)
In Lima, Peru, researchers will demonstrate a standardized community-based screening and treatment program delivered by community health workers to 60 children (6 to 24 months old) at risk of neurodevelopmental delay (NDD).
The community health workers will identify and treat at-risk children and assist their caregivers, addressing multi-level problems. The intervention includes 1) coaching parents on how to stimulate their child’s to promote development, and 2) providing parents with social support and encouragement.
The kids and their primary caregivers will be randomly assigned to one of three interventions:
- monthly nutritional support alone;
- nutritional support plus 3 months of the intervention in the home; or
- nutritional support plus 3 months of the intervention in group settings.
Among the impacts to be measured and evaluated:
- Changes in child development and parenting
- The child, caregiver, and household characteristics that predict who benefits most
- How intervention should be delivered for maximum effect (one-on-one or group settings)
Says project leader Leonid Lecca: “The vicious cycle of developmental delay and limited socioeconomic opportunity (manifested in poor academic performance and child labor) have major impact at the societal level, in terms of economic productivity and social inequality.”
Project collaborators include the Harvard Medical School and Children’s Hospital, the Brigham and Women’s Hospital, and the University of California San Francisco Medical School, as well as stakeholders in Rwanda and Haiti who will help explore how to adapt this model for global dissemination.
Learning Clubs for women’s health and infant development
Research and Training Centre for Community Development (Vietnam)
Vietnamese researchers point to eight major risks to optimal early childhood brain development around the time of birth in resource-constrained settings:
- Intrauterine growth restriction
- Iron deficiency anaemia
- Iodine deficiency
- Unresponsive caregiving
- Insufficient cognitive stimulation
- Maternal mental health problems, and
- Exposure to family violence
And these risks interact: the poorest women who have experienced intimate partner violence are at the highest risk of common mental disorders. And, even when all other factors are controlled, those who experience common mental disorders during pregnancy are less likely to participate in essential preventive health care, including the use of iodized salt to prevent iodine deficiency and taking iron supplements to counter anaemia
Risks continue in early infancy, both for mom and baby: a third of mothers have common mental disorders, 22% of infants are moderately or severely anemic and 7.4% are stunted. Six-month-old infants of mothers with antenatal common mental disorders have infant cognitive development scores on average significantly lower than infants of mothers without common mental disorders in pregnancy.
To date, interventions in these settings have focused on one or at most two of these risks, and outcomes for child development have been, at best, only partially effective.
Capitalizing on 15+ years of experience in rural Vietnam, this project led by Vietnam’s Research and Training Centre for Community Development in Hanoi aims to pioneer a low-cost program addressing all eight risks through a structured, universal program combining information, learning activities and social support with groups of women at the same life stage: Learning Clubs for Women and Infants.
Content will include interventions to address all eight risks early childhood brain development, recognizing and integrating consideration of each woman’s health and social circumstances during pregnancy and in the years in which they are providing primary child care.
The benefit envisioned: enhanced fetal, newborn and early infant development through improved maternal nutrition, mental health, birth outcomes, sensitivity and responsiveness in care-giving and feeding and reduced exposure to family violence.
We estimate that this comprehensive approach will reduce preterm birth, anaemia, stunting, rates of cognitive and social emotional development at age six months, with the effects maintained at least to age three among young children in rural Vietnam.
Project collaborators include the Jean Hailes Research Unit, Australia’s Monash University and the Department of Medicine, University of Melbourne.
What about Dad?
Fathers Involvement: Saving Brains in Vietnam
Hanoi School of Public Health (Vietnam)
Recent research has shown that children of a highly-involved male parent show increased cognitive competence, greater empathy, and less sex-stereotyped beliefs. They have higher IQs, stronger verbal skills, are more academically motivated and successful, have fewer emotional and behavioural problems, show better emotional regulation, better social and problem-solving skills and greater overall life satisfaction.
This project by Hanoi’s School of Public Health aims to mobilize more fathers in parenting and involve them directly in the cognitive and emotional development of their infants, and to indirectly enhance infants’ nutritional status by having fathers encourage mother’s breastfeeding exclusivity and duration.
Fathers will be exposed to:
- Multimedia messages about the importance of breastfeeding and father involvement
- Small group antenatal and postpartum education via community health centers
- Individual at-home counselling
- Light- hearted public fathering contests, organized with the assistance of the local Farmers Association, to praise and reward teams of fathers demonstrating good fathering knowledge and behaviours, and
- Fathers Clubs, developed in collaboration with the Labour trade union and Farmers Association to provide peer support.The project involves 400 couples (with 400 children) in Vietnam’s Hai Duong province.
“Father-infant involvement is an important emerging innovation in developing countries,” says project leader Dr. Tran Bich. “Evolving cultural norms have resulted in fathering roles that range from traditional expectations of father as primarily economic provider and head of the household to more contemporary involvement with mothers and children.”
Project collaborators include Canada’s Brock University, St. Catherines, and St. Jerome’s University, Waterloo.
A new category of community workers in Zambia dedicated to early childhood development
Zambia Centre for Applied Health Research and Development (Lusaka, Zambia)
Recent research on brain development suggests that no single risk or developmental stress causes most harm; the main problem is the accumulated impacts of multiple early childhood adversities. Single risk factor interventions are, therefore, unlikely to achieve the highest possible impact on child development.
This project of the Zambia Centre for Applied Health and Development is designed as a comprehensive, integrated, community-based child development program, rolled out in Zambia’s Choma District.
The key innovation, and a critical improvement over previous efforts: establishment of a new cadre of health workers with the sole, explicit mission to monitor and support all aspects of child development under the age of 2.
The newly-trained, community-based “child development agents” (CDA) will form a natural link between mothers and the larger health system, including community health workers.
The CDA will have three principal responsibilities:
- Monitor children’s nutritional status on a monthly basis through home visits, and ensure immediate treatment of moderate to severe malnutrition and acute infections (malaria, diarrhea, and pneumonia) through local CHWs or public health facilities as needed.
- Ensure all children receive the full health benefits as defined in national guidelines, including exclusive breastfeeding to 6 months of age, a complete set of vaccinations, vitamin A supplementation, growth monitoring, and deworming every 6 months starting at 12 months of age.
- Coordinate local selected volunteer mothers in running a home -based stimulation component similar in nature to the ones successfully implemented in Cambodia
CDAs will be supported with mobile health technology to ensure continuous and efficient communication, monitoring and close implementation of service protocols.
The mobile device will serve three principal functions:
- Provide weekly visit reminders and a list of health services for mothers and children who missed services or appointments
- Allow CDAs to communicate with local CHWs and health facility staff to ensure immediate treatment of acute health conditions
- Support CDAs with visual materials (videos) to compliment their weekly training with volunteer mothers
Each CDA will be responsible for 250 households, which corresponds to approximately 50 to 60 children under the age of 2 in their communities. CDAs will enroll eligible mothers and their child in the study, and then will be responsible for the health and development of the respective child up to 24 months of age. Each week, the CDA will be sent a list mothers and children who missed a scheduled services or appointments through an automated electronic system; list of children that should be visited in the respective week for the monthly nutrition and health follow-up well; and reminder of content of early childhood learning sessions to support child nurturing. They will be monitored by CDA supervisors on a regular basis, and will be given verbal feedback on their performance. In each month, the best 10% of CDAs will receive a symbolic “CDA of the month” award.
The project will directly benefit 225 children in the short term, and, the hope, all Zambian children in the long run. Its main targets: reduced stunting and improved child development at age 2.
Says project leader Dr. Davidson Hamer: “The program has the potential to transform how mothers think about child development and early education, and to increase maternal understanding of age-appropriate development and cognitive stimulation.”
Project collaborators include America’s Harvard School of Public Health, and the Center for Global Health and Development at Boston University, and Zambia’s Centre for Infectious Diseases Research and Ministry of Health, Child Health Unit.
Large-scale award nominees
Putting online a proven, early cognitive stimulation program to help those helping kids in developing countries
University of the West Indies (Kingston, Jamaica)
A package of low-cost materials proven to help early cognitive stimulation will be made available online to support in-home interventions by community workers in developing countries, thanks to this project led by Christine Powell, PhD, Senior Lecturer at the Tropical Medicine Research Institute, University of West Indies. The materials can be used despite limited training by any qualified person (NGO, international agency, local government department) and include a curriculum, training manuals, books, play materials, and training videos, all tailored to the children’s culture.
The curriculum being placed online is the product of years of work pioneering the foundation for early childhood development in low resource settings. The web-based package is expected to provide skills and materials for 10 countries to adapt and implement the home cognitive stimulation package.
Stimulation and nutrition for pre-schoolers in rural Colombia
Universidad de los Andes (Bogotá, Colombia)
While there are government-run programs in urban centers, to now rural kids in Columbia have had available only a home-based daycare system run by women with little if any formal training.
Providing an integrated, two-stage intervention for children from 6 months to 5 years old is the idea behind of a project led by Raquel Bernal of Colombia’s Universidad de los Andes.
In the first stage, facilitators of existing family (home-visiting) services for pregnant women and children up to 30 months old will be trained to promote effective mothering, including nutrition, child development, and interaction with the child.
In the second stage, local mothers running community nurseries will receive 160 hours of training in topics such as fostering child development and developmental milestones in children 24-60 months old, and activities to encourage executive functioning of the child brain. Crucially, both curricular improvements will be implemented along with regular coaching and monitoring visits by trained supervisors.
An estimated 4,800 children will have access to more supportive developmental experiences as a result of this project.
Nutrition and psychosocial stimulation to improve development of malnourished children in Bangladesh
International Centre for Diarrheal Disease Research (Dhaka, Bangladesh)
Early cognitive development will be promoted through this program to treat malnourished children in rural Bangladeshi health clinics, improving the knowledge and skills of both mothers and field staff in early cognitive development. The anticipated outcome: improved language skills among children, as well as better mental and psychomotor development.
The project takes advantage of a time when kids and their parents are interacting with health clinics to provide more than just calories. challenge is how to do it in a way that is feasible to deliver by health workers with lots big workloads. The anticipated outcome: improvements in language, mental, and psychomotor development for approximately 3,000 children.
Golden Generation Program for community-based early childhood development
University of Mataram (Mataram, Indonesia)
The Golden Generation Program will integrate early development, health and nutrition programs to promote thriving children, and includes strategies to:
- enhance staff capabilities in early childhood development centers in villages;
- deploy of specially-trained community workers to coach and certify couples in early childhood development; and
- engage a mobile real-time data platform to link providers and clients to track infant growth and development, and flag needed interventions.
Program impact will be assessed through a randomized trial involving 80 communities, covering approximately 30,000 couples and their infants over a 2-year period.
To foster long-term sustainability and ongoing program development, the Program will also establish community worker cooperatives and a Center for Early Childhood Development at the University of Mataram.
The program is a collaboration between the University of Mataram, the Provincial and District Governments of Nusa Tenggara Barat Province, the Summit Institute of Development and the Harvard School of Public Health.
The Grand Challenges Canada Saving Brains Program promotes fulfillment of human capital potential by focusing on interventions that nurture brain development in the first 1,000 days of life. The goal of the Saving Brains program is to unlock the potential of children by developing and scaling up products, services and policies that protect and nurture early brain development in an equitable and sustainable manner. Almost CDN $30 million has been committed to date. In addition to projects, the Saving Brains program is investing in an authoritative quantification of the economic impact and true costs of poverty-related risk factors for cognitive and human capital development.
Grand Challenges Canada invites global, regional and corporate partners committed to enabling innovation for early brain development to join us in Saving Brains.
Please visit grandchallenges.ca and look for us on Facebook, Twitter, YouTube and LinkedIn.
About Grand Challenges Canada
Grand Challenges Canada is dedicated to supporting bold ideas with big impact in global health. We are funded by the Government of Canada through the Development Innovation Fund announced in the 2008 Federal Budget. We fund innovators in low and middle income countries and Canada. Grand Challenges Canada works with the International Development Research Centre (IDRC), the Canadian Institutes of Health Research (CIHR) and other global health foundations and organizations to find sustainable long-term solutions through integrated innovation – bold ideas which integrate science, technology, social and business innovation. Grand Challenges Canada is hosted at the Sandra Rotman Centre.
About Canada’s International Development Research Centre
The International Development Research Centre (IDRC) supports research in developing countries to promote growth and development. IDRC also encourages sharing this knowledge with policymakers, other researchers and communities around the world. The result is innovative, lasting local solutions that aim to bring choice and change to those who need it most.
As the Government of Canada’s lead on the Development Innovation Fund, IDRC draws on decades of experience managing publicly funded research projects to administer the Development Innovation Fund. IDRC also ensures that developing country researchers and concerns are front and centre in this exciting new initiative.
About Canadian Institutes of Health Research
The Canadian Institutes of Health Research (CIHR) is the Government of Canada’s health research investment agency. CIHR’s mission is to create new scientific knowledge and to enable its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to more than 14,100 health researchers and trainees across Canada. CIHR will be responsible for the administration of international peer review, according to international standards of excellence. The results of CIHR-led peer reviews will guide the awarding of grants by Grand Challenges Canada from the Development Innovation Fund.
About the Department of Foreign Affairs, Trade and Development Canada
The mandate of Foreign Affairs, Trade and Development Canada is to manage Canada’s diplomatic and consular relations, to encourage the country’s international trade, and to lead Canada’s international development and humanitarian assistance.
About Sandra Rotman Centre
The Sandra Rotman Centre is based at University Health Network and University of Toronto. We develop innovative global health solutions and help bring them to scale where they are most urgently needed. The Sandra Rotman Centre hosts Grand Challenges Canada.
- Simple Method May Help Predict Tiny Preemies’ Outlook (nlm.nih.gov)
- Indiana University study shines new light on consequences of preterm births (eurekalert.org)
- Study Identifies New Consequences of Preterm Births (counselheal.com)
- Testing for Neonatal Sepsis: The Next Generation of Biomarkers (promega.wordpress.com)
- Neonatal Pain-Related Stress and NFKBIA Genotype Are Associated with Altered Cortisol Levels in Preterm Boys at School Age (plosone.org)
rom the thesis abstract: “Gun violence in America must be addressed at the highest levels of society. Newtown, Aurora, and Virginia Tech were attacks on the very fabric of America. School shootings represent attacks on our nations’ future. A public health approach to gun violence focuses on prevention. Public safety professionals, educators and community leaders are squandering opportunities to prevent horrific acts of extreme violence. Preparedness is derived by planning, which is critical to mobilizing resources when needed. Rational public policy can work. Sensible gun legislation, which is accessible through a public health approach to gun violence, neither marginalizes nor stigmatizes any one group. University administrators must fully engage the entire arsenal of resources available to confront this pernicious threat. The academic community can create powerful networks for research, collaboration and information sharing. These collective learning environments are investments in the knowledge economy. In order for the police to remain relevant, they must actively engage the community they serve by developing the operational art necessary to cultivate knowledge, relationships and expertise. Police departments must emphasize strategies that improve performance. Police officers must understand the mission and meaning of ‘To Protect and Serve’ and the consequences of public safety, which often comes at their personal peril. Gun violence in America is a public health epidemic and preventing it requires a collective responsibility.”
Author: Welch, Edward J. Publisher: Naval Postgraduate School (U.S.)
Naval Postgraduate School (U.S.). Center for Homeland Defense and Security
Date: 2013-03 Copyright: Public Domain Retrieved From: Naval Postgraduate School, Dudley Knox Library: http://www.nps.edu.Library/index.aspx Format: Media Type: application/pdf Source: Cohort CA1105/1106 URL: https://www.hsdl.org/?view&did=736339 [FULL TEXT]
- [Reblog] If Gun Violence is a Health Epidemic, Can We Quarantine It Like a Virus? (jflahiff.wordpress.com)
- Experts: Gun Violence Is Public Health Crisis in US (voanews.com)
- Violence- the Cancer We Need to Cure (beyondentertainmentblogdotcom.wordpress.com)
- Holder warns of deadly shootings rapid rise (msnbc.com)
Strongly believe solitary confinement is a mental health issue.
How we treat the least of us is a reliable measure of just how human we are.
I’ve been know to take to the streets, so to speak, against war & the death penalty.
Most recently at the Supreme Court at the annual Starvin’ for Justice event this past June/July.
These days, when I don’t take to the streets I voice through other means, including this blog.
That’s me on the left holding up the sign. Kirk Bloodsworth, the speaker, is the first person exonerated from death row using DNA technology. The gentleman on the right holding up a sign is another Returned Peace Corps Volunteer (the preferred title of those of us who served). We shared stories, and perhaps reflected on how our overseas service shaped our views on peace and justice.
(For anyone who would say “get a job”, well my reply is witnessing against injustice is my job.)
(Oh, and for the record, I am now gainfully employed for the first time in three long years of job hunting.
Being unemployed against one’s will certainly is a mental health issue, but nothing compared to greater injustices)
Ever since solitary confinement came into existence, it has been used as a tool of repression. While it is justified by corrections officials as necessary to protect prisoners and guards from violent superpredators, all too often it is imposed on individuals, particularly prisoners of color, who threaten prison administrations in an altogether different way. Consistently, jailhouse lawyers and jailhouse doctors, who administer to the needs of their fellow prisoners behind bars, are placed in solitary confinement. They are joined by political prisoners from various civil rights and independence movements.
CCR’s Challenges to Solitary Confinement
In May 2012, the Center for Constitutional Rights (CCR) filed a lawsuit against the state of California for its use of prolonged solitary confinement in the infamous Pelican Bay prison. Ruiz, et al. v. Brown, Jr., et al., is a federal class action challenging prolonged solitary confinement and deprivation of due process, based on the rights guaranteed under the Eighth and Fourteenth Amendments, at Pelican Bay. The case challenges inhumane, unconstitutional conditions under which thousands of prisoners live. Ruiz reasserts the importance of fundamental human rights and the Constitution’s guarantee that no one may be subjected to cruel and unusual punishment, and that all are entitled to the due process of law.
CCR’s case against solitary confinement at Pelican Bay is the latest in a long history of challenges to the use of isolation in prisons. InWilkinson v. Austin, the U.S. Supreme Court unanimously ruled in support of CCR’s claims that prison officials cannot confine prisoners in long-term solitary confinement in a
super maximum prison without first giving them the opportunity to challenge their placement. CCR has engaged in solidarity efforts alongside hunger striking prisoners, as well as engaged in advocacy and education efforts around the impact of the use of isolation in prisons.
Solitary Confinement is Torture
The devastating psychological and physical effects of prolonged solitary confinement are well documented by social scientists: prolonged solitary confinement causes prisoners significant mental harm and places them at grave risk of even more devastating future psychological harm.
Researchers have demonstrated that prolonged solitary confinement causes a persistent and heightened state of anxiety and nervousness, headaches, insomnia, lethargy or chronic tiredness, nightmares, heart palpitations, and fear of impending nervous breakdowns. Other documented effects include obsessive ruminations, confused thought processes, an oversensitivity to
stimuli, irrational anger, social withdrawal, hallucinations, violent fantasies, emotional flatness, mood swings, chronic depression, feelings of overall deterioration, as well as suicidal ideation.
Exposure to such life-shattering conditions clearly constitutes cruel and unusual punishment – in violation of the Eighth Amendment to the U.S. Constitution. Further, the brutal use of solitary has been condemned as torture by the international community.
A Growing Human Rights Movement against the Use of Solitary Confinement
Across the United States and the world, there is an emerging movement calling for the end of solitary confinement.
In the U.S., prisoner-led movements have attracted media attention and public scrutiny to harsh conditions of confinement, including overcrowding, the use of isolation, deplorable health conditions, substandard medical care, and the discriminatory and careless treatment of people with mental illnesses. Several prisoner-led hunger strikes have drawn attention to these harsh
conditions, including efforts in Georgia, Ohio and California. Advocates have joined in solidarity and alongside prisoners to protest the use of solitary confinement.
International human rights experts and bodies have also condemned indefinite or prolonged solitary confinement, recommended that the practice be abolished entirely and argued that solitary confinement is a human rights abuse that can amount to torture. In August 2011, Juan Mendez, the United Nations Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, concluded that even 15 days in solitary confinement constitutes torture or cruel, inhuman or degrading treatment or punishment, and 15 days is the limit after which irreversible harmful psychological effects can occur. However, many prisoners in the United States have been isolated for far longer.
Read more at http://ccrjustice.org/solitary-factsheet
- Citing Solitary Confinement Concerns, UN Demands Access To California Prisons (mintpressnews.com)
- Wasted Minds: An Insider’s Look at the Torturous Effects of U.S. Solitary Confinement (moorbey.wordpress.com)
- California lawmakers examine solitary confinement (sacbee.com)
- Solitary Confinement and the Criminal Justice Debate (ppgreview.ca)
- UN Top Torture Investigator Wants Access to American Prisons (alternet.org)
- Does Solitary Confinement in U.S. Prisons Qualify as Torture? (sitehighway.com)
- Two notable new ACLU reports on solitary confinement in US prisons (sentencing.typepad.com)
- Prison overcrowding could amount to torture: UN (abc.net.au)
- California And Louisiana Death Row Conditions Result In Torture, Report Finds (eurasiareview.com)
- !Virginia takes a STAND AGAINST SOLITARY CONFINEMENT! (halleluja) (childreninprison.wordpress.com)
Part 5 of the TED Radio Hour episode Haves And Have-Nots.
About Jacqueline Novogratz’s TEDTalk
About Jacqueline Novogratz
Jacqueline Novogratz is redefining the way problems of poverty can be solved around the world.
She is a leading proponent of financing enterprises that can bring affordable clean water, housing and health care to poor people so that they no longer depend on traditional charity and aid.
The Acumen Fund, which she founded in 2001, has an ambitious plan: to create a blueprint for alleviating poverty using market-oriented approaches.
Rather than handing out grants, Acumen invests in fledgling companies and organizations that bring products and services to the world’s poor.
Novogratz places a great deal of importance on identifying solutions from within communities rather than imposing them from the outside.
In her book, The Blue Sweater, she tells stories which emphasize sustainable bottom-up solutions over traditional top-down aid.
- Is ‘Patient Capitalism’ The Answer To Poverty? (wnyc.org)
- Dignity, not dependence (aiddebate.wordpress.com)
- Acumen’s Jacqueline Novogratz: making sustainability profitable (theguardian.com)
- Haves And Have-Nots (wnyc.org)
- Book Giveaway: The Blue Sweater by Jacqueline Novogratz (beth.typepad.com)
- Inspiring a life of immersion: Jacqueline Novogratz on TED.com (ted.com)
- The Blue Sweater 500 (bethkanter.org)
In 2010, some 223,000 people around the world died from lung cancer caused by exposure to air pollution, the World Health Organization (WHO) said yesterday. And more than half of those deaths are believed to have been in China and elsewhere in East Asia. Here are the world’s worst cities for air pollution, according to the WHO.+
Exposure to air pollution is getting worse in parts of the world, especially industrializing countries, according to the WHO. The WHO’s key announcement yesterday was that it has included outdoor air pollution on its definitive list of the world’s known carcinogens—an addition that, it hopes, will get governments to do something about it. Air pollution is the world’s worst environmental carcinogen and more dangerous than second-hand smoke, for instance, the health body said.+
As the chart above shows, the cities with the worst air are often not big capitals, but provincial places with heavy industry in them or nearby. Ahwaz, for instance, in southwestern Iran, far outstrips infamously polluted cities like New Delhi or Beijing, with 372 parts per million of particles smaller than 10 micrometers (PM10), compared to the world average of 71. Life expectancy for the city of 1.2 million residents is the lowest in Iran.+
Why so bad? In Ahwaz, Iranian meteorology officials have blamed the US for the spike, claiming the presence of US forces in Iraq during the Iran-Iraq war of the 1980s destroyed agriculture and caused desertification. But researchers cite heavy industry in and around the city, like oil, metal and petrochemical processing, and blame the desertification on the draining of marshes and a national project that has diverted local water away from the city.
- How air pollution in China has hit previously unimaginable levels (qz.com)
- The World’s Worst Cities for Air Pollution Might Not Be the Ones You’d Expect (theatlanticcities.com)
- Air Pollution Does Cause Cancer, World Health Organization Says (ktla.com)
- The World Health Organization Declares Air Pollution an Official Carcinogen (inhabitat.com)
- The world’s worst cities for air pollution, and they’re not the ones you’d expect (crofsblogs.typepad.com)
- Polluted air a leading cause of cancer deaths (scotsman.com)
- Air pollution causes cancer, WHO concludes. (telegraph.co.uk)
- The air we breathe definitively and scientifically linked to cancer (sott.net)
- WHO agency: Air pollution causes cancer (kansascity.com)
Landmark report ranks threats, outlines four core actions to halt resistance
Every year, more than two million people in the United States get infections that are resistant to antibiotics and at least 23,000 people die as a result, according to a new report issued by the Centers for Disease Control and Prevention. The report, Antibiotic Resistance Threats in the United States, 2013, presents the first snapshot of the burden and threats posed by antibiotic-resistant germs having the most impact on human health. The threats are ranked in categories: urgent, serious, and concerning.
Threats were assessed according to seven factors associated with resistant infections: health impact, economic impact, how common the infection is, a 10-year projection of how common it could become, how easily it spreads, availability of effective antibiotics, and barriers to prevention. Infections classified as urgent threats include carbapenem-resistant Enterobacteriaceae (CRE), drug-resistant gonorrhea, and Clostridium difficile, a serious diarrheal infection usually associated with antibiotic use. C. difficile causes about 250,000 hospitalizations and at least 14,000 deaths every year in the United States.
“Antibiotic resistance is rising for many different pathogens that are threats to health,” said CDC Director Tom Frieden, M.D., M.P.H. “If we don’t act now, our medicine cabinet will be empty and we won’t have the antibiotics we need to save lives.”
Four Core Actions to Fight Antibiotic Resistance
- Preventing Infections, Preventing the Spread of Resistance
- Tracking Resistance Patterns
- Improving Use of Today’s Antibiotics (Antibiotic Stewardship)
- Developing New Antibiotics and Diagnostic Tests
- Antibiotics and the Rise of Superbugs (vision1health.wordpress.com)
- Untreatable infections: CDC sets threat levels for drug-resistant bacteria (cnn.com)
National Institute of Environmental Health Sciences (NIEHS) – A US Government Environmental Health Resource
In the spirit of back to school, here is a great source for homework help in environmental health studies.
The National Institute of Environmental Health Sciences (NIEHS), located in Research Triangle Park, North Carolina, is one of 27 research institutes and centers that comprise the National Institutes of Health (NIH) , U.S. Department of Health and Human Services (DHHS) . The mission of the NIEHS is to discover how the environment affects people in order to promote healthier lives.
The NIEHS traces its roots to 1966, when the U.S. Surgeon General announced the establishment of the Division of Environmental Health Sciences within the NIH. In 1969, the division was elevated to full NIH institute status. Since then, the NIEHS has evolved to its present status as a world leader in environmental health sciences, with an impressive record of important scientific accomplishments and a proud history of institutional achievements and growth.
Today the NIEHS is expanding and accelerating its contributions to scientific knowledge of human health and the environment, and to the health and well-being of people everywhere (229KB)
Some Web sites/pages of interest
- Brochures and fact sheets - for general information or background information for a presentation
Topics include substances (as formaldehyde) , manufactured products (as cell phones),medical conditions (as asthma) and general health (as children’s health).
- Environmental Health topics include conditions/diseases, environmental agents (as radon), exposure routes (as airways) and population research (as occupational health).
- Environmental Health Science Education website provides educators, students and scientists with easy access to reliable tools, resources and classroom materials.
- Kids’ Pages provide fun and engaging activities, songs, stories, jokes, and other resources designed to introduce children to the concept of how they interact with their environment and how the environment may affect their health.
- EHP Science Education
- Toxnet - Databases on toxicology, hazardous chemicals, environmental health, and toxic releases.
- LactMed -A peer-reviewed and fully referenced database of drugs to which breastfeeding mothers may be exposed. Among the data included are maternal and infant levels of drugs, possible effects on breastfed infants and on lactation, and alternate drugs to consider.
- Hazardous Substances Data Bank (HSDB) - Comprehensive, peer-reviewed toxicology data for about 5,000 chemicals.
- TOXMAP:® Environmental Health e-Maps -Geographic representation of estimated US releases of certain toxic chemicals reported annually to the US Environmental Protection Agency (EPA Toxics Release Inventory/TRI)
- Household Products -links over 12,000 consumer brands to health effects from Material Safety Data Sheets (MSDS) provided by manufacturers and allows scientists and consumers to research products based on chemical ingredients
- ToxTown -uses color, graphics, sounds and animation to add interest to learning about connections between chemicals, the environment, and the public’s health. Tox Town’s target audience is students above elementary-school level, educators, and the general public.
- Environmental Health Disparities & Environmental Justice Meeting (July 29-31,2013) -focused on identifying priorities for action to address environmental health disparities (EHD) and environmental justice (EJ). This meeting brought together researchers, community residents, healthcare professionals, and federal partners committed to addressing EHD and EJ, in particular the grantees funded by NIEHS, EPA, NIMHD, CDC, OMH, and IHS. For the purposes of this meeting, EHD is defined as the unique contribution of the environment to health disparities.
Includes links to meeting materials and additional resources
- 3-D images show flame retardants can mimic estrogens in NIH study (eurekalert.org)
- Alternative Testing Strategies Needed to Cope With New Wave of Emerging Nanomaterials (azonano.com)
- Study: No link between mercury exposure and autism-like behaviors (eurekalert.org)
- Nanotechnology safety: New tests for determining health and environmental effects (nanowerk.com)
New Report: Call for President Obama Urged to ‘Remove Public Veil of Ignorance’ Around State of US Health
In a call to action on the sorry comparative state of U.S. health, researchers at Columbia University’s Mailman School of Public Health are urging President Obama to “remove the public veil of ignorance” and confront a pressing question: Why is America at the bottom? The report, published in the journal Science, appeals to the President to mobilize government to create a National Commission on the Health of Americans. The researchers underscore the importance of this effort in order for the country to begin reversing the decline in the comparative status of U.S. health, which has been four decades in the making.
This is not a challenge that can be left to private groups, no matter how well meaning. Drs. Ronald Bayer and Amy Fairchild, both Professors of Sociomedical Sciences, argue, “The health status of Americans is a social problem that demands social solutions.” More is at stake than the U.S. healthcare system, which fails to provide needed care to millions of Americans. “There is a need for bold public policies that move beyond individual behavior to address the fundamental causes of disease,” Bayer and Fairchild conclude.
A January 2013 report by the U.S. National Research Council (NRC) and Institute of Medicine (IOM) ranks the United States last among peer nations in health status and compares it unfavorably to 17 peer countries at almost every stage of the life course. The report, titled “U.S. Health in International Perspective: Shorter Lives, Poorer Health,” emphasizes that socioeconomic causes are the drivers of these outcomes and details the categories in which the U.S. has the worst or next-to-worst results:
- The U.S. has higher rates of adverse birth outcomes, heart disease, injuries from motor vehicle accidents and violence, sexually acquired diseases, and chronic lung disease.
- Americans lose more years of life to alcohol and other drugs.
- The U.S. has the highest rate of infant mortality among high-income countries.
- The U.S. has the second highest incidence of AIDS and ischemic heart disease,
- For decades, the U.S. has experienced the highest rates of obesity in children and adults as well as diabetes from age 20 and up.
For 14 years, the American Lung Association has analyzed data from air quality monitors to compile the State of the Air report. The more you learn about the air you breathe, the more you can protect your health and take steps to make our air cleaner and healthier.
Want to know what the air quality is where you live or another US location?
Just enter the zipcode at the home page.
Thanks to the Clean Air Act, the United States continues to make progress providing healthier air. The “State of the Air 2013″ shows that the nation’s air quality is overall much cleaner, especially compared to just a decade ago. Still, over 131.8 million people—42 percent of the nation—live where pollution levels are too often dangerous to breathe. Despite that risk, some seek to weaken the Clean Air Act, the public health law that has driven the cuts in pollution since 1970.
Ozone Pollution — Nearly 4 in 10 people lived in areas with unhealthful levels of ozone in 2009-2011.
Year-round Particle Pollution — More than 44.3 million people live in an area burdened year-round by unhealthful levels of deadly particle pollution.
Short-term Particle Pollution — Many cities endured more days where particle pollution spiked during this period. Fifteen percent (15%) of people in the United States live where they suffered too many days with unhealthful levels of particle pollution.
Cleanest Cities — Only four cities made the cleanest list in all three categories, but several were among the cleanest in two.
People at Risk —More than 4 in 10 people live in counties that have unhealthful levels of either ozone or particle pollution. Learn more about people who face the greatest risk—probably someone you know is one of them.
What Needs to be Done to Get Healthy Air —What do we need to do as a nation? How can you help clean up the air?
- Agency to start monitoring pollution next to Southern California freeways (sacbee.com)
- Air pollution ‘an invisible killer’ (bbc.co.uk)
- Hot weather in Europe exacerbating ozone pollution (independent.com.mt)
- Nitrogen pollution: another of Lebanon’s blights (dailystar.com.lb)
- Boralpure Smog-Eating Tile (iitbuildingscience.wordpress.com)
- Wildfire smoke spreads in Valley, sparks health concerns (fresnobee.com)
- Respiratory Disparity? Obese People May Not Benefit from Improved Air Quality (ehp.niehs.nih.gov)
- American Lung Association of the Mid-Atlantic Warns of Increased Pollution as Temperature Soars (paramuspost.com)
- Protect Yourself from Outdoor Air Pollution by Checking the Air Quality Index (virtual-strategy.com)
- The Macroeconomic Effect of the Clean Air Act; how it incentivized development in clean air technologies. (coherentramblingsforcoherentminds.wordpress.com)
By Sy Mukherjee on July 17, 2013
In the summer of 2012, the mosquito-borne West Nile virus made a surprising comeback in America. In Dallas, the most affected region, 400 people contracted the disease and 19 of them died. That came as a shock to public health officials, since West Nile virus was thought to be in such precipitous decline that it was practically eradicated.
Now, a little detective work has led epidemiologists to the reason for its resurgence: warmer winters and wetter springs. In other words, the consequences of global climate change are fueling West Nile. And it’s just the tip of the iceberg. Health officials expect the number of people contracting other infectious diseases to rise right alongside global temperatures.
The diseases that are propagated by climate change tend to come in fungal, algal, tick-borne, and mosquito-borne forms. For instance, dengue fever — which causes a high fever, painful head and body aches, and rashes — will likely continue infecting Americans in hot and humid climates, as well as regions that are close to warming oceans:
- First West Nile case of the year in MA (wwlp.com)
With more and more families opting out of vaccinating their kids, one of the most sacred of public health goals, the concept of herd immunity, is being threatened.
A recent piece in Scientific American featured tantalizing graphics — on view above — illustrating this scary trend. According to this analysis, the vaccination rates in some states — Oregon, West Virginia and Colorado, for instance, are shockingly low. So low, in fact, that they’ve dropped below the “herd immunity” levels (or what is thought to be the safe threshold) for MMR (measles, mumps and rubella) and DTP (diphtheria, tetanus and pertussis).
So what’s the deal with herd immunity? According to the CDC, a population has reached herd immunity when a sufficient proportion is immune to a particular infectious disease. Immune population members get that protection either by being vaccinated or by having a prior infection.
- What Is Herd Immunity? (scientificamerican.com)
- Making Sense of “those” Measles Outbreaks (this-little-light-of-mine.org)
- Despite the Science, Marin Vaccination Opt-Outs Increase (blogs.kqed.org)
- Pneumonia vaccine for children also protects older adults (upi.com)
- Measles Goddess’ Wrath Hits Victoria (luckylosing.com)
- IH warns of whooping cough ‘surge’ in West Kootenay (revelstoketimesreview.com)
- Racing Towards Death- Do You Want To? (scitablescience.wordpress.com)
- Tony Abbott wrong on child immunisation rates (abc.net.au)
- I’ll admit it: Wakefield’s research has been replicated over and over again (thepoxesblog.wordpress.com)
One of the success stories in Chicago’s civic innovation community is the rapid spread of health related apps that have come out of both the volunteer civic technology community and paid development efforts. This started last year with Tom Kompare’s Chicago flu shot app that helped Chicago residents find free flu shots near them. (Later on, this flu shot app spread to Boston and Philadelphia.)
Professionally, Kompare is a web developer with the University of Chicago. In his spare time, he’s one of the most active civic technologists in Chicago.
Kompare’s flu shot app was just the start of the Chicago Department of Public Health partnering up with civic technologists on a number of projects including Foodborne Chicago, the Chicago Health Atlas, and Tom Kompare’s newest app Back to School.
Back to School is an app built for parents to make sure that their child has the immunizations they need to go back to school. CDPH hosts several immunization events for school children throughout the city and the apps helps parents find events near them. This will be also good trial run for the larger immunization effort that CDPH will run this fall.
Not only do these two apps use the same data format, this data format is now a proposed national standard.
[Repost] Putting Chronic Disease on the Map: Building GIS Capacity in State and Local Health Departments
It is good to see these efforts to survey and prevent chronic diseases. As stated at the US Administration on Aging Web site…Older Americans are disproportionately affected by chronic diseases and conditions, such as arthritis, diabetes and heart disease, as well as by disabilities that result from injuries such as falls. More than one-third of adults 65 or older fall each year.
Techniques based on geographic information systems (GIS) have been widely adopted and applied in the fields of infectious disease and environmental epidemiology; their use in chronic disease programs is relatively new. The Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention is collaborating with the National Association of Chronic Disease Directors and the University of Michigan to provide health departments with capacity to integrate GIS into daily operations, which support priorities for surveillance and prevention of chronic diseases. So far, 19 state and 7 local health departments participated in this project. On the basis of these participants’ experiences, we describe our training strategy and identify high-impact GIS skills that can be mastered and applied over a short time in support of chronic disease surveillance. We also describe the web-based resources in the Chronic Disease GIS Exchange that were produced on the basis of this training and are available to anyone interested in GIS and chronic disease (www.cdc.gov/DHDSP/maps/GISX). GIS offers diverse sets of tools that promise increased productivity for chronic disease staff of state and local health departments.
- Rate of Chronic Disease Increasing Exponentially. (zedie.wordpress.com)
U.S. Health in International Perspective: Shorter Lives, Poorer Health
- January 9, 2013
- Consensus Report
- Public Health, Aging
- Understanding Cross-National Health Differences Among High-Income Countries
- Board on Population Health and Public Health Practice, Division of Behavioral and Social Sciences and EducationThe United States is among the wealthiest nations in the world, but it is far from the healthiest. For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This health disadvantage prevails even though the U.S. spends far more per person on health care than any other nation. To gain a better understanding of this problem, the NIH asked the National Research Council and the IOM to investigate potential reasons for the U.S. health disadvantage and to assess its larger implications.
No single factor can fully explain the U.S. health disadvantage. It likely has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions. Without action to reverse current trends, the health of Americans will probably continue to fall behind that of people in other high-income countries. The tragedy is not that the U.S. is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.
- Why Is the United States So Sick? (slate.com)
“The poorer outcomes in the United States are reflected in measures as varied as infant mortality, the rate of teen pregnancy, traffic fatalities, and heart disease. Even those with health insurance, high incomes, college educations, and healthy lifestyles appear to be sicker than their counterparts in other wealthy countries. The U.S. Council on Foreign Relations, a nonpartisan think tank, described the report as “a catalog of horrors.”
Findings that prompted this reaction include the fact that the rate of premature births in the United States is the highest among the comparison countries and more closely resembles those of sub-Saharan Africa. Premature birth is the most frequent cause of infant death in the United States, and the cost to the health care system is estimated to top $26 billion a year.
As distressing as all this is, much less attention has been given to the obvious question: Why is the United States so unwell? The answer, it turns out, is simple and yet deceptively complex: It’s almost everything.
Our health depends on much more than just medical care. Behaviors such as diet, physical activity, and even how fast we drive all have profound effects. So do the environments that expose us to health risks or discourage healthy living, as well as social determinants of health, such as education, income, and poverty.
The United States fares poorly in almost all of these. In addition to many millions of people lacking health insurance, financial barriers to care, and a lack of primary care providers compared with other rich countries, people in the United States consume more calories, are more sedentary, abuse more drugs, and shoot one another more often. The United States also lags behind on many measures of education, has higher child poverty and income inequality, and lower social mobility than most other advanced democracies.
The breadth of these causal factors, and the scope of the U.S. health disadvantage they produce, raises some fundamental questions about U.S. society. As the NRC/IOM report noted, solutions exist for many of these health problems, but there is “limited political support among both the public and policymakers to enact the policies and commit the necessary resources.”
One major impediment is that the United States, which emphasizes self-reliance, individualism, and free markets, is resistant to anything that even appears to hint at socialism. …”
- Charted: Female mortality trends in 21 high-income countries (projectmillennial.org)
- Yes, the Status of Health in the U.S. Is a Disaster. Why Do You Ask? (delong.typepad.com)
- Study: U.S. most expensive healthcare, mediocre outcomes (upi.com)
- U.S. Health Disadvantage is Not Inevitable (inequalitiesblog.wordpress.com)
We are getting a lot of inquiries about where to go for testing and treatment after exposure to toxic levels of Mycotoxins from damp and moldy environments.
Unfortunately few doctors are experienced in testing or treating patients that are suffering from Biotoxin Illness and other health issues that arise after living or working for long periods of time inside of a home/office/school with poor indoor air.
- MedlinePlus: Molds, including
- Molds (US Occupational Safety and Health Administration - OSHA)
- Legal Aspects of Mold Contamination (Clean Water Partners - Environmental Law Experts) For Renters,Landlords, Home Sellers, Home Buyers, Employers, Employees
- Mold - The "New" Hidden Pandemic Sweeping Across America (momsmoldresources.wordpress.com)
- Curious case of toxic mold pits Chamber of Commerce employees against City of Madison (al.com)
- Mold forces woman from home and into search for answers (al.com)
- Preventing mold from forming in your home (mysouthwestga.com)
- Understanding Mold (moldremoversnj.wordpress.com)
- The way crucial is actually Health in our life (meizitangstrongbuys.wordpress.com)
- Mycotoxins=diabetes? (larahentz.wordpress.com)